When Depression Won’t Lift, Spravato® May Offer a New Path Forward

Spravato® is the brand name for esketamine, an FDA-approved nasal spray for treatment-resistant depression. Unlike traditional antidepressants that work on serotonin, Spravato acts on glutamate, a brain chemical involved in mood and the connections between brain cells. It is taken as a nasal spray in a certified medical office, where you are monitored for about two hours after each dose. Many people notice improvement faster than with standard antidepressants, though results vary from person to person.

Spravato is approved for adults with treatment-resistant depression — meaning depression that has not improved after trying at least two different antidepressants — and for adults with major depressive disorder who have active suicidal thoughts. At RayMex Wellness, every person starts with a full psychiatric evaluation so we can confirm the diagnosis, review your medical history, and make sure Spravato is safe and appropriate for you before starting.

Yes, most commercial insurance plans in Massachusetts cover Spravato for treatment-resistant depression, and many patients pay only a small copay per session. Coverage under Medicare and MassHealth varies. Because plans differ, our team verifies your specific benefits before you begin and explains your expected out-of-pocket cost. Manufacturer savings programs may also help lower costs for eligible patients. Costs are estimates and not guaranteed.

Plan for about two hours at each visit. You self-administer the nasal spray under supervision, then rest in a calm space while we monitor you, since Spravato can cause temporary dizziness or drowsiness. In the first few weeks, sessions are usually twice a week, then they gradually space out to weekly and then every one to two weeks as you stabilize. You will need someone to drive you home, as you cannot drive after a session.

RayMex Wellness provides Spravato treatment in person at our Stoughton, Massachusetts office at 11 Freeman St, Suite 8, Stoughton, MA 02072. We are convenient to Brockton, Canton, Sharon, Norwood, and surrounding South Shore communities. Spravato must be given in a certified medical setting, so this part of care is in-person only. Call (617) 419-0482 to ask about starting treatment.

They are related but not the same. Spravato (esketamine) is a specific, FDA-approved form of ketamine delivered as a nasal spray and regulated under a federal safety program called REMS. Ketamine used off-label (often by IV) is not FDA-approved specifically for depression and is not covered by insurance the same way. Because Spravato is FDA-approved and REMS-certified, it follows strict safety monitoring and is more commonly covered by insurance.