Gravity Psychiatry & Wellness PLLC
When depression persists despite treatment.
SPRAVATO®
esketamine nasal spray CIII
FDA-approved treatment for eligible adults with treatment-resistant depression.
Evaluation and supervised treatment in Bloomington–Normal, Illinois.
Care begins with an individual evaluation to review your treatment history, discuss potential benefits and risks, and determine whether SPRAVATO® may be appropriate for you.
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Supervised on-siteIn-office administration
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2+ hours of monitoringAfter each treatment
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Arrange a ride homeNo driving after treatment
Important safety information
SPRAVATO® carries boxed warnings for sedation, dissociation, respiratory depression, abuse and misuse, and suicidal thoughts and behaviors. Antidepressants can increase suicidal thoughts and behaviors in people age 24 and younger. Blood pressure may increase. Treatment is provided only through the SPRAVATO® REMS program, with monitoring for at least two hours and assessment before discharge. Arrange transportation home; do not drive until the next day after restful sleep. SPRAVATO® is not approved for children or shown to prevent suicide. An evaluation is required; treatment response varies. Review the full safety information, contraindications, and Medication Guide with your clinician.
About treatment
What Is Spravato®?
Spravato® (esketamine) nasal spray is a prescription medicine approved for:
- Treatment-resistant depression (TRD) in adults, used on its own or together with an oral antidepressant.
- Depressive symptoms in adults with major depressive disorder (MDD) who have acute suicidal thoughts or behavior, used together with an oral antidepressant.
It is taken only in a certified clinic under supervision. Spravato® is not approved for use in children or for use as an anesthetic.
A Different Treatment Approach
Spravato® acts at NMDA receptors involved in glutamate signaling. How this produces its antidepressant effect is not fully understood.
Clinic-Based Only
You self-administer the nasal spray under direct observation by a healthcare professional, followed by at least two hours of monitoring and an assessment before discharge. It is not dispensed for at-home use.
Individualized Psychiatric Care
At Gravity, treatment is guided by an individualized psychiatric care plan. Recommendations consider your symptoms, treatment history, goals, and ongoing needs.
Important: The ability of Spravato® to prevent suicide or reduce suicidal thoughts or actions has not been proven. It does not replace hospitalization if a higher level of care is needed, even if you feel better after a dose.
Your evaluation
Could Spravato® Be Appropriate for You?
For treatment-resistant depression, your clinician considers your diagnosis, previous treatments, current symptoms, and overall health.
Some medical conditions prevent SPRAVATO use. An individual evaluation is needed to assess eligibility and discuss potential benefits, risks, and alternatives.
Factors Considered for TRD Treatment
- Age 18 or older
- Major depressive disorder with limited response to at least two different antidepressants at adequate doses and durations
- Ongoing symptoms that are still affecting mood, functioning, or quality of life despite treatment
- Willing and able to attend frequent in-office visits, monitoring, and follow-up
Health and Safety Review
- Past or current bipolar disorder or psychosis
- Uncontrolled high blood pressure or certain heart and vascular conditions
- Current substance use concerns or history of misusing medications or other substances
- Pregnancy, plans for pregnancy, or breastfeeding
Your medical history helps determine whether treatment is appropriate and what monitoring is needed.
A consultation includes a review of previous treatments, your current symptoms, and your medical history. Recommendations are based on your individual clinical needs.
Your visits
What to Expect with Spravato® at Gravity
Knowing what to expect can help you prepare for treatment. Your clinician will explain the schedule, monitoring requirements, and instructions for each visit.
Consultation & Clinical Evaluation
- Psychiatric evaluation to assess whether Spravato® is appropriate.
- Review of your depression history, prior medications, and response patterns.
- Screening for medical conditions, blood pressure concerns, and substance use risk.
- Coordination with your other healthcare providers, when appropriate and with your permission.
Treatment Schedule for Treatment-Resistant Depression
The labeled schedule for TRD is outlined below. Continuing treatment depends on your response and tolerability. Your clinician will confirm your individual plan.
Weeks 1–4: Induction Phase
Twice per week. Response and tolerability are reviewed throughout this phase and at its completion.
Weeks 5–8: Maintenance Phase
Once per week, with continued review of symptoms, side effects, and daily functioning.
Week 9 Onward: Ongoing Maintenance
Weekly or every other week. Frequency is individualized to the least frequent schedule that maintains your response.
Preparing for Treatment Day
- Allow time for check-in and dosing, followed by at least two hours of monitoring. Some visits take longer; your clinician determines when you are ready to leave.
- Avoid food for at least 2 hours and liquids for at least 30 minutes before dosing.
- Bring an up-to-date list of medicines and supplements. Do not stop or change prescribed medicines without instructions from your prescriber.
- If you use a nasal corticosteroid or decongestant, follow your clinician’s instructions and use it at least 1 hour before SPRAVATO®.
- Arrange transportation home before treatment. Do not drive yourself.
- Wear comfortable clothing; you’ll mostly be resting or reclining.
- Ask the office about bringing headphones or a blanket. Personal items must not interfere with monitoring.
During and After the Visit
- Arrival: We review symptoms and medications, check blood pressure, confirm transportation arrangements, and answer your questions.
- Dosing: You self-administer the nasal spray in a designated treatment space under direct observation by a healthcare professional.
- Observation: You remain for at least two hours after dosing while a healthcare professional monitors blood pressure, breathing, oxygen levels, alertness, and side effects. You are assessed before discharge, and monitoring continues longer if needed.
- Afterward: Do not drive, operate machinery, or perform tasks requiring full alertness until the next day after restful sleep. Plan a low-demand remainder of the day and follow your clinician’s instructions.
A Gravity patient education film · 2 minutes 23 seconds
SPRAVATO® at Gravity
A narrated, animated guide to evaluation, in-office treatment, and important safety information, featuring photographs of our office.
Use your device’s media volume to adjust the narration. For larger captions, use the player’s full-screen control.
Listen to the narration only
The same complete narration, including important safety information.
Original patient education from Gravity Psychiatry & Wellness PLLC. Captions are included. An individual clinical evaluation is required; treatment response varies. This film does not replace medical advice.
Read the video transcript
When depression continues despite treatment, it may be time to review your options. At Gravity Psychiatry and Wellness, care begins with a conversation about your symptoms, your treatment history, and what matters to you.
SPRAVATO, esketamine nasal spray, is an FDA-approved prescription treatment for adults with treatment-resistant depression. For this condition, it may be used on its own or with an oral antidepressant. An individual evaluation is required. Treatment response varies.
Before treatment, we review your medical history, medications, potential benefits, and risks. We also discuss the visit schedule, transportation, and insurance questions.
SPRAVATO is not a take-home medication. In a certified healthcare setting, you use the nasal spray under direct observation. After dosing, you remain for at least two hours of monitoring, including breathing and blood pressure checks. Your clinician determines when you are ready to leave. Allow additional time for check-in and dosing.
Arrange transportation home before your visit. Do not drive, operate machinery, or perform tasks requiring full alertness until the next day, after restful sleep.
Important safety information. SPRAVATO can cause serious sleepiness, feeling disconnected from yourself or your surroundings, breathing problems, and increased blood pressure. It carries risks of abuse and misuse. Antidepressants may increase suicidal thoughts or actions in people age twenty-four and younger. Report new or worsening symptoms promptly.
Do not use SPRAVATO if you have certain blood-vessel conditions, previous bleeding in the brain, or an allergy to esketamine, ketamine, or its ingredients. Discuss pregnancy or breastfeeding with your clinician. SPRAVATO is not approved for children and has not been shown to prevent suicide. It does not replace emergency care. Review the full prescribing information and Medication Guide with your clinician.
To ask about an evaluation at Gravity, call (309) 245-7115.
Gravity Psychiatry and Wellness, PLLC. Grounded in care. Elevating mental wellness.
Important safety information
Safety, Side Effects, and REMS Monitoring
SPRAVATO® has a Boxed Warning and requires treatment in a certified healthcare setting. Your clinician reviews your medical history, medications, and individual risks before recommending treatment.
Key Serious Risks
Serious side effects can include:
- Significant sleepiness or sedation
- Feeling disconnected from yourself or your surroundings (dissociation)
- Breathing problems, including slowed breathing
- Increases in blood pressure
- Risk of misuse, abuse, and dependence as a controlled substance
- Increased risk of suicidal thoughts and behaviors in some people taking antidepressants, especially young adults
Because of these risks, Spravato® is only given in certified healthcare settings through the SPRAVATO REMS program, with monitoring during and after each treatment.
Who should not use SPRAVATO?
Do not use SPRAVATO if you have aneurysmal vascular disease, an arteriovenous malformation, a history of bleeding in the brain, or an allergy to esketamine, ketamine, or its ingredients. SPRAVATO may harm an unborn baby; discuss pregnancy planning with your clinician. Breastfeeding during treatment is not recommended.
Common Side Effects
Common side effects often occur during or shortly after treatment and usually improve the same day. They can include:
- Dissociation or feeling detached
- Dizziness or spinning sensation
- Nausea or vomiting
- Feeling “drunk,” unsteady, or very sleepy
- Headache
- Increased blood pressure
- Unusually elevated mood
Tell your clinician promptly about new or worsening depression, suicidal thoughts, unusual changes in mood or behavior, difficulties with thinking or memory, or new urinary symptoms such as frequent or painful urination or blood in the urine.
Emergency symptoms: If you ever have chest pain, trouble breathing, a sudden severe headache, vision changes, seizures, or intense agitation, seek emergency care or call 911 right away.
This is not a complete list of risks. Review the Full Prescribing Information, including Boxed Warning and Medication Guide, and discuss them with your clinician.
Gravity Psychiatry & Wellness PLLC
Inside Gravity
A closer look at our Bloomington–Normal office. SPRAVATO® visits include clinical supervision, monitoring, and an assessment before you leave.
Call (309) 245-7115Planning for care
Insurance, Cost, and Support Programs
Costs may include the medication and separate clinical services for administration and monitoring. Ask our office what can be estimated for your plan before deciding on treatment. Your health plan determines coverage and your share of the cost.
How Our Office Can Help
- Review your insurance information in relation to Spravato® treatment.
- Clarify which parts of treatment are billed as clinic services and monitoring.
- Provide cost estimates when your plan gives us enough information.
- Submit required clinical documentation and prior authorization forms when needed.
Questions to ask your insurer
Once you and your clinician decide that Spravato® may be appropriate, call the number on your insurance card and ask:
- Is the Spravato® medication covered under my medical or pharmacy benefit?
- Are my Spravato® treatment visits covered under my medical plan or behavioral health benefit?
- What are my copays, coinsurance, and deductible for these services?
- Is Gravity Psychiatry & Wellness PLLC in network for my plan, and does my coverage include Spravato® treatment at this location?
Manufacturer support and savings programs
Manufacturer programs, including SPRAVATO withMe, may help eligible patients understand coverage and explore support for medication and, in some cases, observation costs. Eligibility and program terms can change.
Ask our office about current program information. These programs are run by the manufacturer; Gravity does not determine eligibility or guarantee coverage or savings.
Program information does not replace information from your health plan or require you to use a specific product.
Important: Final out-of-pocket costs depend on your insurance plan, deductible, and any assistance program decisions. An estimate or prior authorization is not a guarantee of payment.
Your questions
Frequently Asked Questions
Select a question to expand the answer.
How might I feel during treatment?
You may feel sleepy, dizzy, or disconnected from yourself or your surroundings. Effects vary, and some can be serious. A healthcare professional monitors you during the visit and determines when you are ready to leave. Tell the clinician promptly if you have difficulty staying awake, breathing problems, or other concerns.
Can I drive myself home after Spravato®?
No. Arrange transportation home before treatment. Do not drive, operate machinery, or perform tasks requiring full alertness until the next day after restful sleep. Discuss transportation questions with the office before your visit.
How long will I be in the office for each session?
Allow time for check-in and dosing, followed by at least two hours of monitoring. Your clinician assesses you before discharge. Monitoring may continue longer if needed, so do not plan around an exact departure time.
Do I have to stop my current medications?
For treatment-resistant depression, Spravato® can be used alone or together with an oral antidepressant. For depressive symptoms in MDD with acute suicidal thoughts or behavior, it is used with an oral antidepressant. We also review your other medications and supplements for potential interactions. Do not stop or change prescribed medicines without instructions from your prescriber.
How is treatment response assessed?
Your clinician reviews symptoms, daily functioning, and side effects throughout treatment. Benefit is assessed at the end of the initial four-week TRD treatment phase to guide decisions about continuing. Response varies, and improvement is not guaranteed.
How does Spravato® fit with other treatment options?
Spravato® is one option for eligible adults with treatment-resistant depression. Your evaluation includes a discussion of alternatives, potential benefits and risks, and the practical requirements of treatment. Recommendations are individualized.
Can I keep seeing my current therapist or psychiatrist?
With your permission, we can coordinate with your existing therapist or psychiatric provider. Your treatment plan should clearly identify who manages medications, follow-up, and other aspects of your care.
Contact Gravity
Grounded in care. Elevating mental wellness.
Interested in an evaluation? Call our office to ask about appointment availability, the treatment schedule, and insurance requirements. If available, have your insurance card and a list of previous depression treatments nearby. A clinical evaluation is required before treatment can be recommended.
For referring clinicians
Referrals may be faxed to (309) 204-8259. For questions, call (309) 245-7115.
Spravato® (esketamine) is a registered trademark of Janssen Pharmaceuticals. This page is for educational purposes only and does not replace individualized medical advice. Treatment decisions should always be made in direct conversation with your healthcare provider.
Not a crisis service. If you are experiencing a psychiatric emergency, call 911 or go to your nearest emergency department. You may also call or text 988 to reach the Suicide & Crisis Lifeline.