- Treatment
Spravato® FDA-
approved esketamine for treatment-resistant depression
Spravato® (esketamine) is the first FDA-approved nasal spray for treatment-resistant depression and MDD with suicidal ideation — covered by most major insurers for qualifying diagnoses.
Why patients choose Spravato®
FDA
Approved in 2019
~2h
Session length including monitoring
2x/wk
Dosing in induction phase
70%
Response rate in clinical trials
Spravato® is covered by most major insurers for qualifying diagnoses. Hudson Mind handles all prior authorization.
- Board-certified psychiatrists
- Evidence-based protocols
- Personalized treatment plans
- 281 Broadway, New York City
- Insurance support available
- — What it is
What is a Spravato® (esketamine)?
Spravato® (esketamine) is an FDA-approved nasal spray form of esketamine — a molecular relative of ketamine — for adults with treatment-resistant depression (TRD) or major depressive disorder with acute suicidal ideation or behavior.
Approved by the FDA in 2019, Spravato is the first new class of antidepressant in decades. It acts on the brain's glutamate system rather than serotonin, producing improvement significantly faster than traditional antidepressants.
Spravato is always administered at a certified healthcare facility — like Hudson Mind — under clinical supervision, with patients monitored for at least two hours after each dose.
Spravato® vs. IV ketamine
Spravato (esketamine) is FDA-approved, self-administered nasally, and reimbursable by most insurers for qualifying diagnoses. IV ketamine is administered intravenously, used off-label for a broader range of conditions, and may offer a faster or stronger onset. Both are available at Hudson Mind.
How Spravato® works
1
Nasal delivery to the brain
esketamine is absorbed through the nasal mucosa and reaches the brain within minutes, producing rapid pharmacological effects.
2
Blocks NMDA glutamate receptors
esketamine interrupts glutamate-driven neural patterns associated with depression, unlike SSRIs which target serotonin.
3
Triggers neuroplasticity
downstream effects promote growth of new synaptic connections in mood-regulating circuits weakened by depression.
4
Rapid antidepressant effect
many patients experience improvement within hours to days, far faster than oral antidepressants.
- How Spravato® works
1
Nasal delivery to the brain
esketamine is absorbed through the nasal mucosa and reaches the brain within minutes, producing rapid pharmacological effects.
2
Blocks NMDA glutamate receptors
esketamine interrupts glutamate-driven neural patterns associated with depression, unlike SSRIs which target serotonin.
3
Triggers neuroplasticity
downstream effects promote growth of new synaptic connections in mood-regulating circuits weakened by depression.
4
Rapid antidepressant effect
many patients experience improvement within hours to days, far faster than oral antidepressants.
- — Who it helps
Who is Spravato® approved for?
Spravato has two FDA-approved indications and is always used alongside an oral antidepressant as part of a comprehensive treatment plan.
01
Treatment-resistant depression (TRD)
Adults with MDD who have not responded to at least two adequate antidepressant trials of different classes.
02
MDD with suicidal ideation
Adults with major depressive disorder and acute suicidal ideation or behavior requiring rapid symptom reduction.
03
Severe depression
Patients with moderate-to-severe depression who haven't achieved adequate relief from oral medications alone.
04
Depression with anxiety
Anxious depression — a common presentation that Spravato's glutamate mechanism addresses alongside mood symptoms.
05
Insurance-covered ketamine seekers
Patients who prefer an FDA-approved, insurer-reimbursable esketamine option over off-label IV ketamine.
06
Medication-sensitive patients
Those who have had difficulty tolerating side effects of multiple oral antidepressants.
- — Signs you may benefit
Signs you may be a candidate for Spravato®
If several of the following apply, Spravato may be an appropriate option to discuss with a Hudson Mind clinician.
- Failed two or more antidepressant medications from different classes
- Persistent low mood, hopelessness, or inability to experience pleasure
- Active or recent suicidal thoughts in the context of MDD
- Partial response to antidepressants — some improvement but not remission
- Preference for an FDA-approved, insurance-covered treatment
- Desire for faster relief than oral antidepressants can provide
- Difficulty tolerating side effects of multiple oral antidepressants
- Depression significantly impairing work, relationships, or daily life
- Prior positive response to ketamine therapy
- — Our protocol
How Hudson Mind administers Spravato®
Every Spravato session at Hudson Mind follows a structured, evidence-based protocol supervised by board-certified clinicians in a comfortable, monitored setting.
01
Psychiatric evaluation & insurance verification
A comprehensive evaluation confirms your diagnosis and eligibility, and our team handles all insurance prior authorization on your behalf.
- First step
02
Induction phase (weeks 1–4)
Spravato is administered twice weekly for four weeks. You self-administer the nasal spray under direct clinical supervision in our treatment suite.
- Induction
03
Two-hour monitoring period
After each dose, you remain at our facility for at least two hours while we monitor blood pressure, mood, and dissociation. This is a regulatory requirement and safety standard.
- Every session
04
Maintenance phase
Frequency reduces to once weekly for four weeks, then every one to two weeks. Maintenance schedules are personalized based on your clinical response.
- Ongoing
- — The Experience
What to expect at a Spravato® session
Here's what a typical Spravato session looks like at Hudson Mind — from arrival to going home.
1
Before your session
Avoid food for at least four hours before your appointment. You are safe to take public transit, but you may need someone to drive you home after each session, as you may not drive yourself home. Avoid nasal decongestants for at least one hour prior.
2
Arrival & check-in
Your care team takes baseline blood pressure and reviews how you're feeling. You'll be settled into a comfortable recliner in one of our monitored treatment suites.
3
Self-administering the spray
Under clinician guidance, you self-administer the Spravato nasal spray — two sprays per nostril — at designated intervals. The process takes about 5–10 minutes.
4
The monitoring period
You relax for a minimum of two hours while we monitor blood pressure, mood, and any dissociative effects. Dissociation, if any, typically resolves within the monitoring window.
5
Discharge & recovery
Once monitoring is complete and our clinical team confirms you're ready, you'll be discharged and free to head home.
Not sure if Spravato® treatment is right for you?
Our team will walk you through your options and help you take the next step — no pressure, no commitment required.
Treatments offered
5
TMS FDA approved
2008
Ketamine in clinical use
50+ yrs
Spravato has been genuinely transformative for patients who were out of options. Seeing someone stabilize — and knowing insurance covered it — makes this one of the most rewarding treatments we offer.
Hudson Mind Team
- — Questions
Frequently asked questions
Still have questions? Book a free 15-minute discovery call with our care team.
Ready to see if Spravato® is covered for you?
Our team will verify your insurance benefits and handle prior authorization — so you can focus entirely on your care.
Is Spravato® covered by insurance?
Yes. Spravato is FDA-approved and covered by most major insurance plans for treatment-resistant depression and MDD with suicidal ideation, subject to prior authorization. Hudson Mind manages the entire prior authorization process.
How is Spravato different from IV ketamine?
Spravato (esketamine) is FDA-approved, administered nasally, and insurance-reimbursable for specific diagnoses. IV ketamine is used off-label for a broader range of conditions and may offer faster or stronger onset. Both are available at Hudson Mind.
What does the dissociation feel like?
Some patients experience mild perceptual changes, floating sensations, or time distortion during the monitoring period. These effects are temporary, monitored by your care team, and typically resolve within the two-hour session window.
Can I drive after Spravato?
How quickly does Spravato work?
Some patients report improvement in depressive symptoms within hours to days of their first dose. For others, meaningful improvement builds over the first several weeks.
Do I have to stop my other medications?
- — Related Care
Explore more at Hudson Mind
Spravato is often used alongside other treatments at Hudson Mind.
Treatment
Ketamine Therapy
IV ketamine infusions — a faster-onset, off-label alternative to Spravato for patients who prefer infusions or don't qualify.
Treatment
TMS Therapy
FDA-approved, non-invasive magnetic brain stimulation. No medication, no sedation. Covered by most major insurance plans.
Treatment
SGB (Stellate Ganglion Block)
A nerve block targeting the sympathetic nervous system. Used for PTSD, anxiety, and trauma-related symptoms.
Start your path back to feeling like yourself
Schedule a discovery call with a member of the Hudson Mind intake team to discuss whether Spravato® is the right next step for you.
