Spravato® (Esketamine)
Spravato Treatment in
Mason, Ohio.
Thinking Therapeutics is a REMS-certified Spravato® treatment center in Mason, Ohio. Care is provided by Nikki Ruoss, APRN, PMHNP-BC, a board-certified psychiatric mental health nurse practitioner, in a calm, private in-office suite with monitored sessions.
What Spravato is.
Spravato® is the brand name for esketamine, a prescription nasal spray approved by the FDA for adults with treatment-resistant depression, used together with an oral antidepressant. It is also approved for depressive symptoms in adults with major depressive disorder who have acute suicidal ideation or behavior.
Because of its risks, Spravato is only available through a restricted program called Spravato REMS. That means it cannot be picked up at a pharmacy and taken at home — it is self-administered by the patient inside a certified healthcare setting, with a clinician present and a monitoring period afterward.
For complete product information, see the official Spravato site and the Spravato REMS program .
Treatment-resistant depression
Depression is generally described as treatment-resistant when at least two antidepressants, each taken at an adequate dose for an adequate length of time, have not produced enough relief.
If you have cycled through medication after medication and still feel weighed down, that experience is common and it is not a personal failure. It simply means a different mechanism of action may be worth considering.
Who may qualify
- Adults 18 and older diagnosed with major depressive disorder
- Inadequate response to two or more prior antidepressant trials
- Willing to continue an oral antidepressant alongside treatment
- Able to attend in-office sessions and stay for monitoring
- Able to arrange transportation home after each session
Certain conditions make Spravato unsafe, so eligibility is always confirmed during an individual evaluation.
What happens during treatment.
01
Check-in
We review how you have been doing and check your blood pressure before dosing. You settle into a recliner in the treatment suite.
02
Self-administration
You spray the medication yourself, following simple instructions, while Nikki or a trained team member supervises.
03
Monitoring
You stay at least two hours. Blood pressure is rechecked and you are observed until you are stable and cleared to go home.
Induction and maintenance schedule
- Weeks 1–4 (induction): two sessions per week.
- Weeks 5–8: one session per week.
- Week 9 onward (maintenance): one session every week or every other week, guided by your response.
Your dose and interval are individualized and reviewed at every visit.
Monitoring and transportation
Every session includes a minimum two-hour observation period, so plan for roughly two and a half hours in the office.
You must arrange a ride home. Do not drive or operate machinery until the next day, after a full night's sleep. Bring headphones, music, or a blanket if that helps you relax.
Safety and side effects.
The most commonly reported effects are dissociation (feeling detached from yourself or your surroundings), dizziness, nausea, sedation, headache, a temporary rise in blood pressure, and a reduced sense of taste. These usually begin shortly after dosing and ease during the monitoring period.
Spravato carries boxed warnings for sedation, dissociation, potential for misuse, and suicidal thoughts and behaviors — which is why sessions are supervised and you are observed before leaving. Tell Nikki about all medications and supplements you take, and about any history of high blood pressure, heart or blood-vessel conditions, or substance misuse.
Please review the full prescribing information, including boxed warnings . This page is general information, not medical advice.
Insurance and prior authorization.
Spravato is generally billed through your medical benefit and almost always requires prior authorization. Insurers typically ask for documentation of your diagnosis and the antidepressants you have already tried.
Before your first session we verify your benefits and submit the authorization, then walk you through what your plan approved and what you can expect to owe. Coverage varies by plan, so we confirm your specific benefits rather than promising a result.
For Referring Clinicians
Submitting a Spravato referral
Download the referral form, include the diagnosis and prior antidepressant trials with doses and durations, and fax or email it to the practice. We contact the patient promptly, handle the prior authorization, and keep you updated on progress. Collaborative communication and timely appointments are a priority.
Frequently asked questions.
How do I qualify for Spravato?
Spravato is approved for adults with treatment-resistant depression — generally meaning depression that has not responded adequately to at least two antidepressant medications tried at an appropriate dose and duration. It is also approved for depressive symptoms in adults with major depressive disorder and acute suicidal ideation or behavior. Nikki reviews your full history during an evaluation to determine whether it is appropriate for you.
Is Spravato the same as ketamine?
They are related but not the same. Spravato is esketamine, an FDA-approved nasal spray administered under a restricted distribution program in a certified setting. Ketamine infusions are used off-label for depression and are given intravenously.
How long does each visit take?
Plan on about two and a half hours. You self-administer the nasal spray under supervision, then remain for at least two hours of monitoring before you are cleared to leave.
Can I drive myself home?
No. You must arrange a ride home and cannot drive or operate machinery until the day after your session, following a restful sleep.
Does insurance cover Spravato?
Many plans cover Spravato for treatment-resistant depression, typically after a prior authorization documenting prior antidepressant trials. We verify your benefits and handle the authorization paperwork before scheduling so you know your expected cost in advance.
How often will I come in?
The induction phase is twice weekly for the first four weeks. After that, visits usually move to once weekly, then to once weekly or every other week for maintenance, based on your response.
Read more about Spravato
Ready to talk about Spravato?
Thinking Therapeutics, 7588 Central Park Blvd, Suite 321, Mason, OH 45040.