A Patient's Journey Through SPRAVATO® Treatment at Greenbrook

Step 1: Initial Evaluation

The first step is to talk to your primary care provider or mental health provider about SPRAVATO®. They can refer you to one of our clinics by filling out a short form on our website. You can also refer yourself by completing a similar form here: https://www.greenbrooktms.com/esketamine-form 

Once this is completed, a member of the Greenbrook Care Team will reach out to you to gather preliminary information and schedule a pre-assessment with a Greenbrook medical provider. During this pre-assessment, we will evaluate whether SPRAVATO® is a viable treatment option for you. Certain conditions, such as uncontrolled high blood pressure, may make treatment a risk. We will discuss the risks and benefits of treatment with you, and together, you and your provider will decide whether to move forward. 

Once approved for treatment, our Care Team will work with your insurance and pharmacy to ensure your medication is available. When you arrive at your local Greenbrook center, you will meet your Behavioral Health Technician (BHT) who will take you to your treatment room and check your vital signs to ensure safe treatment. 

Your first SPRAVATO® treatment (the induction treatment) will be administered nasally at either 56 mg (two sprayers) or 84 mg (three sprayers). Our team will walk you through the procedure, including how to properly use the SPRAVATO® nasal device. We even provide a trainer sprayer with no medication for practice. Any questions or concerns you have will be addressed before starting. When you are ready, we will hand you the SPRAVATO® nasal sprayer to begin your first treatment. 

Following your treatment, you will remain under mandatory observation at Greenbrook for two hours. This allows our team to monitor for potential side effects, such as dissociation, sedation, or nausea. 



Side effects typically peak around 40 minutes after treatment begins. At that point, we will check your vital signs and ensure you are feeling okay. We will conduct another check at the two-hour mark before you are cleared to leave with your pre-arranged ride. Throughout the observation period, a provider and BHTs will be available to assist you as needed. 

The standard regimen for SPRAVATO® starts with twice-weekly treatments for the first month, known as the induction phase. After the first month, you will enter the maintenance phase, where the frequency decreases to once a week. From there, you and your Greenbrook provider will tailor your treatment plan based on your individual needs. 

It is difficult to predict exactly how SPRAVATO® will affect everyone. Many patients report improved depression symptoms over time. Some find relief within just a few treatments, while others take longer to notice positive effects. Some may experience side effects, while others may not have any. It is important to communicate with your Greenbrook Care Team about any effects, both positive and negative, so they can adjust your treatment plan accordingly.