Spravato in Seattle

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Bellevue Pain and Wellness is one of Seattle, Bellevue, Redmond and Kirkland’s top physician offices administering Spravato (esketamine nasal spray). Spravato is administered and monitored personally by our board certified anesthesiologist and pain management specialist in a controlled, safe and comfortable setting.


Spravato(esketamine nasal spray) is an exciting new therapy that was recently approved by the United States Food and Drug Administration. 


Spravato is FDA approved for treatment of adults with treatment-resistant depression also known as TRD. Additionally Spravato was recently approved for an additional indication, depressive symptoms in adults with major depressive disorder also known as MDD with thoughts or actions of self harm or suicidal thoughts. Spravado is administered gently intranasally with two (56mg) or three (84mg) units each spread 5 minutes apart. Spravato shows efficacy where other medications have not worked to relieve difficult-to-treat depression. 


Our office is proudly registered with the Spravato REMS (www.SpravatoREMS.com) Program which is required for administration of Spravato. REMS is simply a safety monitoring program which typically is used whenever a new therapy becomes available for patient use. That doesn't mean this is something we don't have experience with, however. Intravenous ketamine has been used for decades by anesthesiologists and pain management specialists for treatment of multiple diverse diagnoses including chronic pain, complex regional pain syndrome, chronic headaches including migraines, and bipolar disorder. You may be referred by your psychologist or psychiatrist or you may also self-refer if your insurance allows.


At this time, Spravato is only indicated and used for difficult to treat depression and depression with thoughts of self-harm. Spravado is administered in an induction phase, twice-weekly for the first month, once weekly for the second month and then once weekly or every other week for the third month. After the third month, the patient is able to determine if they would like to continue the therapy based on the response of his or her depression, and then can determine what maintenance schedule will best benefit his or her mood and functionality. Some patients elect for every other week or every month. 


In order to administer Spravato, you and your doctor will need to complete Spravato enrollment form which details the different types of antidepressant medications you've been on in the past as well as other relevant past medical history. Reasons that someone would not be eligible for Spravato might be that the depression has responded well to other medications or the patient has a vascular problem like heart disease, stroke, aneurysm, or uncontrolled high blood pressure. Otherwise most patients are candidates for Spravato treatment. 


Spravado is typically covered by most commercial insurance plans and Medicare however our office will work to verify that your plan will prior authorize your treatment. Once you decide to proceed with your treatment course, you and your doctor will book a time to start your therapy. you typically need a driver to accompany you to your appointment. The administration and monitoring take a total of 2 hours and during that two-hour period of time, you're free to read, listen to music, work on your laptop, or watch a movie. Most patients like to sit back and relax. 


Check out our prior blog post on IV intravenous ketamine here: https://www.bellevuepainwellness.com/blog/ketamine-therapy-an-alternative-approach-to-block-and-reverse-chronic-pain


If you are in the Seattle Bellevue Redmond Kirkland area and you are interested in seeing if you're a good candidate for Spravato/Esketamine, visit our website at www.bellevuepainwellness.com or send us a message at www.bellevuepainwellness.com/contactus. Otherwise, please call 425-998-7884.


Feel free to check out a few other notable blog posts about chronic lower back pain and shooting here: 




Bellevue Pain and Wellness PLLC is a Seattle Redmond Kirkland Bellevue area pain clinic directed by pain doctor, Robert Bowers M.D., who is board certified in pain medicine and anesthesiology by the American Board of Anesthesiology. 


Robert Bowers MD

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