Are You a Candidate for Spravato Treatment?

Spravato is typically considered when an individual meets the criteria for treatment-resistant depression. This means the patient has tried two or more oral antidepressants, at appropriate doses and durations, without significant relief. The decision to move forward with Spravato, administered nasally and in a controlled environment, usually comes after a detailed review of what previous treatments were attempted, how symptoms have shifted, and whether the depression continues to disrupt functioning despite ongoing care. It is not used as a first step, instead, it may be considered when other interventions have lost their effectiveness.

The diagnosis must also align with major depressive disorder, with or without suicidal thoughts. Other forms of depression may be present, but Spravato is typically prescribed for major depression that resists standard medication therapy. Even within this group, providers assess whether the patient’s mental and physical health supports the introduction of this treatment. Certain underlying conditions may also need to be taken into account before a final decision is made.

At Psychiatry of the Palm Beaches, the treatment team looks at the full context of the patient’s condition and health. They consider how long symptoms have lasted, the degree of impairment they cause, and whether the patient has engaged with talk therapy or other supportive approaches. If medication after medication has failed to offer real improvement, the possibility of Spravato may be explored as part of a new direction.

To determine eligibility for Spravato, providers conduct a thorough psychiatric evaluation that includes a full medication history, physical health status, and current symptom patterns. The patient’s responses to previous medications are also documented to confirm treatment resistance and to better understand which classes of drugs were tried and what side effects, if any, developed. This allows for a better sense of how the patient’s brain chemistry has interacted with past medications, which is a key part of deciding whether a different mechanism like Spravato might offer relief.

Assessment also includes a review of physical health. Blood pressure, cardiovascular function, and any history of substance use are considered. Because Spravato is administered intranasally and monitored in a clinic setting, the individual’s comfort with that process and ability to participate in scheduled treatments are also part of the discussion. Providers may also use clinical screening tools to measure the severity of symptoms, including mood disturbances, anxiety overlap, suicidal ideation, and sleep disruption. Spravato requires consistency and oversight, so confirming readiness is also a part of the process.

Spravato is approved for use in adults, 18 years or older. For older adults, the eligibility criteria remain the same, although providers may take additional steps to monitor cardiovascular health or evaluate how age-related changes in metabolism might influence treatment response. The decision to prescribe any medication takes into account the individual’s complete medical profile, including any coexisting conditions or medications that could interact with the treatment. Cognitive function and mobility may also be assessed to ensure the individual can safely participate in monitored sessions.

At Psychiatry of the Palm Beaches, the approach to age involves a number of considerations about the broader clinical picture. The treatment team evaluates age and mental health history, physical health status, and the individual’s ability to engage in ongoing care. While the medication is approved for adults broadly, each case is treated with a personalized lens to determine whether Spravato fits into the overall care plan.

Many individuals living with treatment-resistant depression also experience symptoms of anxiety or have a history of trauma. While Spravato is not specifically approved to treat PTSD or generalized anxiety disorder on their own, it may still be considered when depression is the primary condition and other coexisting symptoms are present. In these cases, the response to treatment is closely observed to determine whether both mood and anxiety symptoms shift as care progresses.

For those with PTSD, careful evaluation is necessary. Some individuals may have trauma-related symptoms that intensify during specific treatments, so providers look for patterns in how the patient has responded to past medications or therapy. The controlled environment in which Spravato is administered allows providers to intervene quickly if distressing reactions occur, which adds a layer of safety for individuals with complex psychiatric histories.

At Psychiatry of the Palm Beaches, the treatment team evaluates how mental health conditions interact in each patient’s life. When anxiety or PTSD symptoms are part of the larger picture, the care plan is adjusted accordingly.

Spravato treatment is available at Psychiatry of the Palm Beaches. For more information, contact us or schedule an appointment online. We have convenient locations to serve you in Boynton Beach, FL, Royal Palm Beach FL, and Palm Beach Gardens, FL. We serve patients from Boynton Beach FL, Palm Beach Gardens FL, Royal Palm Beach FL, Delray Beach FL, Lake Worth Beach FL, Juno Ridge FL, North Palm Beach FL, Golden Lakes FL, Westlake FL, and surrounding areas.