Stedfast Psychiatry patients in Jupiter receive Spravato at our Palm Beach Gardens office, about 15 minutes away; the evaluation and prior authorization happen in Jupiter or by video. Spravato is FDA-approved for treatment-resistant depression in adults. Sessions are twice weekly for the first four weeks, then weekly or every two weeks, each with at least two hours of in-office monitoring and a ride home.
How Jupiter patients get Spravato
For Jupiter patients, Spravato is delivered at our Palm Beach Gardens office, 11641 Kew Gardens Ave, Suite 209, about 15 minutes by car. The evaluation, screening scales and insurance authorization are done at the Jupiter office or by video, so you only travel for the treatment sessions.
The Jupiter office at 3893 Military Trail, Suite 3 serves Jupiter Inlet Colony, Egret Landing, Loxahatchee Club, Jupiter Country Club and Rialto and the surrounding communities of Tequesta, Juno Beach, Palm Beach Gardens, Hobe Sound and North Palm Beach. Jupiter Medical Center is a useful landmark for first-time visitors.
The Jupiter team includes psychiatrist Dr. David Husted, psychiatric nurse practitioner Hannah Ray and physician assistant Makenzie Cummings. Any of them can determine whether you meet the criteria for treatment-resistant depression and refer you to the Spravato team.
Who qualifies
Spravato is for adults 18 and older with treatment-resistant depression, which the FDA label defines as major depressive disorder that has not responded adequately to at least two different oral antidepressants taken at a proper dose for a proper length of time in the current episode. It is also approved for adults with major depressive disorder who are having acute suicidal thoughts or behavior, where the goal is to reduce depressive symptoms quickly while a longer-term plan takes hold.
It is not approved for bipolar depression, PTSD, generalized anxiety disorder or OCD, and we do not prescribe it off-label for those conditions. Before starting, we check your blood pressure history, cardiovascular and cerebrovascular history, substance use history and current medications. People with aneurysmal vascular disease, an arteriovenous malformation or a history of bleeding in the brain cannot take it. People with uncontrolled high blood pressure, a history of substance use disorder, or who are pregnant or breastfeeding need a careful conversation first.
How Spravato works
Ketamine is a mixture of two mirror-image molecules, S-ketamine and R-ketamine. Esketamine is the purified S form, which binds more tightly to its target. That target is the NMDA receptor, a docking site for glutamate, the brain's main excitatory chemical messenger. By briefly blocking NMDA receptors on a specific set of inhibitory neurons, esketamine triggers a surge of glutamate signaling in the prefrontal cortex. That surge switches on growth pathways (BDNF and mTOR are the ones most studied) that help neurons regrow the connections, called synapses, that chronic stress and depression wear down.
The practical result is a drug whose antidepressant effect can begin within hours to days rather than weeks. The dissociation and dizziness you may feel during a session are a separate, short-lived effect of the same receptor action and clear within about two hours. Spravato is a Schedule III controlled substance, which is one reason it is only given in a certified office and never sent home.
Esketamine nasal spray (Spravato) was FDA-approved on March 5, 2019 for treatment-resistant depression with an oral antidepressant, on August 3, 2020 for major depressive disorder with acute suicidal ideation or behavior, and on January 21, 2025 as a standalone treatment for treatment-resistant depression.
Source: U.S. Food and Drug Administration, NDA 211243 approval letters
In TRANSFORM-2, esketamine plus a new oral antidepressant improved MADRS depression scores by about 4 points more than placebo plus a new antidepressant at day 28, with remission in 52.5 percent versus 31 percent of patients.
Source: Popova et al., American Journal of Psychiatry, 2019
In SUSTAIN-1, patients in stable remission who continued esketamine had a 51 percent lower risk of relapse than those switched to placebo (26.7 percent versus 45.3 percent relapsed).
Source: Daly et al., JAMA Psychiatry, 2019
In ESCAPE-TRD, 27.1 percent of patients on esketamine reached remission at week 8 compared with 17.6 percent on extended-release quetiapine, and 21.7 percent versus 14.1 percent stayed relapse-free through week 32.
Source: Reif et al., New England Journal of Medicine, 2023
What a session is like
Your first visit is an evaluation with one of our psychiatrists or psychiatric nurse practitioners to confirm the diagnosis, document prior antidepressant trials, review your medical history and check your blood pressure. We handle REMS enrollment and insurance prior authorization before your first dose.
On treatment days, do not eat for two hours before your appointment or drink liquids for 30 minutes before. You will self-administer the spray under supervision: one device (28 mg) per nostril, with a five-minute rest between devices. The first session is 56 mg; later sessions are 56 or 84 mg depending on your response and tolerance. You then rest in a reclining chair for at least two hours while staff check your blood pressure and how you feel. Dissociation, dizziness and sleepiness usually peak within the first 40 minutes to an hour and settle by the end of monitoring. You must have someone drive you home, and you cannot drive until the next day after a restful night's sleep.
Cost and insurance
Spravato has two cost components: the drug itself and the office fee for supervised administration and two hours of monitoring. Most commercial plans cover Spravato for treatment-resistant depression after prior authorization that documents your diagnosis and at least two failed antidepressant trials. Medicare Part B covers it when it is given in our office, with the drug and monitoring billed together under specific HCPCS codes; you are responsible for the Part B deductible and 20 percent coinsurance unless a supplemental plan picks that up. Medicare Advantage plans generally cover it but usually require their own prior authorization.
Janssen, the manufacturer, runs a savings program that can bring the per-treatment drug cost to as little as $10 for eligible patients with commercial insurance; it is not available to Medicare or Medicaid patients by federal rule. Our team verifies your benefits and tells you your expected cost before the first session. Self-pay pricing is available on request. Visit our Spravato cost, insurance and Medicare page for a full breakdown.
Read the full Spravato guide, including cost, insurance and Medicare, side effects and safety and Spravato vs ketamine infusions.
Frequently asked questions
Where do Jupiter patients go for Spravato sessions?
Treatment sessions are at our Palm Beach Gardens office, 11641 Kew Gardens Ave, Suite 209, about 15 minutes from Jupiter. Because you cannot drive after a dose, plan on a ride or a rideshare. The consultation, screening and insurance work are done at the Jupiter office or by video.
Does insurance cover Spravato in Jupiter?
Most commercial plans and Medicare Part B cover Spravato for treatment-resistant depression with prior authorization documenting at least two failed antidepressant trials. Coverage usually has two parts: the medication and the monitored session. Our team verifies both before your first dose. Call (561) 437-2199 to start.
How do I find out if I am a candidate from Jupiter?
Book a consultation at (561) 332-4129 or by video. The provider reviews your antidepressant history, blood pressure, substance use history and any vascular conditions, which are the main exclusions. If Spravato fits, the Palm Beach Gardens team schedules your induction series.
What is Spravato used for?
Spravato (esketamine) nasal spray is FDA-approved for two uses in adults: treatment-resistant depression, meaning major depressive disorder that has not responded to at least two oral antidepressants, and major depressive disorder with acute suicidal thoughts or behavior. Since January 2025 it can be used alone for treatment-resistant depression; before that it had to be paired with an oral antidepressant. It is not approved for bipolar disorder, PTSD, anxiety disorders or chronic pain, and we do not prescribe it for those.
Is Spravato the same as ketamine?
Not exactly. Ketamine is a mix of two mirror-image molecules. Spravato contains only one of them, esketamine, which is the more potent half at the NMDA receptor. Spravato is given as a nasal spray at a fixed dose in a certified office and is FDA-approved for depression. IV ketamine infusions use the full mixture, are dosed by weight, and are an off-label use not approved by the FDA for depression, which is why insurance rarely covers them.
How long does Spravato take to work?
Faster than oral antidepressants, but not instantly for everyone. In the clinical trials, separation from placebo was measurable within 24 hours in the suicidal ideation studies and by the end of the four-week induction phase in the treatment-resistant depression studies. In practice, many patients notice a shift in mood, energy or hopelessness within the first one to two weeks. We assess your response formally at the end of induction before deciding whether to continue.
How is Spravato administered?
You spray it yourself, under supervision, in our office. Each device delivers 28 mg, one spray per nostril. A 56 mg dose is two devices and an 84 mg dose is three, with five minutes of rest between devices. You cannot take Spravato home. After the dose you stay in a monitored room for at least two hours while staff check your blood pressure and alertness, then a companion drives you home.
Spravato for other Florida cities
If you are in crisis, call or text 988 or go to the nearest emergency room. Spravato is an FDA-approved prescription medicine with a REMS program; results vary. Reviewed by Dr. David Husted.