SPRAVATO® FAQs

Answers to Your Most Pressing Questions About Esketamine Treatment in Franklin, TN

At Tennessee Ketamine & Wellness Center in Franklin, TN, we specialize in cutting-edge treatments for depression, including SPRAVATO® (esketamine) nasal spray. This FDA-approved therapy offers a new path forward for individuals living with treatment-resistant depression or major depressive disorder with suicidal thoughts. Below, you’ll find answers to the most common questions we receive about SPRAVATO®, including what it is, how it works, who it’s for, and what you can expect from the treatment process.

What is SPRAVATO® and how does it work?

SPRAVATO® is a prescription nasal spray form of esketamine, a derivative of ketamine, that is used in conjunction with an oral antidepressant. Unlike traditional antidepressants, which target serotonin or norepinephrine, SPRAVATO® works on the glutamate system—a neurotransmitter involved in mood regulation and synaptic plasticity. By acting as an NMDA receptor antagonist, it helps restore balance to damaged neural pathways and can lead to rapid improvements in depressive symptoms, especially when conventional treatments have failed.

Who is eligible for SPRAVATO® treatment?

SPRAVATO® is FDA-approved for adults diagnosed with treatment-resistant depression (TRD) or major depressive disorder (MDD) accompanied by suicidal thoughts or behavior. To qualify, patients must have tried at least two other antidepressant medications without sufficient improvement. Our team conducts a thorough evaluation to determine if SPRAVATO® is appropriate, ensuring that medical and psychiatric history, current medications, and overall health are carefully reviewed.

How is IV ketamine different from SPRAVATO® or oral ketamine?

While both treatments involve forms of ketamine and target glutamate pathways, SPRAVATO® is esketamine—a more potent isomer of ketamine—administered intranasally under FDA guidelines. IV ketamine is racemic ketamine, delivered through infusion and often used off-label. SPRAVATO® is FDA-approved for depression, meaning it follows a standardized dosing and monitoring schedule, whereas IV ketamine is typically customized more flexibly by providers. Both options are available at our clinic, and our clinicians will help determine which route is better suited to your needs.

What does a SPRAVATO® treatment session involve?

Each SPRAVATO® session takes place at our clinic under direct medical supervision. After checking in, you will self-administer the nasal spray in a private, comfortable room. You’ll then be monitored closely by our clinical team for at least two hours, as required by FDA protocol. During this time, we track your vital signs and observe how you respond to treatment. Most patients are relaxed and awake throughout, though some experience mild dissociation or drowsiness, which usually fades within the monitoring window.

How often will I need to come in for treatment?

SPRAVATO® treatment follows a structured schedule:

Weeks 1–4 (Induction Phase): Two sessions per week
Weeks 5–8: One session per week
Week 9 and beyond (Maintenance Phase): Every 1–2 weeks, based on your progress

The total number of treatments varies per individual, and we tailor your maintenance plan according to how well you respond and your ongoing needs.

Are there any side effects associated with SPRAVATO®?

Yes, like all medications, SPRAVATO® can produce side effects. The most common include dizziness, nausea, dissociation, headache, increased blood pressure, and drowsiness. These typically appear during or shortly after treatment and usually subside within a few hours. All sessions are medically supervised to manage any discomfort that may arise. Most patients tolerate SPRAVATO® well and report that any side effects lessen over time.

Will I be monitored during and after my treatment?

Absolutely. SPRAVATO® must be administered in a certified clinical setting due to its dissociative effects and potential impact on blood pressure. You’ll be closely monitored by trained healthcare professionals for at least two hours post-dosing. We’ll evaluate your physical response, side effects, and overall comfort before you leave the clinic. You will not be discharged until it is safe to do so.

Can I drive after a SPRAVATO® session?

No. Patients are not allowed to drive themselves home or operate heavy machinery on the day of treatment. Because SPRAVATO® can cause temporary drowsiness, dizziness, or dissociation, you will need to arrange for a trusted friend, family member, or rideshare service to pick you up after each session. This requirement is strictly enforced for your safety.

Is SPRAVATO® covered by insurance?

SPRAVATO® is FDA-approved, which means many insurance plans do provide coverage—especially when it’s prescribed for treatment-resistant depression. Coverage can vary by provider and plan, so our administrative team will help you navigate the benefits verification process. We work directly with insurers and offer support in obtaining prior authorizations and managing out-of-pocket costs if applicable.

What kind of results can I expect—and how soon?

Many patients begin noticing improvement in mood, energy, and clarity of thought within the first few treatments—sometimes as early as the first week. Clinical studies have shown that SPRAVATO® can significantly reduce depressive symptoms and suicidal ideation in patients who have not responded to other treatments. While individual outcomes vary, patients often report feeling more emotionally stable, more motivated, and better able to engage in daily life and therapy.

Still Have Questions About SPRAVATO®?

If you’re struggling with treatment-resistant depression or have questions about how SPRAVATO® might fit into your care plan, Tennessee Ketamine & Wellness Center is here to help. Our team provides personalized, medically supervised care to support you every step of the way.

Schedule A Consultation

We know how busy life can be, so we offer the option of contacting you based on your preferences to discuss Ketamine Infusion Therapy. Please provide your information below and we will contact you in the timeframe that you choose.