Find out how we assess candidacy for Spravato for TRD and what to expect from safe in clinic care in Atlanta and Decatur.
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If you live with depression that has not improved with standard meds, you are not alone. Many adults keep trying and still feel stuck. Spravato for TRD is a nasal spray used in a clinic setting. It may help when two or more antidepressants did not work. At Atlanta Spravato and TMS Center, we follow a clear path to decide if Spravato for TRD is right for you. We use simple language, careful screening, and a team that guides you step by step. (FDA Accessdata)
What Spravato is and when it is used
Spravato is esketamine. It targets NMDA receptors in the brain. It is a controlled medicine in class CIII. You take it by nasal spray in a certified clinic with close monitoring. The Food and Drug Administration lists Spravato for treatment resistant depression in adults. It can be used alone or with an oral antidepressant. It is also used with an oral antidepressant for major depressive disorder with acute suicidal thoughts or behavior. It is not approved for children. (FDA Accessdata)
Spravato sessions include dosing and observation in the clinic. You stay at least two hours after each dose. Your blood pressure is checked. Your breathing is checked. You cannot drive until the next day after a restful sleep. These safety steps are required by the Spravato REMS program. (FDA Accessdata)
Who we consider for Spravato for TRD
We look for adults with major depression who have not improved after several good trials of antidepressants. Many sources describe TRD as depression that does not respond after two adequate trials. That means the right dose and enough time. We confirm your history with care. We also consider your current symptoms, risks, and goals. (PsychiatryOnline)
If you have major depression with urgent suicidal thoughts, Spravato may be considered along with an oral antidepressant. Note that Spravato has not been proven to prevent suicide. Hospital care may still be needed. Your safety is always first. (FDA Accessdata)
How our candidacy assessment works
Our assessment has four parts. Each part uses simple questions and objective checks.
History and goals
We ask about your depression history, past meds, side effects, therapy, hospital stays, and supports. We confirm what you want from care. We want to know what better looks like for you.Medication and treatment review
We list each antidepressant you tried. We record dose and time on the medicine. We note add on meds like mood stabilizers or atypical antipsychotics. We also review therapy, TMS, and ECT if used. This helps us confirm TRD status based on adequate trials.Medical and safety screening
We check blood pressure and heart history. We ask about stroke or aneurysm. We ask about bleeding in the brain. We ask about liver issues. We review substance use and sleep. We review pregnancy plans. Some conditions mean Spravato is not safe. We also check current meds to avoid drug interactions. Spravato can raise blood pressure and can cause sedation and dissociation. This is why we monitor you for at least two hours after each dose. (FDA Accessdata)Practical fit and support
Spravato needs regular clinic visits in the first month. We confirm you can attend. We confirm you have a support person to drive you home on treatment days. We help with scheduling and insurance steps.
Red flags that may delay or rule out Spravato
There are times when we do not start Spravato. Your safety guides the call.
Aneurysm or arteriovenous malformation
History of bleeding in the brain
Uncontrolled high blood pressure
Severe heart or brain disease where a blood pressure rise is risky
Allergy to ketamine or esketamine
Pregnancy or plans to become pregnant soon
Current misuse of drugs or high risk of misuse
These items are based on FDA guidance and our clinical judgment. We will explain each point in plain language and offer other options when needed. (FDA Accessdata)
What you can expect at our clinic
We support telehealth for evaluation across Georgia. This makes the first steps easier. Treatments take place in person in Atlanta and Decatur. Here is the usual flow.
Telehealth intake
We meet by secure video if you live in Georgia. We review your history and complete screening forms. We plan labs and any needed notes from prior doctors. We set goals for the first eight weeks.In person medical visit
We meet you at our Atlanta or Decatur location. We recheck vitals and confirm the plan. We review how Spravato works and what you may feel during a session. We answer all questions.First treatment day
You use the nasal spray in a calm room with our staff present. We check blood pressure before and after dosing. Many people feel light, tired, or detached for a short time. This is called dissociation. We watch your breathing and how you feel. You rest for at least two hours. You do not drive until the next day after a good sleep. (FDA Accessdata)The first month
Most people come twice a week for four weeks. We track symptoms with simple scales. We adjust the dose when needed. We watch for blood pressure spikes, nausea, and dizziness. We coordinate with your therapist or primary doctor if you agree. The FDA advises that we check benefit at the end of week four to guide next steps. (FDA Accessdata)Ongoing care
If you respond, we move to weekly or every other week. If there is little change, we will discuss options. These include TMS, medication changes, and therapy plans.
How we measure response and decide to continue
We use several measures to track change.
Symptom scales
We use common tools to track mood, sleep, focus, and energy. This gives clear numbers you can see over time.Function check
We ask how you feel at work, at home, and with friends. We look at energy and motivation. Small gains still matter.Side effect check
We ask about nausea, dizziness, and dissociation. We track how long these last. Most effects peak around forty minutes after dosing and fade by about four hours. (FDA Accessdata)Shared decision
At the end of the first month we review your progress and your goals. We decide together to continue, adjust, or switch.
Safety steps we follow every visit
Blood pressure before dosing
Blood pressure check at about forty minutes
Continued checks as needed for at least two hours
Pulse oximetry to watch breathing
Staff at your side for support
Clear rules on no driving until the next day after a restful sleep
These steps follow the Spravato REMS program and FDA label. (FDA Accessdata)
Common questions we hear
Will I feel different right away
Some people notice a lift within the first day. Others need several sessions. Results vary. We will monitor week by week and set realistic goals together. The FDA label supports a check of benefit after the first month to guide the plan. (FDA Accessdata)
How does Spravato compare to TMS or ECT
These are different tools. Spravato is a medicine. TMS uses magnetic pulses on the scalp. ECT uses brief controlled seizures under anesthesia. Each has its own use cases. We offer TMS on site and will explain which fits your history and goals. For many adults with TRD, a thoughtful sequence of options is needed. That is normal. (PMC)
Is Spravato safe with my current meds
We check your list for blood pressure effects and for medicines that increase sedation. We coordinate with your other doctors when needed. The label warns about blood pressure rise and sedation risk. We follow those rules. (FDA Accessdata)
Can I do therapy during Spravato
Yes. Many people keep therapy while on Spravato. Therapy can support coping skills and relapse prevention. National mental health guidance supports a mix of treatments for many people. (National Institute of Mental Health)
When Spravato for TRD is not the next step
Sometimes the best next step is different. Reasons include medical risk, lack of access to rides, or your preference. We will map other paths. Options can include TMS, a new medicine plan, or therapy. If you ever have active suicidal thoughts, urgent help is the priority. The FDA has not shown that Spravato prevents suicide. Hospital care may still be needed. Call 988 for the Suicide and Crisis Lifeline if you are in the United States. Use your local emergency number if you are outside the United States. (FDA Accessdata)
Why choose Atlanta Spravato and TMS Center
Local access in Atlanta and Decatur
Telehealth intake across Georgia for evaluation
A calm setting with private rooms
A trained team that follows the FDA label and REMS rules
Clear updates to your referring clinician if you agree
Support with insurance and scheduling
A full range of options including TMS and medication management
How to start in three simple steps
Book a telehealth evaluation if you live in Georgia
Bring your med list and a history of prior treatments
Plan for a support person to drive you home on treatment days
You can learn more about Spravato basics on our Spravato page and see what to expect on a visit. Read the Spravato overview and the what to expect guide on our site for more details.
Key takeaways you can trust
Spravato for TRD can help when standard meds have not given enough relief. The right fit comes from careful screening, safe in clinic dosing, and steady follow up. At our center in Atlanta and Decatur, we combine evidence based care with a kind and simple process. If you think you may be a fit for Spravato for TRD, reach out today. We are ready to help. (FDA Accessdata)
Helpful sources for you
Read the FDA label for Spravato. It explains who it is for, how it is given, and how we keep you safe. (FDA Accessdata)
See depression facts from NIMH. It shows how common this illness is and why treatment matters. (National Institute of Mental Health)
See recent data on depression from CDC. It shows how many people are affected in the United States. (CDC)
Local service details
Telehealth evaluation across Georgia.
In person treatments in Atlanta and Decatur.
This helps you start fast and stay on track.
If you are in or near Atlanta or Decatur and want to see if Spravato for TRD fits your needs, schedule a telehealth evaluation now. Our team will listen, guide, and support your next step.
