SPRAVATO® Treatment
Innovative Therapy for Treatment-Resistant Depression
SPRAVATO® Coverage Available
We accept a wide range of insurance plans for SPRAVATO® treatment. Contact us to verify your coverage.
CIGNA
Oscar
Harvard Pilgrim
Mass General Brigham
Carelon
Commonwealth Care Alliance
Network HealthCIGNAOscarHarvard PilgrimMass General BrighamCarelonCommonwealth Care AllianceNetwork HealthHope is Here
At Heritage Health System, we are committed to providing advanced treatment options for individuals struggling with severe depression. One of the innovative therapies we offer is SPRAVATO® (esketamine) nasal spray, an FDA-approved medication designed to help patients who have not responded adequately to traditional antidepressant medications.
SPRAVATO® is unique because it is believed to work differently than traditional antidepressants by targeting glutamate, the most abundant excitatory neurotransmitter in the brain, rather than serotonin or norepinephrine.
Contact Us to Learn More
FDA-Approved Innovation
SPRAVATO® (esketamine) CIII nasal spray is a prescription medicine approved by the U.S. Food and Drug Administration (FDA) for adults with:
Treatment-Resistant Depression (TRD)
As monotherapy or in conjunction with an oral antidepressant for adults who have not responded to at least two prior antidepressant treatments
MDD with Suicidal Thoughts
Used with an antidepressant taken by mouth for depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior
SPRAVATO® is administered as a nasal spray and must be given in a certified medical facility under professional supervision. It is only available through a restricted program called the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program.
A Different Mechanism of Action
SPRAVATO® contains esketamine, the S-enantiomer of ketamine. It is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist that acts on the glutamate system in the brain - a completely different mechanism from traditional antidepressants that target serotonin or norepinephrine.
While the exact mechanism is still being studied, the prevailing scientific understanding is that esketamine preferentially blocks NMDA receptors on GABAergic inhibitory interneurons. This blockade transiently enhances glutamatergic activity, leading to increased release of glutamate and stimulation of AMPA receptors.
This cascade activates downstream neurotrophic signaling pathways, resulting in:
What Clinical Trials Have Shown
In short-term Phase 3 clinical trials, SPRAVATO® in conjunction with an oral antidepressant showed statistically significant improvement in depressive symptoms at 4 weeks compared to placebo plus an oral antidepressant.
Most of the improvement in depressive symptoms was seen as early as 24 hours after the first treatment session, with effects continuing to strengthen over the treatment period.
Patients with treatment-resistant depression were evaluated for safety across five Phase 3 studies (three short-term and two long-term studies), establishing the safety profile of SPRAVATO®.
Available as 56 mg (2 nasal spray devices) or 84 mg (3 nasal spray devices), each delivering 28 mg of esketamine per device. The dose is individualized based on efficacy and tolerability.
Treatment Timeline
Induction Phase (Weeks 1-4)
SPRAVATO® is administered twice per week. The recommended dose is 56 mg or 84 mg, adjusted based on efficacy and tolerability. Most patients begin to see improvement during this phase.
Maintenance Phase (Weeks 5-8)
Treatment sessions are reduced to once per week at the same dose (56 mg or 84 mg). The goal is to sustain the improvements achieved during induction.
Continuation Phase (Week 9+)
Dosing frequency is individualized based on your response - either once weekly or every two weeks - to maintain remission or response at the lowest effective frequency.
Safety First: The SPRAVATO® REMS Program
Because of the risks of sedation, dissociation, respiratory depression, and potential for abuse and misuse, the FDA requires that SPRAVATO® be available only through a restricted distribution program called the SPRAVATO® REMS (Risk Evaluation and Mitigation Strategy).
Certified Healthcare Setting
SPRAVATO® can only be administered in healthcare settings certified in the REMS program. Our clinic is fully certified.
Direct Observation
You self-administer the nasal spray under the direct observation of a healthcare provider throughout the entire session.
2-Hour Monitoring
After administration, you are monitored for at least 2 hours for sedation, dissociation, changes in blood pressure, and respiratory status.
No Home Use
SPRAVATO® must never be dispensed directly to a patient for home use. All doses are administered in-clinic.
What We Monitor During Treatment
SPRAVATO® can cause a temporary increase in blood pressure that typically peaks around 40 minutes after administration and lasts for about 2 hours. Our clinical protocol includes:
Before Dose
Blood pressure is assessed before each treatment session. If significantly elevated, we evaluate the risks and benefits before proceeding.
During Session
Blood pressure is reassessed approximately 40 minutes after dosing (corresponding with peak plasma concentration) and as clinically needed.
Before Discharge
We confirm your blood pressure is stabilized and you are clinically stable before you are discharged, approximately 2 hours after dosing.
Is SPRAVATO® Right for You?
Tried Multiple Antidepressants
Have not responded to two or more antidepressant medications - known as treatment-resistant depression (TRD)
Severe or Persistent Depression
Experience depressive symptoms that significantly impact daily life, functioning, and well-being despite treatment
Seeking New Options
Want a rapid-acting treatment approach with a different mechanism of action than traditional antidepressants
Coverage and Cost Information
SPRAVATO® is widely covered by insurance plans. According to the manufacturer, 9 out of 10 commercially insured patients are covered for SPRAVATO® treatment. SPRAVATO® is also covered under Medicare and Medicaid.
Insurance Types Accepted
- Commercial insurance plans
- Medicare
- Medicaid
- Private insurance
Savings Program
The SPRAVATO® withMe Savings Program may be available for eligible commercially insured patients to help with out-of-pocket costs. Our team will verify your insurance and discuss all available options before starting treatment.
Our staff will work with you to obtain insurance approval before starting treatment.
What to Expect During Treatment
Arrive & Check In
Patient arrives at our clinic for the scheduled treatment session. You will need to arrange transportation home.
Administration
Under the direct supervision of a healthcare provider, you self-administer the SPRAVATO® nasal spray in our certified treatment room.
Monitoring Period
You will rest comfortably in our clinic for approximately 2 hours while our medical team monitors your vitals and checks for side effects.
Return Home
Once cleared by our healthcare provider, you may return home. Do not drive, operate machinery, or make important decisions until the next day after a full night's rest.
What Our Patients Say
Frequently Asked Questions
How long does a treatment session take?
Will I need to stop my current antidepressant?
How soon will I feel better?
Can I drive myself home after treatment?
How is SPRAVATO® different from ketamine infusion clinics?
What side effects should I expect?
Take the First Step
If you or a loved one is struggling with treatment-resistant depression, SPRAVATO® may offer new hope. Heritage Health System is here to guide you through every step of the process - from insurance verification to ongoing treatment.
What You Need to Know
SPRAVATO® can cause serious side effects including: sedation, dissociation, respiratory depression, and risks of abuse and misuse. SPRAVATO® may cause a temporary increase in blood pressure that can last for about 2 hours after administration.
SPRAVATO® is available only through a restricted program called the SPRAVATO® REMS. You will be monitored for at least 2 hours after each dose by your healthcare provider. You must arrange for transportation home and should not drive or operate machinery until the next day after a restful sleep.
The most common side effects include: feeling disconnected from yourself, your thoughts, feelings, and things around you (dissociation); dizziness; nausea; feeling sleepy; spinning sensation (vertigo); decreased sensitivity or numbness; anxiety; lack of energy; increased blood pressure; vomiting; feeling drunk; headache; and feeling very happy or excited (euphoria). These usually happen right after taking SPRAVATO® and go away the same day.
SPRAVATO® is not for use as a medicine to prevent or relieve pain (anesthetic). It is not known if SPRAVATO® is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. It is not known if SPRAVATO® is safe and effective in children.
Please see full Prescribing Information, including Boxed WARNINGS, and Medication Guide for SPRAVATO® and discuss any questions with your healthcare provider.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Your Data Privacy Matters
HIPAA Compliance
Heritage Health System is fully compliant with the Health Insurance Portability and Accountability Act (HIPAA). All protected health information (PHI) you provide is encrypted, securely stored, and never shared without your explicit written authorization except as required by law.
You have the right to access, amend, and request an accounting of disclosures of your health information at any time.
Massachusetts Privacy Law
As a Massachusetts-based practice, we adhere to the Massachusetts Health Care Privacy Laws (M.G.L. c. 111, § 70E) and the Massachusetts Data Breach Notification Law (M.G.L. c. 93H). These state laws provide additional protections beyond HIPAA, including stricter requirements for the use and disclosure of medical records.
Massachusetts law requires us to maintain reasonable procedures to protect personal information and to notify you promptly in the event of any breach of your unsecured protected health information.
Encrypted Data
All form submissions use TLS encryption. Your data is transmitted securely.
HIPAA Secure
We maintain administrative, physical, and technical safeguards required by HIPAA.
Your Rights
You may request access to your records, request amendments, and opt out of communications at any time.
Get Started with SPRAVATO®
Submit your information below and we will contact you to discuss SPRAVATO® treatment options.
Patient Information
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Ready to Take the Next Step?
Whether you're exploring SPRAVATO® for treatment-resistant depression or need personalized mental health care, Heritage Health System is here to support you.