FDA-Approved Depression Treatment

Spravato Treatment Sanford NC

A breakthrough nasal spray treatment for people with depression that hasn't responded to other medications, supervised, safe, and done right here in our clinic.

Home Services Spravato
Spravato treatment consultation at Well Centered Wellness Sanford NC
Understanding Spravato

What Is Spravato?

Spravato (esketamine) is an FDA-approved nasal spray for adults who have tried antidepressants but haven't found enough relief. It works differently from traditional antidepressants, rather than slowly adjusting serotonin levels over weeks, it targets a brain chemical called glutamate and can start working much faster, sometimes within hours or days.

Think of it this way: if traditional antidepressants are like slowly filling a bucket, Spravato is like turning on the tap, it can create change quickly in the pathways that regulate mood, motivation, and outlook. It's not a cure, but for many people, it provides the relief they've been searching for when nothing else has worked.

Spravato is given in our clinic as a nasal spray while you relax in a comfortable setting. Our clinical team monitors you throughout the session to make sure you're safe and comfortable. It's always combined with an oral antidepressant as part of a full psychiatric care plan.

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Is It Right for Me?

Who Is Spravato For?

Spravato is specifically approved for two types of patients. You may be a candidate if you fall into one of these categories.

Treatment-Resistant Depression (TRD)

You've been diagnosed with major depression and have tried at least two different antidepressant medications at the right dose for the right amount of time, and neither worked well enough. This is called treatment-resistant depression, and Spravato was specifically developed for you.

Major Depression with Suicidal Thinking

You have major depressive disorder along with active suicidal ideation or behavior and need a treatment that can begin working quickly. Spravato has a specific FDA approval for this situation and can be a critical bridge while longer-acting treatments take effect.

Currently on an Antidepressant

Spravato is not a stand-alone treatment, it's used alongside an oral antidepressant. If you're already taking one and it's not doing enough, adding Spravato to your regimen may be the combination that finally brings meaningful relief.

Symptoms We Help

Signs That Spravato Might Help You

If you've been living with depression that feels impossible to shake despite treatment, these experiences may sound familiar.

Depression unresponsive to medication
Persistent sadness or emptiness
Loss of interest in things you used to enjoy
Fatigue and low energy every day
Difficulty concentrating or thinking clearly
Feelings of hopelessness or worthlessness
Sleep disturbances (too much or too little)
Suicidal thoughts
Tried multiple antidepressants without relief
Your Treatment Journey

What to Expect with Spravato

Spravato treatment is structured, safe, and done entirely in our clinic. Here's exactly what happens from start to finish.

1

Evaluation & Qualification

We review your full psychiatric history, the antidepressants you've tried, and your current symptoms to confirm you meet the criteria for Spravato. We also review any contraindications and complete the necessary insurance paperwork.

2

In-Office Treatment Session

You self-administer the nasal spray under the supervision of our clinical team in a private, comfortable room. You'll rest for about two hours while we monitor your blood pressure, mood, and any side effects. You cannot drive yourself home after the session, so a designated driver is required.

3

Induction Phase (First Month)

In the first four weeks, you'll come in twice a week, this is the induction phase where your brain begins to respond to the treatment. Many patients notice changes in mood, sleep, or energy during this period.

4

Maintenance Phase

After the induction phase, sessions move to once a week for a month, then once every one to two weeks for ongoing maintenance. We continuously assess your response and adjust as needed alongside your oral antidepressant.

Spravato esketamine nasal spray treatment at Well Centered Wellness
The Science, Simply Explained

How Spravato Works in the Brain

Traditional antidepressants like SSRIs work on serotonin, a brain chemical that regulates mood. They can take four to six weeks to work, and for many people, they simply don't work well enough.

Spravato works on a different system entirely. It blocks a receptor in the brain called NMDA, which triggers a rapid release of glutamate, the brain's main "go" signal. This surge of glutamate helps rebuild the neural connections that depression has damaged, almost like repairing worn-out wiring. The result can be a faster and more meaningful improvement in mood, energy, and quality of life.

Rapid Onset

Many patients notice changes within 24 hours of their first session, far faster than traditional antidepressants.

FDA-Approved & Clinically Proven

Spravato received FDA approval after large clinical trials showing significant reduction in depressive symptoms in patients who had failed multiple other treatments.

Always Supervised

Every session is monitored by our clinical team. Spravato can only be administered in a certified healthcare setting, you will never take it home.

Coverage & Cost

Does Insurance Cover Spravato?

Because Spravato is FDA-approved for treatment-resistant depression and major depressive disorder with suicidal ideation, many insurance plans, including Medicare and Medicaid, cover it. Coverage depends on your specific plan, documented history of prior antidepressant failures, and clinical diagnosis.

Our team handles the insurance pre-authorization process for you. We'll verify your benefits, document the required prior treatment history, and help you understand your out-of-pocket costs before your first session. In many cases, patients pay little to nothing.

Janssen, the maker of Spravato, also offers a patient assistance program for those who qualify. We can walk you through those options during your consultation.

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Common Questions

Spravato Frequently Asked Questions

Is Spravato the same as ketamine?
Spravato (esketamine) is chemically related to ketamine but is not the same thing. Esketamine is a more refined molecule derived from ketamine, formulated specifically as a nasal spray and approved by the FDA for depression. Unlike IV ketamine infusions, Spravato is given in a controlled, monitored clinical setting and is covered by insurance for qualifying patients.
Will I feel "high" during the session?
Some patients experience dissociative effects, a feeling of being slightly detached from their surroundings, during the two-hour monitoring period. This is expected, temporary, and fully resolved by the time you leave the clinic. This is why you must have someone drive you home after each session. Most patients describe the experience as calm and manageable.
How quickly will I feel results?
Some patients notice a lift in mood within 24 hours of their first session. Others need a few sessions before noticing significant change. Spravato works faster than traditional antidepressants for most people, but individual responses vary. Our team closely monitors your progress and adjusts your treatment plan accordingly.
Can I stop taking my current antidepressant?
No. Spravato is approved as an add-on therapy, meaning it must be used alongside an oral antidepressant, not as a replacement. Our psychiatric team will help you find the right combination and make any adjustments to your overall medication plan as part of your care.
Who should not use Spravato?
Spravato is not appropriate for everyone. It is not recommended for people with certain heart or blood vessel conditions, a history of psychosis or certain other psychiatric conditions, uncontrolled high blood pressure, or those who are pregnant or breastfeeding. Our team will conduct a thorough medical evaluation to confirm it is safe for you before proceeding.
Diagnoses We Treat

Conditions Spravato Is Approved to Treat

Spravato has specific FDA-approved uses. Our psychiatric team confirms eligibility through a full evaluation before treatment begins.

Treatment-Resistant Depression Major Depressive Disorder with Suicidal Ideation Depression Not Responding to Standard Antidepressants

These categories reflect FDA labeling for esketamine. Whether Spravato is appropriate for you depends on your individual psychiatric history and a clinical evaluation by our team.

What Patients May Experience

Potential Benefits of Spravato

Every patient responds differently, and Spravato does not guarantee a specific outcome. Here's what many patients and the clinical research point to.

Rapid-Acting Relief Potential

For treatment-resistant depression, some patients notice a change in mood within days rather than the weeks typically needed for standard antidepressants to take effect.

FDA-Approved Option

Spravato is FDA-approved specifically for people whose depression hasn't responded adequately to other treatments, offering a next step when standard antidepressants haven't been enough.

Used Alongside an Oral Antidepressant

Spravato is administered in combination with an oral antidepressant, integrating into your existing psychiatric care plan rather than replacing it.

Closely Monitored Care

Every dose is self-administered in our office under direct observation from our clinical team, in line with REMS safety requirements for esketamine.

Is Spravato Right for You?

Candidate Information

Spravato may be appropriate for adults with treatment-resistant depression who have tried standard antidepressants without adequate relief, or for adults with major depressive disorder experiencing suicidal thoughts who are under close psychiatric care. A full evaluation is required to confirm candidacy.

Spravato may not be appropriate for everyone. Per REMS requirements, it is not recommended for patients with certain conditions, including:

  • Aneurysmal vascular disease or arteriovenous malformation
  • A history of intracerebral hemorrhage
  • Certain uncontrolled cardiovascular conditions where a temporary rise in blood pressure could pose a risk
  • Inability to arrange a ride home, since patients cannot drive themselves after a dosing session

This is not a complete list. Our clinical team will review your full medical and psychiatric history before determining whether Spravato is a safe option for you.

If you are experiencing a mental health crisis or having thoughts of self-harm, please call or text 988 or go to your nearest emergency room.

Pricing & Insurance

Pricing for Spravato depends on your visit type, dosing phase, and insurance plan. Many insurance plans cover Spravato for patients who meet FDA criteria for treatment-resistant depression or major depressive disorder with suicidal ideation.

  • Coverage varies by plan and diagnosis
  • Our team can help verify your benefits
  • Prior authorization support provided
  • Patient assistance program information available

Contact us for current pricing and to verify insurance coverage.

After Each Session

Recovery & Aftercare

What to plan for after your Spravato session, so your recovery is as smooth as the treatment itself.

On-Site Monitoring Before Discharge

You'll be monitored in our office for at least two hours after dosing, and our clinical team must confirm you're clinically stable before you leave.

No Driving Until the Next Day

Per REMS requirements, you cannot drive or operate machinery on the day of treatment. Plan to wait until the next morning, after a full night's sleep, before driving.

Arrange a Ride Home in Advance

Have a designated driver or ride arranged before each session, you will not be permitted to drive yourself home.

Track Mood & Side Effects Between Sessions

Keeping notes on your mood, energy, and any side effects between visits helps our team fine-tune your treatment plan over time.

Who Oversees Your Care

Meet the Provider Who Oversees Spravato Treatment

Derrick Bieller PA-C, Founder and Owner, Well Centered Wellness
Founder & Owner

Derrick Bieller

Physician Assistant, PA-C

Derrick oversees Spravato treatment at Well Centered Wellness. He served 20 years in the U.S. Army, the last 10 as a Physician Assistant, and attended the University of Nebraska Medical Center, where he graduated top of his class. His clinical training includes Behavioral Health alongside Family Medicine, Emergency Medicine, and more.

In addition to Spravato, Derrick and our psychiatric team also provide general psychiatric care, including medication management and full mental health evaluations.

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Patient Experiences

What Patients Say About Spravato Treatment

These reflect representative patient experiences and are not guarantees of results, every patient's response to treatment is different.

After years of trying different antidepressants with no real change, Spravato was the first thing that gave me a sense of hope again.

R.T.
R.T.
Representative patient experience

The monitoring made me feel safe the whole time. I was nervous before my first session, but the team walked me through every step and never rushed me.

M.D.
M.D.
Representative patient experience

It didn't happen overnight, but within a few weeks I noticed I could get through the day without that heavy, exhausted feeling I'd carried for years.

S.P.
S.P.
Representative patient experience
A Whole-Person Approach

Spravato Works Best Alongside Full-Spectrum Care

Depression rarely exists in isolation. These related services can complement your Spravato treatment plan.

Psychiatric Care

Spravato is always paired with an oral antidepressant and ongoing psychiatric management, the foundation of your overall mental health care plan.

Neurofeedback

Neurofeedback can support brain regulation alongside Spravato, helping reinforce the calmer, more stable patterns some patients work toward.

Hormone Therapy

Hormone imbalances can worsen depression symptoms. Addressing hormone health alongside psychiatric treatment may support more complete relief.

Holistic Wellness

Nutrition, lifestyle, and stress-management support reinforce mental health treatment and help sustain progress between Spravato sessions.

Learn More

Further Reading on Spravato & Esketamine

These trusted medical resources offer more background on esketamine, REMS safety requirements, and treatment-resistant depression.

You Deserve Relief

Ready to Try Something That Actually Works?

If antidepressants haven't given you the relief you deserve, Spravato may be the answer. Book a consultation with our psychiatric team today and let's find out if you're a candidate.

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