Trying medication after medication and still feeling stuck is one of the most defeating experiences a person can go through. Spravato (esketamine) reaches a part of the brain that standard antidepressants never could.
At Placid Psychiatry in Fullerton, CA, we offer Spravato treatment for adults whose depression has not responded to standard care.
Spravato (esketamine) is an FDA-approved nasal spray, used together with regular antidepressant pills, for adults with treatment-resistant depression or major depressive disorder with active suicidal thoughts. It works on glutamate receptors in the brain, a different pathway than standard antidepressants, and can bring relief faster than typical antidepressant pills. You self-administer the spray inside a certified clinic, where a provider monitors you for at least two hours.
Common side effects on dosing days include feeling disconnected, dizziness, nausea, and a short rise in blood pressure, and these typically resolve by the end of the day. Spravato is approved only for adults, and a full psychiatric evaluation is required before treatment to confirm it’s the right fit.
Getting the psychiatric evaluation right is what makes everything else work. We review your full psychiatric history, past medication responses, current symptoms, and any medical factors contributing to your depression before recommending Spravato Treatment.
For patients who have previously explored ketamine infusion therapy, we factor that history in as well. We also check for anything that could make Spravato unsafe, because the goal is not just to find what works but to make sure it is right for you specifically. Every evaluation is thorough, unhurried, and focused entirely on your wellbeing.
When depression keeps showing up despite treatment, the problem is not willpower or patience. Our treatment resistant depression psychiatrist goes through every medication tried, understands where each one fell short, and builds a Spravato plan around what your brain actually needs moving forward.
Living with MDD affects every part of daily life. When medication for major depression has not delivered the relief it should, it is time to look deeper. We assess how your symptoms are affecting your functioning and whether Spravato belongs in your treatments for major depressive disorder going forward.
Suicidal depressive thoughts need care that does not wait. Spravato, nasal ketamine spray is approved for adults with thoughts of suicidal depression alongside major depressive disorder and works faster than traditional antidepressants. We approach every evaluation like this with compassion, clinical care, and the attention each person genuinely deserves.
Some people see partial improvement on oral antidepressants but never full relief. The sadness lifts a little but the motivation, focus, and sense of self do not come back. We look at the full picture of your care and determine whether ketamine treatment for depression through Spravato is what your recovery actually needs next.
Getting the psychiatric evaluation right is what makes everything else work. We review your full psychiatric history, past medication responses, current symptoms, and any medical factors contributing to your depression before recommending Spravato Treatment. For patients who have previously explored ketamine infusion therapy, we factor that history in as well. We also check for anything that could make Spravato unsafe, because the goal is not just to find what works but to make sure it is right for you specifically. Every evaluation is thorough, unhurried, and focused entirely on your wellbeing.
Everything starts with a thorough one on one review of your depressive history, past medications, current symptoms, and any medical conditions that may be relevant. We look at the complete picture of your health before a single treatment decision is made.
We build a plan around your specific symptom profile, schedule, and existing medications before your first visit begins. Your plan accounts for how your brain has responded to previous treatment and what your esketamine nasal spray for depression needs to achieve going forward.
Spravato is self administered in our psychiatric clinic under direct clinical supervision with each visit lasting about two hours. We monitor your blood pressure and track how each esketamine dosage is working throughout the full induction phase.
After every visit we check in on how you are feeling and document your progress carefully. We adjust your ketamine treatments plan with your input whenever needed and stay closely involved between appointments as well.
Once your depression improves we build a maintenance plan that holds that progress in place through reduced appointments and medication adjustments. We coordinate with any other providers involved so your overall treatment stays consistent and on track.
Feeling like just another appointment is something no one dealing with depression should ever experience. We take the time to really listen, review every factor driving your depression, and explain how Spravato treatment works in a way that actually makes sense.
We build every esketamine treatment for depression plan around the person in front of us, not a general protocol. Patients choose us because they feel genuinely supported, clearly informed, and confident in every step of their treatment from the very first visit.
Hear directly from patients who took the first step and found the support they were looking for.
Have questions about our psychiatry services? We have answers.
Spravato is for adults with depression that hasn’t improved after two or more antidepressants, or with major depressive disorder and active suicidal thoughts. A psychiatrist confirms candidacy through a full evaluation.
There’s no single best option, but ECT, ketamine, esketamine, and psilocybin currently show the strongest results. ECT is often considered the gold standard for severe cases, though cognitive side effects limit its use.
You self-administer the nasal spray at the clinic, then stay for about two hours while staff monitor your blood pressure and response. Dosing starts twice weekly, then tapers to weekly and eventually every one to two weeks.
The main downsides are required clinic visits, possible dissociation or blood pressure changes during sessions, and cost or insurance hurdles. It also requires REMS-certified in-clinic administration and cannot be taken at home.
