Spravato

Wondering if Spravato treatment is right for you? Learn how it works, what it costs, and how to get started at Axis Integrated Mental Health. If you’ve tried traditional mental health treatments for depression without success, see the experts at Axis Integrated Mental Health in Louisville, Westminster, and Aurora, Colorado. The outstanding mental health team offers Spravato® nasal spray to diminish the constant sadness associated with depression and suicidal thoughts. Schedule an in-person or telehealth evaluation at Axis Integrated Mental Health by phone or request one online today to determine if Spravato is right for you.

What is Spravato, and How Does It Work?

Spravato® is the first and only FDA-approved nasal spray specifically developed for treatment-resistant depression (TRD). It contains esketamine, a fast-acting form of ketamine that targets glutamate and NMDA receptors, unlike traditional antidepressants that affect serotonin or norepinephrine.

According to Johnson & Johnson, Spravato is a breakthrough treatment that works differently—and faster—than oral medications, especially for patients who’ve tried multiple treatments with little or no relief. It is also used as a monotherapy or a standalone treatment for depression when traditional antidepressants have failed.

What is the Science Behind Spravato? 

The science behind Spravato® centers on neuroplasticity—your brain’s ability to form new connections and heal from past trauma. Unlike traditional antidepressants that target serotonin over weeks, Spravato works within hours by acting on the NMDA receptor, part of the brain’s glutamate system. This helps “reboot” damaged neural circuits associated with depression, especially in people whose brains have become stuck in patterns of hopelessness or numbness. As described in our blog on rewiring the mind with psilocybin, ketamine, and TMS, Spravato promotes rapid synaptic growth and improved communication between brain regions tied to mood and cognition. That’s why it’s often life-changing for people who haven’t responded to other treatments—it doesn’t just mask symptoms, it helps retrain your brain. And because the molecule's half life is so short, it has fewer side effect.

Who is Spravato For? 

Spravato is approved for adults with:

• Treatment-Resistant Depression (TRD): Depression that hasn't improved after two or more antidepressants.

• Major Depressive Disorder (MDD) with Suicidal Thoughts: Spravato can reduce suicidal ideation quickly in crisis situations .

At Axis Integrated Mental Health, we specialize in complex cases for people who’ve tried everything and still feel stuck. We offer both in-person and telehealth medication management visits to co-create a mental health treatment plan with you that may include Spravato.

Am I a candidate for Spravato?

To determine if you’re a candidate for Spravato, the Axis Integrated Mental Health team completes physical and mental health exams. During a psychiatric evaluation, they ask questions about your moods, past treatments, current medications, emotions, medical history, and lifestyle. They tailor a depression treatment that’s best suited for you. Take our qualification quiz to see the types of questions we will ask and to see if you're a candidate for Spravato Treatment. 

How Does Spravato Treatment Differ From IV Ketamine Therapy? 

IV ketamine and Spravato® (esketamine nasal spray) are both fast-acting treatments for depression, but they differ in how they’re administered, how they’re regulated, and how insurance covers them. IV ketamine is delivered through an infusion directly into the bloodstream and is often used off-label for depression, meaning it’s not FDA-approved for that purpose—though many patients see strong results. Spravato, on the other hand, is FDA-approved specifically for treatment-resistant depression and administered as a nasal spray under supervision in a certified clinic, like Axis Integrated Mental Health. It also tends to be covered by insurance, while IV ketamine usually is not. For a deeper breakdown of the science and pros and cons of each option, check out Esketamine vs. Ketamine: Are They the Same Thing? and Which Is Better: Ketamine Infusions vs. Spravato?.

Is Spravato the Same as At-Home Ketamine?

No—Spravato is not the same as at-home ketamine, and the differences are critical for your safety and long-term mental health. Spravato is a prescription nasal spray containing esketamine, the FDA-approved version of ketamine for treatment-resistant depression. It must be administered in a certified clinic under medical supervision, with strict safety protocols, monitoring, and follow-up care.

At-home ketamine, often sold as lozenges or tablets, is not FDA-approved for depression and lacks the clinical oversight that makes treatment effective and safe. As we explain in this blog on 7 crucial reasons to avoid at-home ketamine, using ketamine at home can lead to misdiagnosis, improper dosing, safety risks, and even worsening symptoms if not monitored closely. While some companies market it as a convenient alternative, it doesn’t offer the same medical support, structure, or outcomes as Spravato treatment in a clinic like Axis.

In short: Spravato is real medicine with real oversight, designed to help you heal—not just dissociate.

What to Expect During Spravato Treatment at Axis Integrated Mental Health?

Other clinics may offer Spravato—but at Axis, you get a deeply personalized experience with additional supports like therapy or Deep TMS to maximize healing:

• Phase 1: Induction
  2 treatments per week for 4 weeks

• Phase 2: Maintenance
  1 treatment per week, then tapering based on your response

• Session Time: Each visit lasts about 2 hours, including post-treatment observation

You’ll receive your dose in a private, comfortable room with eye masks, music, blankets, and trained staff who monitor you the whole time. You can’t drive home afterward, so we coordinate safe rides or use our Axis Lyft Transportation Program.

What Should I Know Before Starting Spravato Treatment?

Avoid food and drinks before ketamine treatment as directed by your provider. During Spravato treatment at Axis Integrated Mental Health, you undergo two treatment sessions weekly during the first four weeks. Throughout the second four weeks, you receive one treatment weekly at the Axis Integrated Mental Health office. You cannot take Spravato at home — you must be under supervision during treatment. Please note that we also do randomized drug testing, urine or cheek samples, when patients are seeing us for treatment.

After a period of eight weeks, you can taper off the treatments based on what is tolerable for your situation and your unique treatment response. 

It takes about 10 minutes for Spravato nasal spray to take effect. Side effects may include:

• Dizziness
• Out-of-body experience
• Sedation
• Nausea
• Headache
• Feeling drunk
• Anxiety
• Excitability
• Need to urinate

During Spravato treatment, you have access to curated music, eye masks, noise-canceling headphones, warm blankets, and comfortable chairs. 

Because of the potential side effects of ketamine, this medication is administered at the Axis Integrated Mental Health office, and you remain in the clinic until any side effects wear off. Have a family member or friend drive you home, and avoid driving until the following day.

The most intense side effects typically occur during the first two treatment sessions, gradually decreasing in intensity over time. 

Why is Drug Testing Necessary With Spravato? 

Drug testing is a standard part of Spravato treatment—not because we’re judging you, but because we’re protecting you. Spravato (esketamine) is a controlled substance with dissociative and sedative effects. When combined with certain other substances—especially benzodiazepines, opioids, or alcohol—it can increase the risk of serious side effects like excessive sedation, respiratory issues, or even loss of consciousness.

At Axis Integrated Mental Health, drug testing helps ensure that your treatment is safe, effective, and tailored to your needs. It also allows our psychiatric team to spot potential interactions that could interfere with your progress. Think of it as one more tool in our safety toolbox—alongside medical supervision, monitoring, and personalized care—to help you get better without unexpected complications.

How Can I Prepare for Spravato Treatment? 

Preparing for Spravato treatment is just as important as the treatment itself. At Axis Integrated Mental Health, we guide you through every step to ensure you feel informed, safe, and ready. Before your first session, you’ll receive a checklist with key instructions—like avoiding food 2 hours before your appointment and arranging for a ride home afterward, since you won’t be able to drive post-treatment.

We also encourage patients to set intentions for their sessions, similar to the practices outlined in our guide on preparing for ketamine infusion therapy. While Spravato is different from IV ketamine, many of the mental preparation tips still apply. Creating a calming ketamine music playlist, wearing comfortable clothes, and bringing questions to your care team can help ease anxiety. 

Not sure what to ask? Check out these 7 important questions to ask your psychiatrist before you begin. If you’re looking for a comprehensive resource to feel mentally and physically prepared, read advice from our patients in our Ketamine Therapy Guide below.

At Axis, we don’t just administer Spravato—we help you build the foundation for long-term healing.

What Should I Do After Spravato Treatment? 

How Much Does Spravato Treatment Cost in Denver?

The cost of Spravato® (esketamine) treatment can vary widely depending on your insurance coverage, location, and treatment plan. Here's a general breakdown:

Without Insurance

• Initial phase (Weeks 1–4): $4,720–$6,785 total
  (2 treatments per week, each dose costing ~$590–$885 not including observation fees and medical support)

• Maintenance phase (Week 5+): $590–$1,770 per month
  (1–2 treatments per week, depending on your provider’s recommendation)

With Insurance

Most commercial insurance plans do cover Spravato when medically necessary. Your out-of-pocket cost can be as little as $0 after prior authorization and deductible/coinsurance.

At Axis Integrated Mental Health, the team helps handle all insurance paperwork and prior authorizations so patients pay as little as possible—often $0–$25 per visit for those with approved coverage.

Learn more about Spravato Costs in our deep dive. 

Can You Qualify for Paid Mental Health Leave While Being Treated with Spravato?

Many patients are eligible for paid mental health leave while undergoing Spravato treatment, especially if their depression symptoms are impacting their ability to work. In Colorado, programs like FAMLI (Family and Medical Leave Insurance) allow eligible employees to take time off for mental health treatment while still receiving 90% of their salary up to $1,324 per week partial wage replacement. At Axis Integrated Mental Health, our team can provide the necessary documentation and help you navigate the process so you can focus on healing, not paperwork. For more on how to advocate for your needs at work, read How to Prioritize Your Mental Health as a Manager or learn How to Train Managers and CXOs for Mental Health. If you're considering taking time off, our guide on Taking FAMLI Leave for Mental Health walks you through what to expect and how to get started.

Spravato vs. Other Treatment Options

Unlike traditional SSRIs that take weeks to work, Spravato can reduce symptoms within hours to days. But it’s not the only advanced option available at Axis. 

Treatment	How It Works	Who It’s For
Spravato	Nasal ketamine spray targeting glutamate	TRD + suicidal ideation
TMS Therapy	Uses magnetic fields to stimulate brain areas	Medication-resistant depression, OCD

 

Here's a quick comparison of the two treatments. 

Axis offers all of these under one roof, allowing for personalized combinations based on what actually works for your brain. Read our blog to compare depression treatments like ketamine, tms, and psilocybin.

What Do Patients Say About Spravato Treatment? 

Patients have been enthusiastic about the impact Spravato has had on their lives. Please view our Youtube channel for more patient testimonials or click on the video below. 

You might undergo psychotherapy, nutrition or lifestyle coaching, deep transcranial magnetic stimulation (TMS), or other drug-free treatments for depression as well. 

The Axis Integrated Mental Health team helps reduce the cost of mental health care for patients by consulting on insurance strategies that can reduce costs, obtaining prior authorizations,  and securing transportation plans. 

Schedule an in-person or telehealth Spravato evaluation at Axis Integrated Mental Health by calling the office or using the online booking feature today.

Why Axis is Different

Axis isn’t a pop-up ketamine clinic or corporate chain.

We’re an award-winning, woman-owned, locally-owned and operated clinic with:

• A top-rated psychiatric care team in Colorado voted by the public as the Best of Mile High™ award winners in both 2024 and 2025. We were named ColoradoBiz Magazine's Top Startup of the Year, a Colorado Company to Watch among numerous other awards.

• A genuine commitment to helping the community we live and work in through our corporate philanthropy activities like the 266k Project and our pro bono programs for the poor and first responders.

• Integration of therapy, psychiatry, TMS, and Spravato to simplify complex insurance processes and make cutting-edge mental health care affordable.

• Transparent pricing + full insurance support

• A welcoming environment that where real healing happens

FAQs to Add to the Page

1. How fast does Spravato work compared to other antidepressants?

2. Will my insurance cover Spravato treatment at Axis?

3. What should I do before and after Spravato Treatment?

4. How is Spravato different from IV ketamine?

5. How much does Spravato treatment cost?

6. Can Spravato help with Long Covid Depression?