How Do I Qualify for Spravato?

The core criterion: two prior antidepressant trials

Spravato is approved for adults with treatment-resistant depression. In practice that usually means you have taken at least two different antidepressants, each at an adequate dose for an adequate length of time, without enough improvement. Insurers ask for the same history, so bringing a list of what you have tried — names, doses, roughly how long, and why each was stopped — speeds everything up.

Other things we confirm

• You are 18 or older with a diagnosis of major depressive disorder.
• You are able to continue an oral antidepressant alongside treatment.
• Your blood pressure and cardiovascular history are safe for dosing.
• You can attend in-office sessions and stay for the two-hour monitoring period.
• You can arrange a ride home after every session.

When Spravato is not the right fit

Some conditions make esketamine unsafe, including certain blood-vessel and bleeding conditions and a history of specific brain injuries. Pregnancy, breastfeeding, and untreated substance use are also carefully considered. If Spravato is not appropriate, we discuss other options during the same visit.

What an evaluation looks like

The first appointment is a conversation, not a procedure. We go through your history, symptoms, prior treatment, medical background and goals, then decide together whether to move forward and start the insurance authorization.

This article is general information, not medical advice. Eligibility and dosing are decided during an individual evaluation with Nikki Ruoss, APRN, PMHNP-BC, a board-certified psychiatric mental health nurse practitioner.