Living with depression can be exhausting—especially when you’ve tried one or more antidepressants without achieving the relief you hoped for. If your symptoms continue despite treatment, you are not alone. Many people with depression require additional treatment options beyond traditional medications.
At Bruce Hubbard MD, we provide comprehensive psychiatric evaluations to determine whether SPRAVATO® (esketamine) may be an appropriate treatment option as part of your individualized treatment plan. Our experienced psychiatric team offers medication management, Transcranial Magnetic Stimulation (TMS), and SPRAVATO® therapy, allowing us to recommend the treatment that best fits your specific needs rather than a one-size-fits-all approach.
As a certified SPRAVATO® REMS Treatment Center, we administer treatment in a comfortable medical setting under the supervision of trained healthcare professionals while carefully monitoring your safety throughout each visit.
SPRAVATO® contains esketamine, a form of ketamine that has been approved by the U.S. Food and Drug Administration (FDA) for specific uses in adults. Unlike intravenous (IV) ketamine or compounded ketamine products, SPRAVATO® is an FDA-approved prescription medication that is administered as a nasal spray under the supervision of a healthcare provider in a certified treatment setting.
Unlike traditional antidepressants, which primarily affect serotonin, norepinephrine, or dopamine, SPRAVATO® works differently. While its exact mechanism of action is not fully understood, it is believed to affect the brain’s glutamate system, an important pathway involved in communication between brain cells. This represents a different therapeutic approach than conventional antidepressant medications.
Because SPRAVATO® has specific safety requirements, it is available only through the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program, a program established by the U.S. Food and Drug Administration (FDA) to help ensure the medication is administered safely.
Every patient is different. During your psychiatric evaluation, we’ll work with you to determine whether medication management, Transcranial Magnetic Stimulation (TMS), SPRAVATO®, or another treatment approach is most appropriate for your individual needs.
SPRAVATO® may be appropriate for adults who have not achieved adequate improvement with previous antidepressant treatment. During your consultation, one of our psychiatric providers will carefully review your medical history, previous treatments, current medications, and overall health to determine whether SPRAVATO® is an appropriate option.
You may be a candidate if you:
Not everyone with depression is an appropriate candidate for SPRAVATO®. Some patients may benefit more from medication adjustments, psychotherapy, Transcranial Magnetic Stimulation (TMS), or other evidence-based treatments. Our goal is to recommend the treatment that offers the greatest potential benefit based on your individual circumstances.
Choosing a provider for SPRAVATO® therapy is about more than simply finding a certified treatment center. Depression is a complex medical condition, and successful treatment often requires ongoing psychiatric expertise and individualized care.
At Bruce Hubbard MD, SPRAVATO® is provided as part of a comprehensive behavioral health program rather than as a standalone procedure.
Every patient begins with a thorough psychiatric assessment to confirm the diagnosis, review previous treatments, evaluate current medications, and determine whether SPRAVATO® is an appropriate treatment option.
Our psychiatrists and advanced practice providers have extensive experience evaluating and treating adults with depression, anxiety disorders, obsessive-compulsive disorder (OCD), and other psychiatric conditions.
Because we offer medication management, TMS, and SPRAVATO® therapy, we can recommend the treatment—or combination of treatments—that best aligns with your clinical needs.
Our staff works with patients and insurance companies to verify benefits and obtain prior authorization when required. We understand that navigating insurance requirements can be frustrating, and we strive to make the process as straightforward as possible.
SPRAVATO® treatments are administered in a quiet, comfortable clinical setting where patients can relax while being monitored by trained medical staff throughout the observation period.
Depression treatment does not end after a single visit. We continue to monitor your progress, adjust treatment plans when appropriate, and coordinate your care with your referring provider when applicable.
Beginning a new treatment can feel overwhelming. Our goal is to make every step of the process as comfortable and straightforward as possible. Before treatment begins, you’ll meet with one of our psychiatric providers to determine whether SPRAVATO® is appropriate for your diagnosis, medical history, and treatment goals.
Your first visit includes a detailed psychiatric assessment. We’ll review:
If SPRAVATO® is recommended, we’ll explain the treatment process, discuss potential benefits and risks, and answer any questions you may have.
Many insurance plans require prior authorization before SPRAVATO® treatment can begin.
Our staff will:
Because every insurance plan is different, coverage and out-of-pocket costs vary by patient.
SPRAVATO® is administered as a nasal spray that you self-administer under the supervision of our medical staff.
Before treatment:
After administering the medication, you’ll remain comfortably seated in one of our treatment rooms while our staff monitors your response.
Many patients choose to:
The treatment environment is designed to be calm, private, and supportive.
Because SPRAVATO® can cause temporary side effects such as sedation, dizziness, increased blood pressure, or feelings of dissociation, patients remain in the office for at least two hours following each treatment.
During this observation period, our clinical staff will:
You may not drive or operate machinery until the day after treatment, following a restful night’s sleep.
You will need a responsible adult or transportation service to take you home after every treatment.
Every patient’s treatment plan is individualized.
A typical treatment schedule may include:
Weeks 1–4
Two treatments each week
Weeks 5–8
One treatment each week
Maintenance Treatment
Some patients continue treatment every one to two weeks, while others may gradually reduce treatment frequency depending on their response and the recommendation of their psychiatric provider.
SPRAVATO® carries important safety warnings and is available only through the FDA’s Risk Evaluation and Mitigation Strategy (REMS) Program.
Potential side effects may include:
Most side effects occur shortly after treatment begins and improve during the observation period.
Before each treatment, we’ll review any changes in your medical condition or medications to help ensure SPRAVATO® remains appropriate for you.
Our team is trained to recognize and manage these effects while you are in our care.
For complete prescribing information, including the Boxed Warning, please visit the official SPRAVATO® website.
Many commercial insurance plans and some government insurance programs provide coverage for SPRAVATO® for eligible patients.
Coverage depends on factors such as:
Our staff has extensive experience working with insurance companies and will assist with:
If insurance does not cover treatment, we’ll discuss available options with you before treatment begins.
No.
SPRAVATO® contains esketamine, a form of ketamine that has been approved by the U.S. Food and Drug Administration (FDA) for specific uses. Unlike IV ketamine or compounded ketamine products, SPRAVATO® is an FDA-approved nasal spray that is administered only in certified healthcare settings through the REMS Program.
Plan to be in our office for approximately two hours after receiving the medication, plus a short amount of time before treatment for check-in and after treatment for discharge.
No.
Many patients feel relaxed or sleepy during treatment, but most remain awake and able to communicate with our staff throughout the visit
No.
Because SPRAVATO® may temporarily affect alertness and coordination, you must arrange transportation home after every treatment and should not drive or operate machinery until the following day after a restful night’s sleep.
Every patient responds differently.
Some patients notice changes early in treatment, while others require several weeks before experiencing meaningful improvement. Your psychiatric provider will monitor your progress throughout treatment and adjust your treatment plan as appropriate.
Many patients continue taking prescribed antidepressant medications while receiving SPRAVATO®, although treatment plans vary depending on the indication being treated and individual circumstances. Your provider will discuss the approach that is most appropriate for you.
Many insurance plans provide coverage for eligible patients, although prior authorization is often required.
Our office will verify your benefits and help guide you through the approval process.
Living with treatment-resistant depression can feel discouraging, but you do not have to navigate it alone.
Our experienced psychiatric team is committed to helping you understand your treatment options and develop a personalized plan based on your medical history, symptoms, and goals.
Whether SPRAVATO®, medication management, TMS, or another evidence-based treatment is most appropriate, we’ll work with you to identify the approach that best fits your needs.
Schedule Your SPRAVATO® Consultation Today
Call (619) 295-8005 or request an appointment online to learn whether SPRAVATO® may be an appropriate treatment option for you.
Medical Review
This information is provided for educational purposes only and is not intended as medical advice or as a substitute for an evaluation by a qualified healthcare professional.
Last Reviewed: July 2026
Medical Reviewer: Bruce Hubbard, MD
Medical Director
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