Spravato & Ketamine
Treatment-resistant depression care in Lutherville, with new-patient evaluations usually available within a week.
SPRAVATO® Treatment
A New Option for Treatment-Resistant Depression
SPRAVATO® (esketamine) is an FDA-approved nasal spray for adults with depression that hasn’t improved after two or more antidepressants. It is also approved for adults with major depressive disorder who are having suicidal thoughts, taken together with an oral antidepressant.
Unlike daily medication, SPRAVATO® is given in our office, in a private treatment room, under the supervision of our clinical team. Many patients notice a change within the first few weeks.
Our program is led by Ashley McKenzie, CRNP-PMH, and Jordan Doehner, CRNP-PMH, both certified prescribers under the SPRAVATO® REMS program.
IS SPRAVATO® COVERED BY INSURANCE?
In most cases, yes.
Most insurance plans cover SPRAVATO® for treatment-resistant depression after a prior authorization. We handle the authorization for you, including the paperwork and follow-up with your plan.
We are in network with:
CareFirst PPO and BlueChoice HMO plans
Carelon (Maryland Medicaid)
Cigna
Aetna
UnitedHealthcare
Johns Hopkins EHP
Medicare
Most insured patients pay their usual office-visit copay. For eligible commercial plans, the manufacturer’s SPRAVATO withMe program can lower the medication cost to as little as $10 per treatment. We confirm your coverage and tell you your expected cost before your first treatment, not after.
What to Expect
Before Treatment
Your first visit is a consultation where we:
Review your medical and treatment history, including the medications you’ve tried
Talk through your goals and answer your questions
Verify your insurance coverage and tell you your cost before you start
Decide together whether SPRAVATO® is a good fit
Submit the prior authorization, which usually takes 5 to 10 business days
How Often
First month: twice a week
Second month: once a week
After that: weekly or every other week, depending on how you respond
During Treatment
Plan on about two hours.
You take the nasal spray yourself, under our supervision, in your private room
The room is yours for at least two hours: relax, listen to music, read, or nap
A wristband tracks your vitals; our staff monitor it from the front desk, so nobody needs to interrupt you
Don’t eat for two hours or drink anything for 30 minutes beforehand
Arrange a ride home; you cannot drive until the next day
Ongoing Care
We work closely with your referring provider to:
Check in on your mood and symptoms at every visit
Adjust your dose and your treatment plan as your response becomes clear
Keep your oral antidepressant and SPRAVATO® working together
Plan the move from twice-weekly to weekly visits, and later to every other week, as you improve
Ensure continuity of care with your current psychiatrist or therapist, here or elsewhere
Treatment Days and Times
SPRAVATO® treatments are offered Monday through Thursday, with start times at 10:00 AM, 12:30 PM and 3:30 PM.
Each treatment room is private, and we schedule so that you have the same room and the same time each visit whenever possible.
Our Space
A comfortable, private environment designed with your treatment experience in mind.
During your visit, you'll have a private space to relax, get comfortable, and make yourself at home. We've also included a variety of small comforts and activities to help make your treatment experience as relaxing as possible.
Safety Information
SPRAVATO® can cause side effects during and shortly after treatment, including:
Sleepiness and dizziness
Feeling disconnected from your surroundings (dissociation)
A temporary rise in blood pressure
Nausea
That is why SPRAVATO® is only given in certified settings, with monitoring, and why you cannot drive afterward. These effects usually pass before you leave.
SPRAVATO® is not approved for use as an anesthetic or for children, and it is not a substitute for hospitalization when hospitalization is needed.
Our team will walk through all of this with you before your first treatment.
Who May Benefit
SPRAVATO® may be appropriate for adults who:
Have not responded to multiple antidepressants
Are experiencing severe depressive symptoms under medical care
Getting Started
You can begin your journey in two ways:
Schedule a consultation directly with our team
Ask your current provider for a referral
We will guide you through every step, from evaluation to treatment and follow-up care.
KETAMINE
For patients who are not candidates for SPRAVATO®, or whose insurance does not cover it, we also offer generic ketamine, given as a nasal spray in the office under the same monitoring. Ketamine is not covered by insurance and is offered on a self-pay basis at $150 per session. Your provider will discuss whether it is an option for you.
FREQUENTLY ASKED QUESTIONS
Does insurance cover SPRAVATO®?
Most plans do, after a prior authorization that we handle for you. See the plans listed above, and call us if you’re not sure what your plan covers.
How soon can I start?
New-patient evaluations are usually available within a week. Treatment begins once your plan approves the authorization, which typically takes 5 to 10 business days.
How long is each visit?
Two hours. You take the spray at the start, and the rest of the visit is the monitoring period in your private room.
Can I drive myself?
No. You’ll need a ride home, and you shouldn’t drive until the next day. Rideshare is fine.
Will I feel strange?
You might. Many people feel dreamy, lightheaded or disconnected for 30 to 60 minutes after the spray; that’s expected, it passes before you leave, and your provider will talk you through it before your first dose.
Do I keep taking my antidepressant?
Yes. SPRAVATO® is used together with an oral antidepressant, not instead of one.
Can I bring someone with me?
A companion can wait in our lobby and is the ideal ride home. Treatment rooms are private and single-occupancy.
For Referring Providers
We partner with primary care, psychiatry and therapy practices across the Baltimore area.
Our center offers:
A simple referral process: call (410) 343-9869 or email hello@resilientpsychiatry.com with the patient’s name and plan
Prior authorization handled by our team
Updates after the evaluation and at each phase of treatment
The patient stays with you for ongoing care
Contact us to learn how we can support your patients with SPRAVATO® treatment.