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Mental Health Care Provider holding Spravato box at Alpha Psychiatric Services in Chesapeake, Virginia

SPRAVATO® (esketamine)

If you struggle with treatment-resistant depression, there is a different choice to turn to! SPRAVATO® is a prescription medicine, used along with an antidepressant taken by mouth to treat. SPRAVATO® is for adult patients only.


About SPRAVATO® (esketamine)

SPRAVATO® is the first FDA-approved nasal spray medication, taken with an oral antidepressant, for treatment-resistant depression in adults (TRD) and depressive symptoms in adults with major depressive disorder (MDD) with suicidal thoughts or actions. SPRAVATO® works differently than other medications for treatment-resistant depression. Today’s most commonly used oral antidepressants are thought to treat depression by increasing levels of neurotransmitters (serotonin, norepinephrine and dopamine) in areas of the brain that affect mood. SPRAVATO® targets the N-methyl-D-aspartate (NMDA) receptor and is believed to work differently than currently available oral antidepressants.

Discuss with Your Healthcare Provider Before Taking SPRAVATO®

SPRAVATO® is not for everyone. Talk to your healthcare provider about your full medical history, including if you:

  • have a history of abusing or being dependent on prescription or street drugs

  • have a problem with alcohol

  • are pregnant or planning to become pregnant

  • are breastfeeding or planning to breastfeed

  • take prescription or over-the-counter medicines

  • take vitamins or herbal supplements


As part of the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS), a healthcare provider will discuss the risks of sedation, dissociation, and abuse and misuse with you before starting SPRAVATO®. You and our healthcare provider must complete a Patient Enrollment Form for you to receive SPRAVATO® in our certified treatment center.

Your First Treatment Center Visit

We will continue to be involved with your care during SPRAVATO® treatment and will be available to answer questions or address concerns as you undergo treatment. Your first visit to our certified SPRAVATO® treatment center will be a consultation, and we will:

  • Receive your medical information from your healthcare provider

  • Conduct our own assessment to determine if SPRAVATO® may be right for you

  • Verify your insurance information as part of the eligibility confirmation


If SPRAVATO® is recommended, we will build a treatment plan with you and enroll you in the SPRAVATO® REMS Program.

Preparing For Treatment

Plan for rides to and from the treatment center. You won’t be able to drive, operate machinery, or do anything where you need to be completely alert until the day after a treatment session, following a restful sleep.

Bring a form of entertainment, like a book or playlist, for the session. A healthcare provider at the treatment center will monitor you for at least two hours after treatment.

Avoid eating two hours before, and drinking liquids 30 minutes before the treatment session. Some patients taking SPRAVATO® may experience nausea or vomiting.

If you take a nasal corticosteroid or nasal decongestant medicine, take these medicines at least one hour before taking SPRAVATO®.

Frequently Asked Questions

  • What is Transcranial Magnetic Stimulation?
    Transcranial magnetic stimulation, often referred to as TMS is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when antidepressant medications haven’t been effective, have ceased working, or as an alternative to medication.
  • How does TMS work?
    TMS involves delivering magnetic pulses to specific parts of the brain.
  • How long is TMS treatment?
    A typical initial course of treatment is about 19-37 minutes daily over 4-6 weeks.
  • Is TMS therapy covered by my insurance?
    A vast majority of commercial and Medicare plans have recognized the effectiveness of treating depression with TMS Therapy and now cover TMS as part of their plans.
  • How does NeuroStar TMS Therapy work for people with depression?
  • Is TMS Therapy a good alternative for patients who cannot tolerate the side effects of antidepressant medications?
    TMS does not circulate in the blood throughout the body, so it does not have side effects like weight gain, sexual dysfunction, nausea, dry mouth, sedation, etc. The most common side effects reported during clinical trials were headache and scalp discomfort — generally mild to moderate — occurring less frequently after the first week of treatment
  • Is TMS Therapy like other alternative therapies that use magnets to treat some illnesses?
    No. TMS Therapy involves a unique method of using pulsed magnetic fields for a therapeutic benefit. The intensity of the magnetic field is similar to that of an MRI. These techniques differ radically from the popular use of low intensity, static magnetic fields. Those products deliver weak and undirected static fields that are not capable of activating brain cells. The activation and stimulation of brain cells is a key part of why TMS is so effective.
  • Can I receive TMS Therapy if I don't live in Chesapeake?
    Absolutely! While our treatment center is based in Chesapeake, we proudly extend our TMS therapy services to individuals across the Hampton Roads region. Whether you reside in Chesapeake, Norfolk, Virginia Beach, Portsmouth, Hampton, Newport News, or Suffolk, our transformative TMS therapy is accessible to you. Your location within the Hampton Roads community is not a barrier to receiving quality mental health care. If you're ready to explore the benefits of TMS therapy, we welcome you to contact us. Your well-being matters, no matter where you call home.
  • Are there any news resources about NeuroStar TMS Therapy?
    Yes! Click here to view the News results for NeuroStar TMS Therapy on Google.
  • TMS Clinical Trials & Academic Studies *
    *The NeuroStar Advanced Therapy System is indicated for the treatment of depressive episodes and for decreasing anxiety symptoms for those who may exhibit comorbid anxiety symptoms in adult patients suffering from Major Depressive Disorder (MDD) and who failed to achieve satisfactory improvement from previous antidepressant medication treatment in the current episode. The NeuroStar Advanced Therapy system is intended to be used as an adjunct for the treatment of adult patients suffering from Obsessive-Compulsive Disorder (OCD). NeuroStar Advanced Therapy is only available by prescription. A doctor can help decide if NeuroStar Advanced Therapy is right for you. Patients’ results may vary. Visit for full safety and prescribing information. ​ 1. Carpenter LL, et al. (2012). Transcranial Magnetic Stimulation (TMS) for Major Depression: A Multisite, Naturalistic, Observational Study of Acute Treatment Outcomes in Clinical Practice. Depres- sion and Anxiety, 29(7):587-596. 2. George MS, et al. (2010). Daily Left Prefrontal Transcranial Magnetic Stimulation Therapy for Major Depressive Disorder: A Sham-Controlled Randomized Trial. Arch Gen Psychiatry, 67(5):507-516. 3. Dunner DL, et al. (2014). A Multisite, Naturalistic, Observational Study of Transcranial Mag- netic Stimulation (TMS) for Patients with Pharmacoresistant Major Depressive Disorder: Durability of Benefit Over a 1-Year Follow-Up Period. J Clin Psychiatry. 75(12):1394-1401. pubmed/25271871 4. O’Reardon JP, et al. (2007). Efficacy and Safety of Transcranial Magnetic Stimulation in the Acute Treatment of Major Depression: A Multisite Randomized Controlled Trial. Biol Psychiatry, 62(11):1208-1216.
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