Spravato™ Q & A

What is Spravato™?

Spravato™ is brand name for esketamine produced by Janssen Pharmaceutical Company of Johnson & Johnson. Spravato™ is only available in a nasal spray form, and only approved by the FDA for treating patients suffering from treatment-resistant depression (TRD). 

Is Spravato™ right for me?

Spravato™ is FDA approved exclusively for adults suffering from Treatment Resistant Depression (TRD).  Patients suffering from depression are typically considered treatment-resistant if they have not sufficiently responded to at least TWO different antidepressants of adequate dose and duration in the current depressive episode. To determine if Spravato™ is right for you, contact the office to discuss your specific situation and treatment options.

Where do I get Spravato™?

Although Spravato™ esketamine is administered as a nasal spray, people will not be permitted to purchase it for home use. To guard against abuse, patients will need to use Spravato under medical supervision at a clinic or doctor’s office that has been certified by the maker of Spravato™ as an authorized provider.  Transformation Health Services is a certified authorized provider of Spravato™.

Do I qualify for treatment with Spravato™?

Spravato™ is not for everyone.  Spravato™ is only approved for adults suffering from Treatment Resistant Depression (TRD).  To determine if you qualify, your doctor will work with you on the qualification process. Contact our team to discuss your specific situation, review the qualification requirements, and learn about treatment options.  

Does my insurance cover Spravato™?

Spravato™ was approved by the FDA in March 2019.  It is expected that many insurance providers will begin offering coverage for qualified patients.  As first step, call your insurance provider to ask if they provide coverage for Spravato™ treatments.

If you need additional help, contact Janssen CarePath (the maker of Spravato™) will help you understand your insurance coverage and other possible affordability options. 

Register for the Janssen CarePath Savings Program

The CarePath Savings Program is a rebate program for those with private/commercial health insurance that will reduce the cost per dose to $10 per treatment for up to $7150 worth of treatments. This program does not pay for costs associated with the treatment center fees which may or may not be reimbursable by insurance plans.

Where do I go to get Spravato™ treatments?

Spravato™ treatments are administered under the direct supervision of a healthcare provider and the supporting medical staff at Transformation Health Services (505 South Independence Blvd. Ste. 207, Virginia Beach, VA 23452). 

  • It is an intra-nasally, self-administered medication.

  • It will require up to 2 hours of observation in the clinic following each administration.

  • The dose will be either 56mg or 84mg depending on the person.

  • The course of treatment is twice weekly for 4 weeks, then weekly to every other week indefinitely.

  • Spravato™ is not available for use outside the medical clinic.  

What are the potential side effects and risks of Spravato™? 

  • Dissociation, dizziness, nausea, sedation, spinning sensation, reduced sense of touch and sensation, anxiety, lack of energy, increased blood pressure, vomiting and feeling drunk. If these common side effects occur, they usually happen right after taking SPRAVATO® and go away the same day. These are not all the possible side effects of SPRAVATO®. Learn more about possible side effects by visiting www.spravato.com. 

  • Seven percent of patients experienced nasal crusting, discomfort, dryness and/or itchiness related to treatment with SPRAVATO®.

Are there any restrictions with Spravato™ use? 

  • Some patients taking SPRAVATO® may experience nausea or vomiting. Because of this, you should avoid eating two hours before, and drinking liquids 30 minutes before, taking SPRAVATO®.

  • Do not drive, operate machinery or do anything where you need to be completely alert until the day after a treatment session, following a restful sleep, even if you think you feel well enough to do so.

  • Because of this driving restriction you will need to plan for your rides on treatment days.

  • Taking Spravato and benzodiazepines together can cause excessive sedation (sleepiness, trouble thinking clearly, inability to drive or use heavy machinery).

  • You should not use Spravato if you are allergic to esketamine or ketamine, or if you have:

  • a blood vessel disorder affecting your brain, chest, stomach, heart, or arms and legs;

  • a history of aneurysm;

  • a history of bleeding in your brain; or

  • an abnormal connection between your veins and arteries (a condition called arteriovenous malformation).

  • a localized weakening and ballooning in an artery wall called an arterial aneurysm

  • pregnancy

  • a mother who is producing milk and breastfeeding

  • history of drug abuse

What is the recommended dosing for Spravato

Dosage adjustments should be made based on efficacy and tolerability. Evidence of therapeutic benefit should be evaluated at the end of the induction phase to determine need for continued treatment. 

Induction Phase (Weeks 1 to 4)

Day 1 starting dose: 56 mg

Administer twice per week

Subsequent doses: 56 mg or 84 mg

Maintenance Phase (Weeks 5 to 8)

Administer once weekly 56 mg or 84 mg

 Week 9 and after: 

 Administer every 2 weeks or once weekly* 56 mg or 84 mg

* Dosing frequency should be individualized to the least frequent dosing to maintain remission/response.

How do I prepare for my Spravato™ consultation?

  • Obtain prior medical and psychiatric records

  • List previous psychiatric medications, dosing, length of treatment and response

  • Contact your insurance provider to see if Spravato treatment is covered

  • Complete intake packet prior to your appointment and return to medical provider for review

Email: patientforms.ths@gmail.com

Phone: 757-490-MIND

Fax: 757-930-6464

We have two locations:

Medication management and therapy services are provided at:

508 South Independence Blvd. Suite 200

Virginia Beach, VA 23452

Spravato Treatment

505 South Independence Blvd. Suite 207

Virginia Beach, VA, 23452


Monday-Friday 9am - 6pm

Transformation Health Services LLC