Spravato

Spravato

SPRAVATO® (esketamine) CIII Nasal Spray is the only FDA-approved treatment used as monotherapy or in conjunction with an oral antidepressant for adults with treatment-resistant depression and for depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior in conjunction with an oral antidepressant.

Resources Provider Order Form

Sage Elevate Referral Pathways

Pathway 1: Evaluation & Treatment

Best-in-class, coordinated care model
Same-day welcome call to verify demographics and insurance
Appt with Licensed provider for evaluation for Spravato® treatment plan
Contraindications reviewed per Prescribing Information
Treatment in REMS-certified, serene, spa-like facility
Treatment note provided within 24 hours
Sage Elevate manages Spravato® dosing while referring provider overall treatment plan.
Care collaboration

Pathway 2: Provider-Directed Spravato® Administration

Provider submits order with dose and frequency
Same-day welcome call to verify demographics and insurance
Office notes reviewed for clinical eligibility
Patient education provided including driver required, 2-hour observation, fasting requirements
Treatment delivered in REMS-certified, spa-like facility
Treatment note provided within 24 hours
Referring provider retains all clinical and dosing decisions

Referral Form

Administration Information

To ensure safe and appropriate use, SPRAVATO® nasal spray is administered only at REMS-certified treatment centers

After taking SPRAVATO®, patients are monitored and evaluated by a healthcare provider for at least 2 hours until patients are safe to leave

Treatment involves multiple sessions, with the frequency and duration varying depending on the individual patient's needs and the specific indication.

Weeks 1-4

Two times per week

Weeks 5-8

Once per week

Weeks 9+

Ongoing Maintenance
Once per week or every 2 weeks

Potential Side Effects

SPRAVATO® may cause increased blood pressure, sedation or loss of consciousness. In some cases, patients may display diminished or less apparent breathing. Other side effects may occur.

See a full list of serious side effects on the drug manufacturer website.

Helpful Resources

What is Spravato?

Patient Support

Patient Referral Form

Spravato Treatment Consent Form

Patient Forms

Before you attend your first appointment at Sage Elevate, please make sure to review the documents below. The Behavioral Health Consent Form, Patient Consent Form and HIPAA Privacy Authorization Form need to be filled out and signed ahead of your appointment, whereas the other forms are for reference only. Please contact us if you have any questions.