SPRAVATO® (esketamine)
When depression has not responded to what you've already tried.
SPRAVATO® is an FDA-approved nasal treatment that may be considered for appropriate adults with treatment-resistant depression.
For some adults, depression does not respond adequately to traditional antidepressants. SPRAVATO® is an FDA-approved treatment option that works through a different pathway and may be considered when standard approaches have not provided enough relief.
Treatment is provided in a private, closely monitored setting, with the care and attention that define The Sanctuary.
A different approach to treatment-resistant depression
SPRAVATO® (esketamine) is an FDA-approved prescription nasal spray used in combination with an oral antidepressant for adults with treatment-resistant depression.
Esketamine works differently from traditional oral antidepressants. While many antidepressants act on neurotransmitters such as serotonin or norepinephrine, esketamine acts on the brain's glutamate system, which is thought to be involved in pathways related to mood and neuroplasticity.
Because it works through a different pathway, SPRAVATO may be considered when standard treatments have not provided adequate relief.
Who may be considered
SPRAVATO® is FDA-approved for adults with treatment-resistant depression — depression that has not responded adequately to at least two oral antidepressants, used in combination with an ongoing oral antidepressant.
It is not FDA-approved for other conditions, and it is not appropriate for everyone. A comprehensive evaluation helps determine whether SPRAVATO may be a considered option for you.
Certain medical and psychiatric conditions, medications, pregnancy, or other individual factors may affect whether SPRAVATO is appropriate. These are reviewed carefully during your evaluation.
What treatment looks like at The Sanctuary
SPRAVATO is administered only in a certified healthcare setting under the required REMS (Risk Evaluation and Mitigation Strategy) program. You self-administer the nasal medication under clinical supervision, in a private, calming environment designed for comfort and discretion.
After administration, you are monitored by a healthcare provider for at least two hours, consistent with current prescribing information, before you are cleared to leave.
There is time to settle in before treatment, and time to recover before going home.
Your treatment rhythm
For treatment-resistant depression, treatment typically begins with an induction phase, followed by a maintenance phase. During induction, sessions are usually scheduled twice weekly for the first four weeks.
During maintenance, the frequency is adjusted based on your response and tolerability. Treatment is individualized — there is no single schedule that fits every patient, and your plan is guided by clinical judgment.
SPRAVATO® and Ketamine
Both SPRAVATO® and ketamine are interventional psychiatric treatments, but they are distinct medications, with different routes of administration, regulatory pathways, and treatment experiences.
Neither is universally better. The appropriate treatment is determined through clinical evaluation, based on your history, symptoms, and goals.
Learn About Ketamine TherapySafety and REMS
Because SPRAVATO can cause temporary effects such as sedation, dissociation, increased blood pressure, and changes in perception, it is available only through a restricted REMS program.
This means treatment is supervised, patients are monitored for at least two hours after each dose, and you must arrange for a responsible adult to drive you home. You should not drive or operate machinery until the next day after a restful sleep, per prescribing instructions.
We take these precautions seriously, while keeping the experience as calm and supported as possible.
What to expect on treatment day
Your visit is designed to feel prepared, calm, and unhurried.
- A brief check-in and review of how you've been feeling
- Time to settle into a private, comfortable space
- Self-administration of the nasal medication under clinical supervision
- A restful period of observation and monitoring
- Time to recover and reorient before leaving
Throughout your visit, our team remains nearby to monitor your safety and comfort. You will not be rushed, and you will have time to feel ready before you go.
Frequently Asked Questions
Official Resources
For complete clinical information, please refer to official prescribing information and patient resources.
Could SPRAVATO® be part of your path forward?
SPRAVATO is not right for everyone. A comprehensive evaluation helps us determine whether it may be an appropriate part of your treatment plan.
Request a SPRAVATO Evaluation