Spravato® (Esketamine): A Breakthrough Treatment for Depression in Nebraska
Understanding Treatment-Resistant Depression (TRD)
Depression is one of the most common mental health conditions worldwide. While traditional antidepressants help millions of people each year, some individuals continue to struggle with symptoms despite trying multiple medications. This condition is known as treatment-resistant depression (TRD).
Living with TRD can feel overwhelming. Many patients describe feeling like they’ve “tried everything,” yet the depression still lingers. This can affect relationships, work, school, and overall quality of life. Fortunately, new treatment options are available—one of the most promising being Spravato® (esketamine).
What is Spravato?
Spravato is an FDA-approved nasal spray medication for adults with TRD. Unlike traditional antidepressants, which work on serotonin, dopamine, or norepinephrine pathways, Spravato targets the glutamate system, specifically NMDA receptors in the brain.
This unique mechanism helps restore connections between brain cells (synapses) that may have been damaged by depression. Because of this, patients often report faster improvements in mood compared to standard medications that may take weeks to work.
How Does Spravato Work?
Spravato is derived from ketamine, a medication long used in hospitals as an anesthetic. Researchers discovered that ketamine—and specifically its active isomer, esketamine—produces rapid antidepressant effects at lower doses.
Spravato works by:
Increasing glutamate release in the brain.
Stimulating new connections between neurons (synaptogenesis).
Helping reset brain activity patterns disrupted by chronic depression.
For many patients, this leads to improved mood, focus, and energy within hours or days instead of weeks.
The Spravato Treatment Process
Spravato is only available in certified clinics under medical supervision. Here’s what to expect if you begin treatment:
Initial Evaluation
Your provider will complete a full assessment to determine whether Spravato is the right fit. Typically, you must have tried at least two other antidepressants without sufficient improvement.In-Clinic Treatment
You’ll check in with your care team.
You’ll self-administer Spravato via a nasal spray, under staff guidance.
You’ll stay in a comfortable, quiet treatment room for about two hours, where your provider will monitor your vital signs (blood pressure, heart rate) and overall well-being.
Post-Treatment Care
Because Spravato can cause temporary drowsiness, dizziness, or dissociation, you’ll need someone to drive you home. Most patients are able to resume normal activities the following day.
Who is Eligible for Spravato?
Spravato is intended for:
Adults diagnosed with treatment-resistant depression (failed two or more antidepressants).
Adults with major depressive disorder (MDD) with suicidal thoughts or behaviors, in some cases.
It is not recommended for individuals with certain medical conditions (such as uncontrolled hypertension or aneurysms). A full medical evaluation is always necessary before beginning treatment.
How Often is Spravato Given?
Spravato treatment is structured in phases:
Weeks 1–4: Twice weekly treatments
Weeks 5–8: Once weekly treatments
Week 9 and beyond: Maintenance phase, typically every 1–2 weeks (based on your provider’s recommendation and how well you’re doing)
This tapering schedule helps patients stabilize and maintain improvements over time.
Benefits of Spravato
Many patients who try Spravato experience:
Rapid relief of depressive symptoms
Better energy, focus, and concentration
Increased motivation and daily functioning
Renewed hope and quality of life
For individuals who have battled depression for years without success, this treatment can feel life-changing.
Risks and Side Effects
Like all medications, Spravato can have side effects. The most common include:
Dissociation (feeling disconnected from reality)
Drowsiness or dizziness
Nausea
Headache
Increased blood pressure (monitored during treatment)
Because of these possible effects, it’s essential that treatment occurs in a certified clinic under supervision.
Spravato vs. Traditional Antidepressants
SpravatoTraditional AntidepressantsWorks on glutamate systemWorks on serotonin, dopamine, or norepinephrineEffects may be seen in hours or daysEffects often take weeksAdministered in clinicTaken daily at homeUsed after other medications failOften first-line treatment
This makes Spravato an excellent option for patients who feel stuck or have lost hope with standard medications.
Is Spravato Covered by Insurance?
Yes—most major insurance providers cover Spravato for patients who meet eligibility requirements. At Nebraska Peace of Mind, our team works directly with your insurance company to handle prior authorizations and approvals, so you can focus on your health.
FAQs About Spravato
1. How quickly will I notice improvement?
Some patients feel relief within hours or days. For others, it may take several treatments to notice significant changes.
2. Do I have to stop my current antidepressants?
No. Spravato is usually prescribed in addition to an oral antidepressant.
3. How long will I need to stay on Spravato?
It depends on your response. Some patients continue long-term maintenance, while others may taper off under their provider’s guidance.
4. Is Spravato the same as ketamine therapy?
Spravato is related to ketamine but is a purified isomer (esketamine) specifically developed and FDA-approved for depression.
5. Do I need a ride home after every session?
Yes. Because Spravato can cause temporary side effects, you cannot drive until the next day.
Spravato at Nebraska Peace of Mind
At Nebraska Peace of Mind Behavioral Health, we are proud to offer Spravato treatment for individuals struggling with treatment-resistant depression. Our clinic provides a calm, supportive environment, with private treatment rooms designed for your comfort.
Our team of providers will walk with you every step of the way—from insurance approvals and treatment planning to ongoing follow-up and support.
Taking the Next Step
If you’ve tried multiple medications without success, you are not alone—and there is hope. Spravato may be the breakthrough you’ve been waiting for.
Contact Nebraska Peace of Mind today to schedule a consultation and learn whether Spravato is right for you.