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.

Advantages of SPRAVATO™

Medical professionals recommend SPRAVATO™ for patients who tried and did not respond to two or more antidepressants. SPRAVATO™ treatment offers these benefits:

  • Alternative to ketamine infusion: IV Ketamine infusions have been shown in multiple large randomized controlled clinical trials to be safe and effective as a treatment for depression. However, some patients prefer not to have an IV infusion. Spravato provides an alternative, FDA approved ketamine based treatment for depression.
  • Medical supervision: During your SPRAVATO™ treatment regimen, your doctor will work closely with you to ensure your well-being. You will receive each dosage at the office.
  • New option for treatment-resistant depression: SPRAVATO™ is one of the first new types of depression medication in decades. If you don’t have success with other depression medicines, SPRAVATO™ may be an alternative for you.

Depression Treatment in Manhattan, NYC

At Principium Psychiatry, our psychiatric professionals specialize in treating depression and other mental health conditions. In addition to SPRAVATO™, some of the antidepressants we prescribe include:

  • SSRIs such as sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa) and escitalopram (Lexapro)
  • SNRIs such as desvenlafaxine (Pristiq) and duloxetine (Cymbalta)
  • Atypical antidepressants such as bupropion (Wellbutrin) and vortioxetine (Trintellix)
  • MAOI antidepressants such as Nardil (Phenelzine) and Parnate (tranylcypromine)
  • Augmentation medications such as Abilify (aripiprazole), Seroquel (quetiapine), Rexulti (brexpiprazole)
  • Mood stabilizers such as Lamictal (lamotrigine), Depakote (Valproic Acid), and lithium

This is a sample of the types of medications which your provider at Principium will consider, and is by no means a comprehensive list. Principium provides comprehensive treatment for depression and anxiety. Some patients will receive psychotherapy alone, others will receive only medication, and yet others will receive a combination of medication and therapy. Principium looks holistically at patients and symptoms to provide the best individualized care while minimizing side effects.

Therapy and Additional Treatment Options

A comprehensive treatment plan for depression often involves multiple kinds of psychiatric services. Our services for patients with depression include:

  • Psychotherapy: Talk therapy approaches like cognitive behavioral therapy (CBT) help you address your thoughts and feelings related to your depression.
  • TMS therapy: FDA-approved TMS therapy services involves the use of magnetic fields to stimulate nerve cells in the brain.
  • Pharmacogenetic testing: This testing allows your DNA to be analyzed in order to predict which medications will work best with your physiological profile.

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What to Expect From a Ketamine SPRAVATO™ Appointment

The typical treatment schedule for SPRAVATO™ starts with appointments twice a week, then transitions into visits every one to two weeks. These sessions involve:

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If you need to drive to our clinic, you should plan a ride since you can’t operate machinery until the day after treatment. To reduce your risk of nausea or vomiting, avoid eating two hours before and drinking 30 minutes before your session.


After your doctor takes your blood pressure, you’ll take SPRAVATO™ as a nasal spray with their supervision.


Your doctor will monitor you for side effects for two hours after your dosage. Feel free to bring music, a book or another kind of entertainment for this time.

Why Choose Principium Psychiatry’s SPRAVATO™ Treatment Center

When looking for a SPRAVATO™ clinic near you in NYC, consider Principium Psychiatry. Patients come to our midtown office because of our:

  • Beautiful and convenient locations: We have four convenient office locations, one located in Midtown Manhattan within Grand Central Station, one in Lower Manhattan located along Wall Street, another office in Greenwich Connecticut, and our fourth and newest office is located in Santa Monica California!
  • Experienced leadership: Dr. Ziv Cohen has faculty positions at Cornell University and Columbia University. Other providers at Principium are likewise affiliated with Cornell, Columbia, New York Presbyterian Hospital, and Mt. Sinai Medical Center.
  • Expertise in new treatments: We use cutting-edge therapies like SPRAVATO™, TMS and medical marijuana to give our patients the options they need.

Spravato FAQs

  • 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

The nasal spray medication used in SPRAVATO™ is covered by every major insurance provider in-network through Principium. However, Ketamine is an off-label treatment. Therefore, the appointment for SPRAVATO™ is not covered in-network while the medicine SPRAVATO™ used in the appointment is covered. Please call our office to learn more.

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.

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.

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.

Simply call our office at 917-993-5018. Alternatively, you can book an appointment online at ZocDoc: https://www.zocdoc.com/doctor/ziv-cohen-md-40226. 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.

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.

Schedule a SPRAVATO™ Assessment Today

During our first appointment with you, we’ll evaluate your suitability for treatment. Learn if you could benefit from taking SPRAVATO™ by scheduling a visit online.

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