If you or a loved one is struggling with Treatment-Resistant Depression (TRD), Spravato® (esketamine) may be a treatment option worth considering. Spravato is an FDA-approved nasal spray form of ketamine that has shown remarkable results in individuals who haven’t found relief through traditional antidepressants. At Innerbloom Ketamine Therapy in San Luis Obispo, we are proud to offer this insurance-covered treatment to qualified patients in a safe, supportive, and medically supervised setting.
To help guide you through the process, here are all the steps involved in getting started with Spravato treatment at our clinic:
Step 1: Call Us to Verify Insurance
Spravato can be expensive, but the good news is that it is often covered by insurance if we are in-network with your plan and you have a clinical diagnosis of treatment-resistant depression (TRD). The first step is to call our clinic and speak with us directly so we can verify whether we accept your insurance and determine if you qualify for coverage.
Step 2: Obtain a Referral from Your Psychiatrist
Before starting treatment, you’ll need to get a referral from a licensed psychiatrist. This is a requirement for Spravato treatment at Innerbloom and ensures that you have a diagnosis of treatment-resistant depression and appropriate clinical oversight. Once your psychiatrist sends us the referral, we’ll take it from there.
Step 3: Phone Call & Intake Form
After we receive your referral, we’ll reach out to answer any initial questions you may have about the treatment and program logistics. During this call, we’ll also request a copy of your insurance card and send you our New Patient Intake Form to complete.
Step 4: Medical Review & In-Person Consultation
Once you submit the online intake form, Dr. Rivas will review your medical history. If appropriate, we’ll schedule an in-person consultation at the clinic. This appointment includes a comprehensive medical evaluation with Dr. Rivas to ensure you’re a safe candidate for treatment. He’ll answer any questions you have, go over what to expect, and guide you through the next steps. You’ll also complete a few forms and, if cleared, we’ll schedule your first treatment session. Please be prepared to pay your typical office visit co-pay for this appointment (generally ~$30-40).
What to Expect During Spravato Treatment
Spravato treatments are administered twice a week for the first four weeks (induction phase), followed by once a week for a month, and then potentially every other week for ongoing maintenance, depending on your response. Each session lasts just over 2 hours and takes place at our clinic under direct supervision.
Patients relax in a private room, reclining in a comfortable chair with a soft blanket, eyeshades, and headphones, listening to a specially curated playlist that supports the therapeutic experience. You’re welcome to bring a book or another quiet activity to enjoy while you relax and recover after your treatment, during the observation period before you’re cleared to head home.
Please remember:
- Please refrain from eating for 2 hours before your appointment (you may drink water up to 30 minutes beforehand).
- Avoid caffeine before your treatment.
- Continue taking all regular medications as prescribed by your doctor unless otherwise advised.
- You must arrange for a safe ride home after each session. Due to the psychoactive effects of Spravato, driving is not permitted.
- Please note, your driver must come in to sign you out of your appointment, or we will collect the driver information of any Uber/Lyft services before you depart.
- Concerned about co-pays adding up? Depending on your insurance plan, you may qualify for savings programs that can reduce your out-of-pocket cost to as little as $10—or even $0—per session!
Common Experiences During a Spravato Session
During a Spravato (esketamine) treatment session, most patients experience a range of dissociative and gentle psychedelic-like effects that begin within minutes of administration and typically peak around 40 minutes after the nasal spray is given. After that, the medicine quickly begins to wear off. Here’s what patients commonly report during the appointment:
- Dissociation or detachment: Feeling disconnected from your body or surroundings (often described as a “floaty” or “out-of-body” sensation).
- Time may feel distorted, slowing down or speeding up.
- Some report vivid internal imagery or thoughts.
- Sedation or drowsiness: Many patients feel very relaxed, sleepy, or even lightly doze off while waiting for the medicine to wear off.
- Emotional changes: Some experience a wave of calm, sadness, euphoria, or even moments of emotional release.
- Mild nausea or dizziness: These are possible and usually short-lived. Patients are monitored closely and offered support if needed.
Optional Psychotherapy Services
Although Spravato does not require psychotherapy as part of the FDA-approved protocol, we strongly believe that mental health support enhances outcomes. That’s why we offer preparation and integration sessions with our licensed ketamine-assisted psychotherapist, Cindy Nelson, LMFT.
These sessions are optional for Spravato patients and available at an out-of-pocket rate of $150 per 50-minute session. Cindy can help you properly prepare, set intentions, process emotional material, and integrate insights from your treatment into daily life for lasting change. Ketamine-assisted psychotherapy has been shown to enhance the effectiveness of ketamine-based treatments.
You’re Not Alone
Our team is here to support you every step of the way. If you’re ready to explore Spravato as a treatment option for treatment-resistant depression, give us a call today. We’re happy to walk you through the process and answer any questions.
About the author:
Libby Rivas serves as the Clinic Manager at Innerbloom Ketamine Therapy, bringing a unique blend of professional expertise, personal experience, and heartfelt compassion to her role. Married to Dr. Ray Rivas, Libby is deeply rooted in the health and wellness community, equipping her with a profound understanding of how to support others. With extensive experience in small business management and customer service, Libby ensures that every patient at Innerbloom receives personalized care and attention.