MEDICATIONS
Esketamine nasal spray (Spravato)
A rapid-acting prescription treatment for treatment-resistant depression, given in certified clinics.
How it works
Esketamine acts on the glutamate system. It is self-administered as a nasal spray under supervision in a certified office, with monitoring for at least two hours afterward, alongside an oral antidepressant.
What the evidence says, use by use
Evidence is specific to the condition, population and—for devices—the exact product. One label never covers everything.
Who usually provides it
Certified psychiatry and interventional-psychiatry clinics.
Cautions & things to know
- Can cause dissociation, sedation and blood-pressure increases; no driving the day of treatment.
- Not the same as IV ketamine, which is used off-label.
Questions for a clinician
Conversation prompts, not a treatment plan.
- Do I meet the definition of treatment-resistant depression?
- What does insurance require before approving it?
Educational, not medical advice. NeuroCoach is an educational and care-navigation resource, not a medical provider. Information about medications, supplements, therapies, devices, clinical trials and community experiences is provided for education and exploration and is not a recommendation, diagnosis or treatment plan. Evidence varies substantially among interventions. Decisions about medical or mental-health treatment should be made with an appropriately qualified healthcare professional. Do not start, stop or change medication, supplements or treatment based solely on information found here.
Sources
Sources checked October 5, 2026. Links support this page; they don’t imply endorsement of NeuroCoach.