Spravato (Esketamine) Therapy

Spravato is an FDA-approved option for patients struggling with treatment-resistant depression (TRD). Dr. Zlatin Ivanov, board-certified in Psychiatry and Addiction Psychiatry, provides individualized care using advanced therapies like Spravato for NYC patients who haven’t found relief with standard antidepressants. With his expertise in complex cases and evidence-based psychiatry, Dr. Ivanov at Online Psychiatrists helps patients navigate this treatment safely and effectively.

What is Spravato?

Spravato (esketamine hydrochloride) is a prescription nasal spray derived from ketamine, approved for adults with major depressive disorder (MDD) who have not responded to at least two different antidepressants. Unlike traditional medications such as SSRIs, Spravato works differently in the brain and is always taken under the supervision of a qualified healthcare provider.

Studies published in The American Journal of Psychiatry and indexed on PubMed show that esketamine can help patients with treatment-resistant depression.

For example, a 2019 trial found that using esketamine nasal spray along with an oral antidepressant led to faster improvements in depressive symptoms than a placebo. Later research also highlights esketamine’s ability to reduce severe suicidal thoughts within just hours of treatment.

Patient Experience

Who is a Good Candidate for Spravato?

Spravato is recommended for patients experiencing:

• Treatment-resistant depression (TRD) after trying multiple antidepressants without relief.
• Major depressive episodes with suicidal thoughts or behaviors.
• Adults for whom other therapies, including psychotherapy or psychostimulants, have not been effective.

It is not recommended during pregnancy, for patients with certain cardiovascular conditions such as hypertensive encephalopathy, or those with a history of drug misuse or dependence. A full evaluation with your doctor ensures Spravato is safe and appropriate.

How Does Spravato Work?

Unlike standard antidepressants, which target serotonin, esketamine therapy works on the brain’s NMDA receptors, helping to restore balance in glutamate activity. This process can lead to rapid improvement in mood and reduction of depressive symptoms, even within hours of dosing.

Each treatment uses Spravato nasal spray under observation in a clinic setting. Because of possible side effects such as sedation, dizziness, or an increase in blood pressure, patients remain under monitoring for at least two hours.

Advantages of Spravato

Spravato offers an option for people who haven’t found relief with other treatments. Some of its main benefits include:

• Tends to work more quickly than many traditional antidepressants.
• Can help reduce suicidal thoughts in certain patients.
• Given in a supervised clinic so you’re supported and monitored throughout the process.
• Can be combined with oral antidepressants to improve overall effectiveness.
• Provides a structured treatment plan, with healthcare providers closely tracking your progress and adjusting care as needed.

What to Expect During Spravato Treatment

Your Spravato session begins with a quick check of your blood pressure and a review of any recent medications or health changes. You will then administer the nasal spray yourself, while a clinician supervises to ensure everything goes smoothly. Afterward, you’ll have a brief rest period so the team can monitor for side effects like dizziness, nausea, or mild dissociation.

Doses follow an FDA-approved schedule, and as your depression symptoms improve, sessions are typically spaced farther apart. Throughout the process, the staff focuses on keeping you safe, comfortable, and supported at every stage.

Spravato Treatment Process with Dr. Zlatin Ivanov

At Dr. Ivanov’s clinic, the Spravato process begins with a thorough consultation to see if the treatment is right for you. During this visit, your medical history is reviewed, and any potential risks — including rare complications like changes in blood pressure or unusual neurological effects — are discussed.

Once a plan is in place, your Spravato treatment in NYC is scheduled in a controlled setting where your response is closely monitored. Sessions can be combined with oral antidepressants or psychotherapy to improve results. This careful, individualized approach ensures patients receive effective, safe care while following a structured treatment program.

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If you’ve been struggling with treatment-resistant depression and are searching for Spravato treatment, Dr. Zlatin Ivanov offers expert care in a safe, supportive environment. Contact us today to learn more about your options and schedule your consultation.