Stop Suffering & Start Healing Give us a call  (888) 280-2585
A private, monitored Spravato treatment room at Bishop Health
Interventional Psychiatry · FDA-Approved

Spravato Treatment in Portland, Maine

FDA-approved esketamine nasal spray for treatment-resistant depression — taken in a private room, monitored by our clinical team, often covered by insurance.

Spravato is the FDA-approved esketamine nasal spray for treatment-resistant depression, taken in-office under clinical supervision. At Bishop Health in South Portland, every visit includes a two-hour monitored rest period in a private room, and treatment can begin as early as your second appointment. Most insurance plans cover Spravato with prior authorization.

Is Spravato Right for You?

Spravato tends to be a strong fit if…

You've tried two or more antidepressants without adequate relief
You want a treatment that works faster than oral medication
You'd prefer an FDA-approved option your insurance can cover
You can arrange a ride home after each visit
You can commit to twice-weekly visits for the first month

Spravato is not the right tool if…

You have uncontrolled high blood pressure, or a history of aneurysm or certain vascular conditions
Your primary concern is substance use rather than depression
You're pregnant or planning pregnancy — we'll walk through safer alternatives
You can't arrange transportation — driving after treatment isn't permitted until the next day

All of this is screened at your evaluation — blood pressure is also checked at every treatment visit.

How a Spravato Visit Works

Plan on about two and a half hours per visit — the spray itself takes minutes; the rest is supervised, unhurried recovery time.

Arrive

Check-in & vitals

Blood pressure check, a brief mood review, and you settle into your private room.

Treat

Self-administered spray

You take the nasal spray yourself under clinician guidance — one or more devices, minutes apart.

Rest

2-hour monitoring

Recline, dim the lights, use a weighted blanket if you like. Staff check on you throughout; vitals are rechecked before you leave.

Head home

Your ride drives

No driving or machinery until the next day, after a full night's sleep — arrange your ride before each visit.

The treatment schedule

Weeks 1–4 · Induction

Two visits per week. Treatment can begin as early as your second appointment with us, once evaluation and authorization clear.

Weeks 5–8

Visits step down to once weekly as your response is tracked at every appointment.

Month 3 onward · Maintenance

Weekly or every-other-week, tailored to how well your response holds. Many patients continue long-term.

Safety & Side Effects

Spravato is dispensed only through a federally supervised safety program (REMS), which is why every dose happens here under monitoring — never at home.1

Dissociation — feeling detached or dream-like for 30–60 minutes after dosing; it passes during monitoring
Dizziness, nausea, or sleepiness the day of treatment
A temporary rise in blood pressure — checked before and after every dose

Most side effects resolve before you leave the office the same day. Anything persistent gets flagged to your prescriber immediately.

Coverage

Insurance & Cost

Because Spravato is FDA-approved, most commercial plans and MaineCare cover it for treatment-resistant depression — nearly always with prior authorization documenting your prior medication trials.

We run the authorization for you and confirm your out-of-pocket cost before treatment starts. Manufacturer copay assistance can bring commercial copays down substantially; we'll tell you if you qualify.

Insurance & payment details →

Spravato or TMS?

Different mechanisms, schedules, and coverage — see them compared honestly, side by side.

See the comparison →
Spravato at Bishop Health treats: Treatment-Resistant DepressionDepressionDepression with Suicidal Thoughts

Your Spravato Team

MC

Melissa Cunningham, PMHNP-BC

Psychiatric Nurse Practitioner · Oversees treatment visits and coordinates your ongoing medication plan

★★★★★
“The kindness of everyone there consistently reminds you it's a safe space. It helped me through one of the hardest seasons of my life. I highly recommend this resource to anyone who needs it. They genuinely care.”
O. Emerson C. · Therapy · Google review
★★★★★
“Bishop saved my life. The social workers/clinicians/staff showed they all care and love for each individual. I am so lucky and grateful.”
Alanna O. · IOP · Google review

Spravato Questions, Answered

What does dissociation feel like?

Often like watching yourself from a slight distance — floaty, dream-like, sometimes with altered perception of time. It peaks in the first half hour and fades during monitoring. Many patients find it strange but not distressing, especially in a quiet, private room.

Why can't I drive after treatment?

Esketamine temporarily affects attention, judgment, and reaction time — beyond what you may subjectively notice. The FDA label requires no driving or operating machinery until the next day, after a full night's sleep. Plan your ride before each visit; treatment can't proceed without one.

How fast does it work?

Faster than oral antidepressants — some patients notice a shift within the first week or two of induction. Response is measured at every visit, so you and your prescriber will know early whether it's working rather than waiting months.

Do I keep taking my antidepressant?

Yes — Spravato is approved for use alongside an oral antidepressant, not instead of one. Your prescriber manages both together, which is easier when they're the same person, as they are here.

How long is each appointment, really?

Budget about two and a half hours: check-in and vitals, the spray itself, then the required two-hour monitoring period before you're cleared to leave with your ride.

Can I eat or drink before a visit?

We'll ask you not to eat for about two hours before treatment and to limit liquids shortly before — nausea is a known side effect and an empty-ish stomach helps. You'll get exact instructions at your evaluation.

How quickly can I start?

Treatment can begin as early as your second visit — evaluation first, then treatment once prior authorization clears, which typically takes one to two weeks. Admissions can usually schedule your evaluation within two weeks of your first call.

References

  1. U.S. Food & Drug Administration. Spravato (esketamine) approval for treatment-resistant depression (2019) and depressive symptoms in MDD with acute suicidal ideation or behavior (2020); REMS requirements.
  2. Popova V, et al. Efficacy and safety of flexibly dosed esketamine nasal spray combined with a newly initiated oral antidepressant in treatment-resistant depression (TRANSFORM-2). American Journal of Psychiatry. 2019;176(6):428–438.
  3. Daly EJ, et al. Efficacy of esketamine nasal spray plus oral antidepressant treatment for relapse prevention in patients with treatment-resistant depression (SUSTAIN-1). JAMA Psychiatry. 2019;76(9):893–903.