Braden Counseling offers SPRAVATO® (esketamine) treatment for eligible adults experiencing treatment-resistant depression or major depressive disorder with acute suicidal ideation or behavior, as part of a comprehensive mental health care plan.
Our clinical team provides a calm, supportive environment focused on safety, coordination of care, and patient education.
What Is SPRAVATO®?
SPRAVATO® (esketamine) is a prescription nasal spray approved by the FDA for use in combination with an oral antidepressant in certain adults with major depressive disorder.
Unlike traditional antidepressants, SPRAVATO® acts on the brain’s glutamate system. Due to specific safety risks, SPRAVATO® is only available through the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program and cannot be taken at home.
Prescribed For
SPRAVATO® may be considered for adults diagnosed with:
- Treatment-Resistant Depression (TRD)
(Depression that has not adequately responded to at least two antidepressant medications) - Major Depressive Disorder (MDD) with Acute Suicidal Ideation or Behavior
Used alongside an oral antidepressant and broader mental health support
SPRAVATO® has not been shown to prevent suicide or reduce suicidal behavior on its own. Ongoing treatment, monitoring, and safety planning remain essential.
Determining Eligibility
SPRAVATO® is not appropriate for everyone. Eligibility is determined through a clinical evaluation that may include:
- Review of psychiatric history and previous treatments
- Medical history and current medications
- Blood pressure assessment and other safety considerations
- Coordination with your prescribing provider or referral source
Final determination is made by a qualified medical professional.
What to Expect During SPRAVATO® Treatment
SPRAVATO® treatment at Braden Counseling follows federally required safety protocols:
- In-Clinic Administration
- SPRAVATO® is self-administered as a nasal spray under the supervision of trained healthcare staff.
- Monitoring Period
- After administration, patients remain in the clinic for a minimum of two hours for observation and safety monitoring.
- Transportation Requirement
- Patients must arrange transportation home and may not drive or operate machinery until the next day after a full night’s sleep.
- Treatment Schedule
- Treatment frequency varies. Many plans begin with twice-weekly visits and gradually decrease based on clinical response and provider recommendations.
Safety Information & REMS Requirements
SPRAVATO® carries important risks and is subject to a Boxed Warning. Potential risks include:
- Sedation or extreme drowsiness
- Dissociation or perceptual changes
- Increased blood pressure
- Respiratory depression
- Risk of abuse and misuse
- Suicidal thoughts or behaviors
Because of these risks:
- SPRAVATO® is only administered in a certified healthcare setting
- Patients are monitored for at least two hours after each dose
- SPRAVATO® is not dispensed for home use
All patients must be enrolled in the SPRAVATO® REMS program prior to treatment.
Insurance Coverage & Cost Considerations
Coverage for SPRAVATO® varies by insurance plan.
- Many commercial insurance plans and Medicare may provide coverage when medical criteria are met
- Prior authorization is commonly required
- Coverage often depends on documented history of treatment-resistant depression
Our team can assist with:
- Verifying benefits
- Coordinating prior authorization paperwork
- Discussing estimated out-of-pocket costs when available
Coverage is not guaranteed, and patients are responsible for any non-covered services.
Frequently Asked Questions
Getting Started at Braden Counseling
If you are struggling with depression that has not responded to standard treatments, SPRAVATO® may be an option worth discussing with your provider.
Contact Braden Counseling to learn more about evaluations, referrals, and next steps.
SPRAVATO® (esketamine) treatment is available at select Braden Counseling locations, including Sycamore and Sterling, for eligible adult patients.