Spravato (Esketamine) for Treatment-Resistant Depression in Scottsdale, AZ
When multiple antidepressants have not delivered the relief you need, Spravato (esketamine) nasal spray offers an FDA-approved alternative that works differently from traditional medications. At The Schulte Institute in Scottsdale, AZ, Dr. Henry Schulte provides personalized Spravato treatment in a safe, supervised clinical setting — giving patients with treatment-resistant depression and major depressive disorder access to one of the most innovative options in modern psychiatry.
Request an AppointmentWhat Is Spravato (Esketamine)?
Spravato is the brand name for esketamine, an FDA-approved prescription nasal spray for adults with treatment-resistant depression (TRD) — defined as inadequate response to at least two antidepressant medications — and for major depressive disorder (MDD) accompanied by acute suicidal thoughts or behaviors. Unlike traditional antidepressants that work primarily on serotonin, norepinephrine, or dopamine pathways, Spravato targets the NMDA (N-methyl-D-aspartate) receptor in the brain, which is involved in synaptic plasticity and mood regulation. This distinct mechanism allows Spravato to produce rapid antidepressant effects — often within hours to days — rather than the weeks typically required for conventional medications to take effect.
Spravato is administered as a nasal spray by the patient under the direct supervision of a clinical provider in a certified healthcare setting. It is not available for home use. At The Schulte Institute, we are certified to provide Spravato through the Spravato REMS (Risk Evaluation and Mitigation Strategy) program, which ensures all safety protocols are followed throughout the course of treatment. We accept BCBS, Aetna, Cigna, Tricare, and UHC (Optum) commercial insurance plans for Spravato treatment — coverage is subject to prior authorization. For a full overview of how we handle insurance, visit our Insurance Coverage page.
What to Expect During Spravato Treatment at The Schulte Institute
Before beginning Spravato, Dr. Schulte conducts a thorough psychiatric evaluation to confirm candidacy and ensure the treatment is the right fit for your needs. Sessions take place in our Scottsdale office in a comfortable, controlled setting. You self-administer the nasal spray under direct clinical supervision, then remain in our office for a minimum of two hours for monitoring of blood pressure, alertness, and overall response. You will need a designated driver for every treatment appointment day. Our team prioritizes your safety and comfort throughout every step of the process.
Request an AppointmentSpravato Treatment Schedule
Spravato treatment is structured in phases, with session frequency gradually decreasing as patients respond to therapy. The general schedule our Scottsdale providers follow is outlined below.
Induction Phase (Weeks 1–4): Patients receive Spravato twice per week. This phase establishes the initial therapeutic effect and allows Dr. Schulte to closely monitor your response and tolerability to the treatment.
Maintenance Phase 1 (Weeks 5–8): Sessions reduce to once per week, allowing patients to build on the gains made during the induction phase while adjusting to a less frequent schedule.
Maintenance Phase 2 (Week 9 and beyond): Based on your provider’s clinical assessment, sessions may continue once weekly or transition to once every one to two weeks for long-term symptom management and relapse prevention.
Throughout every phase, Dr. Schulte monitors your progress closely, coordinates with any outside providers involved in your care, and adjusts your treatment plan as needed. For patients seeking additional advanced treatment options, The Schulte Institute also offers NeuroStar Advanced TMS Therapy for treatment-resistant depression and OCD, and off-label TMS for conditions including anxiety and bipolar depression — learn more on our TMS Off-Label page.
Who Is a Good Candidate for Spravato in Scottsdale?
Spravato may be appropriate for you if you are an adult who has been diagnosed with treatment-resistant depression or MDD with acute suicidal ideation and have not found adequate relief from at least two antidepressant medications taken at appropriate doses and durations. During your consultation at The Schulte Institute, Dr. Schulte will review your full psychiatric and medical history, current medications, and treatment goals to determine whether Spravato is the right next step in your care.
Certain medical conditions — including aneurysmal vascular disease, arteriovenous malformation, or a history of intracerebral hemorrhage — may preclude the use of Spravato. Our team will discuss all relevant candidacy factors and safety considerations with you in full before beginning treatment. If you are exploring other treatment options alongside Spravato, you may also want to review our Conditions Treated page to learn more about the full range of conditions we address at The Schulte Institute.
Insurance Coverage for Spravato at The Schulte Institute
The Schulte Institute accepts BCBS, Aetna, Cigna, Tricare, and UHC (Optum) commercial insurance plans for Spravato treatment. Please note that coverage is not guaranteed and is determined through prior authorization. Insurance plans typically require documentation of a TRD or MDD diagnosis and a demonstrated history of inadequate response to antidepressant medications. Our administrative team assists with benefit verification and prior authorization paperwork before treatment begins, so you have a clear understanding of your financial responsibility in advance. Call us at (480) 941-9004 with any questions about coverage or to schedule your initial consultation.
Frequently Asked Questions About Spravato (Esketamine) in Scottsdale
What is Spravato (esketamine) and how is it different from traditional antidepressants?
Spravato is an FDA-approved nasal spray containing esketamine, used to treat treatment-resistant depression and MDD with acute suicidal ideation. Unlike traditional antidepressants that target serotonin or norepinephrine pathways and can take weeks to work, Spravato blocks the NMDA receptor in the brain — a glutamate receptor tied to synaptic plasticity — and can produce rapid antidepressant effects within hours to days. It is used in conjunction with an oral antidepressant and must be administered in a certified clinical setting.
How is Spravato administered at The Schulte Institute?
Patients self-administer Spravato as a nasal spray under the direct supervision of Dr. Schulte at our Scottsdale office. It is never dispensed for home use. After each session, you remain in our office for a minimum of two hours while our team monitors your blood pressure, alertness, and overall response. A designated driver is required for every treatment appointment day.
Who qualifies for Spravato at The Schulte Institute in Scottsdale?
Spravato is FDA-approved for adults with treatment-resistant depression who have not adequately responded to at least two antidepressant medications, and for adults with MDD accompanied by acute suicidal ideation or behavior. Dr. Schulte conducts a comprehensive psychiatric evaluation before treatment to confirm candidacy and ensure safety. Certain medical conditions may make Spravato unsafe — all relevant factors will be discussed during your consultation.
How quickly does Spravato work?
One of Spravato’s most significant advantages over conventional antidepressants is its speed of action. Many patients begin to experience meaningful symptom relief within hours to days of their first treatment session — rather than the weeks typically required by oral antidepressants. The full therapeutic benefit develops over the course of the induction and maintenance phases, which Dr. Schulte monitors closely throughout your treatment at The Schulte Institute.
What are the common side effects of Spravato?
Common side effects include dizziness, nausea, dissociation (a temporary feeling of detachment from surroundings), headache, sleepiness, and increased blood pressure. These effects typically occur during or shortly after the treatment session and resolve before you leave our office. Because of these potential effects, patients are monitored for at least two hours after each session and must not drive on treatment days. Dr. Schulte reviews all possible side effects with you in full during your initial evaluation.
Does insurance cover Spravato at The Schulte Institute?
The Schulte Institute accepts BCBS, Aetna, Cigna, Tricare, and UHC (Optum) commercial insurance for Spravato treatment. Coverage is determined through a prior authorization process and requires documentation of a qualifying diagnosis and treatment history. Our team assists with benefit verification before your treatment begins. Call (480) 941-9004 with any questions about coverage.
Can Spravato be used alongside NeuroStar TMS or other treatments?
Yes. Spravato is always used alongside an oral antidepressant as part of a comprehensive treatment plan. At The Schulte Institute, Dr. Schulte may also recommend combining Spravato with other services such as NeuroStar Advanced TMS Therapy depending on your individual clinical needs and treatment response. Our practice collaborates closely with outside providers to ensure coordinated, whole-person psychiatric care.
We accept the following insurance providers for Spravato and TMS services:
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