What Is Spravato and Who Is It For? A Maryland Patient's Guide
What Is Spravato and Who Is It For? A Maryland Patient's Guide
By Tamela Harrison, PMHNP-BC · Sevox Medical Services, Germantown, MD
If you've been living with depression and tried multiple antidepressants without finding real relief, you may have started to wonder whether anything will ever work. That feeling of being stuck is one of the most exhausting parts of treatment-resistant depression — and it's more common than most people realize.
Spravato (esketamine) is an FDA-approved treatment specifically designed for people in this situation. In this guide, we'll walk you through exactly what Spravato is, how it works, who it's for, and what to expect if you pursue treatment at Sevox Medical Services in Germantown, Maryland.
What Is Treatment-Resistant Depression?
Treatment-resistant depression (TRD) is defined as major depressive disorder that has not responded adequately to at least two different antidepressant medications taken at the right dose for the right amount of time. This doesn't mean you've failed treatment — it means the treatments you've tried haven't worked for your brain chemistry, and you need a different approach.
An estimated 30% of people with major depression don't respond well to standard antidepressants. If that describes you, you are not alone — and Spravato may offer a path forward.
What Is Spravato (Esketamine)?
Spravato is the brand name for esketamine, a nasal spray approved by the FDA in 2019. It is approved for two specific conditions: treatment-resistant depression (TRD) for adults who have not responded to at least two antidepressants, and major depressive disorder with suicidal ideation (MDSI) for adults with active suicidal thoughts or behaviors.
Spravato works on an entirely different system in the brain — the glutamate system — rather than the serotonin or norepinephrine pathways targeted by most antidepressants. This is why it can work for patients who haven't responded to other medications. Unlike traditional antidepressants that can take 4–8 weeks to show results, many patients report noticing improvements from Spravato within hours or days of their first sessions.
How Is Spravato Different From Ketamine Infusions?
Spravato uses esketamine, a specific form of ketamine, administered as a nasal spray. Ketamine infusions use a different form given intravenously. Spravato is FDA-approved specifically for depression while ketamine infusions are used off-label, and Spravato is more likely to be covered by insurance because of its FDA approval. At Sevox Medical Services, we offer Spravato as our certified esketamine treatment option.
Who Is a Candidate for Spravato?
Spravato may be right for you if you are an adult (18 or older) diagnosed with major depressive disorder, you have tried at least two antidepressants at adequate doses without sufficient improvement, you do not have certain medical conditions that would make esketamine unsafe, and you are able to arrange transportation to and from each session since you cannot drive after treatment.
The best way to determine whether you qualify is a consultation with Tamela Harrison, PMHNP-BC. She will review your full psychiatric and medical history and give you a clear answer.
What Does a Spravato Session Look Like at Sevox?
All Spravato sessions are conducted in our Germantown, Maryland office under clinical supervision. You arrive and get settled in a private, comfortable room. You then self-administer the nasal spray under Tamela's supervision. You relax in our office for at least 2 hours while we monitor your blood pressure, heart rate, and overall wellbeing. Once cleared, a designated driver takes you home — you cannot drive on the day of treatment.
The standard treatment schedule starts with two sessions per week for the first four weeks, then moves to once weekly, and eventually to a maintenance schedule of every one to two weeks. Plan for each appointment to take approximately 2–2.5 hours including monitoring time.
What Does Spravato Feel Like?
During a session, some patients experience temporary effects including mild dissociation, dizziness or lightheadedness, nausea (usually mild and brief), and changes in perception of time or space. These effects are temporary and typically resolve within 1–2 hours. Tamela will discuss what to expect in detail before your first session so you feel fully prepared.
Does Insurance Cover Spravato?
Because Spravato is FDA-approved, many major insurance plans — including Medicare and Medicaid — cover it for patients who meet the clinical criteria. At Sevox Medical Services, our team will verify your insurance benefits before your first session so there are no financial surprises. Call us at 240-762-4141 and we will check your benefits for free.
Frequently Asked Questions
Is Spravato addictive? Spravato is classified as a controlled substance and is administered only in certified clinical settings — you never take it home. The supervised, structured treatment protocol is specifically designed to minimize any risk of misuse.
How quickly does Spravato work? Many patients notice improvement within the first one to two weeks of treatment, and some as early as the first few sessions. Spravato is generally significantly faster-acting than traditional antidepressants.
Do I have to stop my current antidepressant to use Spravato? No. Spravato is typically used alongside an oral antidepressant, not as a replacement. Tamela will review your current medications and advise you on the best approach.
Is Spravato available via telehealth? No. Because Spravato requires in-office administration and a mandatory monitoring period, all sessions take place in our Germantown, Maryland office.
Taking the Next Step
If you have been struggling with depression despite trying medications, Spravato may offer the relief you have been looking for. Sevox Medical Services is a certified Spravato provider in Germantown, Maryland, and we are currently accepting new patients.
Book a consultation with Tamela Harrison, PMHNP-BC at 240-762-4141 or online at sevoxmedicalservices.com. We'll review your history, answer your questions, and check your insurance — at no obligation.
