At Freedom Behavioral Health Solutions, we offer Spravato® (esketamine), an FDA-approved prescription treatment for adults living with treatment-resistant depression (TRD) and certain forms of major depressive disorder with suicidal thoughts or behaviors.
For individuals who have not experienced sufficient relief from traditional antidepressants, Spravato® works differently by targeting brain chemistry in a way that can produce improvement when other treatments have not.
Spravato® is a prescription nasal spray containing esketamine, a derivative of ketamine. It is administered in our certified medical clinics under supervision of professional staff.
Unlike traditional antidepressants that primarily affect serotonin, norepinephrine, or dopamine systems, Spravato® works on the glutamate system, which plays a key role in mood regulation and neuroplasticity.
Because of its mechanism, Spravato® may produce improvement in depressive symptoms more rapidly than many conventional medications.
Spravato® acts on NMDA (N-methyl-D-aspartate) receptors, which are part of the brain’s glutamate signaling system. Glutamate is the most abundant excitatory neurotransmitter in the brain and plays a central role in learning, memory, and neural connectivity.
In individuals with depression, disruptions in glutamate signaling and synaptic connectivity are believed to contribute to mood symptoms.
When esketamine blocks NMDA receptors:
This process may help restore more adaptive neural communication patterns, particularly in the prefrontal cortex and limbic system.
Rather than simply increasing neurotransmitter levels, Spravato® works by helping rebuild and strengthen neural pathways involved in mood regulation promoting long lasting changes in the brain.
Your Spravato® journey begins with a comprehensive psychiatric consultation and evaluation. During this first visit, one of our providers will review your medical and mental health history, discuss previous antidepressant treatments, and determine whether Spravato® is appropriate for your specific condition. Because Spravato® is approved for treatment-resistant depression and certain severe depressive episodes, eligibility criteria must be carefully reviewed before starting.
If you move forward, we will outline a personalized treatment plan and explain the REMS (Risk Evaluation and Mitigation Strategy) safety protocol required for this medication. Spravato® is always administered in our clinic under medical supervision and must be used in combination with an oral antidepressant.
Once treatment begins, sessions are typically scheduled twice weekly for the first four weeks, followed by weekly treatments for a period of time depending on your response. During each appointment, you will self-administer the nasal spray under provider supervision while seated comfortably in a monitored treatment room. After administration, you will remain in the clinic for at least two hours so our team can observe your response, monitor blood pressure, and ensure your safety.
Some patients experience temporary sensations such as dizziness, sedation, or a feeling of dissociation during the monitoring period. These effects are expected, carefully monitored, and typically resolve the same day. Because temporary impairment may occur, you will need someone to drive you home after each session.
Over the course of treatment, improvements often develop gradually as brain connectivity and mood-regulating pathways respond to the medication. Your provider will track your progress closely and adjust the treatment frequency as clinically appropriate.
Traditional antidepressants primarily influence serotonin, norepinephrine, or dopamine and often take 4–6 weeks to show benefit.
Spravato® works through the glutamate system and may influence synaptic connectivity more directly. Some patients experience improvement earlier in treatment, though response varies and full evaluation over several weeks is important.
Spravato® is not a replacement for therapy and often works best when combined with:
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