Who Is a Good Candidate for Spravato Treatment?

A good candidate for Spravato is an adult with treatment-resistant depression (TRD) – meaning depression that hasn’t improved after trying at least two different oral antidepressants – who is medically stable and able to attend in-person sessions. At our treatment center in Newton, NJ, this innovative nasal spray is offered as part of our integrated approach to mental wellness, providing a new option for those who feel stuck in their journey with depression.

Keep reading to understand how eligibility works and what to expect from the evaluation process.

What Is Spravato and How Does It Work?

Spravato is an FDA-approved prescription nasal spray containing esketamine, a compound related to ketamine. Unlike traditional antidepressants that primarily increase serotonin, norepinephrine, or dopamine, Spravato is thought to target the N-methyl-D-aspartate (NMDA) receptor in the brain – helping restore synaptic connections that can be damaged by long-term depression.

Because it acts on a different neural pathway, Spravato can produce antidepressant effects more rapidly than oral medications, which often take weeks or months to work. It is always used together with an oral antidepressant, not as a stand-alone fix, and given in a monitored setting so a provider can observe you during and after each dose.

Eligibility Criteria for Spravato

Understanding who qualifies is the first step in exploring this treatment option. The criteria are specific and designed to ensure both safety and effectiveness.

Who Qualifies for Spravato Treatment?

You may be a candidate for Spravato if you:

• Are an adult (18 or older).

• Have a confirmed diagnosis of Major Depressive Disorder (MDD).

• Have tried at least two different oral antidepressants without enough improvement.

• Are currently taking – or willing to continue – an oral antidepressant, since Spravato is an adjunctive therapy.

• Can attend in-person sessions at our Newton location.

• Are medically stable enough to be observed after each dose.

Who Is Not Eligible for Spravato?

Spravato is not appropriate for everyone. You may not be a candidate if you:

• Are under 18.

• Have aneurysmal vascular disease or arteriovenous malformation.

• Have a history of bleeding in the brain (intracerebral hemorrhage).

• Have an allergy or hypersensitivity to esketamine, ketamine, or any inactive ingredients in Spravato.

• Are pregnant or breastfeeding.

• Cannot arrange a ride home, since driving after a session is not allowed.

• Have a condition better addressed through other treatment options.

A comprehensive medical history review is essential to identify any contraindications.

The Screening Process

Our practice is founded on a collaborative, judgment-free philosophy. Screening isn’t a quick yes-or-no – it’s a conversation to find the right path within our “whole-person” mental health care model.

What to Expect During Evaluation

Your initial evaluation is a comprehensive discussion with one of our providers. We’ll review your mental health history, past medication trials, current symptoms, and overall health. We’ll also explain the treatment schedule and the two-hour monitoring period required after each administration.

You may also be offered GeneSight genetic testing, which can help our team understand how your body may respond to certain medications – supporting a more tailored plan.

Factors Considered by Providers

Our providers look beyond a diagnosis to consider your entire well-being:

• Your full medical and mental health history.

• Which antidepressants you’ve tried and how you responded.

• Co-occurring conditions, such as anxiety or trauma.

• Any heart, blood pressure, or neurological concerns.

• Your ability to attend monitored, in-person sessions.

• Your treatment goals and whether other therapies, like EMDR or ketamine treatment, might fit.

Is Spravato Right for You?

Making an informed decision is crucial, and we encourage you to be an active participant in your care.

Questions to Ask Your Provider

During your consultation, consider asking:

• Based on my history, am I a strong match for Spravato?

• How does Spravato fit into my broader treatment plan and current medication?

• What does a typical session and monitoring period look like?

• What short-term side effects might I experience during a session?

• How soon might I notice a difference, and how will we measure success?

Next Steps if You Are Not Eligible

If Spravato isn’t the right fit, your journey doesn’t end here. Our integrated model means we can pivot to an approach that suits you better, including:

• EMDR (Eye Movement Desensitization and Reprocessing): A powerful therapy for processing trauma.

• Neurofeedback: A non-invasive technique that helps retrain brainwave patterns.

• Medication Management: Ongoing, personalized medication support.

• Talk Therapy: Foundational support for building coping skills and insight.

Conclusion: Deciding if Spravato Is a Good Fit

A good candidate for Spravato treatment is an adult with treatment-resistant depression who is medically stable and able to attend monitored, in-person sessions. If that sounds like you, an evaluation with our team at Heart Mind Body can confirm whether Spravato – or another supportive treatment – is the right next step in your care.

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