If you’ve tried multiple antidepressants without lasting relief, you may have heard about Spravato® (esketamine) — an FDA-approved treatment for adults with treatment-resistant depression. It offers new hope when traditional medications haven’t worked, but not everyone is immediately eligible for it.
At Blue Water Psychiatry, our board-certified providers in Mesa, Arizona follow a detailed screening and safety checklist to ensure Spravato® is both appropriate and safe for each patient. Here’s what that process looks like — and how to know if you might be a good candidate.
Who Spravato® Is For
Spravato® is designed for adults diagnosed with:
- Treatment-resistant depression (TRD) — depression that has not improved after trying at least two different antidepressants at adequate doses.
- Major depressive disorder (MDD) with suicidal thoughts or behaviors.
Spravato® is used in combination with an oral antidepressant, not as a replacement. It works differently from traditional medications by targeting glutamate, a neurotransmitter involved in brain plasticity and mood regulation. This unique mechanism helps “reset” brain pathways that may have become disrupted by long-term depression.
Initial Eligibility Screening
Before starting Spravato®, your provider performs a comprehensive evaluation that includes:
- Diagnostic review – Confirming your depression diagnosis and treatment history.
- Medication history – Documenting which antidepressants you’ve tried, at what doses, and for how long.
- Medical and psychiatric history – Screening for other mental health or physical conditions that could influence treatment response.
- Substance use assessment – Evaluating for recent or chronic substance use that could interfere with Spravato®.
- Current medications – Checking for interactions, especially with sedatives, stimulants, or blood pressure medications.
This process ensures Spravato® will be both effective and safe within your overall treatment plan.
Physical and Medical Safety Considerations
Because Spravato® can temporarily affect blood pressure and perception, your provider will also screen for certain medical conditions. Patients may need additional precautions or an alternative treatment if they have:
- Uncontrolled high blood pressure
- Aneurysmal vascular disease or history of bleeding in the brain
- Pregnancy or plans to become pregnant
- Severe liver impairment
- Substance misuse or active alcohol use disorder
If any of these apply, your clinician will discuss safer treatment alternatives or coordinate care with your medical specialists.
The In-Clinic Monitoring Requirement
Spravato® must be administered in a certified medical office under direct supervision — such as at Blue Water Psychiatry. Each treatment includes:
- Vital sign checks before and after dosing
- Two hours of on-site monitoring by medical staff
- Transportation planning, since you cannot drive until the next day
This structure ensures every patient’s safety and comfort during the entire process.
Psychological Readiness and Support
Eligibility isn’t only medical — it’s also emotional. At Blue Water Psychiatry, we assess:
- Motivation and understanding of the treatment process
- Support systems, such as family or friends who can assist post-treatment
- Willingness to engage in therapy or medication management alongside Spravato®
Because Spravato® works best as part of a comprehensive treatment plan, readiness and consistency are key to long-term success.
The Spravato® Safety Checklist
Here’s what our Spravato® safety checklist includes before approval:
✅ Confirmed diagnosis of treatment-resistant depression or MDD with suicidal thoughts
✅ History of at least two antidepressant trials without sufficient response
✅ Stable blood pressure and medical status
✅ No uncontrolled substance use or contraindicated medications
✅ Understanding of treatment logistics (on-site dosing and monitoring)
✅ Arranged transportation home after each session
✅ Informed consent and readiness for regular follow-up care
Only once all boxes are checked do we proceed with your personalized dosing and scheduling plan.
What Happens After You’re Approved
Once cleared for treatment, you’ll begin your Spravato® initiation phase, typically consisting of two sessions per week for the first four weeks. After that, treatments taper to once weekly or every other week, depending on your response.
Throughout your journey, your provider will monitor:
- Blood pressure and physical response during each session
- Mood and symptom progress between appointments
- Any side effects, such as mild dizziness or nausea
- Long-term effectiveness and maintenance needs
Adjustments are made as needed to ensure safety and optimal results.
Why Mesa Patients Choose Blue Water Psychiatry for Spravato®
- Certified Spravato® treatment center in Mesa, serving patients across the East Valley
- Board-certified psychiatric providers with expertise in treatment-resistant depression
- Comprehensive screening and monitoring for every patient
- Private treatment suites for comfort and confidentiality
- Flexible scheduling for working adults and families
- Same-week consultations and ongoing follow-up care
- Locally trusted and highly rated for compassionate, evidence-based psychiatry
Our mission is to make Spravato® therapy safe, accessible, and supportive — from first consultation to long-term recovery.
Take the First Step Toward Relief
If you’ve been struggling with depression that hasn’t improved with standard medications, Spravato® could be a breakthrough option. Our expert team at Blue Water Psychiatry will walk you through every step of the screening process to determine if it’s the right fit for you.
📞 Call today at (480) 758-4698 to schedule your free estimate!
