Spravato® (esketamine) nasal spray
An FDA-approved esketamine nasal spray for specific adult indications — self-administered under supervision in a certified healthcare setting, with a monitoring period afterward.
- FDA-approved
- Supervised in-office
- REMS program
Spravato is the brand name for esketamine, a molecule closely related to ketamine, delivered as a nasal spray. Unlike off-label ketamine, esketamine carries specific FDA approvals for adults, and it is always given under supervision in a certified setting with a monitoring period before you leave.
What it is approved for
Esketamine nasal spray is FDA-approved for adults with treatment-resistant depression, and, in combination with an oral antidepressant, for depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behavior. It is used together with an oral antidepressant, not as a stand-alone. Your clinician confirms whether you meet the criteria during your consultation.
How a session works
You self-administer the nasal spray yourself, but only in a certified healthcare setting and under the supervision of your care team. Because temporary effects on alertness and blood pressure are common, you are monitored for at least two hours afterward, and you will not drive until the next day. Sessions are calm, private, and unhurried.
The REMS safeguard
Because of these effects, Spravato is only available through a restricted program called a REMS (Risk Evaluation and Mitigation Strategy). In practice that means it can only be dispensed and administered in enrolled, certified settings with monitoring — a safeguard built to keep supervised care safe.
- Esketamine nasal spray, taken alongside an oral antidepressant
- FDA-approved for specific adult indications
- Self-administered, but only under supervision in a certified setting
- At least two hours of monitoring after each dose
- No driving or heavy machinery until the day after treatment
- More likely than off-label ketamine to be recognized by insurance
How does it compare to IV ketamine?
Spravato is FDA-approved and often more insurance-friendly; IV infusion offers the most dosing control and the deepest research base. The right choice depends on your diagnosis, history, and coverage.
Spravato® is a registered trademark of its manufacturer. This page is educational and does not constitute medical advice or a guarantee of eligibility, coverage, or outcome. Whether esketamine is appropriate for you is a decision made with a qualified clinician.
Ask us about Spravato
A free, confidential consultation is the simplest way to learn whether esketamine could be a fit — and what it would involve.