Spravato (Esketamine) for Treatment-Resistant Depression — Gilbert, AZ
FDA-approved nasal spray targeting glutamate pathways for rapid relief from depression and suicidal ideation. Covered by most major insurance plans.
Relief in hours, not weeks
Unlike traditional antidepressants that take 4–6 weeks, Spravato targets the NMDA receptor for rapid symptom relief.
What Is Spravato and How Does It Work?
Conventional antidepressants (SSRIs, SNRIs) work on the serotonin system and typically require 4–6 weeks to show any effect. Spravato works through a completely different mechanism — the NMDA receptor — which allows it to provide relief within hours to days.
This is why so many patients notice a difference after their very first session. It represents a genuine breakthrough for patients who have spent years cycling through medications without meaningful relief.
How it works
Esketamine rapidly increases glutamate activity, which helps restore the neural connections that depression has weakened. Where SSRIs slowly adjust serotonin over weeks, esketamine reopens plasticity in the brain circuits most affected by depression.
Our role is to deliver this treatment in the safest possible setting — REMS-certified, physician-supervised, with full 2-hour post-dose monitoring in a calm, private environment.
What to Expect During a Spravato Session at Unchained
Every session follows the same 4-step rhythm — no surprises, and our clinical team is with you throughout.
Arrive at Our Office
Check in at our Gilbert clinic. Our team confirms your vitals and ensures you’re ready. Arrange a ride home in advance.
Self-Administer Nasal Spray
Under clinical supervision, you self-administer the Spravato nasal spray. The process takes just a few minutes.
2-Hour Monitored Observation
Relax in a comfortable, private setting while our team monitors you for the required 2-hour observation period.
Head Home with Your Ride
Once cleared by our team, you leave with your pre-arranged ride. Do not drive or operate machinery for the rest of the day.
Who Is Spravato For?
Spravato is specifically designed for patients who meet certain clinical criteria. You may be a candidate if you identify with any of the following.
Failed 2+ Antidepressants
You’ve tried at least two different antidepressant medications at adequate doses without sufficient improvement.
Treatment-Resistant Depression
Your depression has not responded adequately to standard treatment approaches and you need a different mechanism of action.
MDD with Suicidal Ideation
Spravato is also approved for major depressive disorder with acute suicidal thoughts, where rapid symptom relief is critical.
Seeking FDA-Approved Options
You want a rigorously tested, FDA-approved treatment rather than off-label alternatives — with the assurance of insurance coverage.
Is Spravato Covered by Insurance?
Yes — Spravato is FDA-approved, which means most major insurance plans including UHC, Aetna, Cigna, BCBS, and Medicare Part B cover treatment. Our team handles prior authorization on your behalf. Call us to verify your benefits before your first session.
Our team handles the entire prior authorization process in-house so you can focus on your treatment, not paperwork. We verify your benefits and let you know your coverage details before your first session.
How Long Does It Take for Spravato to Work?
Spravato works much faster than traditional antidepressants. Here is the typical response timeline our patients experience.
24–72hours
First noticeable changes
Most patients feel a shift — in mood, motivation, or clarity — within the first 1–3 days after their initial session.
4–6weeks
Significant improvement
Substantial improvement typically occurs within the induction phase — twice-weekly sessions over the first month.
+therapy
Counseling amplifies results
Adding counseling, therapy, or coaching alongside Spravato consistently produces stronger and more durable outcomes.
Individual response varies. Your provider will adjust your protocol based on your specific symptoms and progress.
Spravato vs. IV Ketamine — Which Is Right for You?
Both treatments target similar pathways, but they differ in important ways. Here’s how they compare.
Frequently Asked Questions About Spravato
Common questions from patients starting or considering Spravato.
How long does Spravato take to work?
Many patients notice changes within 24–72 hours of their first session. Significant improvement typically occurs within 4–6 weeks of twice-weekly induction sessions.
Does insurance cover Spravato?
Yes. Spravato is FDA-approved and covered by most major insurers. Our team handles prior authorization. Janssen’s WithMe program can also reduce cost to /session for eligible patients.
What does dissociation feel like during Spravato?
Some patients experience a dreamlike, detached feeling during treatment. It typically resolves within 2 hours. Our clinical team monitors you throughout your 2-hour session.
Can I drive after Spravato treatment?
No. Because of sedation and dissociation effects, you cannot drive on the day of your Spravato session. You must arrange a ride home.
How is Spravato different from IV Ketamine?
Spravato is FDA-approved, given as a nasal spray in-clinic, and typically covered by insurance. IV Ketamine is infused intravenously, acts faster, and is usually self-pay. See our comparison table above.
Administered by REMS-Certified Providers
Every Spravato session is administered in-office by our REMS-certified clinical team, with the full 2-hour post-dose monitoring required by FDA. Our providers handle all prior authorizations and coordinate your care from first visit to treatment completion.
Real Stories, Life Changing Results
At Unchained Psychiatry & Wellness, we are honored to have helped many individuals on their journey to mental wellness. Here are some testimonials from our patients:
Find Out If Spravato Is Right for You
Our team will verify your insurance, handle prior authorizations, and guide you through every step. Schedule a consultation today.