SPRAVATO® (esketamine) for Depression

Relief, when nothing else has worked.

If you or someone you love has been living with treatment-resistant depression or suicidal thoughts, Spravato® could be the breakthrough you’ve been waiting for. FDA-approved and now covered by most insurance plans, this fast-acting treatment offers a real chance for relief—quick, effective, and different from anything you’ve tried before.

At Sonder, we specialize in providing innovative treatments for treatment-resistant depression. As a certified provider of Spravato® and offering other advanced therapies like TMS (Transcranial Magnetic Stimulation), you will collaborate with our expert psychiatric providers to craft a treatment plan tailored to your needs. With cutting-edge, personalized care, we're here to help you find the relief you've been searching for.

Why are people turning to Spravato?

• It works fast—some people feel relief within hours
• It’s delivered in our comfortable outpatient setting, under the care of our compassionate medical team
• It’s FDA-approved for both treatment-resistant depression and acute suicidal ideation
• It’s typically covered by insurance, including both the medication and medical supervision
   

What is Spravato?

Spravatois a prescription nasal spray made from esketamine, a fast-acting medicine related to ketamine. Unlike traditional antidepressants, which target serotonin or other neurotransmitters and can take weeks to work, Spravato acts on the brain’s glutamate system—helping to form new neural connections and relieve symptoms more quickly.

It’s been FDA-approved for adults with treatment-resistant depression and for those experiencing depression with suicidal thoughts. For many, it represents a new beginning after years of struggling with medications that haven’t worked.

At Sonder, we administer Spravato in our certified outpatient treatment center, where your safety, comfort, and progress are our top priorities.

Who is a good candidate for Spravato?

Spravato may be a great option for you if you:

• Have been diagnosed with Major Depressive Disorder (MDD)
• Are experiencing acute suicidal ideation
• Have tried at least two other antidepressants without enough relief

Spravato may not be suitable for everyone, particularly those with a history of psychosis, certain substance use disorders, certain heart conditions, high blood pressure, or liver concerns. Our team at Sonder will conduct a thorough evaluation to ensure Spravato is a safe and effective option for you, helping you find the best path for your treatment.

How does Spravato differ from Traditional Antidepressants?

Most traditional antidepressants—like SSRIs and SNRIs—work by increasing levels of neurotransmitters such as serotonin, norepinephrine, or dopamine in the brain. These medications typically take 4 to 6 weeks to build up in your system and begin relieving symptoms. And for some people, they may not work at all.

Spravato (esketamine) is different.

• Spravato targets the brain’s glutamate system, a completely different pathway than traditional antidepressants.
• Glutamate is the brain’s most abundant excitatory neurotransmitter and plays a major role in mood regulation, learning, and memory.
• By acting on NMDA receptors (a type of glutamate receptor), Spravato helps create new neural connections in the brain— essentially "rewiring" areas affected by depression.
• This mechanism is thought to be responsible for Spravato’s rapid effects , often providing relief within hours or days rather than weeks.

In short: Spravato offers a new way forward, especially for those who haven’t responded to other treatments. It doesn’t just boost brain chemicals—it helps the brain reconnect and heal in a fundamentally different way.

Can I Be on Both Spravato and Antidepressants?

Yes, you can—but it’s not always required. Spravato is FDA-approved both as a stand-alone treatment and as an add-on to an oral antidepressant , depending on your diagnosis. For treatment-resistant depression , it’s typically used alongside an oral antidepressant. However, for patients experiencing acute suicidal thoughts or behavior , Spravato may be used on its own.

That said, some insurance companies may require you to stay on an oral antidepressant in order to approve coverage. Our team will walk you through your specific insurance requirements and work with you and your prescribing provider to determine the best and safest treatment plan for your needs.

Spravato vs. Ketamine: What’s the Difference?

Both Spravato and ketamine-based treatments have shown promise for people with treatment-resistant depression. However, there are key differences:

• Spravato is FDA-approved for depression and must be administered in a certified clinic under medical supervision.
• Ketamine is not FDA-approved for depression (when used off-label) and is available in various forms, including IV infusions, intramuscular shots, and lozenges.
• Insurance typically covers Spravato, while ketamine treatment is usually out-of-pocket.
• Both work by targeting the glutamate system, but Spravato uses esketamine, a more targeted form of ketamine.
   

At Sonder, we prioritize evidence-based, accessible care. For those who qualify, Spravato offers an effective, insurance-covered option with a strong safety profile.

What can I expect during Spravato treatment?

Spravato treatment at Sonder is structured for both comfort and safety:

1. Initial Assessment : The process begins with a call from our Spravato Coordinator, who will discuss your needs, answer any questions, and gather initial information. If Spravato is a good fit for you, we’ll schedule a thorough intake appointment with one of our experienced psychiatric providers to plan your treatment.
2. Authorization: Our Spravato coordinator will handle the prior authorization process with your insurance to secure approval for the medication, which may take up to 30 days. Approval doesn’t guarantee full coverage, so you may have out-of-pocket costs like deductibles or copays. Before starting treatment, we’ll conduct a benefits investigation to clarify your financial responsibilities, ensuring you’re fully informed.
3. In-Clinic Administration: Spravato is delivered through a nasal spray that you’ll administer yourself at our clinic, with support from our trained staff. Afterward, you’ll relax in a comfortable, private room for two hours while our team monitors your safety and ensures your well-being.
   1. Please Note: You must arrange a ride home after every treatment session. For your safety, patients cannot drive themselves after receiving Spravato. A family member, friend, or rideshare service (such as Uber or Lyft) is acceptable. 
      Additionally, you should not drive or operate machinery until the next day, after a full night’s sleep.
4. Treatment Schedule: Spravato treatment starts with two sessions a week for four weeks, totaling eight sessions. Then, you’ll shift to one session per week for the next four weeks. After these first eight weeks, your provider will adjust the schedule based on how you’re responding. You’ll check in with your Spravato provider every four weeks to track your progress and personalize your care.

What are the possible side effects?

Most Spravato side effects are mild and temporary, and not everyone experiences them. You may not have any side effects at all, but potential ones include:

• Feeling detached or “out of it” (dissociation)
• Dizziness
• Nausea
• Headache
• Slightly higher blood pressure
• Needing to urinate more often
• Nasal or sinus discomfort

Our trained staff closely monitors every session to ensure your safety and comfort throughout your treatment.

Does insurance cover Spravato?

Yes! Most insurance plans do cover Spravato (esketamine), including both the medication and the necessary medical supervision as long as their criteria are met. Approval criteria are generally similar across insurance companies, and we work closely with you to ensure your treatment is covered as fully as possible, making the process as smooth and manageable as we can.

Before starting treatment, our team will:

• Conduct a benefits investigation to determine your specific coverage
• Provide a clear estimate of any out-of-pocket costs
• Assist with obtaining prior authorizations, if necessary
• When applicable, explore financing options or manufacturer assistance programs

We accept nearly all insurance plans and are committed to finding the best solution for your needs.

Additional Support (if needed)

• Commercial insurance patients : Many are eligible for the manufacturer’s savings card , which helps cover out-of-pocket costs for the medication, if there are any. This can significantly reduce your costs. Our Spravato coordinator will work directly with the specialty pharmacies to set this up for you.
• Medicare Advantage (MA) patients : While they are not eligible for the savings card, we can help connect them with the Johnson & Johnson Patient Assistance Program (PAP). This need-based program may reduce the cost of the medication, and in some cases, bring it down to $0, if the patient qualifies.
• If insurance doesn’t fully cover : If your insurance doesn’t fully cover the treatment, we can explore additional financial assistance options. These may include flexible payment plans, third-party financing, or other programs designed to reduce your out-of-pocket expenses. Please note that these options may not be necessary for everyone, as many insurance plans provide comprehensive coverage.

Our team is dedicated to helping you through every step of the process, ensuring you have the resources and support you need to start your treatment with confidence.

Is there a long waiting list?

Not at all! Spravato services are currently available at our Minnetonka location and we have immediate openings for new patients.

How do I get started?

Fill out the form below, and Ingrid, our Treatment Coordinator, will get in touch within 1 business day. You can also email us at spravato@sonderwellness.com or call us at 952-999-6097, extension 103.