If you’ve tried one antidepressant after another and still don’t feel better, it’s easy to wonder what’s left to try. At Alivation, we provide Spravato therapy in Lincoln, NE, for adults with treatment-resistant depression.
Spravato® (esketamine) is a prescription nasal spray that works differently from traditional antidepressants. It gives people whose depression hasn’t improved with other medications another option.
Our behavioral health team builds a plan around you. We’ll look at your symptoms, treatment history and overall health together to see if Spravato could be a good fit.
If you’re looking for Spravato therapy in Lincoln, Lancaster County, or Southeast Nebraska, we can walk you through your options and what comes next.
What Is Spravato Therapy?
Spravato (esketamine) is a prescription nasal spray FDA approved for the treatment of treatment-resistant depression in adults. Your provider will evaluate your diagnosis, treatment history, medications, and overall health to determine whether Spravato is appropriate for you.
Most antidepressants work by affecting chemicals like serotonin, norepinephrine, or dopamine. Esketamine works differently by acting on the brain’s glutamate system.
You cannot take Spravato home like other antidepressants. Because of certain risks, such as sedation and dissociation, Spravato is available only through the Spravato REMS Program and must be administered in a certified healthcare setting under medical supervision.
Who May Benefit From Spravato Treatment?
Spravato for depression may be an option for adults with treatment-resistant depression.
It may be worth talking with a provider about advanced treatment options if you’ve tried several antidepressants and are still dealing with symptoms like:
- Persistent low mood
- Loss of interest or pleasure
- Changes in sleep or appetite
- Low energy
- Difficulty concentrating
- Withdrawal from activities or relationships
What is treatment-resistant depression?
Treatment-resistant depression generally refers to major depressive disorder that has not improved adequately after trying at least two antidepressant treatments at appropriate doses and durations. Your provider will review your treatment history to determine whether your depression meets the criteria for Spravato treatment.
How Does Spravato Work?
Traditional antidepressant medications and Spravato affect the brain differently.
Esketamine acts on the brain’s NMDA receptors and glutamate system. Glutamate is a chemical messenger involved in communication between brain cells. Research into esketamine suggests its effects on this system may contribute to its antidepressant action. By influencing glutamate signaling through NMDA receptor activity, esketamine affects communication between brain cells in a way that differs from many traditional antidepressants.
Because esketamine works differently, it has become an option for people with treatment-resistant depression. Some research shows it can work faster than traditional medications for some patients. However, everyone responds differently, and not all patients will see the same results or timing of relief.
What to Expect During Spravato Treatment
Knowing what to expect can make it easier to decide whether Spravato is worth trying.
Initial Consultation
Treatment starts with an evaluation. Your provider will ask about your depression symptoms, past antidepressant treatments, medical history, current medications, and anything else that could affect whether Spravato is right for you.
Bring your questions, too. Ask about the treatment, possible side effects, or what to expect during your visits.
Treatment Sessions
You will use the Spravato nasal spray yourself, but only under the supervision of a healthcare provider at a certified treatment center.
After administration, your provider will monitor you for potential side effects, including changes in blood pressure, sedation, and dissociation.
How Long Does a Spravato Treatment Session Take?
You should plan to remain at the treatment center for at least two hours after using Spravato while your healthcare provider monitors you. The exact length of your visit may vary depending on how you respond to treatment and when your provider determines it is safe for you to leave.
Because Spravato can temporarily affect alertness and coordination, you should arrange transportation home after each treatment. You should not drive, operate machinery, or perform activities that require complete mental alertness until the day after your treatment, following a restful night’s sleep.
How Often Do You Receive Spravato?
For adults with treatment-resistant depression, treatment is generally given twice a week during the first four weeks. Visits may decrease to once weekly during weeks 5 through 8 and then once weekly or every two weeks from week 9 onward, depending on your response to treatment and your provider’s clinical judgment.
Your provider will monitor your symptoms, response to Spravato, side effects, and overall treatment needs to determine the appropriate schedule for you. Do not change the frequency of your treatments without talking with your provider.
Potential Benefits of Spravato Therapy
For some patients, Spravato offers a new option when other antidepressants haven’t helped enough.
Potential benefits include:
- An FDA-approved option for treatment-resistant depression
- A different mechanism from traditional antidepressants
- Potential for earlier improvement in depressive symptoms
- Treatment delivered under medical supervision
- Ability to integrate treatment with ongoing psychiatric and behavioral health care
Some clinical studies have found that certain patients experienced improvement in depressive symptoms relatively soon after treatment, but response varies considerably and Spravato does not provide immediate or guaranteed relief.
Potential Spravato Side Effects and Safety Monitoring
Because Spravato can cause strong temporary effects, you must be monitored during treatment.
Common side effects of Spravato include feeling disconnected, dizzy, nauseous, sleepy, or anxious. You might also feel numb, have low energy, increased blood pressure, vomiting, headaches, or feel unusually excited. These side effects usually start soon after treatment and go away the same day.
Is Spravato Covered by Insurance?
All major insurances cover Spravato, but coverage criteria differ between insurances. Our team will assist in determining if you meet the criteria for your insurance plan.
What affects the cost of Spravato treatment?
Coverage and out-of-pocket costs can depend on your insurance plan, medical necessity requirements, prior authorization, and whether the medication and administration are covered separately. We can help you figure out your next steps for coverage.
Spravato Therapy Near You in Lincoln, Nebraska
Getting depression treatment close to home can make it easier to keep up with your care.
Alivation offers Spravato in Lincoln and serves people in nearby communities and throughout Nebraska.
If you’re in Lancaster County or Southeast Nebraska and looking for a Spravato clinic or treatment center, Alivation offers Spravato along with other behavioral health services.
Getting treatment at a full-service behavioral health clinic helps keep your care connected. Your depression treatment can work alongside medication management, counseling, and other services you may need.
Why Choose Alivation for Spravato Therapy?
If your depression hasn’t improved with treatment, who you see for care matters. We want you to understand your options, feel comfortable asking questions, and get care that fits your needs.
Experienced Behavioral Health Care
Alivation’s behavioral health team includes professionals from multiple disciplines. Walt Duffy, MD, is board-certified in child, adolescent and adult psychiatry, and the broader behavioral health team includes other mental health providers.
Individualized Treatment Planning
Treatment-resistant depression affects everyone differently. Your past medications, symptoms, physical health, and how you respond to treatment all play a role.
We don’t assume one option works for everyone. We look at your needs to decide whether Spravato or another treatment is the right choice.
More Than One Depression Treatment Option
Spravato is one part of Alivation’s broader behavioral health services. Spravato and TMS are both options we offer for appropriate patients, along with counseling, cognitive therapy and medication management.
When earlier treatment hasn’t helped enough, it matters to have more than one option on the table. If you’re comparing Spravato vs TMS, your provider can explain how each works and help you decide which may be a better fit.
Integrated Care
We combine behavioral health with primary care, pharmacy, neurology, and other health services. That way we can look at your mental and physical health together, since each affects the other.
Ongoing Monitoring and Support
You won’t just get a dose and leave. Each visit includes medical monitoring, and we’ll revisit your treatment plan as your needs change.
Schedule a Spravato Consultation
If your depression is not improving with medication, there may be other treatment options for you.
During a consultation, we’ll review your symptoms, treatment history and overall health to see if Spravato might be right for you. You can also ask about treatment sessions, safety, insurance, and other services that may help.
To get started, call Alivation Brain/Behavioral Health at 402-476-6060. You can also use our secure online form to schedule or ask questions.