Interventional Treatment
An FDA-approved nasal spray for treatment-resistant depression, administered under careful medical supervision in our Olympia Fields office.
What Is Spravato?
Spravato is a prescription nasal spray containing esketamine, a fast-acting molecule related to ketamine. It is FDA-approved for adults with treatment-resistant depression, and for major depressive disorder with acute suicidal thoughts or behaviors.
Unlike traditional antidepressants that work on serotonin, esketamine acts on the brain's glutamate system — helping restore neural connections that depression disrupts. That is why many patients feel a difference within days, not weeks.
Because it is classified as a controlled substance, every dose must be given in a certified treatment center like ours — never at home — with a two-hour monitoring window after each session.

Spravato® (esketamine) 28 mg nasal spray, CIII — administered in office under supervision.
Benefits of Esketamine
Many patients feel a meaningful lift in depressive symptoms within 24 to 72 hours of their first sessions — far faster than traditional antidepressants, which can take weeks.
Esketamine works on the glutamate system (NMDA receptors), a pathway entirely different from SSRIs and SNRIs — which is why it can help when other medications have not.
Spravato is the first and only FDA-approved nasal spray for treatment-resistant depression and for major depressive disorder with acute suicidal thoughts.
Clinical trials showed a rapid reduction in depressive symptoms, including suicidal thoughts, making it a valuable option in higher-acuity situations.
Every dose is administered in our office with two hours of monitoring by trained staff, so any side effects are seen and managed immediately.
Esketamine helps the brain form new neural connections, supporting lasting improvement when paired with an ongoing oral antidepressant.
Side Effects
Most side effects are mild and short-lived, beginning within the first hour and easing before you leave our monitoring room. Here is what to know:
A temporary feeling of detachment or "spaced out" sensation. It usually begins shortly after dosing and resolves within about two hours while you are monitored.
You may feel sedated, lightheaded, or unsteady. You cannot drive until at least the day after each session, following a restful night of sleep.
Some patients feel queasy for a short period after dosing. Eating lightly beforehand and staying calm during monitoring helps minimize this.
Esketamine can temporarily raise blood pressure. We check your blood pressure before dosing and throughout monitoring at every session.
Mild headaches can occur after treatment and typically resolve on their own or with standard over-the-counter relief.
Less common, but can appear briefly during the monitoring window and settles as the effects of the dose wear off.
Safety first: Spravato carries a risk of sedation, dissociation, and temporary blood pressure increases, which is why every session includes on-site monitoring. It is not for patients with certain blood vessel conditions, and we screen carefully before starting. Rarely, increased suicidal thoughts can occur — our team reviews all safety warnings with you before treatment.
Treatment Protocol
Treatment follows a structured schedule set by the FDA, paired with an ongoing oral antidepressant. Every session is supervised in office.
Weeks 1 – 4
Two sessions per week. The 84 mg dose is self-administered as a nasal spray under staff supervision, then you rest for two hours of on-site monitoring.
Weeks 5 – 8
One session per week, continuing the same supervised, two-hour monitored format as your symptoms stabilize.
Week 9+
One session every week or every two weeks, tailored to how you are responding and decided together with your psychiatric provider.
Each visit includes blood pressure checks before dosing, administration of the nasal spray, and a comfortable two-hour monitoring period before you head home with your driver.
Common Questions