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FDA-Approved - Now Available as Monotherapy (2025)

Spravato® (Esketamine) Therapy
in West Hartford, CT

A breakthrough nasal spray for adults with treatment-resistant depression. Administered and monitored on-site at our West Hartford office. Now FDA-approved as a standalone treatment - no concurrent oral antidepressant required.

Schedule a Consultation Call (860) 838-8799
Supervised by Dr. Mojdeh Heidari, MD
Understanding the Condition

What Is Treatment-Resistant Depression?

Treatment-resistant depression (TRD) is diagnosed when a person has tried at least two different antidepressants at adequate doses and durations without meaningful improvement. It affects an estimated 30% of people with major depressive disorder.

TRD is not a personal failure - it reflects a biological reality that standard medications don't fully address. The brain's glutamate signaling pathways, which antidepressants often don't target, may be a key factor. Esketamine works differently, acting on NMDA receptors in those pathways.

If you've been living with depression despite trying multiple medications, Spravato® may be a path forward.

Spravato esketamine therapy consultation at Ample Urgent & Primary Care West Hartford CT
The Science

How Spravato® Works

Esketamine takes a fundamentally different approach than traditional antidepressants.

Different Mechanism

Traditional antidepressants affect serotonin, norepinephrine, or dopamine. Esketamine blocks NMDA receptors and rapidly increases synaptic connections in the prefrontal cortex - areas linked to mood regulation.

Rapid Onset

Many patients report improvement within hours to days of their first session - not the 4 - 6 weeks required for most oral antidepressants. For those in acute distress, this speed matters significantly.

FDA Approved

Spravato® received initial FDA approval in 2019 as an adjunct treatment for TRD. In January 2025, the FDA expanded approval to include monotherapy use - making it the only intranasal treatment FDA-approved for treatment-resistant depression as a standalone option.

Standalone or Combined

In January 2025, the FDA approved Spravato® as the first and only monotherapy for treatment-resistant depression - meaning it can now be used on its own, without requiring a concurrent oral antidepressant. It can also be combined with an oral antidepressant for patients who benefit from both.

What to Expect at a Session

Each Spravato® session takes place entirely at our West Hartford office. You'll need to arrange a ride home - you cannot drive the day of treatment. Plan for approximately 2.5 - 3 hours total.

You self-administer the nasal spray Under direct supervision of our clinical staff - Spravato® is not injected or infused
Mandatory 2-hour observation period Required by the REMS program; we monitor blood pressure, dissociation levels, and mood
Typical schedule: twice weekly × 4 weeks Then once weekly × 4 weeks, then once every 1 - 2 weeks for maintenance
Cleared to leave with a designated driver No driving or operating machinery until the following morning
Session Timeline
1
Arrival & check-in (~15 min) Baseline blood pressure, mood assessment, confirm you've eaten a light meal
2
Nasal spray administration (~10 min) Self-administer 56 mg or 84 mg dose (as prescribed) in two 5-minute intervals
3
2-hour monitored observation Rest, read, or listen to music while we monitor vitals every 30 minutes
4
Final assessment & discharge Clearance check before your driver takes you home
Patient consultation for Spravato treatment-resistant depression therapy in West Hartford CT
Am I a Candidate?

Who May Qualify for Spravato®

Spravato® is FDA-approved for adults who meet specific criteria. At your consultation, Dr. Heidari will review your full psychiatric and medication history to determine if you're a good candidate.

Major depressive disorder diagnosis Formally diagnosed by a licensed mental health or medical provider
Failed 2+ antidepressants Adequate dose and duration with inadequate response - not side-effect intolerance alone
Currently on an oral antidepressant Spravato® is used in combination, not as a standalone therapy
Able to arrange a driver You must have a reliable ride home for every session - this is non-negotiable for safety
Not sure if you qualify? Call us at (860) 838-8799 for a brief phone screening before booking a full consultation. We can often answer eligibility questions in 10 minutes.
Coverage & Cost

Insurance & Financial Assistance

Most major commercial insurance plans and Medicare cover Spravato®. We work with you to verify benefits before your first session.

Commercial Insurance

Most major plans - Aetna, Cigna, UnitedHealthcare, Anthem Blue Cross Blue Shield - typically cover Spravato® when TRD criteria are documented. Prior authorization is usually required; we handle that process.

Medicare & Medicaid

Medicare Part D covers Spravato® for qualifying beneficiaries. Medicaid coverage varies by state; Connecticut's Husky plan covers it in many cases. We verify your specific plan before scheduling.

Janssen CarePath Assistance

Janssen Pharmaceuticals offers the Spravato® CarePath patient assistance program for uninsured or underinsured patients. Eligible patients may pay as little as $10 per session. Ask us about enrollment.

Common Questions

Spravato® FAQs

Is Spravato® the same as ketamine infusions?
No. Spravato® is esketamine (the S-enantiomer of ketamine), FDA-approved specifically for treatment-resistant depression. IV ketamine infusions use racemic ketamine and are considered off-label for depression. Spravato® is administered as a nasal spray under FDA's REMS safety program, which requires on-site monitoring. IV ketamine is not covered by most insurance; Spravato® typically is.
What does it feel like during a session?
Many patients experience dissociative effects (feeling detached from surroundings), dizziness, nausea, or sedation during the 2-hour observation window. These effects are temporary and typically resolve before discharge. Our staff monitors you throughout and creates a calm, comfortable environment.
How many sessions will I need before I feel a difference?
Response varies. Some patients notice improvement after 1 - 2 sessions; others take the full 4-week induction period. Clinical trials showed statistically significant improvement in depression scores versus placebo after 4 weeks of twice-weekly dosing. We track your response at each visit and adjust the plan accordingly.
Do I need a referral from a psychiatrist?
Not necessarily. Dr. Heidari can evaluate your history and prescribe Spravato® directly if you meet the clinical criteria. If your situation is complex, we may request records from your psychiatrist or therapist to ensure coordination of care. We welcome patients who are self-referred.
Can I drive myself home after a session?
No. Driving or operating heavy machinery is prohibited on the day of any Spravato® session. You must arrange a responsible adult to drive you home. Rideshare services (Uber, Lyft) are acceptable if a friend or family member is not available, but you should not be alone immediately after discharge.
Take the First Step

Ready to Learn If Spravato® Is Right for You?

Call our West Hartford office to speak with a member of our clinical team, or book a consultation online. We typically respond within one business day.

Schedule Consultation Call (860) 838-8799

Spravato® is a registered trademark of Janssen Pharmaceuticals. Individual results vary. This page is for informational purposes only and does not constitute medical advice.

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