Depression can feel discouraging when you have already tried therapy, antidepressant medications, or multiple treatment approaches without meaningful improvement.
You may be attending appointments, taking medication as prescribed, and doing your best to function—yet still feel stuck with low motivation, sadness, hopelessness, exhaustion, or difficulty reconnecting with your life.
For certain adults with persistent depression, Spravato® (esketamine) nasal spray may be an option worth discussing with a psychiatric provider.
At Next Gen Psyche & Wellness, we provide in-person Spravato treatment in San Diego, California, with clinical monitoring and individualized support throughout the treatment process.
What Is Spravato?
Spravato is a prescription nasal spray containing esketamine. It is FDA-approved for adults with:
- Treatment-resistant depression (TRD), either as a stand-alone treatment or together with an oral antidepressant.
- Depressive symptoms in major depressive disorder (MDD) with acute suicidal thoughts or behavior, when used with an oral antidepressant.
Unlike many traditional antidepressants that primarily affect serotonin, norepinephrine, or dopamine pathways, Spravato works through the brain’s glutamate system, which is involved in mood regulation and neural communication.
Some patients may experience improvement in depressive symptoms as early as 24 hours, although every patient’s response is different and a full treatment plan must be based on clinical evaluation.
Who May Qualify for Spravato Treatment?
Spravato may be considered for adults who continue to experience significant depressive symptoms despite previous treatment.
You may be a candidate if you:
- Have been diagnosed with major depressive disorder.
- Have tried two or more antidepressant treatments without adequate improvement.
- Continue to experience persistent depression that affects work, relationships, motivation, sleep, or daily functioning.
- Are experiencing depressive symptoms associated with acute suicidal thoughts or behavior and need urgent psychiatric evaluation and support.
A psychiatric assessment is required to determine whether Spravato is clinically appropriate and safe for you.
Important: Spravato has not been proven to prevent suicide or reduce suicidal behavior. Anyone experiencing suicidal thoughts, intent, or an emergency should call 988, call 911, or go to the nearest emergency room immediately.
Why Is Spravato Different From Traditional Antidepressants?
Traditional antidepressants can be very effective, but for some patients, they do not provide enough relief even after multiple trials.
Spravato offers a different treatment pathway by targeting glutamate signaling in the brain. This may support changes in the brain networks involved in depression, emotional processing, and mood regulation.
A simple way to understand this is:
Traditional medications may gradually adjust mood-related chemical signaling. Spravato may help create an opportunity for the brain to respond differently when depression has remained persistent despite previous treatments.
Spravato is not a “quick fix,” and it is not appropriate for everyone. Treatment is most effective when integrated into a comprehensive psychiatric care plan that may include medication management, psychotherapy, lifestyle support, and ongoing monitoring.
What Happens During Spravato Treatment?
Spravato is not taken at home. It must be administered in a certified healthcare setting under the supervision of a trained healthcare provider.
During each appointment:
1. Your blood pressure and clinical status are assessed before treatment.
2. You self-administer the nasal spray under provider supervision.
3. You remain in the clinic for monitoring for at least two hours after treatment.
4. Your provider assesses when it is safe for you to leave.
Because Spravato may cause sedation, dissociation, increased blood pressure, or changes in alertness, you must arrange transportation home after each session. You should not drive or operate machinery until the following day after a restful sleep.
Is Spravato Covered by Insurance?
Insurance coverage for Spravato varies depending on your diagnosis, prior medication trials, health plan, medical necessity requirements, and prior authorization criteria.
Some commercial insurance plans, Medicare plans, and Medicaid plans may provide coverage for eligible patients. Coverage is not guaranteed, and approval requirements differ by plan.
At Next Gen Psyche & Wellness, we can help you:
- Determine whether your insurance plan includes Spravato coverage.
- Review eligibility and clinical requirements.
- Coordinate prior authorization documentation when appropriate.
- Discuss possible cost-support resources for eligible patients.
Our goal is to help you understand your treatment options before beginning care.
Spravato Treatment in San Diego
If you have been struggling with depression despite previous treatments, you do not have to keep repeating the same cycle without exploring additional options.
At Next Gen Psyche & Wellness, we provide compassionate, evidence-informed psychiatric care tailored to your symptoms, treatment history, goals, and overall health.
Spravato treatment is available in person at our San Diego clinic:
Next Gen Psyche & Wellness 5222 Balboa Ave., Suite 43 San Diego, CA 92117
Phone: (626) 371-3053
Find Out Whether Spravato May Be Right for You
A consultation can help determine whether you may qualify for Spravato treatment and whether your insurance may provide coverage.
Contact Next Gen Psyche & Wellness to schedule a consultation and begin the eligibility review process.
Medical Disclaimer
This article is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Spravato is available only through a restricted REMS program and must be administered in a certified healthcare setting with required monitoring. Treatment recommendations are made only after an individualized psychiatric evaluation.