Is Spravato covered by insurance?

Yes — Spravato is covered by most commercial insurance and Medicare Part B when criteria are met. We verify benefits and handle prior authorization.

FDA-Approved Treatment

Spravato (Esketamine)

The first FDA-approved nasal spray for treatment-resistant depression and major depressive disorder with acute suicidal ideation — administered safely in our Portland clinic.

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FDA-Approved Treatment

Medical Supervision Every Step

Compassionate Expert Care

Psychiatric provider talking with a patient during a Spravato consultation at Portland Mental Health & Psychiatry

What Is Spravato?

Rapid-Acting Depression Treatment

Spravato (esketamine) is an FDA-approved nasal spray that targets NMDA receptors — a completely different mechanism from traditional antidepressants. Approved in 2019 for treatment-resistant depression and in 2020 for MDD with acute suicidal ideation.

Where oral antidepressants can take 4–8 weeks to show effect, many patients notice significant improvement within hours to days of their first Spravato session.

Compare With TMS Therapy

Spravato treatment and monitoring room at Portland Mental Health & Psychiatry — REMS-certified Spravato treatment suite

Why Spravato

What Makes Spravato Different

A breakthrough option when standard antidepressants haven't been enough.

Rapid Onset

Relief in Hours, Not Weeks

Many patients experience meaningful improvement within hours to days — a critical advantage for those in acute distress or who have waited months for other treatments to work.

FDA-Approved

Clinically Validated Protocol

Spravato follows an established induction and maintenance schedule with rigorous FDA oversight, giving patients and providers confidence in the treatment pathway.

REMS Certified

Monitored for Your Safety

Administered in our certified REMS facility with at least two hours of post-dose monitoring by clinical staff. You cannot receive Spravato at a pharmacy.

Insurance

Covered by Most Plans

Spravato is covered by most commercial insurance and Medicare Part B when FDA criteria are met. We handle all prior authorization paperwork.

Neuroplasticity

Rebuilds Neural Connections

Esketamine rapidly increases synaptic glutamate and promotes neuroplasticity — helping the brain form new, healthier connections that support lasting mood improvement.

Combined Care

Used With Oral Antidepressants

Spravato is always prescribed alongside an oral antidepressant. Your psychiatrist manages both medications and coordinates with your therapist.

Treatment Schedule

Your Spravato Treatment Plan

Each visit lasts approximately 2.5 hours, including self-administration of the nasal spray and a mandatory two-hour monitoring period. You must arrange a driver — you cannot drive after a session.

Induction (weeks 1–4): Twice weekly sessions
Maintenance (weeks 5–8): Once weekly sessions
Ongoing: Every 1–2 weeks as needed
Always used alongside an oral antidepressant

Comfortable Spravato monitoring room with supportive clinical staff — Comfortable, private monitoring during each session

Qualifications

Who Qualifies for Spravato?

Spravato is FDA-approved for adults who meet specific criteria and are currently taking an oral antidepressant.

Failed at least two adequate antidepressant trials (TRD)
Major depressive disorder with acute suicidal ideation (MDD-SI)
Currently on an oral antidepressant regimen
No uncontrolled hypertension or aneurysm history
Not pregnant or breastfeeding

Our psychiatrists conduct a thorough evaluation to confirm Spravato is safe and appropriate before your first session.

TMS technician preparing treatment equipment

Private treatment room at Portland Mental Health & Psychiatry

Your Journey

What to Expect

Psychiatric Evaluation

Confirm diagnosis, review medication history, and determine if Spravato criteria are met.

Insurance & REMS Enrollment

We verify benefits, obtain prior authorization, and enroll you in the REMS program.

Induction Sessions

Twice-weekly nasal spray administration with 2-hour monitored recovery in our clinic.

Maintenance & Follow-Up

Transition to weekly then biweekly sessions. Ongoing psychiatry and therapy continue.

Not Sure Spravato Is the Right Fit?

TMS is another FDA-cleared option for treatment-resistant depression, with a non-medication mechanism. Our team can help you weigh both against your history and preferences.

Explore TMS Therapy

Common Questions

Frequently Asked Questions

Many patients experience dissociative effects, dizziness, nausea, or perceptual changes during the two-hour monitoring window. These resolve before you leave. You relax in a comfortable chair in a quiet, private room.

Yes — most commercial insurance and Medicare Part B cover Spravato when criteria are met. We verify benefits and handle prior authorization before your first session. View insurance details →

Spravato is a nasal spray with rapid effects, often within hours to days, while TMS is a non-medication series of sessions that builds over several weeks. Both are FDA-approved for treatment-resistant depression — we'll help you decide which fits your history and goals. Learn about TMS →

No — you must arrange a driver for every Spravato session. You cannot drive or operate machinery until the day after treatment, per FDA REMS requirements.