Who Qualifies for Spravato Treatment? Patient Eligibility Explained
Who Qualifies for Spravato Treatment?
Who Qualifies for Spravato Treatment? Patient Eligibility Explained
This article helps you understand who may be eligible for Spravato treatment. It explains the main criteria in simple words. It shows what information your clinician will need and why the evaluation is always done in person at a clinic. By the end, you will know what treatment resistant depression means, what safety checks happen, and how to prepare so your first appointment is smooth and stress free. Every plan is personalized, so the final decision is made after a careful clinical review.
What Treatment Resistant Depression Means
Clear Definition
Treatment resistant depression means you have tried at least two different antidepressants at the right dose and for the right amount of time, but your symptoms did not improve enough. Right dose means your clinician increased the medicine as needed and monitored you. Right time means you stayed on the medicine long enough to see if it would help. If there was no improvement or only partial relief after two proper trials, your depression may be called treatment resistant.
Why This Matters For Eligibility
Spravato is designed for adults with treatment resistant depression. That is why your past treatment history is so important. It shows what has been tried and how your symptoms responded. It also helps your clinician build a plan that makes sense for you. If you have a clear record of at least two adequate trials without enough relief, you may meet a key eligibility step for Spravato.
Core Eligibility Criteria
Adult Patients With Treatment Resistant Depression
Spravato is for adults. You need a diagnosis related to major depressive disorder with a history of limited response to prior antidepressants. Your clinician will ask for details about each trial. This includes the names of the medicines, doses, how long you took them, and what benefits or side effects you noticed. This documentation helps confirm treatment resistance. It also guides dose selection and timing if Spravato is started.
Major Depression With Suicidal Thoughts Or Actions
Spravato can also be considered for adults who have major depressive disorder with suicidal thoughts or actions, as part of a focused care plan. In this situation, the goal is to reduce depressive symptoms quickly while keeping you safe and supported. Your team will build a safety plan, increase follow ups, and involve family or trusted supports when appropriate. You will still need a full clinical evaluation to confirm that Spravato is a good fit.
Spravato Is Used With An Oral Antidepressant
Spravato is not used alone. It is paired with an oral antidepressant. This combination supports both early symptom relief and ongoing stability. Your clinician will review your current medicine, adjust it if needed, and explain how Spravato sessions fit into your weekly routine. Therapy remains important, because it helps you build skills that make progress last.
Medical and Safety Screening
Blood Pressure and Cardiovascular Considerations
Your blood pressure and heart health matter during Spravato sessions. Blood pressure can rise for a short time after dosing. That is why staff check your vital signs before and after each session. If you have a history of uncontrolled blood pressure or certain heart conditions, your clinician will review this carefully and may coordinate with your primary care provider or a cardiologist. The goal is to keep you safe from the first dose onward.
Liver, Respiratory, and Other Medical History
Your team will also ask about liver health, breathing issues, and any recent surgeries or hospitalizations. They will review allergies and previous reactions to medicines. This helps them tailor your plan and anticipate any extra monitoring you might need. Share any history of head injury, seizure, or sleep apnea. Full information helps your clinician decide if Spravato is appropriate and how to deliver it safely.
Substance Use and Medication Interactions
Tell your clinician about alcohol use, recreational substances, and all prescription or over the counter medicines you take. Some substances and medicines can interact with Spravato or raise safety concerns. Your clinician’s job is not to judge you. It is to keep you safe. Honest information allows the team to adjust timing, dose, or even delay treatment if needed. If substance use is active, your clinician may recommend extra support before or alongside Spravato.
Situations That May Affect Eligibility
Pregnancy or Breastfeeding
If you are pregnant, planning pregnancy, or breastfeeding, share this at once. Your clinician will discuss risks and possible alternatives. The timing of treatment and the choice of therapies may change based on these plans. The focus is always on safety for you and your family.
Inability To Arrange Transportation
You cannot drive on the day of a Spravato session. You will need a trusted adult to take you home. If reliable transportation is not available, your team will help you think through options. Without a safe ride, Spravato sessions cannot proceed. Planning transport early prevents last minute cancellations.
Challenges With Clinic Attendance
Spravato follows a structured schedule. Most people have two sessions per week during the first month. Many then shift to weekly sessions for a few weeks, followed by maintenance sessions every one to two weeks. If your schedule cannot support these visits, your team will discuss other options or help you remove barriers. Consistency is important for results, especially in the first eight weeks.
Practical Evidence You May Need For Approval
Prior Treatment Records
Bring a list of the antidepressants you have tried. Include the generic and brand names, doses, start and stop dates, and any side effects. Add notes on what did or did not help. If you have records from past clinicians, gather those as well. Clear records help confirm treatment resistance and speed up insurance approval.
Therapy History and Current Supports
Share your therapy history and current supports. This includes the type of therapy you do, how often you attend, and the skills you are practicing. It also includes support from family, trusted friends, or community groups. This information shows that you have a comprehensive care plan. It also helps your clinician coordinate care for the best outcome.
Insurance Documentation
Many insurance plans require prior authorization for Spravato. The plan often asks for proof of previous antidepressant trials and a current diagnosis. Our team can help you check benefits, submit documents, and follow up. Ask about copays, deductibles, and patient assistance programs. When the financial plan is clear, you can focus on your health and not on paperwork.
What Happens If You Are Not Eligible Right Now
Alternative Options
If Spravato is not the right fit today, your clinician will not leave you without a plan. There are other medication strategies that can help. These include trying a different class of antidepressants, adding an adjunct medicine, or changing dose and timing. Therapy can also be adjusted to match your current symptoms. For some patients, TMS therapy may be an option, depending on diagnosis and history. Your team will explain each choice in simple terms.
Reassessment Later
Eligibility can change. If today’s barriers are medical, your clinician may revisit Spravato after those issues are treated or stabilized. If the barriers are practical, such as transportation or schedule, the clinic can help you solve them. If you prefer to wait, that is also okay. Your team will continue to support you and reassess when you are ready. The goal is steady progress at a pace that feels safe to you.
How To Prepare For Your Evaluation
Simple Checklist
Use this checklist to make your first visit easy and productive.
Medication list with current doses and timing.
Record of past antidepressant trials with dates, doses, and results.
Summary of therapy history and current supports.
List of medical conditions, surgeries, allergies, and hospitalizations.
All prescription and over the counter medicines, vitamins, and supplements.
Information about alcohol or substance use, if any.
Questions you want to ask about eligibility, dosing, and safety.
A plan for transportation on treatment days and a calm evening at home.
Bring a notebook or use your phone to jot down answers. Clear information helps your clinician decide quickly and safely. For step by step guidance on the process after you qualify, see our internal guide How to Start Spravato Treatment. For quick answers to common concerns, see Spravato FAQs.
Spravato Treatment at Evolve Psychiatry
Eligibility for Spravato treatment is based on your personal history, current symptoms, and safety needs. Adults with treatment resistant depression often qualify when they can show two proper antidepressant trials without enough relief. Adults with major depression and suicidal thoughts may be considered as part of a focused safety plan. A clinic evaluation reviews blood pressure, heart health, medical history, medicines, and practical supports such as transportation. If Spravato is not the right fit today, your team will offer other options and reassess later. The goal is always the same. You deserve a plan that is clear, safe, and designed for your recovery.
Book an in clinic eligibility review at Evolve Psychiatry. We provide Spravato treatment in person at six locations. Visit us and our team will review your history, explain each step, help with insurance documents, and plan your first visit so you can move forward with confidence.
