Spravato (Esketamine) Treatment for Treatment-Resistant Depression
Experience the Revitalizing Power of Spravato, Covered by Insurance
Nushama currently accepts:
What is Spravato?
Spravato is an FDA-approved prescription nasal spray containing esketamine, used with an oral antidepressant to treat adults with treatment-resistant depression and depressive symptoms in major depressive disorder with suicidal thoughts or behaviors. It can
only be administered in certified clinics under medical supervision.
Esketamine is the S-enantiomer, one of the two mirror-image molecules that make up ketamine, and the more potent of the pair at the NMDA receptor. Link the existing S-ketamine vs R-ketamine post, where Nushama already ranks #1 for the “types of ketamine” cluster. Most competitors cannot explain this.
Mechanism: Unlike traditional antidepressants that target serotonin, esketamine works on the brain’s glutamate system through NMDA receptors, helping restore neural connections disrupted by depression. That is why some patients feel improvement within hours to days
rather than weeks.
Spravato is administered as a nasal spray at our clinic in NYC. It is self-administered under the direct supervision of a licensed medical professional in a clinical setting. Spravato is typically given two times per week for the first month, followed by once a week ongoingly for maintenance treatment.
Who qualifies for Spravato?
You may be a candidate for Spravato if: you have tried two or more oral antidepressants without adequate relief; you have been diagnosed with treatment-resistant depression; or you have major depressive disorder with suicidal thoughts or behaviors. Spravato is approved for adults 18 and older.
A psychiatric evaluation at Nushama confirms whether Spravato is the right fit for your history, diagnosis and current medications.
Suicidal ideation or behaviors
Treatment Schedule
Weeks 1-4: two sessions per week (induction) · Weeks 5-8: one session per week · Week 9+: weekly to biweekly, individualized maintenance.
Some patients notice improvement within 24 hours of the first dose; response is typically evaluated over the first four weeks.
Potential Benefits of Spravato in NYC
One of the main benefits of ketamine nasal spray for depression is that it can be covered by insurance depending on your carrier and policy.
Additionally, it can rapidly improve symptoms, even in individuals who have not responded to other forms of treatment. Spravato may also be a useful option for individuals unable to take traditional antidepressants due to side effects or other contraindications. Spravato is effective approximately 40% of the time.
For those seeking Spravato treatment in NYC, this innovative option provides a promising alternative for managing treatment-resistant depression.
Cost and Insurance
Eligible commercially insured patients pay as little as $10 per treatment for the Spravato medication through the SPRAVATO
withMe program, with a separate rebate available toward each observation fee.
See the full 2026 breakdown, including per-payer detail and prior-authorization steps, in our Spravato cost and insurance guide.
Nushama currently accepts:
Spravato vs IV Ketamine
Both treatments come from the ketamine family and can lift depression quickly. The main differences are how they’re approved, given, and paid for.
| Spravato | IV ketamine | |
|---|---|---|
| FDA approval | Yes, for treatment-resistant depression and depression with acute suicidal thoughts | Used off-label for depression |
| Delivery | Nasal spray, self-administered in clinic | Intravenous infusion |
| Monitoring | At least 2 hours in clinic after each dose | Set by the clinic’s medical protocol |
| Insurance | Widely covered | Typically self-pay |
| Onset | Hours to days | Hours to days |
Nushama offers both under one roof. Our medical team is led by Dr. Steven Radowitz, who built Nushama’s IV ketamine and Spravato programs, and together they have overseen more than 21,000 ketamine infusions. That means your care team can help you choose the right fit, not just the one they happen to offer.
Want the details? Read Spravato vs ketamine: what’s the difference and Is Spravato covered by insurance?
Locations
Manhattan: REMS-certified Spravato at 515 Madison Avenue, 21st Floor, Midtown.
Rockland County: Spravato and ketamine therapy serving Rockland and the lower Hudson Valley.
Aventura / Miami: Spravato treatment for greater Miami.
Outcomes
In the pivotal TRANSFORM-2 trial, roughly seven in ten adults with treatment-resistant depression responded to Spravato plus an oral antidepressant, and about half reached remission within four weeks. Long-term data (SUSTAIN-1) shows continued treatment
significantly reduces relapse risk.
Individual results vary; your care team tracks your symptoms at every session. [cite]
Take the Next Step
You don’t have to navigate depression alone. If you’re searching for a new path forward, Spravato in NYC could be the breakthrough you need.
At Nushama, expert care meets advanced treatment in a welcoming, judgment-free space. From your first consultation to your ongoing care, we’re with you every step of the way.
Ready to begin?
Contact Nushama today to book a free consultation with our medical team, or call 646-394-996. We verify insurance and handle prior authorization before your first journey.
Referring a patient?
Our REMS-certified clinics partner with psychiatrists, primary care physicians and therapists, with regular progress updates and full continuity of care.
Yes. Every Nushama clinic that administers Spravato is REMS-certified, which is the FDA requirement for esketamine treatment.
Every session is supervised on site with two hours of post-dose monitoring.
Spravato is FDA-approved for adults with treatment-resistant depression and for depressive symptoms in major depressive disorder
with suicidal thoughts or behaviors. It is used together with an oral antidepressant.
Spravato contains esketamine, one of the two mirror-image molecules that make up ketamine. Spravato is FDA-approved for
depression and administered as a nasal spray in certified clinics; IV ketamine is used off-label as an infusion.
Nushama accepts Optum (UnitedHealthcare and Oxford) and Cigna for Spravato, with additional payers being added. Most
commercially insured patients also qualify for the SPRAVATO withMe program, which can bring medication cost to as little as $10 per
treatment.
Plan for about two and a half hours: a brief check-in, self-administration of the nasal spray under clinical supervision, then a mandatory
two-hour monitoring period before you leave.
Some patients notice improvement within 24 hours of the first dose; clinical trials evaluate response over the first four weeks. Your
care team tracks symptoms at every visit.
No. You cannot drive until the next day after a restful sleep. Patients leave by rideshare, public transit, on foot, or with a companion.
The most common are temporary: dissociation (feeling detached), dizziness, nausea, sleepiness and a brief rise in blood pressure.
These typically resolve during the two-hour monitoring window, with your care team present throughout.
Yes. Spravato is approved for use together with an oral antidepressant, and your prescribing clinician can coordinate both as part of one
treatment plan.
At REMS-certified clinics in Manhattan (515 Madison Avenue), Rockland County, and Aventura serving greater Miami. Each location
page has address, hours and insurance details.
Nushama pairs the same FDA-required medical protocol with a journey model: intention setting before each session, a private
sensory-designed journey room during the two-hour monitoring period, and integration therapy afterward. The medical team is led by Dr.
Steven Radowitz, and both Spravato and IV ketamine are offered under one roof.
