SPRAVATO KNOWLEDGE CENTER
Spravato Knowledge Center
Clear, physician-reviewed information about Spravato eligibility, treatment, safety, insurance, and what patients can expect. Every article is written from the current FDA-approved prescribing information and other primary sources, with those sources listed on each page.
Looking for our treatment service instead? See Spravato treatment at Innerbloom Medical.
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What Is Spravato?
Spravato is the brand name for esketamine nasal spray, an FDA-approved treatment given in a certified healthcare setting. What it is, how it differs from ketamine, and why it cannot be taken home.
Read article →8 min readHow to use this guide
These pages explain what Spravato is, who its FDA labeling covers, what treatment involves, and how coverage generally works. They are educational and cannot tell you whether treatment is right for you — that requires an evaluation by a clinician.
Each article separates four different things that are easy to confuse: what the FDA-approved label says, what the REMS safety program requires, what insurers commonly ask for, and what Innerbloom Medical specifically does.
Eligibility
Who the FDA labeling covers, and why a clinician evaluation is still required.
The treatment process
Dosing schedules, appointments, monitoring, and transportation.
How Often Is Spravato Treatment Given?
The labeled Spravato dosing schedule for treatment-resistant depression — induction, weeks 5 to 8, and week 9 onward — plus the separate four-week regimen for acute suicidal ideation or behavior.
Read article →8 min readWhat to Expect at Your First Spravato Appointment
A step-by-step walkthrough of a first Spravato treatment visit: evaluation, vital signs, self-administration, the two-hour monitoring period, and the transportation requirement.
Read article →9 min readSafety and warnings
Adverse reactions, boxed warnings, contraindications, and the REMS program.
Spravato Side Effects and What Patients Should Know
The adverse reactions reported most often in Spravato clinical trials, what monitoring is designed to catch, and which symptoms warrant urgent evaluation.
Read article →10 min readSpravato Safety, Warnings, and Contraindications
The Spravato boxed warning, the three labeled contraindications, blood-pressure and pregnancy considerations, and why individual medical screening is required before treatment.
Read article →11 min readWhat Is the Spravato REMS Program?
REMS is an FDA-required safety program. What certification requires of a treatment setting, what the monitoring rules are, and what REMS certification does and does not tell you about a clinic.
Read article →7 min readInsurance and cost
How coverage is typically structured and what prior authorization involves.
Does Insurance Cover Spravato?
How Spravato coverage is typically structured, the difference between the medical and pharmacy benefit, what drives out-of-pocket cost, and the questions worth asking your insurer.
Read article →10 min readSpravato Prior Authorization: A Patient Guide
What prior authorization is, the documentation insurers commonly request for Spravato, how approvals and renewals work, and what to do if a request is denied.
Read article →9 min readComparisons
How Spravato differs from other ketamine-based treatment.
Scottsdale and Arizona resources
Spravato treatment in Scottsdale
Innerbloom Medical is a physician-led clinic in Old Town Scottsdale, Arizona, serving patients across the Phoenix metro area. Treatment is supervised by Dr. Andrew Zabel, a board-certified Emergency Medicine physician.
- Spravato treatment at Innerbloom Medical
- Our Scottsdale clinic, location and parking
- Depression and treatment-resistant depression
- Pricing for out-of-pocket ketamine services
4388 N. Civic Center Plaza, Suite 101, Scottsdale, AZ 85251 • (623) 343-3466
Crisis and urgent help in Arizona
Spravato treatment is not a substitute for emergency care. If you or someone else may be in immediate danger, call 911 or go to the nearest emergency department.
In the United States, call or text 988 for the 988 Suicide & Crisis Lifeline, available 24 hours a day. The Lifeline serves callers in Arizona and can connect you with local crisis services.
Veterans can reach the Veterans Crisis Line by dialing 988 and pressing 1.
Spravato: frequently asked questions
What is Spravato?↓
Spravato is the brand name for esketamine nasal spray, a prescription medication given in a certified healthcare setting. The FDA-approved labeling covers treatment-resistant depression in adults, as monotherapy or together with an oral antidepressant, and depressive symptoms in adults with major depressive disorder who have acute suicidal ideation or behavior, used together with an oral antidepressant.
Is Spravato the same as ketamine?↓
They are related but not the same. Esketamine is the S-enantiomer of racemic ketamine — one of the two mirror-image forms of the ketamine molecule. Spravato is an FDA-approved nasal spray for specific depression indications, while racemic ketamine is FDA-approved as an anesthetic and is used off-label for depression.
Can Spravato be taken at home?↓
No. Under the Spravato REMS program, the medication is dispensed and administered only in certified healthcare settings. Patients spray it themselves under the direct observation of a healthcare provider and are monitored for at least two hours afterward. It is not dispensed for home use.
How long does a Spravato appointment take?↓
The prescribing information requires monitoring for at least two hours after each dose, followed by an assessment of clinical stability before discharge. Plan for the administration itself, the two-hour minimum monitoring period, and time for check-in and check-out.
Can I drive myself home after Spravato?↓
No. The prescribing information instructs patients not to drive or operate machinery until the next day after a restful sleep. You will need someone to drive you or another form of transportation home after every session.
Does insurance cover Spravato?↓
Coverage varies by plan. Many commercial and government plans cover Spravato for patients who meet their criteria, and most require prior authorization before treatment begins. Approval is never guaranteed, and out-of-pocket cost depends on your specific plan's deductible, coinsurance, copay and out-of-pocket maximum.
How do I find out whether Spravato is appropriate for me?↓
Eligibility requires an individualized evaluation by a clinician who reviews your diagnosis, treatment history, medications, and medical conditions. At Innerbloom Medical that evaluation begins with a free physician intake with Dr. Andrew Zabel. An intake is not a guarantee of eligibility or of insurance approval.
Medical review
Andrew Zabel, DO
DO, Board-Certified Emergency Medicine • Medical Director, Innerbloom Medical
Clinical content in the Knowledge Center is reviewed by a licensed physician before publication. Current status for these pages: Medically reviewed by Andrew Zabel, DO.
Sources
Medical statements on this page are drawn from the sources below. Where the FDA-approved prescribing information and other material differ, the prescribing information controls.
PRIMARY SOURCES
- SPRAVATO (esketamine) nasal spray, CIII — full prescribing information
Janssen Pharmaceuticals, via the U.S. National Library of Medicine (DailyMed) • FDA-approved labeling; DailyMed version dated March 13, 2026
- NDA 211243/S-016 supplement approval letter — esketamine monotherapy for treatment-resistant depression
U.S. Food and Drug Administration • Approved January 17, 2025
- SPRAVATO REMS program
SPRAVATO REMS (FDA-required Risk Evaluation and Mitigation Strategy)
- Popova V, et al. Flexibly dosed esketamine nasal spray with a newly initiated oral antidepressant in treatment-resistant depression (TRANSFORM-2)
American Journal of Psychiatry, 2019;176(6):428–438 • Randomized, double-blind, active-controlled trial
- Daly EJ, et al. Esketamine nasal spray plus an oral antidepressant for relapse prevention in treatment-resistant depression (SUSTAIN-1)
JAMA Psychiatry, 2019;76(9):893–903 • Randomized withdrawal, relapse-prevention trial
- Fu DJ, et al. Esketamine nasal spray for rapid reduction of major depressive disorder symptoms in patients with active suicidal ideation with intent (ASPIRE I)
Journal of Clinical Psychiatry, 2020;81(3):19m13191
SUPPORTING SOURCES
- Esketamine nasal spray administered as monotherapy in adults with treatment-resistant depression (NCT04599855)
ClinicalTrials.gov
- Preauthorization (glossary definition)
HealthCare.gov, U.S. Centers for Medicare & Medicaid Services
- 988 Suicide & Crisis Lifeline
U.S. Substance Abuse and Mental Health Services Administration
Wondering whether Spravato may be appropriate for you? Start with a free physician intake.
Book Free Physician IntakeScheduling an intake does not guarantee that Spravato is appropriate for you, that you will be prescribed it, or that your insurance will approve coverage.