Depression Care · Sun City Center, FL
An FDA-approved nasal spray for adults whose depression has not lifted with antidepressants, paired with ongoing medication management.
Spravato is a prescription nasal spray made from esketamine, a form of ketamine. It is approved for adults with treatment-resistant depression, either on its own or with an oral antidepressant. It is also approved, together with an oral antidepressant, for depressive symptoms in adults with acute suicidal thoughts or actions.
Most antidepressants adjust serotonin or norepinephrine and take several weeks to show their effect. Esketamine works on glutamate, the brain's main signaling chemical, by blocking NMDA receptors. That different route is why it can help people whose depression has not responded to the usual medicines.
Spravato can cause temporary sleepiness and a dreamlike, detached feeling, so it is never sent home. It is dispensed only through a restricted safety program called the Spravato REMS, and every dose is taken in a certified treatment setting under staff observation.
Spravato is for adults with major depressive disorder. We confirm whether it fits during a psychiatric evaluation that reviews your history, the medicines you have tried and your current health.
Spravato is approved for depression only. When anxiety, PTSD, OCD, insomnia or bipolar disorder is the main concern, we build your plan around the medication management and other psychiatric care our team provides.
Many patients reach us after several pills and some reading about ketamine clinics. This is how the three most discussed options differ in practice.
| Oral antidepressants | Spravato | IV ketamine | |
|---|---|---|---|
| How it is given | Daily pill at home | Nasal spray you use yourself, under supervision | Infusion through a vein |
| How it acts | Mainly serotonin and norepinephrine | Glutamate, through NMDA receptors | Glutamate, through NMDA receptors |
| FDA approval for depression | Yes, many options | Yes, for treatment-resistant depression | No, used off-label |
| Monitoring | Follow-up visits | At least two hours after every dose | During and after each infusion |
| Driving that day | Usually fine | Not until the next day, after restful sleep | Not the same day |
| Insurance | Commonly covered | Often covered, usually with prior authorization | Varies, often paid out of pocket |
Avoid food for two hours and drinks for 30 minutes before your dose, since nausea can occur.
We take your blood pressure first. If it reads too high, the dose waits until it settles.
You use two or three nasal spray devices yourself, about five minutes apart, while a team member guides you.
You stay seated in a quiet room for at least two hours. Sleepiness, dizziness or a detached feeling usually fades during this time, and we recheck your blood pressure before you leave.
A friend or family member drives you. No driving or operating machinery until the next day, after a full night's sleep.
Your provider sets your dose and spacing, then adjusts them at check-ins. Most treatment plans follow three phases.
The starting phase, when your dose is set and we watch closely how you respond.
Sessions space out as your response becomes clearer.
Ongoing sessions at the lowest frequency that keeps your progress steady.
Some patients notice a change within the first days or weeks. For others, improvement builds more gradually across the first month. We review your progress with you at each check-in and decide together whether to continue, adjust or try another approach.
Emma Armand, PMHNP-BC
Emma Armand is a board-certified psychiatric mental health nurse practitioner. Spravato care starts with her trauma-informed psychiatric evaluation, a full review of every medicine you have tried, and a shared decision about whether the nasal spray belongs in your plan.
Patients on Spravato stay in medication management with regular check-ins, so your spray, any oral antidepressant and the rest of your care are adjusted together. If Spravato is not the right fit, you still leave with a plan, whether that is a medication change, a long-acting injectable or a second-opinion consultation.
Spravato asks for a regular schedule, especially in the first month. These are the details patients usually want settled before they start.
Our office is at 1647 Sun City Center Plaza. Patients come from Riverview, Ruskin, Wimauma, Parrish, Palmetto, Lithia, Plant City and nearby. Line up drivers for the twice-weekly visits of the first month before you begin.
Spravato is a prescription medicine, and many Medicare and commercial plans cover it for treatment-resistant depression, usually after prior authorization. Ask us about your plan when you reach out.
Send us a confidential message through the website and a team member will reply as soon as possible. If you are in immediate danger, call 911. The 988 Suicide & Crisis Lifeline is available 24/7.
Depression that has not improved after two or more antidepressants is called treatment-resistant depression, and it still has options. Spravato is approved for exactly this situation. Before adding anything new, our evaluation also reviews your diagnosis, past doses and how long each medicine was tried, because sometimes the plan itself needs adjusting.
No. Esketamine is one of the two mirror-image halves of the ketamine molecule. Spravato is an esketamine nasal spray that is FDA-approved for depression and given through a restricted safety program, while IV ketamine is an anesthetic infusion used off-label for depression.
Esketamine is a controlled substance with a potential for misuse, which is why Spravato is never sent home with patients. Every dose is stored and taken in our office under observation. We also review any history of substance use before recommending it.
No. You should not drive or operate machinery until the day after your session, following a full night of restful sleep. Plan for a friend or family member to take you home after every visit.
Spravato can be used on its own or together with an oral antidepressant. Your provider decides which approach fits your history and reviews it at each check-in. Do not stop any medicine on your own.
Treatment usually starts with two sessions a week for the first four weeks, then weekly sessions for weeks five to eight. After that, sessions continue weekly or every two weeks based on how you are responding. The total length is different for each patient and is reviewed with you regularly.
Options include changing or combining medicines, psychotherapy and other approaches your provider may discuss. Our office offers psychiatric evaluations, medication management with regular check-ins, and consultation or second-opinion visits. Spravato is one tool within that plan, not the only one.
Book a consultation to find out whether Spravato fits your depression treatment, and leave with a clear next step either way.
In an emergency, call 911. For 24/7 confidential crisis support, call or text 988.
