Spravato® (Esketamine Nasal Spray): Is It Right for You?

Written By Tenia .

Spravato® is the first FDA-approved nasal esketamine treatment for treatment-resistant depression (TRD) and major depressive disorder (MDD) with suicidal thoughts. Unlike traditional antidepressants, it works rapidly and is administered under supervision in certified clinics. Origin Mental Wellness is a certified clinic that offers Spravato.

Lauren Gallagher APRN, PMHNP-BC

When to Consider Spravato

  • You’ve tried at least two antidepressants without adequate response (criteria for TRD).

  • You’re experiencing persistent suicidal thoughts or have severe, disabling depression.

  • You need fast-acting relief, often within hours of dosing.

  • You have experienced intolerable side effects with oral antidepressants

  • You have trouble being consistent with taking oral medications

  • You’re able to commit to in-clinic treatment sessions and 2-hour monitoring post-dose.

How Spravato Works

Spravato contains esketamine, a fast-acting NMDA receptor antagonist (a form of ketamine). It boosts neuroplasticity, helping “reset” and “regrow” brain networks that contribute to depression. Effects can begin within 20 minutes.

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What you need to know: Side Effects & Limitations

  • Common side effects: Dissociation, dizziness, nausea, fatigue, elevated blood pressure and heart rate, unusual taste or numbness.

  • Not a cure-all: Effects don’t directly fix life stressors. Having a therapist to work through coping strategies is still necessary.

  • Cost: Time and having someone drive you to treatment can be a hurdle to jump. However, many of our patients ask friends and family and end up enjoying the time to themselves here at Origin Mental Wellness.

  • Maintenance: Most patients need ongoing treatments—frequency may taper over time.

Long-Term Progress Feels Different Than Acute Effects

Spravato is not a magic switch, but rather a catalyst. For many, the real change happens between sessions, as the brain becomes more flexible and therapy becomes more effective.

This is why we encourage ongoing psychotherapy alongside treatment—it helps reinforce the gains made from Spravato.

Artwork at Origin Mental Wellness

A Final Word: Everyone’s Brain is Unique

Not everyone responds the same. Some people feel relief after their first or second session; for others, it takes several weeks. A small subset of patients don’t respond at all.

If you're considering Spravato, know that you don’t have to figure it out alone. A provider here at Origin Mental Wellness can walk you through the logistics, risks, and whether you're a candidate.

With heartfelt wishes for your health,

Origin Mental Wellness Team

Tenia .
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