A Breakthrough Option for Treatment‑Resistant Depression

At Riverwalk Psychiatry, we are committed to offering advanced, evidence‑based treatments for individuals who have not found sufficient relief with traditional antidepressants. Spravato® (esketamine) is an FDA‑approved nasal spray used in combination with an oral antidepressant for adults with treatment‑resistant depression (TRD) and for depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior.

Spravato works differently than most antidepressants, targeting the glutamate system in the brain rather than serotonin or norepinephrine. Many patients experience improvement more rapidly compared to standard medications.

Who May Be a Good Candidate

Spravato may be appropriate if you:

• Have tried two or more antidepressants without adequate response

• Continue to experience significant depressive symptoms

• Are seeking a more rapid‑acting treatment option

• Can safely participate in monitored treatments

A comprehensive psychiatric evaluation is required to determine whether Spravato is clinically appropriate and safe for you. If you currently see another provider, we can coordinate you treatments with them in order to not disrupt your current care.

How Spravato Treatment Works

Spravato is administered under strict medical supervision as part of a federally required REMS (Risk Evaluation and Mitigation Strategy) program.

What to expect:

1. Pre‑Treatment Evaluation – Full psychiatric assessment, medication review, and consent process

2. In‑Clinic Administration – Self‑administered nasal spray under provider supervision

3. Monitoring Period – You will remain in the clinic for at least 2 hours for observation

4. Safe Discharge – You must have a ride home; driving is not permitted the same day

Typical Treatment Schedule:

• Weeks 1–4: Twice weekly

• Weeks 5–8: Once weekly

• Maintenance: Every 1–3 weeks based on response

Most commercial insurance plans cover Spravato for eligible patients, though prior authorization is typically required. Our team will:

• Verify insurance benefits

• Submit required prior authorization forms

• Review any expected out‑of‑pocket costs before treatment begins

• Coordinate with your current provider

Our Integrative Approach

What makes Spravato treatment at Riverwalk Psychiatry different is our whole‑person, integrative psychiatry model. When appropriate, Spravato can be thoughtfully combined with:

• Medication optimization

• Individual therapy and skills‑based counseling

• Functional medicine insights

• Genetic testing

• Lifestyle and nervous‑system regulation strategies

Our goal is not only symptom reduction, but long‑term emotional resilience and improved quality of life

Safety & Monitoring

Spravato can cause temporary side effects such as:

• Dissociation or feeling “disconnected”

• Dizziness or sedation

• Nausea

• Increased blood pressure

For safety reasons:

• Treatments are only provided in our clinic

• Continuous monitoring by trained staff is required

• Same‑day driving and operating heavy machinery are not allowed

Next Steps

If you are struggling with depression and have not responded to standard treatments, Spravato may be an option worth exploring.

To get started:

• Request a consultation by calling our office or submit an inquiry below

• Our team will guide you through evaluation, insurance review, and scheduling

Spravato® is administered according to FDA and REMS program requirements. Results vary by individual. A full medical evaluation is required prior to treatment.