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Don't let depression keep you in the dark

Greenbrook now offers the only FDA-approved ketamine-based psychedelic treatment for depression.

What's so special about esketamine?

Ketamine is a drug that's primarily known for its uses as an anesthetic. You may have also heard of ketamine being used as a psychedelic street drug, but if it's used under the supervision of a doctor, it can be perfectly safe.


A nasal spray version, called esketamine, was approved by the FDA in March 2019. Its effects can make it helpful for treating depression.


The science behind esketamine nasal spray >

Coverage is key

Esketamine nasal spray for depression is covered by many major insurance companies.


One benefit of having treatment at a Greenbrook center is that our Care Team does all the work for you when it comes to insurance. Phone calls, emails, paperwork: we take care of it for you.


Wrangling insurance companies for coverage of any treatment can be hard (even if you're not struggling with depression!).

How does it feel?

Since it's a psychedelic drug, esketamine nasal spray feels different from other substances you may have experience with (like alcohol). During treatment, you may feel dizzy, euphoric, or intoxicated. Afterwards, you'll be groggy and woozy. You can't do anything hazardous for the rest of your day. That includes operating a motor vehicle, so you'll need someone to drive you home after treatment.

Where can I be treated?

We offer esketamine nasal spray for depression at select Greenbrook centers.


Esketamine nasal spray must be given at a REMS (Risk Evaluation and Mitigation System) certified center by a certified provider.

How to get started

1. NO COST CONSULT

Learn about esketamine nasal spray

The first person you’ll meet with (whether in-person, via phone call, or video call) is your Patient Consultant, who will review your history and explain aspects of esketamine nasal spray treatment.

We focus on insurance so you don't have to

Your Patient Consultant will also explain treatment payment options, including going over standard insurance plan criteria with you. We will coordinate with your health insurance provider to determine benefits.

SHOULD I RECEIVE IV KETAMINE OR SPRAVATO® (NASAL ESKETAMINE)?

IV ketamine

  • Is not FDA-approved for the treatment of depression
  • Is not covered by many insurance companies
  • Is not offered at Greenbrook


Esketamine nasal spray (Spravato®)

  • Is FDA-approved for the treatment of depression
  • Is covered by many insurance companies
  • Is offered at Greenbrook

IS NASAL ESKETAMINE COVERED BY INSURANCE?

Yes! Many major insurance companies cover ketamine-based depression treatment if you haven't gotten better after trying just TWO antidepressants.

2. PRE-ASSESSMENT

Figure out if psychedelic ketamine-based depression treatment is right for you

Next, you will meet with a Greenbrook provider for an evaluation which includes questions about your history and symptoms.

If the Greenbrook provider has determined that you are a candidate for esketamine nasal spray and you are ready to move forward, they will create your individualized treatment plan.

3. TREATMENT

You're ready to start feeling better!

Before treatment, don't eat anything for two hours and don't have any large amounts of fluids for 30 minutes.

At most Greenbrook centers, we try to book esketamine nasal spray treatments in the afternoon to accommodate your schedule. You'd come into the Greenbrook center during the afternoon and get treated, go home, have dinner, then go to bed. By the next morning, most people are ready to resume their day with no restrictions.

TYPICAL NASAL ESKETAMINE

TREATMENT SESSION

Your safety & comfort are our top priorities

Because esketamine is a psychedelic-like treatment for depression, during treatment you may feel dizzy, euphoric, or intoxicated. Throughout your treatment, our Care Team will be on-site to assist you. Your blood pressure will be checked at baseline, 40 minutes in, and before you leave.

After treatment, you'll be groggy and woozy. You can't do anything hazardous for the rest of your day. That includes operating a motor vehicle, so you'll need someone to drive you home after treatment.

View Indications and Important Safety information

Typical Treatment Course

phase 1

2 treatments a week for 4 weeks

phase 2

1 treatment a week for 4 weeks

phase 3

1 treatment every 1-2 weeks

Where to find nasal esketamine spray for depression

GREENBROOK CENTERS ARE PRIVATE, RELAXING, & REMS-CERTIFIED

Curious about ketamine-based therapy for depression?

Your Patient Consultant will help you find out if esketamine nasal spray is right for you!

curious about depression

Please provide the requested information on the form and Greenbrook TMS will contact you shortly. All information will be kept strictly confidential. We do not sell or share your information.

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Esketamine Nasal Spray FAQs

  • What's the difference between ketamine, esketamine, and Spravato®?

    Spravato® is nasal esketamine, a more specific form of ketamine designed to treat depression.


    Spravato® takes the effective part of ketamine and isolates that and then gets rid of the sedating part of ketamine that is not believed to be as important for depression.

  • Who is esketamine nasal spray for?

    Esketamine nasal spray is FDA-approved for people with depression who have not experienced adequate improvement with antidepressant medications.

  • How long is a round of treatment?

    A typical round of esketamine nasal spray treatment consists of 24-26 sessions in four phases:


    • Phase 1: 2 treatments a week for 4 weeks
    • Phase 2: 1 treatment a week for 4 weeks
    • Phase 3: 1 treatment every 1-2 weeks
    • Phase 4: Maintenance program consisting of 12-14 additional treatments

    Before coming to each appointment, be sure you avoid eating anything for two hours. You should also avoid large amounts of fluid for 30 minutes before an appointment.


    Each session takes place at a private, spa-like Greenbrook center. Once you arrive, you'll sit in a chair and self-administer the nasal spray. Your blood pressure is checked at the start of the session, 40 mins into treatment, and prior to leaving the Greenbrook center. 


    You have to stay in the center for no less than two hours. Make sure you have someone to drive you home. 

  • How much is a dose of esketamine nasal spray?

    You'll spray either  2 or 3 sprays in your nostril depending on the dose. 

  • What if ketamine-based depression treatment isn't for me?

    That's okay! Our Patient Consultants will help you decide if ketamine-based depression treatment is right for you. If it isn't, Greenbrook also offeres TMS therapy, which is a non-drug, non-sedating FDA-cleared treatment for depression. You can learn more about TMS by asking your Patient Consultant or taking our TMS quiz. 

  • Can you take esketamine nasal spray while staying on medication?

    Yes. You have to be on an antidepressant medication to receive nasal esketamine spray.

  • Do I need to go to a hospital?

    No. Nasal esketamine must be given at a REMS (risk evaluation and mitigation system) certified center, such as a Greenbrook center.

  • Does esketamine nasal spray work for anxiety?

    No. Esketamine nasal spray is FDA-approved for people with depression who have not experienced adequate improvement with antidepressant medications.

  • Who shouldn't take esketamine nasal spray?

    You shouldn't take esketamine nasal spray if you have:

    • Uncontrolled hypertension
    • History of strokes or brain bleeds
    • Abnormal blood vessels at risk of bleeding, such as aneurysms or ateriorvenous malformations (AVMs)
    • Sensitivity to eketamine

    View Indications and Important Safety Information.

  • Is esketamine nasal spray covered by insurance?

    Yes! It's covered by many major insurance companies. Greenbrook's Care Team will handle all the insurance for you. On average, an insurance company will cover about 28 treatment sessions.

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