Practice Statement

Dr. Cohen’s practice offers comprehensive treatment for mood and anxiety disorders. In addition to psychopharmacology and psychotherapy, Dr. Cohen’s office offers Transcranial Magnetic Stimulation (TMS), a medication-free alternative treatment for depression and other disorders; Ketamine, a cutting-edge psycho-pharmacological approach to depression; and pharmaco-genetic testing to help guide the approach to medication. 

Spravato Information

SPRAVATO™ is a prescription medicine, used along with an antidepressant taken by mouth, for treatment-resistant depression (TRD) in adults.

SPRAVATO™ is not for use as a medicine to prevent or relieve pain (anesthetic). It is not known if SPRAVATO™ is safe or effective as an anesthetic medicine

SPRAVATO™ nasal spray was evaluated for safety in both short- and long-term clinical trials of adults diagnosed with treatment-resistant depression.
Do not take SPRAVATO™ if you have a blood vessel disease (aneurysm), an abnormal connection between your blood vessels (arteriovenous malformation), a history of bleeding in the brain or are allergic to esketamine, ketamine or any of the ingredients in SPRAVATO™. Talk to your doctor to learn more.


How does Spravato Dosing work?

SPRAVATO™ is taken with a daily oral antidepressant
You administer SPRAVATO™ nasal spray yourself under the supervision of a healthcare professional at a certified SPRAVATO™ treatment center
SPRAVATO™ is taken twice a week for the first four weeks
After the first four weeks, SPRAVATO™ is taken once a week for a month
After this, SPRAVATO™ is usually taken either once a week or once every two weeks

What should I tell my doctor before taking Spravato?

Before you take SPRAVATO™, talk to your doctor about your full medical and depression treatment history, including if you have a history of abusing prescription or street drugs or a problem with alcohol.

What are the side effects?

Ketamine is given in small doses for the treatment of depression. As such, a typical side effect is mild sedation. Some patients complain of mild nausea, which is easily treated with anti-anxiety medication. Some patients have mild elevations or reductions in blood pressure. Dr. Cohen will discuss with you side effects in detail during your consultation.

Is Spravato addictive?

No, administered at small doses in a medical setting, there is no evidence that Spravato is addictive. In contrast, those who abuse ketamine recreationally do so at very high doses to induce psycho-active affects.

How do I make an appointment?

Simply call our office at 212-335-0236. Alternatively, you can book an appointment online at ZocDoc: You do not need a referral from a psychiatrist, since Principium Psychiatry is psychiatrist led by our medical director, Ziv Cohen, MD, a Fellow of the American Psychiatric Association. Dr. Cohen will do a comprehensive assessment and provide you with a diagnosis and recommendations, including whether you are appropriate for Ketamine treatment.

If I have already had TMS or ECT without benefit, could Spravato still help me?

Yes, clinical experience supports that Spravato can be effective for patients with treatment resistant depression, including those who have already tried ECT and TMS without benefit.


Dr. Ziv E. Cohen is a Weill Cornell-affiliated and board-certified psychiatrist with extensive experience treating mood disorders, trauma, PTSD, and a variety of other disorders.  His experience lies with individuals across the lifecycle, including adolescents and adults. Dr. Cohen is also Clinical Assistant Professor of Psychiatry at Weill Cornell Medical College of Cornell University, and on the medical staff of New York Presbyterian Hospital, both in New York City.

Sarah Delaney is a Yale-trained psychiatric nurse practitioner. In New York State, psychiatric nurse practitioners are fully licensed psychopharmacologists. She is a skilled practitioner and is on staff at the Columbia University outpatient psychiatric department. In her private practice, she treats a variety of conditions with the most current and comprehensive regimens. Ms. Delaney received her undergraduate and master’s degrees at Yale University. Ms. Delaney works with children, adolescents, and adults to address a wide range of social, emotional, and behavioral issues.

Avi Adri is a board certified Psychiatric Nurse Practitioner, with training and experience in treating clients using a holistic approach. Avi graduated at the top of his class from Stony Brook University with a specialization in the psychiatric care of at risk youth. He is currently on staff at the Psychiatric Department of NYP-Columbia University Medical Center. With over seven years of clinical experience Avi brings a humanitarian ideology of both mind and body with a deep dedication to comprehensive personalized care for all individuals.