Esketamine (SPRAVATO®) Treatment for Treatment-Resistant Depression
Esketamine (SPRAVATO®) Treatment
Two Roads Wellness Clinic® in Danville offers Esketamine (SPRAVATO®) nasal spray for adults with treatment-resistant depression who have not improved with two or more antidepressants. Learn who it’s for, how it works, and what to expect.
Esketamine (SPRAVATO®) Treatment at Two Roads Wellness Clinic®
If you’ve tried multiple antidepressant medications and still feel depressed, you are not alone, and you are not out of options.
We offer Esketamine (SPRAVATO®) nasal spray for adults with treatment-resistant depression, currently at our Danville clinic, with plans to expand to our Champaign and Covington locations soon.
Esketamine, brand name SPRAVATO®, is an FDA-approved prescription nasal spray used for certain adults living with treatment-resistant depression (TRD), meaning depression that has not improved after trying at least two different antidepressant medications at adequate doses and durations.
It is taken in our clinic, under direct medical supervision, not at home. After each treatment, you’ll be monitored for at least two hours before going home.
Esketamine works differently from traditional antidepressants, targeting the brain’s glutamate system, which can help reset certain neural pathways involved in mood and emotional regulation.
What Is Esketamine (SPRAVATO®)?
Esketamine (SPRAVATO®) may be an option for you if:
You are an adult (18+)
You have major depressive disorder and continue to have significant symptoms despite trying at least two antidepressant medications at adequate doses
You are still experiencing depressed mood, low energy, lack of interest, or hopelessness despite prior treatment.
You are under the care of, or willing to be connected with, a mental health provider or prescribing clinician.
Whether this treatment is right for you can only be determined after a thorough evaluation with one of our medical providers.
Important: Esketamine is not for everyone. Certain medical conditions, medications, history of substance use, or pregnancy/breastfeeding may make it unsafe. A comprehensive screening is always required before starting treatment.
Who Might Be a Good Candidate for Esketamine?
How Does Esketamine Treatment Work at Two Roads Wellness Clinic®?
While details are tailored to each person, here’s what you can generally expect:
1. Initial Esketamine Consultation
You’ll meet with a medical provider at Two Roads Wellness Clinic® to:
Review your mental health history and past medications
Discuss your current symptoms and goals
Go over potential benefits, risks, and side effects
Determine if Esketamine (SPRAVATO®) is appropriate and safe for you
If you’re eligible and decide to proceed, we’ll develop a personalized treatment plan and coordinate with your existing therapist or prescriber when possible.
2. Treatment Sessions in Clinic
On treatment days:
You arrive at our clinic.
Our care team checks your vital signs and reviews how you’re feeling.
You self-administer Esketamine nasal spray under supervision from a trained healthcare professional.
You relax in a comfortable room while we monitor you for at least two hours for safety and support.
Before you leave, we reassess your vital signs and mental status to ensure you’re safe to go home with your pre-arranged ride.
3. You Must Have a Ride Home
Esketamine can cause temporary sleepiness, dizziness, or feeling “out of it” (dissociation). Because of this, you:
Cannot drive, operate machinery, or do anything requiring full alertness after your treatment that day.
Must arrange for a trusted adult to drive you home after each session.
Clinical studies have shown that Esketamine (SPRAVATO®):
Can lead to rapid improvement in depressive symptoms, sometimes within 24 hours, with more change seen over several weeks when used as directed.
Has helped some patients who did not improve on multiple antidepressant medications experience meaningful relief from depression symptoms.
However:
Results vary from person to person.
Some people improve quickly; others more gradually; some may not respond.
Esketamine is not a cure and is typically one part of a comprehensive treatment plan that may include talk therapy, lifestyle changes, and other medications.
Your provider will regularly review your response, side effects, and goals to decide whether to continue, pause, or adjust treatment.
What Kind of Results Are Possible with Esketamine?
What Are the Possible Side Effects & Safety Considerations for Esketamine?
Like all medications, Esketamine (SPRAVATO®) can cause side effects. Not everyone experiences these, but the most commonly reported include:
Feeling sleepy or sedated
Feeling “detached” or disconnected (dissociation)
Dizziness or spinning sensation
Nausea or vomiting
Increased blood pressure for a short time
Anxiety or feeling “strange” or “dream-like”
Because of these effects and the potential for misuse or abuse, Esketamine:
Is a controlled medication (CIII)
Can only be given in certified clinics through a special safety program (REMS)
Requires monitoring for at least two hours after each dose
Your provider will go over risks, warnings, and precautions in detail during your evaluation and before starting treatment.
If you ever have thoughts of harming yourself or others, this is an emergency.
Call 988 (Suicide & Crisis Lifeline), dial 911, or go to the nearest emergency room immediately.
Your Care Team at Two Roads Wellness Clinic®
We believe healing often requires more than one path. Our Esketamine program is:
Collaborative – We coordinate with your existing therapist and prescribers when possible.
Trauma-informed & compassionate – We honor your lived experience and move at a pace that feels safe.
Evidence-informed – We follow current clinical guidelines and FDA safety requirements for Esketamine treatment.
Esketamine Treatment FAQs
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That depends on your specific situation. Esketamine may be used with or without an oral antidepressant, based on updated FDA guidance and your provider’s clinical judgment. Never change your medications on your own; any adjustments will be made together with your prescribing clinician.
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Treatment plans are individualized. Many patients start with more frequent visits at the beginning, followed by less frequent maintenance visits if they respond well. Your provider will outline a schedule during your consultation and adjust based on how you’re doing.
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Coverage varies by plan. Our team will:
Help you verify benefits
Explore prior authorization requirements
Discuss out-of-pocket costs and options before starting treatment
Ready to Explore Whether Esketamine Is Right for You?
If you’ve tried at least two antidepressants and still feel weighed down by depression, Esketamine (SPRAVATO®) may be an option worth exploring.
Schedule a consultation at our Danville clinic:
Call: 217-651-6801
Locations: Danville (now), Champaign and Covington (coming soon)
We’d be honored to walk alongside you as you explore a new path forward.
Important Disclaimer
This webpage is for informational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always talk with a qualified healthcare provider about your specific questions, medications, and treatment options, and never delay seeking care because of something you read online.