Spravato® (Esketamine) Therapy

When Depression Doesn't Respond, Science Has Moved On.

Esketamine nasal spray (Spravato) is a breakthrough treatment for treatment-resistant depression — working through entirely different brain pathways than traditional antidepressants.
Spravato® (Esketamine)
A Different Kind of Antidepressant

A different path entirely

Traditional antidepressants work by adjusting serotonin, norepinephrine, or dopamine. Spravato takes a different path entirely — its active compound, esketamine, acts on the brain’s glutamate system. Spravato works by rapidly triggering the brain’s own neuroplasticity mechanisms — helping damaged circuits begin to rebuild. Results can begin within hours to days — not the weeks typical of conventional antidepressants. FDA-approved for treatment-resistant depression (TRD) and major depressive disorder with acute suicidal ideation (MDSI).
Brain Mechanism

What's actually happening in your brain

Glutamate Activation

Esketamine rapidly increases glutamate activity in the prefrontal cortex — the brain region governing mood regulation, decision-making, and emotional control. This surge sets off a cascade of molecular repair signals.

BDNF Release & Synaptogenesis

This cascade triggers the release of BDNF — often called "fertilizer for the brain." BDNF promotes the growth of new synaptic connections, helping restore communication in circuits weakened by chronic stress and depression.

Neurocircuit Remodeling

Over a course of treatment, the brain's default mode network and emotional processing circuits may begin to remodel — shifting patterns of rumination, hopelessness, and emotional dysregulation that have become wired in over time.

You May Be a Candidate If...

We look at what's underneath the signal

Spravato is not a first-line treatment. It is designed for patients who have tried and not achieved adequate relief from other approaches.
  • You have tried two or more antidepressants without sufficient improvement
  • Your depression has been present for months or years despite treatment
  • You are experiencing significant impact on daily functioning, work, or relationships
  • You have been diagnosed with Major Depressive Disorder (MDD)
  • You are currently experiencing or have recently experienced suicidal thinking

Biomarker-Informed Prescribing

Thyroid function, inflammatory markers, sex hormones, cortisol, vitamin D, B12 — these directly shape how psychiatric medications perform in your body. We read that context before prescribing, not after a medication fails to work.

Nutritional Deficiency Screening

Magnesium, zinc, B-complex, vitamin D, omega-3 index, and other nutrients critical for synaptic health and learning-based neuroplasticity.

Medication & Supplement Coordination

We review how current medications may interact with training, and recommend targeted supplements where evidence supports improved neuroplastic response.

Your Spravato Journey

How the process unfolds

Induction Phase

Twice-weekly sessions for the first four weeks. Each session: nasal spray administration, followed by a 2-hour monitored rest period in our clinic.

Maintenance Phase

Once weekly, then every two weeks as response is established. Your physician adjusts frequency based on your individual response and clinical picture.

Ongoing Integration

We coordinate Spravato with your broader treatment plan — medication, lifestyle, and any adjunctive strategies — to support durable improvement.

REMS-Certified Locations

Available at both clinics