Spravato for Depression at Turned Leaf Psychiatry

Who may benefit and what to expect from treatment in a private setting

When depression continues despite treatment, it can be difficult to know what to try next. Turned Leaf Psychiatry now offers Spravato® (esketamine) nasal spray in a private setting in Ridgeland, Mississippi. We begin with an evaluation to understand your symptoms, review previous treatments, and determine whether Spravato may fit your needs.

Who could benefit from Spravato

Spravato is FDA approved for adults with treatment-resistant depression, generally meaning depression that has not improved adequately after at least two oral antidepressants. For this indication, it can be prescribed alone or with an oral antidepressant. It is not approved for patients younger than 18. 1

If you have had only partial relief, ongoing symptoms, or difficulty tolerating previous medications, an evaluation may help clarify your options. Side effects alone do not establish treatment-resistant depression; your provider will review the details of each medication trial.

Spravato is also approved, together with an oral antidepressant, for depressive symptoms in adults with major depressive disorder and acute suicidal thoughts or behavior. It has not been shown to prevent suicide or reduce suicidal thoughts or behavior, and hospitalization may still be necessary. 1

What recent research shows

A peer-reviewed randomized clinical trial published in JAMA Psychiatry in July 2025 studied Spravato used without an oral antidepressant. In the efficacy analysis of 378 adults with treatment-resistant depression, both studied doses improved depression scores more than placebo at four weeks. Differences were also observed about 24 hours after the first dose. 2

This supports Spravato as another treatment option, but it does not mean everyone improves immediately or achieves remission. The trial was funded by Janssen Research & Development, and the main blinded comparison lasted four weeks. 2

What the evaluation looks like

Your evaluation is a conversation about both effectiveness and safety. Be prepared to discuss:

• Your depression history, current symptoms, daily functioning, and any suicidal thoughts.

• Previous antidepressants, including doses, treatment duration, benefits, and side effects. Bring records or a medication list if available.

• Other mental health symptoms, including past mania, hypomania, or psychosis, to help clarify the diagnosis.

• Medical conditions, blood pressure, liver problems, pregnancy or breastfeeding, and any history of substance use or medication misuse.

• All medications and supplements, especially benzodiazepines, opioids, stimulants, and MAOIs. Do not stop prescribed medication on your own. 3

Spravato must not be used in people with certain aneurysmal blood vessel diseases or arteriovenous malformations, a history of intracerebral hemorrhage, or an allergy to esketamine, ketamine, or its ingredients. 1

Elevated blood pressure requires an individualized decision about treatment timing. Moderate liver impairment may require longer observation; use is not recommended in severe liver impairment. Spravato is not recommended during pregnancy, and breastfeeding is not recommended during treatment. 3

What a treatment visit feels like

Before your visit, arrange transportation home. Avoid food for at least two hours and liquids for at least 30 minutes before dosing. If you use a nasal corticosteroid or decongestant, use it at least one hour beforehand. You may wish to bring headphones for quiet music during observation. 4

At the appointment, you administer the nasal spray yourself under a healthcare provider’s direct supervision. Spravato is given in the office through a restricted safety program called REMS; it is not a take-home prescription. 5 6

Some people feel sleepy, dizzy, nauseated, or temporarily disconnected from their surroundings or sense of time. This disconnected feeling is called dissociation. Experiences vary, and side effects can sometimes be distressing. Tell the team how you feel throughout your visit. 5

You will be monitored for at least two hours after dosing, including breathing and oxygen levels. Blood pressure is checked before treatment, around 40 minutes afterward, and again as needed. Discharge depends on clinical stability, so observation may last longer. 3 6

After treatment, someone must drive you home. Do not drive, operate machinery, or do activities requiring full alertness until the next day after a restful sleep. 5

How often treatment is needed

For treatment-resistant depression, the usual schedule is twice weekly during weeks one through four, then weekly during weeks five through eight. From week nine onward, treatment is usually weekly or every other week, based on response. Your provider reassesses benefit after the first four weeks and individualizes continued care. 5

Private treatment at Turned Leaf Psychiatry

We offer Spravato in a private setting where you can focus on treatment and discuss your experience with our team. Privacy remains paired with required clinical supervision and monitoring throughout each session.

Getting started involves an evaluation, outpatient REMS enrollment, and a review of insurance coverage and any prior authorization requirements. Coverage and out-of-pocket costs vary. Manufacturer assistance through SPRAVATO withMe may be available to eligible patients; program restrictions apply. 6

Contact Turned Leaf Psychiatry to request a Spravato evaluation. Together, we can review your treatment history and discuss whether this option makes sense for you.

Important safety information: Spravato carries boxed warnings for sedation, dissociation, respiratory depression, abuse and misuse, and suicidal thoughts and behaviors. Antidepressants can increase suicidal thoughts and behaviors in young adults; report worsening symptoms promptly. Review the full prescribing information and Medication Guide with your provider. If you are in immediate danger or cannot stay safe, seek emergency care now rather than waiting for an outpatient appointment. 3

Request a Spravato evaluation