What is Esketamine?

Esketamine (SPRAVATO®) is an FDA-approved treatment for adults with treatment-resistant depression (TRD) or major depressive disorder (MDD) with suicidal thoughts or behaviors. Unlike traditional antidepressants that work on serotonin or norepinephrine, esketamine targets the brain’s glutamate system, which is critical for synaptic plasticity and rapid mood regulation. See important safety information about SPRAVATO, including Boxed Warning by clicking the link here.

Esketamine is administered as a nasal spray in our clinic under the supervision of a medical professional. Research shows that it can provide rapid relief of depressive symptoms within hours to days.

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How does it work?

Esketamine works on NMDA receptors in the brain, increasing levels of glutamate, which boosts neural activity and strengthens communication between brain cells. This surge in connectivity is thought to “reset” brain circuits involved in mood and emotional regulation, helping patients who haven’t responded to standard antidepressants. Because Esketamine can cause temporary dissociation or increase blood pressure, it is always given in a clinic setting with care monitoring.

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Treatment

Your journey with Esketamine begins with a consultation with a Salma Health psychiatrist to determine whether this treatment is appropriate for you.

Step 1: Initial Evaluation

• Comprehensive psychiatric assessment and review of your past treatments.
• Physical health screening to ensure safety for treatment.

Step 2: First Treatment Session

• Esketamine nasal spray is administered under supervision in our clinic.
• You will remain in a comfortable observation room or area for approximately two hours as our team monitors your vital signs and any side effects.

‍Step 3: Ongoing Treatment

• Induction phase: Twice weekly for four weeks.
• Maintenance phase: Once weekly or every other week, depending on your response.
• Each session includes monitoring and support from our care team.

Step 4: Progress Monitoring

• Regular check-ins with your psychiatrist to track your symptom improvement.
• Adjustments may be made to your treatment plan as needed.

Step 5: Long-Term Care

• Many patients continue maintenance sessions to sustain progress.
• Esketamine may be combined with therapy, lifestyle interventions or medication management as part of your ongoing treatment care plan.

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Important safety information

See Important Safety Information about SPRAVATO, including Boxed Warning by clicking the link here

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Getting started with care

The first step is a simple conversation. Please schedule a free video call to explore whether esketamine might be the right next step for you. We will answer your questions, explain the process and guide you through every step of treatment.