Spravato®
Esketamine Nasal Spray for Treatment Resistant Depression
When antidepressants haven’t been enough, there may still be a path forward. MYINDSET Behavioral Health is a REMS-certified Spravato® treatment center in Brownsburg, Indiana, offering this FDA-approved nasal spray for adults living with treatment-resistant depression. If you’ve tried two or more antidepressant medications without adequate relief, Spravato may help you start feeling better—in some cases, within 24 hours of your first treatment.
Call (317) 207-0273 to find out if Spravato is right for you
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What Is Spravato®?
Spravato® (esketamine) is a prescription nasal spray approved by the U.S. Food and Drug Administration for the treatment of depression in adults. It is the first and only medication in its class approved for treatment-resistant depression, and as of January 2025, it is the first and only FDA-approved standalone therapy for adults with TRD—meaning it can now be used with or without an oral antidepressant.
Spravato is also approved, in combination with an oral antidepressant, for adults with major depressive disorder who are experiencing acute suicidal ideation or behavior.
Since its original approval in 2019, Spravato has been administered to more than 140,000 patients worldwide and is supported by over a decade of clinical research.
How Spravato Works Differently
Most antidepressants work by targeting serotonin, norepinephrine, or dopamine—neurotransmitters that play a role in mood regulation. Spravato takes a completely different approach. It acts on the glutamate system, which is the brain’s most abundant excitatory neurotransmitter.
Spravato is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist. By modulating glutamate signaling, it is believed to help restore synaptic connections between brain cells—connections that can be weakened by chronic stress and prolonged depression.
This process, called synaptogenesis, may help the brain essentially rebuild pathways involved in mood and emotional regulation.
This is why Spravato can work quickly. While traditional antidepressants may take four to six weeks to take full effect, clinical trials have shown that Spravato can produce meaningful improvement in depressive symptoms in as little as 24 hours after the first dose.
Who Is a Candidate for Spravato?
Spravato may be right for you if:
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You are an adult (18 or older) diagnosed with major depressive disorder
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You have tried at least two different antidepressant medications at adequate doses and for adequate durations without satisfactory improvement (treatment-resistant depression)
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You are an adult with major depressive disorder experiencing acute suicidal ideation or behavior (in this case, Spravato is used in combination with an oral antidepressant)
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You are looking for a treatment that works through a different mechanism than traditional antidepressants
Spravato is not appropriate for everyone. Our providers will review your complete psychiatric and medical history, prior medication trials, and current symptoms to determine if Spravato is a safe and appropriate option for you.
Important: Spravato should be discontinued if a patient becomes pregnant. Women of reproductive age should discuss pregnancy planning with their provider before starting treatment.
What to Expect During a Spravato Session
Spravato is only available through a restricted FDA program called the REMS (Risk Evaluation and Mitigation Strategy). This means every treatment session takes place in our certified clinic under the direct supervision of a healthcare provider. Spravato cannot be prescribed for home use. A typical treatment visit includes:
You’ll arrive at our Brownsburg office. We’ll check your blood pressure and review how you’re feeling. If this is your first session, we’ll complete your REMS enrollment paperwork.
You will self-administer the Spravato nasal spray under the direct observation of your provider. The spray is given in two or three devices depending on your prescribed dose (56 mg or 84 mg), with a five-minute rest between each device.
After administration, you will rest comfortably in our treatment area for at least two hours. During this time, our clinical staff will monitor your blood pressure, level of alertness, and any side effects. Many patients relax, listen to music, or rest quietly during this period.
DischargeOnce your provider determines you are clinically stable and safe to leave, you will be discharged. You will need someone to drive you home—you cannot drive, operate heavy machinery, or perform activities requiring full alertness until the next day after a restful night’s sleep.
Plan for approximately 2.5 to 3 hours for each treatment visit. We recommend wearing comfortable clothing and bringing headphones or a book. Please arrange for a ride home before your appointment. Do not eat for two hours before your session, and avoid drinking liquids for 30 minutes before treatment to reduce the risk of nausea.
Treatment Schedule
Spravato treatment follows a structured schedule designed to build on initial symptom improvement and then maintain your progress over time:
Induction (Weeks 1–4) Twice weekly 8 sessions over 4 weeks. This is the intensive phase where your provider will assess your response and adjust dosing (56 mg or 84 mg).
Maintenance (Weeks 5–8)Once weekly 4 sessions over 4 weeks. Treatment frequency is reduced as your symptoms stabilize.
Long-Term Maintenance (Week 9+) Once weekly or every 2 weeks Your provider will determine the optimal frequency based on your ongoing response. Some patients continue treatment long-term; others taper based on sustained improvement.
Research shows that patients who continue Spravato treatment have a significantly lower relapse rate. In a Phase 3 clinical trial, patients continuing Spravato had a 26.7% relapse rate compared to 45.3% for those who discontinued treatment.
Potential Side Effects
Research shows that patients who continue Spravato treatment have a significantly lower relapse rate. In a Phase 3 clinical trial, patients continuing Spravato had a 26.7% relapse rate compared to 45.3% for those who discontinued treatment.
Like all medications, Spravato can cause side effects. Most side effects occur during or shortly after administration and resolve within the two-hour monitoring period. The most commonly reported side effects include:
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Dissociation — a feeling of being disconnected from your thoughts, surroundings, or sense of self. This is temporary and is monitored by your provider.
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Dizziness or lightheadedness
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Nausea or vomiting
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Sedation — feeling sleepy or drowsy
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Increased blood pressure — temporary elevations that are monitored during your session
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Headache
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Numbness or tingling
Spravato carries FDA boxed warnings for sedation, dissociation, respiratory depression, and the potential for abuse and misuse. This is why every treatment session is administered in a certified healthcare setting under direct clinical supervision. Our team monitors you throughout and will not discharge you until it is safe to do so.
Side effects often lessen over time as your body adjusts to the medication. Your provider will discuss all potential risks and benefits with you before treatment begins.
Insurance and Cost
Spravato is covered by many commercial insurance plans and Medicare. Coverage typically requires documentation of treatment-resistant depression, including evidence of inadequate response to at least two prior antidepressant trials.
Our team will work with your insurance company to verify your benefits and obtain any required prior authorization before your first treatment. We want you to have a clear understanding of your costs before you begin.
Janssen CarePath Savings Program: Eligible commercially insured patients may pay as little as $10 per treatment session through the manufacturer’s copay assistance program. Our staff can help you determine if you qualify and assist with enrollment.
If you are uninsured or your insurance does not cover Spravato, please contact our office to discuss alternative options. We are committed to helping you access the care you need.
Why Choose MYINDSET for Spravato Treatment?
REMS-Certified Clinic. MYINDSET Behavioral Health is a certified Spravato REMS treatment center. Our providers, clinical staff, and office have completed the required FDA certification process to safely administer and monitor Spravato treatment.
Psychiatric Providers Who Know You. Unlike standalone infusion centers, Spravato at MYINDSET is integrated into your ongoing psychiatric care. Your nurse practitioner already understands your history, your medications, and your goals. There’s no separate intake at a different facility, no repeating your story, and no gap between your Spravato sessions and the rest of your care.
Comfortable, Private Treatment Environment. Our Brownsburg office provides a calm, private space for your two-hour monitoring period. We understand that depression treatment is deeply personal, and we’ve designed our Spravato program with your comfort and dignity in mind.
Whole-Person Care. Spravato is most effective as part of a comprehensive treatment plan. At MYINDSET we combine Spravato with medication management, individual therapy, and other evidence-based approaches to give you the best possible outcome.
Insurance Navigation Support. Our team handles prior authorizations, benefits verification, and enrollment in the Janssen copay assistance program so you can focus on your treatment rather than paperwork.
Frequently Asked Questions
Q: Is Spravato the same as ketamine?
Spravato (esketamine) is the S-enantiomer of ketamine. While they are chemically related, they are different medications with different routes of administration, regulatory status, and evidence bases. Spravato is FDA-approved, administered as a nasal spray, and available through a structured REMS program. IV ketamine infusions for depression are used off-label and are not FDA-approved for the treatment of depression. MYINDSET offers Spravato, not IV ketamine.
Q: How quickly does Spravato work?
Clinical trials have shown meaningful improvement in depressive symptoms as early as 24 hours after the first dose. However, individual results vary. Some patients notice improvement within the first week, while others may need several sessions before experiencing significant change. Your provider will closely monitor your response.
Q: Can I take Spravato without an oral antidepressant?
Yes. As of January 2025, Spravato is FDA-approved as a standalone treatment (monotherapy) for treatment-resistant depression. Your provider will determine the best approach based on your individual clinical profile.
Q: How long will I need Spravato treatment?
Treatment duration varies. Some patients use Spravato for several months during a particularly difficult episode and then taper off. Others benefit from long-term maintenance. Your provider will work with you to determine the right plan based on your ongoing response and goals.
Q: Can I drive myself to and from appointments?
You can drive yourself to your appointment. However, you cannot drive yourself home after treatment. You must arrange for someone to drive you home after each session. You should not drive, operate heavy machinery, or perform activities requiring full alertness until the next day following a restful sleep.
Q: What if I have high blood pressure?
Spravato can temporarily increase blood pressure. Your blood pressure will be checked before every treatment session and monitored during your visit. If your blood pressure is too high before treatment, your session may be rescheduled. Patients with uncontrolled hypertension or a history of certain cardiovascular conditions may not be candidates for Spravato.
Q: Does insurance cover Spravato?
Many commercial insurance plans and Medicare cover Spravato for treatment-resistant depression. Prior authorization is typically required. Our team will verify your benefits and assist with the authorization process. Eligible commercially insured patients may also qualify for the Janssen CarePath copay assistance program, which can reduce your out-of-pocket cost to as little as $10 per session.
Q: What is the REMS program?
REMS stands for Risk Evaluation and Mitigation Strategy. It is an FDA-mandated safety program that requires Spravato to be administered only in certified healthcare settings, under direct clinical observation, with at least a two-hour monitoring period after each dose. This ensures your safety throughout treatment. MYINDSET is a fully certified REMS treatment center.
Take the Next Step
If you’ve been struggling with depression that hasn’t responded to other medications, you don’t have to keep trying the same approach. Spravato offers a different path—one backed by rigorous clinical research and supported by over six years of real-world evidence. Contact MyINDset Behavioral Health today to schedule a consultation and find out if Spravato is right for you. Phone: (317) 207-0273 Location: 7230 Arbuckle Commons, Suite 256, Brownsburg, Indiana 46112 Email: contact@myindset.com Online: www.myindset.com
If you or someone you know is in crisis: Call 911, go to your nearest emergency room, or contact the 988 Suicide and Crisis Lifeline by calling or texting 988.
MEDICAL DISCLAIMER: The information on this page is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Spravato® is a registered trademark of Janssen Pharmaceuticals, Inc. MyINDset Behavioral Health is not affiliated with Janssen Pharmaceuticals or Johnson & Johnson. Always consult your healthcare provider to determine if Spravato is appropriate for your individual circumstances.