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Spravato Treatment Program

A breakthrough for treatment-resistant depression

What is Spravato?

Spravato is an esketamine nasal spray administered in the presence of a medical professional. It is used to treat adults with treatment-resistant depression and major depression with suicidal ideation. Currently, these are the only two diagnoses approved by the FDA. Spravato is used in conjunction with an antidepressant. Treatment takes place twice a week for 4 weeks. After 4 weeks, the provider and the patient decide together about the need for ongoing treatment.

Hand reaching towards the sun, representing hope and recovery through Spravato therapy

Is Spravato right for you?

Spravato can be prescribed for adults 18 years of age and older with treatment-resistant depression or depression with suicidal ideation. For most insurance companies, treatment-resistant depression means patients have tried at least 2 oral antidepressants without success. For depression with suicidal ideation, two antidepressant trials are not required.

Hand reaching towards the sun, representing hope and recovery through Spravato therapy

Patient Stories

What makes our program special

When you join the Spravato program at Cedar Oaks, you will not simply be put in a room unprepared and administered the medication. We take an integrated approach for more sustainable long-term results. You will work one-on-one with our providers to make sure you are fully prepared and have a clear plan. This could include working on lifestyle changes before and after the program, figuring out personal goals for the program, preparing playlists and mindfulness exercises, and much more. We will be with you each step of the way.

We have crafted a dedicated safe space in our building that is designed with the treatment in mind. We can provide blankets, noise-cancelling headphones, a press-for-help button, and other amenities. The psychiatric practitioner overseeing your treatment will be Shari Scott. Shari attended Duke University for both her NP education and her Master's degree in nursing education and has a great passion for this area. You will also be working with Tyler Royal, a professional trainer and health coach. He is a powerful motivator and will partner with you on this journey.

Headshot of Shari Scott, a psychiatric nurse practitioner in Wake Forest, NC who will guide the ketamine-based Spravato program that uses esketamine treatment

Shari Scott


Headshot of Tyler Royal, the health coach that will help with preparation for esketamine via Spravato, a ketamine-based therapy

Tyler Royal

Health Coach

Program Schedule

This schedule can change depending on your needs, and each session with our providers will be unique to address your needs. We also offer an optional four-week continuation of the program depending on the results of the initial ten.

One2 visits for preparation/planning
Two2 visits for preparation/planning
Three2 visits for Spravato and 1 visit for mindfulness/reflection
Four2 visits for Spravato and 1 visit for psychotherapy with a psychiatric provider
Five2 visits for Spravato and 1 visit for mindfulness/reflection
Six1 visit for Spravato and 1 visit for psychotherapy with psychiatric provider
Seven1 visit for Spravato and 1 visit for mindfulness/reflection
Eight1 visit for Spravato and 1 visit for mindfulness/reflection
Nine1 visit for Spravato and 1 visit for mindfulness/reflection
Ten1 visit for Spravato and 1 visit for psychotherapy, reflection on the program, and future planning

Cost and Insurance Information

All appointments with Shari Scott, PMHNP-BC, including the administration sessions, can be submitted to insurance. We will assist you in connecting with insurance and the Spravato and Me program to understand costs.

The actual medication can be billed to insurance. We will assist with necessary paperwork.

Sessions with Tyler Royal will be an out-of-pocket expense. The program includes six to nine (discounted) 1-hour sessions with Tyler Royal.

For further pricing information, please call our front desk. We are happy to discuss the details further.

Who should not take Spravato?

A complete assessment interview will take place prior to being approved for Spravato. If necessary, your provider may ask to communicate with your primary care provider or specialist. We take your safety seriously. Spravato should not be taken if you have any of the following:

  • Uncontrolled hypertension
  • Blood vessel disease or aneurysmal disease in brain, chest, abdominal aorta, arms, and legs
  • A history of bleeding on the brain
  • An abnormal connection between veins and arteries called arteriovenous malformation
  • Anyone who has had an allergic reaction to ketamine or esketamine
  • Pregnant or breastfeeding
  • History of psychosis