Breakthrough Treatment

Spravato (Esketamine): New Hope for Treatment-Resistant Depression

If you've tried two or more antidepressants without relief, Spravato may be worth exploring with your provider. As a REMS-certified provider, Family1st offers esketamine therapy by appointment — and unlike IV ketamine, Spravato is FDA-approved and often covered by insurance.

Intake & evaluationComprehensive psychiatric assessment to confirm TRD diagnosis

Insurance verificationWe check coverage before your first session — prior auth handled for you

Treatment sessionsSelf-administered nasal spray in our office with 2-hour monitored observation

Ongoing maintenanceLong-term dosing schedule with regular psychiatric check-ins

~54–70%of TRD patients showed response in clinical trials* — individual results vary

FDAApproved — 2019, the first new MDD mechanism in decades

✓Many major insurance plans cover Spravato for TRD — coverage varies by plan

2hrSupervised monitoring per session — REMS compliant

Insurance & payment:

Medicare Part B (in-network) BCBS — credentialing Aetna — credentialing UnitedHealthcare — credentialing Cigna — credentialing

Until credentialing is complete, we provide a detailed superbill for out-of-network reimbursement and offer a generous self-pay discount with sliding-scale options.

*Based on TRANSFORM-2 & TRANSFORM-3 pivotal trials (Daly 2019, Popova 2019). Individual results vary. Spravato requires a comprehensive psychiatric evaluation and is not appropriate for all patients.

Who Qualifies

Are You a Candidate for Spravato?

Spravato is FDA-approved for adults with treatment-resistant depression (TRD) — defined as inadequate response to at least two different antidepressants at adequate doses and duration. Also approved for depressive symptoms in MDD with acute suicidal ideation.

✓Tried 2+ antidepressants with little or no relief

Treatment-resistant depression is defined as inadequate response to at least two antidepressants taken at adequate doses for adequate duration.

✓Diagnosis of Major Depressive Disorder

Current diagnosis of MDD confirmed by a licensed psychiatric provider. Spravato is not approved for bipolar depression.

✓Able to arrange transportation

You cannot drive for the rest of the day after a session due to sedation and dissociation. A designated driver or rideshare is required.

✓No disqualifying contraindications

History of psychosis, certain cardiovascular conditions, aneurysmal vascular disease, or arteriovenous malformation may be contraindications. Assessed at intake.

What to Expect During Your Session

Spravato is given in our calm, private office and monitored the entire time — you're never rushed and never alone.

A comfortable leather recliner in a calm, private office where Spravato treatment sessions are monitored

Settle in. You'll relax in a comfortable recliner — dim lighting, an optional eye mask, and calming music if you'd like.

Self-administer the nasal spray under our supervision — quick and needle-free.

Rest and be monitored for about 2 hours. We check on you throughout for your comfort and safety, as required by the Spravato REMS program.

Head home with your ride. You can't drive for the rest of the day, so plan for a driver or rideshare.

Insurance & cost: Unlike IV ketamine, Spravato is FDA-approved and billable to insurance. We're in-network with Medicare and handle prior authorization for you. For commercial plans we provide superbills, and eligible commercially-insured patients may qualify for SPRAVATO withMe cost assistance. We verify your coverage and out-of-pocket cost before your first session — no surprises.