Spravato® (Esketamine) · FDA Approved · North Miami, FL
When All Else Fails,
Your Brain
Has a New Door.
Spravato® (esketamine) is the first and only FDA-approved nasal spray for treatment-resistant depression — a breakthrough that delivers rapid, meaningful relief when traditional antidepressants have not worked. Administered safely in our clinic, supervised by board-certified psychiatrists.
FDA Approved 2019
Breakthrough Designation
Now: Also Monotherapy
Approved Jan 2025
Insurance Accepted
Medicare · Most major plans
Rapid Response
Relief within 24 hours
English & Spanish
Bilingual care team
Spravato® Clinical Summary
TeleHealth
All of florida
Understanding Spravato®
A Fundamentally Different
Approach to Depression
For decades, antidepressants worked by targeting monoamine neurotransmitters — serotonin, norepinephrine, dopamine — throughout the entire body. Spravato® takes an entirely different approach, targeting the glutamate system and specifically the NMDA receptor.
This mechanism restores synaptic connections in brain cells — connections that become pruned or lost during chronic depression. The result is measurable neuroplasticity: your brain begins building healthier, more resilient pathways within hours, not weeks.
Spravato® received FDA Breakthrough Designation — reserved for therapies that show substantial improvement over existing treatments for serious conditions. In January 2025, the FDA approved it as the first and only monotherapy for treatment-resistant depression.
“Esketamine represents the first truly novel antidepressant mechanism approved in over 30 years — with a speed of action that is genuinely unprecedented.”
— Psychiatry Research, 2024
How It Works in the Brain
NMDA Receptor Targeting
Unlike SSRIs, Spravato® binds to NMDA receptors in the glutamate system — the brain’s primary excitatory pathway.
Synaptic Restoration
Triggers rapid synaptogenesis — helping the brain rebuild connections lost or pruned during chronic depression.
Neuroplasticity Activation
BDNF (brain-derived neurotrophic factor) release promotes neuroplasticity within hours of the first dose.
Sustained Recovery
Unlike antidepressants, effects persist beyond the drug’s presence — the structural changes endure.
Clinical Evidence
The Data Behind Spravato®
Supported by Phase 4 randomized controlled trials, FDA Priority Review, and 5+ years of real-world clinical evidence.
22.5%
Remission Rate at Week 4
Clinical trial data vs 7.6% placebo — a 3x improvement in full remission for treatment-resistant depression patients.
Phase 4 RCT, 2025
24hrs
Rapid Onset of Action
Statistically significant improvement in MADRS depression score within 24 hours of the very first dose.
Published Trial Data
2019
FDA Approval Year
Originally approved for TRD in combination with oral antidepressant. FDA Breakthrough Designation recognized its superior efficacy.
U.S. FDA
2025
Monotherapy Approval
As of January 2025, Spravato® became the first and only FDA-approved monotherapy for treatment-resistant depression.
FDA Priority Review
140K+
Global Patients Treated
Over 140,000 patients have received Spravato® globally across certified treatment centers — with a well-established safety record.
Real-World Data
31
Clinical Trials Completed
Supported by 31 clinical trials and 5+ years of real-world use data reinforcing safety and sustained efficacy across diverse populations.
J&J Research Base
What Spravato® Delivers
Clinical Transformations
Patients Experience
Spravato® does not merely suppress symptoms — it initiates genuine neural recovery. The following clinical benefits have been consistently observed in trial populations and real-world patients, grounded in the neuroscience of glutamate modulation and neuroplasticity.
SSRIs and SNRIs target the monoamine system — after two failed trials, the glutamate system becomes the more relevant therapeutic target. Spravato® directly addresses the synaptic dysfunction that underlies treatment-resistant depression, producing structural change rather than chemical compensation.
Rapid Mood Improvement
Measurable reduction in depressive symptoms within 24 hours — not weeks. Clinical data confirms significant MADRS score improvement after the first dose.
Reduced Suicidal Ideation
FDA-approved for MDD with acute suicidal ideation — Spravato® can be a critical bridge to safety during psychiatric crises.
Restored Synaptic Connections
Neuroplasticity-driven recovery rebuilds the neural infrastructure of mood regulation — not just symptom masking.
Improved Sleep Quality
Glutamate modulation supports healthier sleep architecture, with many patients reporting improved sleep within the first two weeks.
Enhanced Cognitive Clarity
Reduction in cognitive fog, improved concentration, and sharper executive functioning — measurable improvements in daily cognition.
Emotional Stabilization
Greater emotional regulation and reduced reactivity — patients report feeling more grounded and in control of their emotional responses.
Restored Motivation
Anhedonia — the inability to feel pleasure — lifts as reward circuits recover. Patients re-engage with life, relationships, and goals.
Long-Term Durability
Phase 3 trials demonstrated that maintenance Spravato® significantly delays relapse, with many patients maintaining gains for months to years.
The Patient Experience
A Session Designed Around You
Every detail of the Spravato® experience at ACC has been designed for safety, comfort, and dignity.
01
In-Office Administration
You arrive at our private clinic and self-administer the Spravato® nasal spray under the direct supervision of an ACC clinician. The process takes only a few minutes and is completely painless.
🏥Private, supervised clinic setting
👨⚕️Clinician present throughout
💊Self-administered nasal spray
02
Comfortable Monitoring Period
You relax in our comfortable recliner suite for a mandatory 2-hour monitoring period. We check your blood pressure and vitals regularly. You may feel dissociation, dizziness, or sedation — all normal and temporary.
🕒Minimum 2 hours on-site
📊Vitals monitored throughout
🛋️Private, comfortable recliner suite
🎧Bring music, books, or simply rest
03
Safe Discharge & Next Steps
You cannot drive until the following day — please arrange a ride home. Our team reviews your session, schedules your next appointment, and checks in by phone within 24 hours to monitor your response.
🚗Arrange a ride home in advance
📞24-hour follow-up call from our team
📅Next session scheduled before you leave
Treatment Phases
Your Spravato® Treatment Journey
Phase 1 · Induction
Rapid Symptom Relief
Weeks 1–4 · Twice Weekly
Two sessions per week for the first four weeks to rapidly build therapeutic levels and jumpstart neural recovery. Most patients begin noticing mood shifts within the first 1–2 weeks.
Phase 2 · Stabilization
Mood Stabilization
Weeks 5–8 · Once Weekly
Once-weekly sessions to stabilize the improvements achieved during induction and consolidate neural pathway strengthening. Psychiatric monitoring continues throughout.
Phase 3 · Maintenance
Long-Term Wellness
Week 9+ · Every 1–2 Weeks
Ongoing sessions at the frequency determined by your psychiatrist — typically every 1 to 2 weeks — to maintain gains and prevent relapse. Adjusted based on individual response.
Safety & Monitoring
Administered Safely.
Monitored Continuously.
Spravato® is one of the most carefully supervised treatments in psychiatry — every session managed by trained clinical staff in a certified facility.
🛡️
REMS Certified Program
Spravato® is dispensed only through the FDA’s Risk Evaluation and Mitigation Strategy (REMS) program — ensuring every dose is administered in a certified healthcare setting with trained staff.
FDA REMS Certified
🩺
Vitals Monitored Live
Blood pressure, oxygen saturation, and dissociation level are monitored continuously during your 2-hour post-dose observation. Our team is with you throughout.
Real-Time Monitoring
🧬
No Systemic Toxicity
Unlike long-term antidepressants, Spravato® has no hepatic toxicity, no cardiac QTc prolongation risk, and no reported organ system damage at therapeutic doses.
31 Clinical Trials
🔒
Controlled Schedule
Esketamine is a Schedule III controlled substance. ACC’s certified program includes strict dispensing protocols, preventing misuse while ensuring access for qualifying patients.
Controlled & Safe
Common Side Effects
Side effects are temporary and typically occur only during the session and for a short time afterward. They resolve before discharge and diminish over the treatment course.
🌀
Dissociation
A temporary feeling of detachment from reality — monitored closely and resolves within the 2-hour window. Managed through calm environment and clinical support.
Dizziness or Nausea
Common in early sessions; typically mild and brief. Diminishes significantly as your body adjusts over the treatment course.
Sedation
Temporary drowsiness during and shortly after the session. This is why you cannot drive — the following day, all cognitive function is restored.
🩸
Blood Pressure Increase
Temporary and monitored in real time. Patients with uncontrolled hypertension are evaluated carefully before treatment initiation.
Contraindications
Spravato® may not be appropriate for all patients. Your psychiatrist will conduct a thorough medical and psychiatric evaluation before initiating treatment to confirm your eligibility and safety.
✗
Aneurysmal Vascular Disease
History of aortic or intracranial aneurysm, arteriovenous malformation, or intracerebral hemorrhage.
✗
Uncontrolled Hypertension
Spravato® temporarily raises blood pressure. Patients with severely uncontrolled hypertension may not be candidates without prior optimization.
✗
Active Psychosis
Spravato® is not indicated for patients currently experiencing psychotic symptoms or schizophrenia.
✗
Hypersensitivity
Known allergy or hypersensitivity to esketamine, ketamine, or any component of the formulation.
✗
Pregnancy & Breastfeeding
Not recommended during pregnancy or while breastfeeding. Discuss alternative options with your psychiatrist.
Do You Qualify?
Spravato® May Be Right
for You If..
Spravato® is FDA-approved for adults with treatment-resistant depression (TRD) — defined as inadequate response to at least two oral antidepressants — and for major depressive disorder with acute suicidal ideation. Our psychiatrist evaluates each patient individually.
✓You have tried 2 or more antidepressants without adequate relief
✓You experience persistent depressive symptoms despite treatment
✓You have been diagnosed with major depressive disorder (MDD)
✓You are experiencing acute suicidal ideation requiring rapid intervention
✓You prefer a non-oral, non-ECT approach to treatment-resistant depression
✓You are 18 years of age or older
✓You do not have contraindicated medical conditions (reviewed at evaluation)
✓You can arrange transportation home following each session
Free Eligibility Consultation
Not sure if you qualify? Our board-certified psychiatrist will review your history, prior treatments, and current symptoms.
Insurance & Financing
Financial Barriers Should Never
Block Access to Healing.
We believe that treatment-resistant depression deserves treatment — regardless of financial circumstance. Our team handles every aspect of insurance verification, prior authorization, and billing so you can focus entirely on recovery.
✓Medicare Part D — Spravato® typically covered for TRD
✓Most major commercial insurance plans accepted
✓We verify your benefits before your first session — at no cost
✓Prior authorization handled entirely by our team
✓Transparent billing — no surprise charges
✓CareCredit financing available for uninsured patients
✓Spanish-speaking billing team available
🛡️
Insurance Verification
Not sure if you are covered? Our billing team will verify your Spravato® benefits for free — before you commit to anything. No paperwork required from you.
Common Questions
Everything You Need to Know
Honest, detailed answers from our clinical team — because an informed patient is an empowered patient.
Spravato® is an FDA-approved intranasal medication (esketamine) for adults with Treatment-Resistant Depression (TRD) or Major Depressive Disorder with acute suicidal ideation. It works by targeting the glutamate system and NMDA receptors — an entirely different mechanism from traditional antidepressants — enhancing neuroplasticity and restoring synaptic connections in the brain.
Spravato® is appropriate for adults who have tried at least two antidepressants without significant improvement, experience persistent depressive symptoms, struggle with severe or overwhelming depressive episodes, or need rapid relief while staying safe and supported. A free consultation with our board-certified psychiatrist will formally determine your candidacy.
Treatments are conducted in-office only, in a private and monitored space. You self-administer the nasal spray under the direct supervision of an ACC clinician. You remain on-site for a mandatory 2-hour monitoring period during which your vitals are checked regularly. You cannot drive until the following day.
Many patients notice mood improvement within 24 hours of their first session — a speed of action unprecedented in antidepressant therapy. Most experience meaningful improvement within the first 1–2 weeks. Clinical remission at week 4 was achieved by 22.5% of trial patients (vs. 7.6% placebo). Individual responses vary.
Medicare Part D and most major commercial insurance plans cover Spravato® for TRD when clinical criteria are met. Our insurance team handles verification and prior authorization entirely on your behalf — at no cost — before your first session begins.
Yes — in most cases. Spravato® does not interact adversely with most psychiatric medications. Your psychiatrist will review your full medication list at evaluation. Spravato® can be used in combination with oral antidepressants, or — since January 2025 — as a standalone monotherapy.
Both target the NMDA receptor, but Spravato® (esketamine) is the S-enantiomer of ketamine — more potent at lower doses, with a nasal spray format that improves bioavailability. Most importantly, Spravato® has FDA approval for TRD and MDD-SI, is covered by insurance, and is dispensed through the certified REMS program ensuring standardized safety protocols.
After completing the induction and stabilization phases, most patients transition to maintenance sessions every 1–2 weeks. Your psychiatrist evaluates your ongoing response and adjusts frequency as needed. Many patients maintain significant improvement for months to years with periodic maintenance. We remain your long-term partner in care.
Consultations Available This Week
Take the First Step
Toward Mental Clarity
30-minutes consultation with our board-certified psychiatric team. No commitment. No pressure. Just honest, expert guidance on whether Spravato® is right for you — and complete clarity on your insurance coverage before you begin.