There is more than one path through
treatment-resistant depression
We are now offering Spravato® (esketamine) nasal spray — an FDA-approved treatment designed for adults with treatment-resistant depression or major depressive disorder with suicidal ideation. Like ketamine, it works differently from traditional antidepressants, offering rapid relief for people who have not found adequate help through other treatments.
What is Spravato®?
Spravato® (esketamine) is a nasal spray developed by Janssen Pharmaceuticals and FDA-approved in 2019. Esketamine is derived from ketamine and works through the same rapid-acting mechanism, targeting NMDA receptors in the brain rather than the serotonin system that traditional antidepressants rely on.
Because of this different mechanism, Spravato® can produce antidepressant effects within hours to days — a meaningful difference for people who are suffering and have been waiting months or years for relief from other treatments.
Spravato® must be administered in a certified clinical setting and taken alongside an oral antidepressant. Patients self-administer the nasal spray under direct clinical supervision and are monitored for at least two hours after each session.
What to Expect at Each Visit
Blood pressure is checked and a brief screening confirms you are ready for treatment that day.
You administer the nasal spray yourself, with your clinician present throughout. The full dose takes about 10 minutes.
You rest comfortably in our office for at least two hours while we monitor your blood pressure and wellbeing. Some people experience dissociation or dizziness — this is normal and temporary.
A responsible adult must drive you home. You cannot drive or operate machinery on treatment days.
Twice weekly for 4 weeks (induction), then once weekly for 4 weeks, then every 1-2 weeks for ongoing maintenance.
How We Do Things, and Why It Matters
Often when people are considering Spravato, they don't realize that it produces a meaningful altered state. For 30 to 60 minutes after administration, it's common to feel dissociated, emotionally open, and inwardly focused, somewhat like a waking dream where the usual noise of the mind quiets and something deeper becomes accessible. That window is not downtime. It is, in many ways, the heart of the treatment.
The conditions of your experience during that window matter. Research on psychedelic-assisted therapies consistently shows that the environment you're in, the support available to you, and the mindset you bring all shape what you take away from the experience. We take that seriously.
At every Spravato session, a licensed mental health professional is with you in the room. They stay with you for the entire session, not just for check-ins, and are there to monitor you medically and to offer quiet support if something surfaces emotionally. Before the medication takes effect, we offer guided breathwork or meditation to help you arrive with a sense of calm and intention. Afterward, we create space to gently land, through art, grounding conversation, sensory support, or simply being still together.
For patients who want additional support between sessions, individual integration therapy is also available and covered by Blue Cross Blue Shield. These sessions help you make sense of and build on what emerges during treatment. The research on psychedelic-assisted therapies suggests that this kind of reflective work between sessions can meaningfully deepen and sustain the benefits of treatment, and supporting that process is something we have built our whole practice around.
A licensed therapist or psychiatric nurse practitioner stays with you for the full session, providing both medical monitoring and emotional support.
Guided breathwork or meditation before your session, and dedicated time to land afterward, through art, conversation, or quiet.
Designed specifically for psychedelic-assisted therapy to support inward focus and deepen the experience.
A session-specific playlist through a high-quality Bose sound system with noise-cancelling headphones.
Weighted blankets and sensory items available. The space is quiet, calm, and spacious.
Individual integration sessions available and covered by Blue Cross Blue Shield for deeper processing and sustained outcomes.
FDA-Approved Indications
Spravato® is approved for two specific conditions in adults. It is not a first-line treatment — it is designed for people who have tried other antidepressants and not found adequate relief.
Treatment-Resistant Depression
For adults with major depressive disorder who have not responded adequately to at least two antidepressant treatments, tried at appropriate doses and for a sufficient length of time. If you have been through multiple medications without finding meaningful relief, this is what Spravato® was designed for.
Major Depressive Disorder with Acute Suicidal Ideation
For adults with major depressive disorder who are currently experiencing suicidal thoughts or behaviors and need rapid symptom relief. Spravato® is one of the few treatments with demonstrated ability to reduce suicidal ideation quickly, often within hours of the first session.
Spravato® can be used a standalone treatment. There is no need to change your current antidepressant regimen before adding spravato.
Because of its safety profile, Spravato® can only be dispensed and administered in certified healthcare settings enrolled in the Spravato REMS program. We are a certified site.
For Patients & Providers
Whether you're seeking relief yourself or looking for a trusted partner for your patient, we're here to help.
You don't have to keep trying treatments that aren't working
If you've been living with depression and standard antidepressants haven't been enough, Spravato® may offer the kind of relief that has felt out of reach. We offer a free consultation to help you figure out whether it's a good fit for you, no commitment required.
- FDA-approved and covered by Blue Cross Blue Shield
- Administered in our comfortable, supportive Providence office
- No need to stop your current antidepressant
- Rapid onset — many people notice a shift within the first few sessions
- Integration support available to help you make the most of your treatment
A trusted, collaborative partner for your most treatment-resistant patients
We welcome referrals from psychiatrists, therapists, primary care providers, and other clinicians. We will stay in close communication with you throughout your patient's care, and integration therapy is available alongside Spravato® sessions for those who want it.
- REMS-certified Spravato treatment site
- Prompt evaluation, typically within 1-2 weeks of referral
- Collaborative, ongoing communication with referring providers
- Integration therapy available as an add-on service
- We accept Blue Cross Blue Shield and self-pay; prior authorization support provided
Frequently Asked Questions
How is Spravato® different from the ketamine treatment you already offer?
Is Spravato® covered by insurance?
What does the experience feel like?
Who is not a good candidate for Spravato®?
How long does treatment last?
Do I need a referral to get started?
SPRAVATO® is a registered trademark of Johnson & Johnson and its affiliated companies. © Janssen Pharmaceuticals, Inc. PVD Ketamine & Wellness is an independent REMS-certified treatment site and is not affiliated with Janssen Pharmaceuticals or Johnson & Johnson. This page is for informational purposes only and does not constitute medical advice. Please consult a qualified healthcare provider to determine whether Spravato® is appropriate for you.