If standard antidepressants have not eased your depression, your doctor may bring up Spravato treatment. Spravato is a prescription nasal spray containing esketamine, and you take it under supervision at a certified treatment center. Not everyone qualifies, so here are some of the main eligibility criteria:
Adults 18 and Older
The FDA approved Spravato for adults only. Since the approval covers people 18 and older, certified centers generally do not treat younger patients. Your provider will confirm your age at intake, and you may need to show a photo ID.
Age alone does not make you a candidate, and older adults go through the same screening as everyone else. Providers also review your overall health and current medications. If you are older, your provider may look more closely at your blood pressure and memory.
Depression Diagnosis
Spravato treats major depressive disorder, which is a specific clinical diagnosis. Feeling sad for a few days is not the same thing, and a short period of low mood does not qualify. A licensed clinician must make the diagnosis.
The FDA approved Spravato for two groups of adults with major depression. One group has treatment-resistant depression, which means symptoms persist after trying other medications. The second group has major depression with suicidal thoughts, and they take Spravato with an oral antidepressant.
Your provider will review your records, and they may use a standard questionnaire. If you have bipolar disorder or a psychotic disorder, Spravato may not fit your situation. Bring a list of past diagnoses and treatments to your first visit.
Antidepressant Failures
Treatment-resistant depression has a clear definition. You must have tried at least two antidepressants, and neither one brought adequate relief. When they review each past medication, providers typically check these details :
- Doses within the effective range
- Use for several weeks
- Use during your current depressive episode
- Notes on your response and side effects
When you stopped a medication early because of side effects, your provider may still count that trial. Insurance companies often ask for written proof of each trial. Request your pharmacy records ahead of time, and the Spravato treatment center will use them for insurance approval.
Lack of Major Heart Conditions
Spravato raises blood pressure for a short time, and the effect takes a while to peak. Some heart and blood vessel conditions rule out treatment completely. Your provider will not prescribe Spravato if you have any of these conditions:
- An aneurysmal vascular disease in the chest, abdomen, brain, or limbs
- An arteriovenous malformation
- A history of bleeding in the brain
Other heart problems call for extra caution. If you have uncontrolled high blood pressure, heart disease, or a past stroke, your provider will weigh the risks carefully. Staff checks your blood pressure before each dose, and they recheck it during monitoring.
Try Spravato Treatment Today
Spravato eligibility rests on several factors, and if you meet these criteria, the next step is a consultation with a certified provider. You cannot drive on treatment days, so plan a ride home in advance. Bring your medication list and insurance card to the first appointment. Once your provider reviews your history, they will explain whether Spravato fits your treatment plan.
