What Is Spravato?
Spravato (esketamine) is an FDA-approved nasal spray for adults with treatment-resistant depression (when symptoms have not improved after trying at least two antidepressants). Under current FDA labeling, it may be
used on its own (monotherapy) or together with an oral antidepressant,
depending on the patient's treatment plan and clinical needs.
- Some patients notice symptom improvement within hours to days, but response varies
- Works differently than traditional antidepressants
- May be used for certain adults with MDD with acute suicidal ideation or behavior, when clinically appropriate
- Given only in a monitored clinical setting (REMS requirements apply)
Who Is Spravato For?
Spravato may be appropriate for adults who:
- Have tried two or more antidepressants without adequate improvement
- Have ongoing depression symptoms that significantly affect daily functioning
- Feel emotionally numb, hopeless, or “stuck” despite treatment
- Are looking for an option that may work faster than traditional medication changes
- Meet eligibility criteria after a psychiatric evaluation
Spravato treatment is provided in-person at our Frisco, TX clinic and starts with an initial evaluation to confirm fit and next steps.
Is this the right next step?
Spravato may be worth discussing if you are an adult with depression that has not improved enough after trying at least two antidepressants.
If you are unsure whether your past medication trials count, that is exactly what we review during the evaluation.
During your consultation, we review your diagnosis, treatment history, current symptoms, medical history, medications, safety considerations,
and insurance requirements. If Spravato is not appropriate, we will discuss other evidence-based options.
Your Spravato Treatment Journey
At Wholesome Clinic, Spravato treatment is structured, supervised, and personalized—from your initial evaluation through ongoing maintenance planning.
Step 1: Comprehensive Initial Evaluation
We complete a diagnostic assessment, review your treatment history (including prior antidepressant trials), and confirm whether Spravato is an appropriate option for you.
Step 2: Insurance Authorization & REMS Enrollment
Our team supports the administrative steps, which may include insurance verification, prior authorization, required documentation, and REMS program requirements.
Step 3: First Spravato Session (Induction Begins)
Treatment begins with a supervised in-office session. You self-administer the nasal spray, followed by at least two hours of monitoring for safety and tolerability.
Weeks 1–4: Induction Phase (Typically 2 Sessions per Week)
During induction, we monitor symptoms, side effects, and overall functioning at each visit. Response and timing vary by patient.
Weeks 5–8: Stabilization Phase (Typically Weekly Sessions)
We continue tracking progress and adjust the plan as clinically appropriate, based on your response and tolerability.
Week 9 and Beyond: Maintenance Therapy
Maintenance frequency is individualized (for example, weekly, every other week, or monthly), depending on clinical response and your treatment plan.
Ongoing Monitoring & Support
We track outcomes, address side effects, and coordinate next steps as part of your broader mental health care plan.
Quick Overview: Your Spravato Pathway
- Full psychiatric evaluation and eligibility screening
- Insurance authorization and REMS requirements (as applicable)
- In-office supervised dosing with monitoring
- Induction phase (Weeks 1–4)
- Stabilization phase (Weeks 5–8)
- Maintenance planning (after Week 8)
- Ongoing monitoring and follow-up
Book Initial Spravato Consultation
Safety, REMS Compliance & Monitoring
Spravato must be administered in a certified medical setting under the Spravato REMS program. Patients are monitored for at least two hours after each dose, and you must arrange transportation home after treatment. Wholesome Clinic (7978 Preston Rd, Ste 804, Frisco, TX 75034) is a REMS-certified Spravato treatment center.
Potential Benefits (Response Varies)
- Some patients report a reduction in depressive symptoms
- Improved ability to function day-to-day
- Improved clarity or emotional responsiveness
- A different mechanism than traditional antidepressants (glutamate pathway)
- Ongoing monitoring of symptoms and safety at each visit
Why Choose Wholesome Clinic?
- Evaluation-first process with clear next steps
- REMS-certified Spravato treatment center (in-office in Frisco, TX)
- Licensed psychiatric providers experienced in treatment-resistant depression
- Comfortable, private treatment rooms
- Compassionate, non-judgmental care
- Convenient North Texas location
- Whole-person, trauma-informed approach
Take the Next Step
If you’ve tried antidepressants without enough improvement, you’re not alone. A Spravato evaluation can help determine whether this treatment is a good fit and what to expect.
Schedule Your Evaluation