Physician-Supervised Treatment Option for Adults with Treatment-Resistant Depression
SPRAVATO® (esketamine) nasal spray offers a distinct pharmacological pathway for those living with major depressive disorder who find that multiple medications have not provided lasting relief. This should be administered under the direct supervision of a healthcare provider. At Transformation Health Services, we administer SPRAVATO® at our locations in Virginia Beach, Richmond, Suffolk, Fredericksburg, and Brooklyn. Each treatment session takes place in the office under provider supervision, followed by at least 2 hours of post-dose monitoring before the patient is cleared to leave.
What is SPRAVATO®?
SPRAVATO® is an FDA-approved nasal spray containing esketamine, a derivative of ketamine, indicated for adults with treatment-resistant depression (TRD) and for adults with major depressive disorder who have acute suicidal ideation or behavior. It works differently from traditional antidepressants, which primarily target serotonin, dopamine, or norepinephrine. Esketamine acts on the NMDA receptor system, a glutamate pathway associated with synaptic plasticity and mood regulation. It is dispensed only through a restricted program under the FDA’s Risk Evaluation and Mitigation Strategy (REMS) requirements.
Who May Benefit from SPRAVATO®?
This treatment is clinically indicated for a specific population. It may be appropriate for adults who:
- Have been diagnosed with major depressive disorder and have not responded adequately to at least two different oral antidepressants.
- Are experiencing major depressive disorder with active suicidal ideation or behavior, as determined by a licensed provider.
- Are medically stable enough to tolerate the required observation protocol and transportation restrictions.
- Are willing to engage in a concurrent oral antidepressant regimen as part of a comprehensive treatment plan.
Candidacy is determined through a clinical evaluation. Our providers will review your history, current medications, and overall health picture before recommending this pathway.
The SPRAVATO® Experience at Transformation Health Services
From your first inquiry to your ongoing sessions, our team structures the process to be as clear and manageable as possible.
Clinical evaluation
Your provider reviews your psychiatric history, current medications, and overall medical background to confirm that this treatment aligns with your clinical needs and FDA criteria.
Treatment scheduling
Sessions are scheduled according to the standard protocol. The induction phase requires twice-weekly visits, with your schedule adjusting as you move into the maintenance phase.
Supervised dosing sessions
Each session takes place in a private clinical setting. You self-administer the nasal spray, and your provider monitors you for a minimum of two hours before you are cleared to leave with a designated driver.
Ongoing coordination and monitoring
Your clinical team tracks your response across sessions and works alongside your broader mental health providers to ensure your overall care plan reflects your progress.
Why Choose Transformation Health Services for SPRAVATO®?
Certified REMS-compliant treatment settings
All esketamine treatment sessions are conducted at our REMS-certified locations, ensuring compliance with all FDA requirements for safe administration and monitoring.
Licensed, experienced mental health providers
Our clinical team brings specialized training in mood disorders and psychiatric pharmacology.
Integrated care approach
This nasal spray treatment is one part of a broader therapeutic picture at Transformation Health Services. Where appropriate, your team may coordinate it alongside therapy, medication management, or other services we offer.
Multiple locations, consistent standards
Whether you are seen in Virginia Beach, Brooklyn, or any of our other offices, the clinical standards and care protocols remain consistent.
Frequently Asked Questions
No. This nasal spray formulation (esketamine) is FDA-approved, administered under clinical supervision, and is covered by many insurance plans under specific criteria. Ketamine infusions use a different compound form and are not FDA-approved for depression.
For treatment-resistant depression, the usual schedule is twice weekly during weeks 1 to 4, once weekly during weeks 5 to 8, and then once weekly or every 2 weeks from week 9 onward based on response. For depressive symptoms in adults with MDD and acute suicidal ideation or behavior, the recommended regimen is 84 mg twice weekly for 4 weeks, with 56 mg as an option based on tolerability.
This may be eligible for coverage under commercial and government insurance plans when medical criteria are met. Our team can assist with prior authorization and coverage verification at your initial evaluation.
Dissociation, dizziness, nausea, and sedation are among the most commonly reported effects and typically occur during or shortly after dosing. This is why the two-hour post-dose monitoring period is required.
Ready to Take the Next Step?
If standard antidepressants have not brought the relief you need, contact us to schedule a clinical evaluation at any of our Virginia Beach, Richmond, Suffolk, Fredericksburg, or Brooklyn locations, or reach out to learn more about whether esketamine fits your clinical picture.
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