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You've tried more than one antidepressant. You've given each one enough time to work, the way your provider recommended. And you're still waiting to feel like the version of yourself you remember.
If you've been searching for Spravato near me, esketamine near me, or Spravato Miami while looking for what else is out there, this guide is meant to answer the questions that usually come up first.
Spravato (esketamine) is an FDA-approved nasal spray used together with an oral antidepressant for adults who haven't found enough relief through other treatments. This guide walks through how it works, who it may be appropriate for, what a treatment session actually looks like, how it compares to ketamine infusions, and how insurance coverage typically works.
At ARC Mental Health in Miami, every one of these questions gets answered as part of a real evaluation, not a generic FAQ page.
What Is Spravato?
Spravato is the brand name for esketamine, a nasal spray cleared by the FDA specifically for use alongside an oral antidepressant. It's administered only in a certified medical office, under direct clinical supervision, rather than taken home like a typical prescription.
Unlike most antidepressants, which can take several weeks to show any effect, Spravato works through a different mechanism in the brain, one that some patients notice responding to sooner.
It's not intended to replace ongoing psychiatric care. It's typically added to a broader treatment plan that continues to include an oral antidepressant and regular follow-up with your provider.
How Does Spravato Work?
Most oral antidepressants act on the brain's serotonin system. Spravato works differently, targeting the brain's glutamate system instead, which may help form new neural connections tied to mood regulation.
This doesn't mean Spravato works instead of everything else you've tried — it works through a different biological route, which is part of why it may be considered when other approaches haven't provided enough relief. At ARC Mental Health, this distinction is exactly what our providers walk through with patients before recommending it.
Who May Be a Candidate for Spravato?
Spravato is generally considered for adults who have tried two or more antidepressant medications without finding sufficient relief.
It's also FDA-approved for adults with major depressive disorder who are experiencing more severe symptoms, including suicidal thoughts, though that determination requires a same-day clinical evaluation and close professional supervision rather than self-assessment.
If you recognize yourself in either situation, the next step is a comprehensive psychiatric evaluation, not a decision to make alone. A provider will review your history, symptoms, and overall health before recommending Spravato.
"When we're evaluating whether Spravato is right for a patient, we're not just counting how many medications they've tried. We're looking at the full picture — symptom severity, safety, and how they've responded to treatment so far. The goal is finding the right fit for that person, not applying the same protocol to everyone." — Dr. Alberto Rojas, MD, Psychiatrist, ARC Mental Health
What Happens During a Spravato Treatment Session?
Knowing what to expect can make that first appointment feel less uncertain.
You self-administer the nasal spray while a member of your care team is present. Afterward, you'll rest in a comfortable, monitored space for about two hours so your provider can check in on you before you leave.
During this time, some patients notice temporary effects such as dizziness, detachment, mild nausea, or a temporary rise in blood pressure. These are monitored closely and typically resolve the same day. Because of this, you will not be able to drive yourself home, so it's important to arrange a ride in advance.
A full course of Spravato treatment usually begins with an induction phase, several sessions per week over the first few weeks, followed by a maintenance phase with sessions spaced further apart. Your care team will walk you through the specific schedule that fits your situation, and this can be adjusted over time based on how you're responding.
What to Expect After Treatment
Many patients report noticing changes within hours to days of starting treatment, though this varies significantly from person to person, and it's not something that can be guaranteed for any individual patient.
Follow-up sessions during the maintenance phase give your provider a chance to check on your progress and adjust your plan as needed.
Depression treatment is rarely a straight line, and small adjustments along the way are a normal part of the process, not a sign that something has gone wrong.
Spravato vs. Ketamine Infusions: What's the Difference?
It's common to see Spravato and ketamine infusions mentioned together, since both work on similar pathways in the brain. They are not the same treatment, however, and understanding the difference matters when you're deciding what to ask about.
Spravato is FDA-approved specifically for depression, administered as a nasal spray, and can only be given in a certified medical office that meets specific safety requirements. Ketamine infusions, by contrast, are given intravenously and are typically used "off-label" for depression, meaning the FDA has not specifically approved ketamine for this use, even though some clinics offer it.
Both approaches are taken seriously from a safety standpoint, but they follow different regulatory pathways, administration methods, and monitoring protocols. If you're trying to decide between the two, that's a conversation to have directly with a psychiatric provider.
Is Spravato Covered by Insurance?
Cost is often one of the first questions patients have before considering a new treatment, and it's a reasonable one to ask early rather than after you've already committed to a plan.
Most major insurance providers offer coverage for Spravato when it's determined to be medically appropriate. Our office can help confirm your specific benefits and assist with any prior authorizations required.
ARC Mental Health accepts Medicare, Medicaid, and most major commercial insurance plans, including Aetna, Cigna, Oscar, United Healthcare, and Florida Blue, among others. Prior authorization for Spravato typically takes about one to two weeks, depending on your plan. Our team handles this process directly with your insurance provider, so you can focus on your treatment instead of the paperwork.
How to Prepare for Your First Spravato Appointment
Walking into an unfamiliar appointment is easier when you know roughly what to bring and what to expect.
It helps to arrive with a list of every medication you're currently taking, along with a brief summary of what you've already tried for depression.
Since you won't be able to drive yourself home after treatment sessions, it's worth arranging transportation before your first appointment. Wearing comfortable clothing is reasonable, since you'll be seated and resting for a couple of hours during the monitored observation period.
Beyond that, the most useful thing you can bring is a clear sense of your own questions.
Common Questions About Spravato
Does Spravato hurt?
The nasal spray itself isn't painful, though some patients notice a brief unusual sensation. Most discomfort reported is related to the temporary side effects that occur during the monitored observation period, not the administration itself.
Can I drive home after treatment?
No. Because of the temporary effects Spravato can cause, you will need someone else to drive you home after every session.
How long does a full course of treatment take?
This varies by patient, but treatment generally starts with a more frequent induction phase over several weeks, followed by a maintenance phase with sessions spaced further apart, based on how you respond.
Common Misconceptions About Spravato
Myth: Spravato is just a brand name for ketamine.
Reality: Spravato (esketamine) is a distinct, FDA-approved medication with its own approval pathway, administration method, and safety requirements, separate from ketamine infusions.
Myth: Spravato replaces the need for an antidepressant.
Reality: Spravato is approved to be used alongside an oral antidepressant, not in place of one.
Myth: Everyone feels better within hours.
Reality: Some patients notice changes within hours to days, but responses vary, and Spravato is not guaranteed to work the same way for everyone.
Frequently Asked Questions
Will I need to keep taking my current antidepressant?
Yes. Spravato is approved for use together with an oral antidepressant, not as a standalone replacement for it.
Do I have to stop taking my current antidepressant while on Spravato?
No. Spravato is FDA-approved to be used alongside an oral antidepressant, not as a replacement for it. Your provider will continue managing your current medication throughout treatment, and any changes to your plan would only happen as part of an ongoing conversation with your psychiatrist — not something you'd need to figure out on your own beforehand.
Is Spravato covered by insurance?
Most major insurance providers offer coverage for Spravato when it's determined to be medically appropriate. Our office can help confirm your specific benefits and handle any required authorizations.
How long does insurance authorization take before I can start?
Authorization timelines vary by insurance plan, but our office handles the entire process directly with your insurer so you're not left tracking it down yourself. We'll let you know where things stand and give you a realistic timeframe once we've submitted your specific case, so you're not left guessing between your evaluation and your first session.
How soon will I know if Spravato is working for me?
Many patients report noticing changes within hours to days, though responses vary and this isn't something that can be predicted with certainty for any individual patient.
How often do I need to come in, especially at the beginning?
Treatment typically starts with an induction phase — several sessions per week over the first few weeks — followed by a maintenance phase with sessions spaced further apart. Your care team will map out the exact schedule based on your evaluation, and it can be adjusted over time depending on how you're responding. Because you won't be able to drive yourself home after a session, it's worth planning transportation for that first phase in particular.
Do I need a referral to start Spravato treatment?
This depends on your specific insurance plan. Some plans require a referral, while others don't. Our office can help clarify what your plan requires.
Can I continue therapy while receiving Spravato treatment?
Yes. Spravato is typically added to an existing treatment plan rather than replacing other forms of care, including ongoing therapy.
What happens if Spravato doesn't work for me?
Your provider will reassess your treatment plan at follow-up visits. Not responding to Spravato doesn't mean no other options exist; it's information that helps guide what comes next.
Why Choose ARC Mental Health for Spravato Treatment?
At ARC Mental Health, we offer Spravato treatment at our Miami Lakes and South Miami locations, with fully bilingual care (English/Spanish) throughout the process. We've treated more than 7,000 patients, and we work directly with your insurance to help simplify prior authorization. Because we also offer psychiatric evaluations, therapy, and TMS under the same roof, your Spravato treatment is coordinated with the rest of your care rather than handled separately. We serve patients throughout Miami Lakes, Miami Gardens, Hialeah, Hialeah Gardens, Doral, South Miami, Kendall, Coral Gables, Pinecrest, Sunset, and Coconut Grove.
That same evaluation-first approach means no two treatment plans look exactly alike. Our team is available to answer your questions about candidacy, cost, and what to expect, before you commit to anything.
Take the Next Step
If you've been exploring new treatment options for depression and Spravato is one of them, you don't have to figure out on your own whether it's the right fit.
At ARC Mental Health in Miami Lakes, Hialeah, South Miami, and surrounding communities, our team can walk you through a full evaluation and answer your questions about insurance coverage.
Reach out to schedule a free initial consultation and take that next step at your own pace.
Spravato is offered at our Miami Lakes (14400 NW 77th Ct., Ste. 100, Miami Lakes, FL 33016) and South Miami (7241 SW 63rd Ave., Ste. 101-A, South Miami, FL 33143) locations.
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