Spravato® Treatment in Littleton, Colorado
Spravato® (esketamine) is an FDA-approved nasal spray for adult treatment-resistant depression. It is administered in our REMS-certified Littleton clinic with required monitoring.
Spravato® at a Glance
Littleton, CO 80128 · Serving the southwest Denver metroUnderstanding the Treatment
What is Spravato®?
Spravato® is a prescription nasal spray containing esketamine, and it works differently than the antidepressants you’ve likely already tried. Standard antidepressants act on monoamines (brain chemicals like serotonin); esketamine acts on the glutamate system (the brain’s main signaling pathway, through NMDA receptors). That different mechanism is why it can help when medication after medication has fallen short.
It’s FDA-approved as monotherapy or together with an oral antidepressant for adults with treatment-resistant depression. Spravato is only administered in certified health care settings like ours under the Spravato REMS safety program; it is never dispensed for use at home.
- FDA-approved for treatment-resistant depression
- You self-administer the spray in-office, in a private, comfortable room
- Monitored by our clinical team for about 2 hours each visit
- May be used alone or alongside an oral antidepressant and therapy, based on your treatment plan
Why the different mechanism matters
The pivotal treatment-resistant depression studies assessed symptom change over a four-week induction phase, although some patients notice changes sooner. Response timing varies and improvement is not guaranteed, so we measure symptoms throughout treatment.
Is Spravato® Right for You?
Who qualifies for Spravato®
Being upfront about eligibility saves you time and protects your hope. Spravato may be a strong fit if several of these describe you:
- You’ve been diagnosed with depression and tried two or more antidepressants without adequate relief
- You can receive treatment in a certified health care setting and complete the required monitoring after each dose
- You can set aside about two hours per visit and arrange a ride home on treatment days
- You want to explore an FDA-approved option and have us verify your plan’s coverage requirements
When Spravato® isn’t the right fit
Spravato is contraindicated with aneurysmal vascular disease, arteriovenous malformation, or a history of intracerebral hemorrhage. It is not recommended for those with a history of psychosis (seeing, feeling, or hearing things that are not there, or believing things that are not true). Elevated blood pressure may require delaying a dose while the risks and benefits are assessed. Pregnancy, plans for pregnancy, and breastfeeding also require a specific discussion before treatment and cannot be explicitly recommended given the limited safety and monitoring data available. If Spravato isn’t safe or suitable for you, we’ll explain why and discuss alternatives for your care.
The Process
How Spravato® works at Fortifying Wellness
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1
Consultation & medical evaluation
Dr. Wagner takes the time to understand your full story: your symptoms, history, medical health, every treatment you’ve tried and how it went, and your goals. You leave with a clear working diagnosis and a plan you helped shape, and nothing starts without safety screening and informed consent. If Spravato is determined to be an appropriate and safe treatment for you, we begin the insurance process.
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2
Insurance verification & REMS registration
Your insurance will likely require a prior authorization documenting medical necessity. We assist with these forms, and with your registration in the Spravato REMS program. This process can take anywhere from a few business days to a few weeks.
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3
Your first treatment visit
Once approved, your medication is ordered through our designated REMS-certified pharmacy and delivered to our clinic. You receive any education materials you need, then self-administer the medication in a private room. We monitor you over two hours, checking your vital signs throughout, and confirm you meet criteria for discharge. Your designated person then signs you out and drives you home; patients may not leave alone by rideshare.
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4
A tapering schedule
Treatment typically begins twice weekly for the first four weeks, then weekly for four weeks. At week nine we evaluate your response and set an appropriate maintenance schedule, spacing treatments out as your progress allows. Each visit follows the same comfortable, monitored routine.
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5
Measurement & maintenance
We track your symptoms with validated rating scales and adjust the plan together, including how Spravato fits with an oral antidepressant, therapy, or other care.
The Research
The trials behind Spravato’s FDA approval
Spravato® was approved on the strength of a phase 3 clinical program in treatment-resistant depression. The key evidence, linked in full:
TRANSFORM-2 Pivotal Trial
Esketamine nasal spray plus an oral antidepressant relieved treatment-resistant depression significantly better at four weeks than the antidepressant alone.
SUSTAIN-1 Relapse Trial
Among patients whose depression had lifted, continuing esketamine substantially lowered the risk of relapse compared with an antidepressant alone.
U.S. Food & Drug Administration
The current prescribing information permits Spravato® as monotherapy or with an oral antidepressant for adults with treatment-resistant depression, administered under the required safety and monitoring program.
These are simplified summaries of independent studies; follow the links for full methods and limitations. Study results describe research populations, not a promise of individual outcomes. We track your response with validated symptom scales.
Safety & Side Effects
What a session feels like
Some patients experience a dreamlike, floating, or detached sensation (dissociation). Other common side effects include dizziness, nausea, sleepiness, and a temporary rise in blood pressure. We monitor you on site for at least two hours and until you are clinically ready to leave.
You shouldn’t drive or operate heavy machinery until the next day, after a restful night’s sleep. A designated, trusted adult signs you out and takes you home after every treatment.
Cost & Coverage
Insurance & cost
Coverage and prior-authorization requirements for Spravato vary by plan. Our team confirms your plan’s specific criteria, submits the prior authorization, and explains expected out-of-pocket costs before your first treatment.
Spravato® Questions
Frequently asked questions
How is Spravato® different from ketamine infusions?
Spravato is esketamine, the S-enantiomer of ketamine, delivered as a nasal spray. It’s FDA-approved for treatment-resistant depression and given only in certified health care settings under the Spravato REMS safety program. Coverage and prior-authorization criteria depend on the specific plan. Ketamine infusions are an off-label use and are typically self-pay. We can help you compare the two options, including our IV ketamine therapy program.
What does a Spravato® session feel like?
After you self-administer the nasal spray in our office, some patients describe a temporary dreamlike, floating, or detached sensation. Drowsiness, dizziness, and nausea can also occur. You rest in a private room while our team monitors you for at least two hours, and you leave once you’re clinically ready.
Can I drive home after Spravato®?
No. On treatment days you’ll need a designated, trusted adult, such as a family member or close friend, who will sign you out and drive you home or accompany you in a rideshare. You shouldn’t drive or operate heavy machinery until the next day, after a restful night’s sleep.
Will insurance cover Spravato®?
Coverage and prior-authorization criteria depend on your specific plan. Our Littleton team verifies your benefits, handles the prior authorization, and explains expected out-of-pocket costs before you start.
How fast does Spravato® work?
Response timing varies, and improvement is not guaranteed. The pivotal treatment-resistant depression studies assessed symptom change over a four-week induction phase; some patients notice changes sooner. We use validated rating scales to evaluate your response throughout treatment.
Related conditions & treatments
Take the Next Step
Find out if Spravato® is right for you
A free consultation with our Littleton team. Your questions answered, your benefits verified, no obligation.
7345 S. Pierce St, Suite 205, Littleton, CO 80128 · Serving Littleton, Ken Caryl, Columbine, Highlands Ranch, Centennial, Lone Tree, Englewood, Lakewood & the south Denver metro