Spravato


Houston, TX

In-Clinic Treatment for Treatment-Resistant Depression 

We Verify Benefits & Send a Written Estimate

30+ Years of Clinical Leadership

TMS, Ketamine & Therapy, Coordinated Into One Plan

Proven Protocols, Tracked Outcomes

Houston Mind & Brain offers Spravato (esketamine) as an evidence-based, in-clinic, nasal spray therapy for adults whose depression has not responded adequately to standard antidepressants. Spravato works differently from typical antidepressants and can produce symptom relief in hours to days for many people. Treatment is given in a safe, supervised medical setting with clinician oversight.

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What Is Spravato ?

Spravato is a prescription nasal spray that contains esketamine, a derivative of ketamine. Unlike most antidepressants that act on serotonin or dopamine, esketamine works on the brain’s glutamate system and supports neuroplasticity. Because of this distinct mechanism, Spravato can provide rapid relief for people with treatment-resistant depression or acute suicidal ideation or behavior. Clinical trials have shown substantial response rates in treatment-resistant depression populations, with some studies reporting response rates approaching 70% (Popova et al., 2019). 

Who Might Benefit?

Spravato is considered when standard antidepressant treatments haven’t provided sufficient benefit. Typical candidates include adults with:

Treatment-resistant depression (failed two or more adequate antidepressant trials)

Severe depressive symptoms needing faster relief than oral medications typically provide

Depression with a key feature of suicidal ideation, where rapid reduction of risk is needed (we evaluate carefully and tailor care)

We perform a careful clinical evaluation to confirm safety and appropriateness before recommending Spravato.

How Spravato Works

Esketamine modulates NMDA receptors within the brain’s glutamate system. The shift in signaling can increase neuroplasticity and help mood circuits form healthier connections - often leading to faster symptom relief than conventional antidepressants. Because Spravato is a nasal spray, it’s easy to administer in-clinic with clinician oversight.

What to expect step-by-step

Evaluation & safety check

Your initial visit includes a review of medical and treatment history, a detailed psychiatric assessment, and a safety screening. We’ll discuss realistic expectations, possible side effects, and after-visit planning (you must have a responsible adult to drive you home).

In-clinic dosing & monitoring

During your treatment session, you self-administer the Spravato nasal spray under our supervision, and you will remain in the clinic for about 2 hours for observation of vitals and possible side effects. You cannot drive the same day and should plan for transportation and a calm evening.

Typical treatment phases

Induction (Weeks 1–4): Two sessions per week to build effect rapidly.

Optimization (Weeks 5–8): Once per week, adjusted by response.

Maintenance (ongoing): Many patients move to every two weeks or another personalized frequency to maintain gains. We individualize the plan to your clinical response.

Safety & Side Effects

Spravato is administered under medical supervision to minimize risk. Common, generally temporary side effects (most often on the day of dosing) include:

Dissociation or feeling “spaced out”

Dizziness or lightheadedness

Nausea

Sleepiness/fatigue

Temporary increases in blood pressure

We monitor vitals during the observation window and ensure patients have not had an adverse reaction before leaving. Serious reactions are uncommon; the clinic will review your personal risks before starting treatment.

Pricing & Insurance

Spravato is commonly covered by insurance when medical criteria are met; Houston Mind & Brain verifies coverage and manages prior authorization. Some patients with private insurance are eligible for a Spravato savings program making treatment even more affordable for those that qualify. If you do not have insurance coverage or are unable to get approved for Spravato through insurance, we recommend you consider intranasal racemic ketamine as this would be more cost effective than paying for Spravato out-of-pocket. 

How Houston Mind & Brain Delivers Spravato

At HMB, we provide Spravato in a clinical program designed around safety, clinical rigor, and patient experience:

MD-led care and physician oversight. Our clinicians are trained extensively by Dr. Cho, who has worked in academia for 30 years, researching brain function, cognition, and neurostimulation. His expertise shapes our practice and each treatment plan follows research-informed protocols grounded in scientific evidence.

Collaborative review. We hold weekly case reviews with Dr. Cho so providers share expertise and ensure consistent, high-quality care for Spravato and other advanced therapies.

Extended consults & individualized planning. We offer longer initial evaluations so we can thoughtfully review history and select the safest and most effective treatment plan.

Insurance navigation & cost transparency. Many insurers cover Spravato when the medical criteria are met. Our staff helps verify benefits, manage prior authorization, and explain any expected out-of-pocket costs before treatment starts.

Frequently Asked Questions

  • How soon will I feel better?

    Some people notice improvements within hours to days; benefits typically build over weeks during ongoing sessions (Janik et al., 2025; Turkoz et al., 2021). We’ll track your response closely and adjust the plan when needed.

  • Will I be able to drive home after a session?

    No. You must plan for a responsible adult to drive you home and to be with you for the remainder of the day. Most people can resume normal activities the next day.

  • Is Spravato covered by insurance?

    Many insurers cover Spravato when criteria are satisfied. We’ll verify your benefits, pursue prior authorization, and review any expected costs so there are no surprises.

  • How much does Spravato typically cost?

    Spravato (esketamine) billing includes two separate components: the medication and the in-clinic observation time.


    The medication cost may be billed through either your pharmacy benefit or medical benefit, depending on your insurance plan. For eligible patients with commercial insurance, manufacturer savings programs often reduce the cost of the medication to as little as $10 per treatment.


    The observation visit (required monitoring time in the clinic) is billed separately as a medical service. Your cost for this portion depends on your plan and may include a copay, deductible, or coinsurance.


    For patients with commercial insurance, programs such as Spravato WithMe may provide additional reimbursement for observation costs (up to program limits).


    We verify your benefits and review expected costs with you in advance so there are no surprises.

  • What if Spravato doesn’t work for me?

    We’ll continuously evaluate your response and can pivot to alternatives (TMS, ketamine therapy, medication changes, psychotherapy, or combined care). We are committed to helping you achieve relief faster and regain control of your life.

I have greatly benefited from the services of Houston Mind & Brain. I would encourage anyone seeking neurological or psychiatric treatment to visit them. I have particularly benefited most from their TMS treatment. It has changed my life for the better in so many ways. They have knowledgeable and friendly staff and providers who really do care about your health and because they are a smaller office you really do get that personal connection with the providers and staff. Highly recommend!

Jessie

We Accept Insurance and Make Care Affordable

We accept most major plans for FDA-cleared treatments (including standard TMS and Spravato). We verify benefits, manage prior authorization, and provide a written estimate before treatment so there are no surprises.

  • Do you accept Medicaid?

    No - we accept Medicare but do not accept Medicaid. If you have questions about coverage, call our team and we’ll help.

  • Will my insurance cover TMS?

    Many commercial plans cover standard TMS when medical-necessity criteria are met. Accelerated/fast-track TMS is often self-pay. We verify benefits and submit prior authorization on your behalf.

  • What if I’m out of network?

    This is uncommon because we are credentialed with most plans. If needed, we can provide a superbill for out-of-network reimbursement.

  • How do I get a written estimate?

    Request a free 20-minute expert call. We’ll run a benefits check, explain likely coverage, and send a written estimate of patient responsibility before any treatment.

  • Can I get sliding scale pricing for TMS?

    Yes. We offer sliding scale pricing for eligible patients and can provide a written cost estimate before treatment. To be considered, we’ll ask for proof of income, such as tax documents.


    At this time, sliding scale pricing is not available for Medicare patients or for accelerated TMS protocols.

Integrated Care That Delivers Results

Research-informed care that integrates medication management, psychotherapy, TMS, and Spravato/ketamine into a coordinated treatment plan. Treatments are thoughtfully sequenced and monitored within a structured clinical model to support safety, consistency, and meaningful outcomes.

Why Choose Houston Mind & Brain?

MD-led, research-informed brain health - advanced treatments, personalized plans, and practical insurance support.

Insurance Help & Clear Pricing

30+ Years MD Led Psychiatry

Accelerated TMS & Fast Track Paths

Clinical Research & Outcomes Tracking

Integrated Treatment Options

Spravato, Ketamine & KAP Programs

Hear From Our Patients

100+ Five Star Reviews. Real Stories. Real Recovery.

Free 20 Minutes

Speak to a Specialist

Call us at (832) 699-7922 or complete the form below.

Contact Us

What Happens After I Request My 20-min Call?

We’ll reply within one business day.

A clinician or senior team member will call to discuss next steps (your free 20-minute call).

We’ll verify insurance, send a written cost estimate, and help schedule an evaluation if needed.