How Spravato Works


A straightforward guide to the science, the session, and what to expect - before you decide anything.

Before You Scroll

Spravato In 30 Seconds

Spravato works on the brain's glutamate system - not serotonin, not dopamine. It's a mechanistic departure from every conventional antidepressant, which is why it reaches patients other treatments haven't.

THE MECHANISM 

A different system

a different kind of relief

In depression, mood-regulating circuits can become weakened over time. Spravato, containing the compound esketamine, activates the process that rebuilds them. Esketamine blocks NMDA receptors on neurons, where a neurotransmitter, glutamate, binds. This mechanism triggers a surge of glutamate activity, which promotes neuroplasticity and allows for the rapid formation of new neural connections. Healthy brain activity can be restored in an underactive brain that contributes to depressive symptoms. 



Spravato delivers esketamine efficiently through the nasal membrane. Combined with its neural mechanism, this rapid process is why relief can come within hours for some patients, not weeks.

Spravato 84 mg dose kit box on a wooden table with blurred plant and furniture in the background

WHAT TO EXPECT

Benefits Build, Side Effects Are Minor and Short Lived

Benefits

Some patients notice meaningful improvement within the first one or two sessions - particularly relief from passive suicidal ideation. For most, improvements in mood, motivation, and day-to-day functioning accumulate across the first month and continue into the maintenance phase.

side effects

During and shortly after dosing, temporary dissociation, dizziness, nausea, or mild blood pressure increase may occur. These typically peak within the first hour and resolve within the two-hour observation window. Serious long-term adverse effects are uncommon, and every session is clinically monitored to ensure this is the case.

Black snowflake-like emblem on a white background

Comparing Your Options

Spravato vs Other Treatments

Two people seated in a living room, talking across a small side table.
Spravato vs Medication

Traditional, gold-standard antidepressants typically adjust serotonin levels, with positive and negative effects distributed throughout the body. Spravato acts directly on glutamate signaling and has provided symptom relief in patients who haven't responded to multiple antidepressant trials. 

Spravato vs TMS

TMS uses magnetic pulses to stimulate underactive mood circuits - no medication, no systemic effects. Spravato acts pharmacologically through the glutamate system. Both address treatment-resistant depression that hasn't responded to medication. The right fit depends on your history, how quickly relief is needed, and practical factors like schedule and insurance.

Woman in a red sweater reads a yellow book in a cozy living room with gray chairs and a coffee table
Spravato 84 mg dose kit box on a wooden table with blurred plant and furniture in the background

Not sure which fits?

We'll help you work that out.

Black snowflake-like emblem on a white background

Comparing Your Options

Spravato vs Other Treatments

Not sure which fits?

We'll help you work that out.

Woman in a red sweater reads a yellow book in a cozy living room with gray chairs and a coffee table
Spravato vs Medication

Traditional, gold-standard antidepressants typically adjust serotonin levels, with positive and negative effects distributed throughout the body. Spravato acts directly on glutamate signaling and has provided symptom relief in patients who haven't responded to multiple antidepressant trials. 

Spravato vs TMS

TMS uses magnetic pulses to stimulate underactive mood circuits - no medication, no systemic effects. Spravato acts pharmacologically through the glutamate system. Both address treatment-resistant depression that hasn't responded to medication. The right fit depends on your history, how quickly relief is needed, and practical factors like schedule and insurance.

Two people seated in a living room, talking across a small side table.
Spravato 84 mg dose kit box on a wooden table with blurred plant and furniture in the background

FAQ

Common Questions

Straight answers to the things people most often want to know before starting. If something isn’t covered here, call us or send a message, we’ll get back to you the same day.

  • Will I feel anything during the session?

    Some patients experience dissociation, drowsiness, or perceptual changes - others notice very little. When effects occur they typically peak within the first hour and resolve before you leave.

  • How soon might I notice a difference?

    Some patients report shifts within the first session or two. For others, it builds across the first month. Your clinician monitors progress and adjusts the plan accordingly.

  • Can I continue my current medication?

    In most cases, yes. Spravato is commonly used alongside an oral antidepressant. Your clinician reviews your full medication list before treatment begins to assess whether changes are appropriate.

  • Does insurance cover it?

    Often, yes. Because Spravato is FDA-approved, it has broader insurance coverage than similar treatments, such as IV ketamine. Vivant Mind verifies your benefits and manages prior authorization before treatment starts.

  • Can I drive home after a session?

    No. You must arrange a ride. This is a non-negotiable requirement under the REMS program governing Spravato's dispensing.

Three people chatting on a beige couch in a bright living room

Integrative Care.
One Practice.

Beige circular hands around a smiling heart icon on a white background

Integrated Care

TMS, Spravato, meds, and therapy, coordinated across your care plan.

Hand cradling a stylized green lotus with a small beige center on a white background

Physician Led

Psychiatrist leads your care from first consultation to final session.

Hands clasping in beige and olive inside a circular ring with three connected dots.

No Hidden Fees

Rates listed upfront. Insurance verified before you commit.

Stylized green figure with raised arms above two tan leaves and sun rays

Evidence Based

Every treatment is FDA-approved or clinically proven.

Beige lightbulb with puzzle pieces, green checkmark, and green accent rays

Results Tracked

Symptom tracking built in. We adjust based on your response.

Beige head silhouette with green heart-shaped plant sprouting from the top

Built to Calm 

A space built to feel as good as the care inside it.

Learn more

Not Sure Which Path to Take?

Guides, comparisons, and resources to help you decide with confidence.

Woman wearing a head-mounted device in a bright clinical setting, smiling softly

Is TMS Right For Me?

A short self-screen to see if TMS might fit your symptoms and history.

Spravato medicine box on a wooden table in a living room setting

Compare Treatments

Side-by-side look at TMS, Spravato, medication, and therapy.

Two people talking in an office, one gesturing while smiling.

Pricing Guide

Self-pay rates, insurance plans, and payment schedules, all in one place.

Smiling person in black scrubs with arms crossed on a plain white background

Free 20 Minutes

Speak to a Specialist

Contact Us

Take the First Step.

Abstract pale gray starburst logo on a white background

We'll reply within one business day.

Abstract pale gray starburst logo on a white background

A clinician will call to confirm whether treatment is a good fit, no pressure.

Abstract pale gray starburst logo on a white background

We verify your insurance, provide a written cost estimate, and schedule your evaluation.

Prefer to call?

(718) 233-5006

500 Manhattan Ave, Brooklyn, NY