Spravato Therapy in Lincoln, NE

If you have tried traditional antidepressants and your depression has not improved, it can feel discouraging when your options seem limited. At Alivation, we provide Spravato therapy in Lincoln, NE, for adults with treatment-resistant depression.

Spravato® (esketamine) is a prescription nasal spray that works in a different way than traditional antidepressants. It offers another option for people whose depression has not improved with other medications.

Our behavioral health team creates a treatment plan just for you. We look at your symptoms, treatment history and overall health to see if Spravato could be right for you.

If you are looking for Spravato therapy in Lincoln, Lancaster County, or Southeast Nebraska, our team can help you learn about your options and what to do 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. Experts are still learning exactly how Spravato helps with depression.

You cannot take Spravato home like other antidepressants. Because of certain risks, such as sedation, dissociation, breathing problems, and possible misuse, 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 may be an option for adults with treatment-resistant depression, commonly defined as depression that has not responded adequately to at least two antidepressant treatments.

You may want to discuss advanced treatment options with a provider if you have tried multiple antidepressants but continue experiencing depressive symptoms, such as:

• 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.

If your antidepressants are not helping, talk to your provider before making any changes. Depression symptoms can change over time, and things like other medications, health issues, or life events can affect how well your treatment works.

Spravato is not right for everyone. Your provider will review your diagnosis, past treatments, medications, medical history, and overall health before recommending it.

If you or someone you know is experiencing suicidal thoughts or is in immediate danger, call or text 988 for the Suicide & Crisis Lifeline. In a life-threatening emergency, call 911 or go to the nearest emergency room. Alivation does not provide crisis, emergency or inpatient psychiatric services.

How Does Spravato Work?

Traditional antidepressant medications and Spravato affect the brain differently.

Esketamine is related to ketamine and acts on the brain's NMDA receptors and glutamate system. Glutamate is a chemical messenger involved in communication between brain cells. Research into ketamine and esketamine suggests their effects on this system may contribute to their 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.

Spravato is one part of a larger treatment plan and is not a guarantee of quick results.

What to Expect During Spravato Treatment

Understanding what to expect from treatment can help you decide if you want to try Spravato.

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.

This is also a good time to ask any questions you have about the treatment, possible side effects, and what will happen 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. You cannot take Spravato home.

After administration, your provider will monitor you for potential side effects, including changes in blood pressure, sedation, and dissociation. You should arrange transportation home after your treatment and follow your provider's instructions about when it is safe to leave and resume normal activities.

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?

Spravato treatment typically begins with more frequent visits and may become less frequent as treatment continues. The FDA-approved dosing schedule includes an induction phase, an optimization phase, and a maintenance phase.

For adults with treatment-resistant depression, treatment is generally given twice a week during the first four weeks. If treatment continues, 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 have not 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 for some patients

• 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.

Spravato vs. Ketamine Therapy

Spravato and ketamine are related treatments, but they are not the same.

Ketamine has two mirror-image molecular forms, and esketamine is one of them. Spravato is the brand-name intranasal esketamine product that is FDA approved for treatment-resistant depression in adults.

Ketamine has long been FDA-approved as an anesthetic. Intravenous ketamine has also been studied and used off-label for depression. Spravato, by comparison, has a specific FDA-approved indication for treatment-resistant depression and is administered as a nasal spray through REMS-certified healthcare settings.

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. Spravato can also cause serious side effects, including sedation, dissociation, respiratory depression, increased blood pressure, problems with thinking clearly and bladder problems. There is also a risk of abuse and misuse. These risks are why Spravato must be administered in a certified setting and followed by an observation period of at least two hours.

Let your provider know right away if you have any concerning symptoms during treatment. After you leave, get medical help if you have symptoms your provider said need urgent care.

Is Spravato Covered by Insurance?

Whether Spravato is covered by insurance depends on your insurance company, your plan, and your benefits.

Some insurance companies may need prior approval or proof that other antidepressants did not work. Costs may include both the medicine and the clinic visit. The manufacturer suggests asking your insurer if Spravato is covered and what your out-of-pocket costs might be.

Medicare coverage is different from private insurance. The manufacturer's savings program does not include Medicare or other government programs. However, Medicare may still cover Spravato, so you should check your specific coverage and costs.

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. Alivation can help you understand the next steps for determining 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 serves people in Lincoln, nearby communities, and throughout Nebraska.

For patients in Lancaster County and Southeast Nebraska seeking a Spravato clinic or treatment center, Alivation provides access to 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 be coordinated with medication management, counseling, and other services you may need.

Why Choose Alivation for Spravato Therapy?

If your depression has not improved with treatment, finding the right provider is important. We want you to know 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 a neuropsychiatrist who is board-certified in child, adolescent and adult psychiatry, and the broader behavioral health team includes psychiatric and 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 look at each person's needs to decide if Spravato or another treatment is best, instead of assuming one option works for everyone.

More Than One Depression Treatment Option

Spravato is one part of Alivation's broader behavioral health services. We also provide psychiatric evaluations, counseling, cognitive therapy, medication management and TMS for appropriate patients.

It is important to have several treatment options when depression has not improved with earlier care.

Integrated Care

We combine behavioral health with primary care, pharmacy, and other health services. This helps us see your mental and physical health as connected parts of your overall well-being.

Ongoing Monitoring and Support

Spravato treatment involves more than getting a dose and leaving. Each visit includes medical monitoring, and your overall treatment plan will be reviewed as your needs change.

Care in Lincoln

Alivation has been serving Lincoln and nearby communities for many years. Our Lincoln clinic lets patients in Lancaster County and Southeast Nebraska get behavioral health care close to home.

We want to help you understand your next steps if past depression treatments have not given you the relief you need.

If your depression is not improving with medication, there may be other treatment options for you.

During a consultation, our team will 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.