Finding hope when oral antidepressants aren’t enough.
If you have tried multiple antidepressant medications but still feel the heavy weight of depression, you are not alone. Studies show that after two oral antidepressants fail to work, the chance of a third one working drops to about 14%.
At Grace Health Services, we offer a different path forward. We are proud to be a certified treatment center in Stafford, VA, offering Spravato® (esketamine) CIII nasal spray. This is an FDA-approved prescription medicine used along with an oral antidepressant for adults with treatment-resistant depression (TRD).
Spravato® (Esketamine) Treatment in Stafford, VA at Grace Health Services.
What is Spravato®?
Spravato® is not a pill. It is a prescription nasal spray that you take under our supervision at our office.
Standard antidepressants work on chemicals in your brain like serotonin. Spravato® works differently. It targets the N-methyl-D-aspartate (NMDA) receptor. By acting on a different pathway in the brain, it may help restore connections between brain cells that can improve your symptoms.
Who is this treatment for?
Spravato® is specifically for adults who:
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Have Treatment-Resistant Depression (TRD): This means you have struggled with major depressive disorder and have not seen enough improvement after trying at least two antidepressant pills.
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Have Major Depressive Disorder (MDD) with acute suicidal ideation or behavior: This is for adults with depressive symptoms who currently have thoughts of self-harm.
Note: Spravato® does not take the place of hospitalization if your provider thinks you need immediate hospital care.
What to Expect: Your Treatment Journey
Because Spravato® can cause side effects like sedation (sleepiness) and dissociation (feeling disconnected), it is never taken at home. You will always come to our Stafford office for treatment.
1. The Consultation
First, we will review your medical history. We need to make sure Spravato® is safe for you. We will check for conditions like high blood pressure or a history of aneurysm, which may mean you cannot use this medicine.
2. Treatment Days
You will give the spray to yourself, but a healthcare provider will guide you.
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Nasal Spray: Each device contains two sprays (one for each nostril).
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Dosage: Depending on your prescription, you will use either two devices (56 mg) or three devices (84 mg). You wait 5 minutes between each device.
3. Monitoring (The "Observation Period")
After you use the spray, you will relax in our comfortable office for at least 2 hours.
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We will check your blood pressure before and after the dose.
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We will monitor you for sleepiness or dissociation.
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Most side effects, if they happen, go away on the same day.
4. Going Home
You cannot drive or operate machinery until the next day after a restful sleep. You will need a family member or friend to drive you home from our clinic.
Typical Dosing Schedule
Spravato® is not a daily medicine. It follows a specific schedule to help you get the best results.
For Treatment-Resistant Depression (TRD):
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Weeks 1–4 (Induction): You will visit us twice a week.
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Weeks 5–8 (Maintenance): You will visit us once a week.
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Week 9 and ongoing: Dosing usually moves to once every week or once every two weeks, depending on how you feel.
For Depressive Symptoms with Acute Suicidal Ideation:
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The recommended dose is 84 mg twice per week for 4 weeks.
Benefits of Spravato® in Stafford VA.
Why choose this treatment?
Spravato® offers a new mechanism of action for patients who have not found relief with standard oral antidepressants.
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Works differently than traditional pills: While most antidepressants work on serotonin, norepinephrine, or dopamine, Spravato® targets the N-methyl-D-aspartate (NMDA) receptor. This unique pathway may help restore connections between brain cells.
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Rapid reduction of symptoms: Clinical trials have shown that Spravato® can reduce depressive symptoms quickly. In studies of patients with acute suicidal ideation, symptom reduction was observed as early as 24 hours after the first dose.
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Proven effective for resistant depression: It is specifically FDA-approved for adults with Treatment-Resistant Depression (TRD), meaning it is designed for those who have cycled through multiple other treatments without success.
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Delays relapse: In long-term studies, patients who stayed on Spravato® were less likely to experience a return of depressive symptoms compared to those who stopped.
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Safe, monitored environment: Because it is only available through a certified Risk Evaluation and Mitigation Strategy (REMS) program, your treatment is always supervised by healthcare professionals to ensure your safety.
Like all potent medications, Spravato® carries risks. Most common side effects peak shortly after dosing and resolve the same day.
What you need to know before starting.
Common Side Effects:
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Dissociation: Feeling disconnected from yourself, your thoughts, or your surroundings.
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Dizziness or Vertigo: A sensation of spinning or lightheadedness.
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Sedation: Feeling very sleepy or lethargic.
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Nausea or Vomiting: Some patients experience stomach upset.
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Numbness: A decreased feeling of sensitivity in the body.
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Anxiety: Feeling anxious or agitated shortly after administration.
Serious Side Effects:
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Sedation and Respiratory Depression: In rare cases, patients may become overly sedated or have slowed breathing. This is why we monitor you for at least 2 hours.
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Increased Blood Pressure: Spravato® causes a temporary rise in blood pressure that usually lasts for about 4 hours. We check your blood pressure before and after every treatment.
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Bladder Problems: Although rare, some patients report trouble urinating or frequent urgency.
If you experience chest pain, shortness of breath, or a sudden severe headache after treatment, tell your provider immediately.
FDA Approval & Regulatory Information
Spravato® (esketamine) is a landmark medication in the field of psychiatry.
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FDA Approved: The U.S. Food and Drug Administration (FDA) has approved Spravato® for two specific indications:
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Treatment-Resistant Depression (TRD): Approved for adults who have not responded adequately to at least two different antidepressants.
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Major Depressive Disorder (MDD) with Suicidal Ideation: Approved to treat depressive symptoms in adults with MDD with acute suicidal ideation or behavior.
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Classification: It is a Schedule III (CIII) controlled substance, meaning it has medical use but also carries a risk for abuse or dependence.
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REMS Program: To ensure patient safety, the FDA requires Spravato® to be dispensed only through the restricted "Spravato REMS" program. It can only be administered in certified healthcare settings—it is never available at a standard pharmacy for home use.
Frequently Asked Questions
Is Spravato® covered by insurance?
Many insurance plans cover Spravato®. There are also savings programs available, such as "Spravato withMe," which helps eligible patients with affordability and cost support. We can help you investigate your benefits.
Is this the same as Ketamine infusion?
No. Spravato® is esketamine, which is a derivative of ketamine. Unlike generic ketamine infusions, Spravato® is FDA-approved specifically for treating depression and goes through a rigorous safety program called REMS.
Can I eat before my appointment?
Because some patients get nausea, you should avoid food for at least 2 hours before your appointment and avoid liquids for 30 minutes before.
Do I stop taking my oral antidepressant?
No. Spravato® is indicated to be taken in conjunction (together) with an oral antidepressant. You will continue your daily pill regimen while coming in for nasal spray treatments.
Appointments are available within a week!
Our certified providers at Grace Health Services in VA are dedicated to understanding and treating a variety of mental health challenges. Drawing from both modern research and years of hands-on experience, we aim to provide nothing but the finest care from the moment of diagnosis.