If you’ve been struggling with depression or other mental health conditions that haven’t improved with traditional treatments, Spravato® (esketamine nasal spray) may be an option.
At our licensed facility, we provide safe, professional Spravato® treatment in Virginia in a supportive environment, helping clients find relief when other approaches haven’t worked.
- All 5 of our PMHNPs are licensed to prescribe Spravato®
- Our Virginia-based PMHNPs work alongside with our therapists to bring a holistic approach to treatment
- We never take a one-size-fits-all approach; every client is unique
- What is Spravato®?
- Spravato® vs. Esketamine: What’s the Difference?
- Spravato® vs. Traditional Antidepressants
- Who is Spravato® For?
- What is Treatment-Resistant Depression?
- Spravato® Treatment
- Conditions Spravato® is Used to Treat
- Virginia Spravato® Providers
- What to Expect During a Spravato® Treatment Session
- Our Spravato® Treatment Rooms
- How Much Does Spravato® Nasal Spray Cost?
- Questions about Spravato® Treatment
- Our Psychiatry Office
- Set Up a Spravato® Treatment Today
What is Spravato®?
Spravato® is an FDA-approved nasal spray that contains esketamine, a form of ketamine. It’s used in combination with an oral antidepressant and is designed for adults who have not responded well to other depression treatments.
Unlike traditional antidepressants, which can take weeks to work, Spravato® acts on different brain pathways and may provide relief in a much shorter time frame (24-48 hours).
Spravato® vs. Esketamine: What’s the Difference?
These terms are sometimes used interchangeably, but here’s the breakdown:
- Esketamine: The active drug that works on the brain’s NMDA receptors
- Spravato®: The brand name of the FDA-approved nasal spray that delivers esketamine in a safe and regulated way
Spravato® vs. Traditional Antidepressants
| Feature | Spravato® (Esketamine Nasal Spray) | Traditional Antidepressants (SSRIs, SNRIs, etc.) |
|---|---|---|
| Mechanism of Action | Works on glutamate receptors (NMDA receptors) to rapidly improve mood and brain connectivity | Works on serotonin, norepinephrine, or dopamine levels over time |
| Onset of Relief | Often within hours to days | Typically 4–6 weeks for noticeable effects |
| Administration Method | Nasal spray administered in-office under medical supervision | Oral medication taken daily at home |
| FDA Approval | Approved for treatment-resistant depression and MDD with suicidal thoughts or actions | Approved for major depressive disorder and other general mood conditions |
| Monitoring Required | Must be monitored by a provider for about 2 hours after each session | Routine follow-ups every few weeks |
| Potential Side Effects | Short-term dizziness, dissociation, nausea, increased blood pressure | Commonly fatigue, sexual side effects, weight gain, insomnia |
| Insurance Coverage | Often covered with prior authorization for treatment-resistant depression | Widely covered by most insurance plans |
| Best For | Individuals who haven’t found relief with 2+ antidepressants | Those beginning depression treatment or responding to oral medications |
Who is Spravato® For?
Spravato® may be recommended if:
- You’ve tried at least two antidepressants without significant improvement.
- You’re struggling with treatment-resistant depression (TRD).
- You’re dealing with major depressive disorder (MDD) with suicidal thoughts or actions.
- You have certain conditions such as bipolar depression (when appropriate and prescribed by a provider).
Spravato® is not typically the first treatment option. It’s designed for individuals who haven’t found relief with more traditional approaches.
What is Treatment-Resistant Depression?
Treatment-resistant depression (TRD) refers to depression that does not improve after trying two or more antidepressant medications.
People with TRD often experience:
- Persistent sadness or hopelessness
- Loss of interest in activities
- Difficulty functioning day-to-day despite therapy and medication
Spravato® offers a new pathway to relief for those facing TRD.
Spravato® Treatment
Spravato® treatment is always taken in a medical office, under the supervision of a licensed mental health provider. At our office in Richmond, we’re with you as you administer the nasal spray. Because of its potential side effects, you’ll stay in the office for about 2 hours after each dose while we monitor you for safety.
Treatment begins with twice-weekly sessions, followed by a tapering schedule as symptoms improve.
Here’s what a typical Spravato® treatment schedule looks like:
- The first 1-4 weeks: 2 sessions per week, 2 hours per session
- Weeks 5-8: 1 session per week, 2 hours per session.
After 8 weeks, patients enter a maintenance phase and will develop a maintenance schedule with their prescriber.
Conditions Spravato® is Used to Treat
Major Depressive Disorder (MDD)
Spravato® is FDA-approved for adults with major depressive disorder who haven’t responded to other medications.
Treatment-Resistant Depression (TRD)
One of the most common reasons patients seek Spravato® is for treatment-resistant depression, where traditional antidepressants haven’t worked.
Suicidal Depression
Spravato® may also be prescribed for people experiencing major depression with suicidal thoughts or behaviors, offering faster relief than standard medications.
Bipolar Depression
In some cases, Spravato® may be considered as part of a treatment plan for bipolar depression, under close provider supervision.
Virginia Spravato® Providers
At our office in Richmond, Virginia, our experienced Spravato® providers specialize in helping individuals find relief from treatment-resistant depression and other mood disorders. Each provider is trained and certified in administering esketamine (Spravato®) treatments, ensuring your safety, comfort, and care throughout the process.
Allison Ernest
PMHNP-BC, RN, MSN
Elizabeth Markey
PMHNP-BC, MSN, CNM, PMH-C
Jennifer Peele
PMHNP, FNP-BC, APRN
Jonathan Yoder
PMHNP-BC
Ryan Ernest
PMHNP-BC
What to Expect During a Spravato® Treatment Session
Here’s what a typical session looks like:
- Arrival & Check-In – You’ll meet with a provider to review your symptoms and treatment plan.
- Administration – You self-administer Spravato® nasal spray under supervision from a prescriber.
- Observation Period – You’ll relax in a comfortable space while we monitor your blood pressure, heart rate, and overall wellbeing for about 2 hours.
- Transportation Home – Because Spravato® can cause temporary dizziness or disorientation, you’ll be required to have a friend or family member pick you up from the office and drive you home.
Our Spravato® Treatment Rooms
We have 3 dedicated Spravato® treatment rooms in our Richmond, Virginia office.
How Much Does Spravato® Nasal Spray Cost?
The cost of Spravato® varies depending on your insurance coverage and treatment plan. Many insurance providers cover Spravato®, when medically necessary. Our staff will work directly with your insurance provider to confirm coverage before beginning treatment. You can view a list of insurance providers we work with →
Questions about Spravato® Treatment
Not exactly. Spravato® contains esketamine and is FDA-approved, while IV ketamine therapy is an off-label use of ketamine.
Some patients notice improvements within the first few sessions, though results vary. In some cases, noticeable changes can be seen in as little as 24 hours.
Treatment plans vary, but many patients start with twice-weekly sessions for the first month, then switch to once a week for the second month as symptoms improve. From there, your prescriber will work with you on an individualized maintenance plan.
Yes, some patients experience side effects. These include dizziness, nausea, drowsiness, and dissociation (feeling detached). These usually fade within a few hours.
Our Psychiatry Office
Our psychiatry office is located in the heart of West End Richmond, in the Innsbrook business complex—at the crossroads of I-64, I-295, Hwy 288, and West Broad St. We share the Liberty Plaza I building with several law offices, financial services companies, and other Richmond-area businesses, at the corner of Cox Rd. & North Park Dr.
4801 Cox Road, Suite 205
Glen Allen, VA 23060
Directions →
Set Up a Spravato® Treatment Today
If you’ve been searching for Spravato® near me, our Virginia team of PMHNPs are here to help. We provide safe, supportive, and personalized treatment plans to help clients find relief from treatment-resistant depression and related conditions.
Schedule a consultation below and learn if Spravato® is right for you.