Spravato® (Esketamine Nasal Spray) — When Antidepressants Haven’t Worked

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Insurance-Covered SPRAVATO® Treatment in Rockville including Medicare & Medicaid

Bright Horizons Psychiatry accepts Medicare and most major private insurance plans in Maryland, including Aetna, CareFirst Blue Cross Blue Shield (BCBS), Cigna, Elevance, Kaiser Permanente, Optum, Tricare, and United Healthcare.

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The Bright Horizons Psychiatry medical team

Our board-certified and academically-affiliated psychiatrists are experts in SPRAVATO® for treatment-resistant depression. As specialists in advanced interventional psychiatry — TMS, Spravato, and IM ketamine — we deliver safe, evidence-based care with rigorous protocols and personalized treatment plans tailored to each patient.

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Dr. Amir Etesam

Psychiatrist

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Shelly Valliath

Nurse Practitioner

Anita Paudel — Nurse Practitioner at Bright Horizons Psychiatry

Anita Paudel

Nurse Practitioner

A comfortable, focused environment for SPRAVATO® therapy at Bright Horizons Psychiatry

Each Spravato session takes place in a private treatment room designed for calm and comfort. After self-administering the nasal spray under clinical supervision, you’ll relax in a reclined chair while our team monitors you closely for the full two-hour observation period required by the REMS protocol.

Many patients use the time to rest with an eye mask, listen to music, or simply let the treatment work. Plan to have someone drive you home afterward — you won’t be able to drive for the rest of the day.

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Spravato treatment could begin in just a few weeks

Step 1
Get in touch with Bright Horizons Psychiatry

Book a free consultation through our online calendar or call us at (240) 599-1001. Our team is ready to discuss how Spravato (esketamine) therapy can help you.

Step 2
Intake call & insurance coordination

Our clinician will assess your needs and discuss whether Spravato is the right fit for you. We’ll address any questions about Spravato treatment costs and insurance coverage, and handle all insurance verification and prior authorization on your behalf.

Step 3

Scheduling & getting started

We’ll onboard you and walk you through exactly what to expect — from your first dosing session to the two-hour monitoring period and arranging a ride home. We’ll schedule your sessions at times that work for you, so Spravato treatment fits into your life.

Getting Ready

Before Your First Visit

Four simple steps between booking and walking through our doors. We handle most of the heavy lifting — you just need to follow along.

Step 1

Book Your Appointment

Use our online booking system or call (240) 599-1001. Choose in-person at our Rockville office or telehealth from anywhere in Maryland.

Step 2

Complete Intake Forms

You’ll receive an email with secure links to our intake paperwork. Takes about 15–20 minutes. Complete it before your appointment so we can focus on you, not forms.

Step 3

Insurance Verification

Our team verifies your coverage and benefits before your first visit. We’ll contact you if there are any issues — no surprise bills later.

Step 4

Gather Your Documents

Bring (or have ready) a photo ID, your insurance card, a list of current medications, and any relevant medical records from previous providers.

Frequently asked questions

That’s exactly who Spravato was developed for. The FDA approved Spravato (esketamine) specifically for treatment-resistant depression — defined as not responding adequately to at least two antidepressants. Spravato works through a different mechanism than traditional medications: instead of slowly adjusting serotonin or norepinephrine, it acts on the brain’s glutamate system, which can produce noticeable relief within days or weeks rather than months. Many patients who saw little benefit from years of antidepressants respond well to Spravato.

No. Spravato is a nasal spray you self-administer under our supervision — there are no needles and no procedures. Some patients feel mild nasal discomfort or a brief unusual taste, but the dosing itself is painless. The most common experience during the session is a feeling of dissociation or floating, which fades within the two-hour monitoring period.

Many patients notice mood improvements within the first one to two weeks of treatment — significantly faster than traditional antidepressants, which often take 6–8 weeks. The standard protocol is twice-weekly dosing for the first four weeks, then weekly, then every other week. Your psychiatrist at Bright Horizons Psychiatry will track your response and adjust the schedule based on how you’re progressing.

Yes — Spravato is covered by Medicare, Medicaid and most major commercial insurance plans for patients with treatment-resistant depression. Coverage typically requires prior authorization and documentation of previous antidepressant trials. Our team at Bright Horizons Psychiatry handles the entire insurance verification and prior authorization process for you, so you know your out-of-pocket cost before your first session.

The most common short-term side effects occur during or shortly after the dosing session and resolve within the two-hour monitoring period. These include dissociation (a temporary feeling of being disconnected from your body or surroundings), mild sedation, dizziness, nausea, increased blood pressure, and headache. Because of these effects, Spravato is only administered in REMS-certified clinics like ours, where you’re monitored throughout. You cannot drive the rest of the day after a session and will need to arrange a ride home.

Yes — with one important exception. Each Spravato session takes about 2.5 hours total (dosing plus the required two-hour monitoring period), and you can’t drive for the rest of that day, so plan your transportation in advance. You should also avoid operating heavy machinery and making important decisions until the next day. Outside of your dosing days, you can work, exercise, and continue your normal routine without restriction.