SPRAVATO® (Esketamine) Nasal Spray: Approved Uses & What to Expect

Esketamine nasal spray (SPRAVATO®)

SPRAVATO® (esketamine) is FDA-approved for adults with treatment-resistant depression (with an oral antidepressant or on its own) and for depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior, alongside an oral antidepressant. It has not been shown to prevent suicide.

FDA status

Approved for the two uses above

Setting

Self-administered only in a REMS-certified treatment center

Monitoring

At least two hours after each dose

Coverage

Often covered with prior authorization

How a session works

You spray the medicine into your nose yourself, under a healthcare provider's direct observation. Staff check your blood pressure and monitor you for at least two hours. You cannot drive or operate machinery until the next day after a restful sleep.

Boxed warning

SPRAVATO® carries a boxed warning for sedation, dissociation, respiratory depression, abuse and misuse, and suicidal thoughts and behaviors in younger patients. Because of these risks it is available only through a restricted REMS program.

Insurance

Many plans cover SPRAVATO® for its approved uses when criteria are met, usually requiring documentation of prior antidepressant trials and prior authorization.

Common questions

Can I use SPRAVATO® at home?

No. It is never dispensed for home use; every dose is taken in a certified treatment center.

This guide is educational and not medical advice. If you are in crisis, call or text 988.