Labyrinth Psychiatry Group and TMS Center · Cranford, NJ
SPRAVATO® (Esketamine) Treatment in Cranford, NJ
SPRAVATO is an esketamine nasal spray for adults with depression that has not improved enough with antidepressants. You take it yourself in the office while a clinician watches, then stay for at least two hours of observation, so plan a ride home.
Who SPRAVATO is for
Adults whose depression has not improved enough with antidepressants.
SPRAVATO is a prescription form of esketamine, a medicine related to ketamine, given as a nasal spray. The FDA has approved it for two groups of adults:
- Treatment-resistant depression. In the FDA studies this meant major depression that had not improved enough after at least two different antidepressants, each taken at an adequate dose for long enough. Since January 21, 2025, SPRAVATO can be used on its own or together with an oral antidepressant.
- Depression with suicidal thoughts or actions. For adults with major depression and acute suicidal thoughts or behavior, SPRAVATO is used together with an oral antidepressant. It has not been shown to prevent suicide, and it does not replace a hospital stay when one is needed.
Labyrinth treats adults only and gives SPRAVATO either on its own or with an oral antidepressant, whichever is right for the individual patient. Whether SPRAVATO fits you is decided at an evaluation, based on your diagnosis, what you have already tried, your medical history, and your safety.
How to start at Labyrinth
From the first call to the first treatment.
- 01
Call or send a request
Call 908-336-1187 or send a request and mention SPRAVATO, so the office can plan the right evaluation.
- 02
Psychiatric evaluation
The psychiatrist reviews your diagnosis, every antidepressant you have tried (the dose, how long, and why it stopped), your medical history, your blood pressure, and your safety. Bring a list of past medications, including ones you stopped because of side effects.
- 03
Insurance approval
SPRAVATO may be covered under your medical benefit or your pharmacy benefit, depending on your plan, and plans can ask for approval before the first treatment. The office staff handle that approval (prior authorization) for you. Depending on your insurance company, it usually takes 1 to 4 weeks from the first call to the first treatment.
- 04
Program enrollment
SPRAVATO is only given through an FDA-required safety program called the SPRAVATO REMS. Patients treated in a medical office are enrolled in it, and the office completes this with you.
- 05
First treatment visit
You take the first doses in the office under direct supervision, then stay for observation. The visit steps are below.
- 06
Review after four weeks
According to FDA guidelines, how well SPRAVATO is working and whether you need ongoing treatment are evaluated at the end of the first four weeks. Your psychiatrist goes over this with you before you decide together whether to continue.
A treatment visit
What happens on a SPRAVATO day.
- 01
Before you arrive
Do not eat for at least 2 hours before a treatment and do not drink liquids for at least 30 minutes before. If you use a steroid or decongestant nasal spray that day, use it at least 1 hour before. Arrange for someone to drive you home.
- 02
Blood pressure check
Your blood pressure is taken before any dose. If it is too high, treatment may wait for another day.
- 03
The doses
You spray the medicine yourself while a clinician watches. Each device gives two sprays, one in each nostril, and holds 28 mg. A 56 mg dose is two devices and an 84 mg dose is three, with a 5-minute rest between devices.
- 04
Observation
You stay in the office for at least 2 hours. The team rechecks your blood pressure about 40 minutes after the dose and watches your breathing and oxygen level. Feeling disconnected, dizzy, or sleepy is common during this time, and so is an upset stomach.
- 05
Going home
You leave when the clinician decides you are stable. Do not drive or operate machinery until the next day, after a night of restful sleep.
The schedule
Eight visits in the first month, then fewer.
- Weeks 1 to 4. Two treatment visits a week.
- Weeks 5 to 8. One treatment visit a week.
- Week 9 onward. One visit a week or every two weeks, at the least frequent schedule that keeps you well.
Each dose is 56 mg or 84 mg, set by your psychiatrist. Plan each visit around the doses plus at least two hours of observation, and around the ride home.
SPRAVATO treatment hours at Labyrinth
- Monday: 9 AM to 5 PM
- Tuesday: 9 AM to 7:30 PM
- Wednesday: 9 AM to 5 PM
- Thursday: 9 AM to 7:30 PM
- Friday: 9 AM to 5 PM
- Saturday: 8 AM to 4 PM
What the research shows
What the studies found, and what they did not.
SPRAVATO with an antidepressant
In TRANSFORM-2, a four-week study that supported the FDA approval, patients started SPRAVATO together with a new oral antidepressant. After four weeks, 63 percent had responded, meaning their depression score fell by at least half, and 48 percent were in remission. Among patients who started the new antidepressant with a placebo spray instead, 50 percent responded and 30 percent were in remission. TRANSFORM-2 results
SPRAVATO on its own
In the study behind the 2025 approval, 22.5 percent of patients using SPRAVATO alone were in remission after four weeks, compared with 7.6 percent on a placebo spray. Johnson & Johnson, 2025
How soon it can work
In that study, patients on SPRAVATO were doing better than those on placebo by day 2, about 24 hours after the first dose, and the difference held through day 28. How long does it take SPRAVATO to work?
Staying well
In a longer study, patients in stable remission who kept taking SPRAVATO with an antidepressant went longer before their depression returned than patients switched to a placebo spray. FDA label
Side effects and warnings
The most common side effects in the treatment-resistant depression studies were feeling disconnected, dizziness, nausea, sleepiness, a spinning sensation, numbness, anxiety, tiredness, higher blood pressure, vomiting, feeling drunk, and headache. The label carries a boxed warning for sedation, dissociation, slowed breathing, misuse, and suicidal thoughts. A response cannot be guaranteed.
Safety screening
When SPRAVATO is not an option.
The FDA label rules SPRAVATO out for people with:
- An aneurysm or other aneurysmal disease of a blood vessel (including the aorta, the brain, and the arteries of the arms and legs), or an arteriovenous malformation
- A past bleed inside the brain (intracerebral hemorrhage)
- An allergy to esketamine, ketamine, or any ingredient of the spray
Also tell the care team about:
- High blood pressure, heart disease, or a past stroke
- Pregnancy, or plans to become pregnant; SPRAVATO may harm an unborn baby
- Any past problem with alcohol, drugs, or prescription medicine misuse
- Every medicine and supplement you take, including nasal sprays
Cost and insurance
What you pay depends on your plan.
- SPRAVATO may be covered under your medical benefit or your pharmacy benefit, depending on your plan.
- The manufacturer reports that 9 out of 10 people with commercial insurance are covered for SPRAVATO.
- Through the SPRAVATO withMe savings program, eligible patients with commercial insurance may pay as little as $10 per treatment for the medicine. Restrictions and monthly maximums apply, and the program does not cover the observation part of the visit.
Ask the office what your plan requires and what you would pay before your first treatment. Insurance and access
Plans the office takes for SPRAVATO
Insurance plans for SPRAVATO at Labyrinth.
- Aetna (commercial)
- Cigna (commercial)
- Horizon Blue Cross Blue Shield (commercial)
- UnitedHealthcare (commercial)
- UnitedHealthcare Medicare
- UnitedHealthcare Oxford
Confirmed by the practice on October 1, 2026. This list is not a guarantee of coverage. Confirm your benefits with the office and your plan. On the manufacturer's treatment center finder, this office is listed under Dr. Salvatore Savatta's name.
Other options for hard-to-treat depression
SPRAVATO or TMS?
Both are offered in Cranford for depression that has not improved enough with medication. SPRAVATO is a nasal spray taken in the office, with at least two hours of observation and no driving until the next day. TMS uses magnetic pulses five days a week, with no observation period, and you can drive yourself. The evaluation looks at which fits your history and your week.
Common questions
SPRAVATO questions patients ask first.
How much does SPRAVATO cost per session?
It depends on your plan. SPRAVATO may be covered under your medical or your pharmacy benefit, and plans often need to approve it first. Through the manufacturer's SPRAVATO withMe program, eligible patients with commercial insurance may pay as little as $10 per treatment for the medicine; that program does not cover the observation part of the visit. Ask the office what you would pay before your first treatment.
How long does it take to start SPRAVATO?
Usually 1 to 4 weeks from your first call to your first treatment, depending on your insurance company. The office staff handle the insurance approval (prior authorization) for you.
How do I get prescribed SPRAVATO?
Through a psychiatric evaluation. The psychiatrist confirms the diagnosis, reviews the antidepressants you have tried, checks your medical history and blood pressure, and decides with you whether SPRAVATO fits. It cannot be prescribed for home use.
What disqualifies you from SPRAVATO?
The FDA label rules it out for people with an aneurysm or aneurysmal blood vessel disease, an arteriovenous malformation, a past bleed inside the brain, or an allergy to esketamine or ketamine. High blood pressure, pregnancy, and a history of substance misuse are weighed carefully at the evaluation.
Can I get SPRAVATO online or take it at home?
No. SPRAVATO is only given in certified healthcare settings, where you take it under direct supervision and stay for at least 2 hours of observation. Telehealth can be part of your wider care, but not the treatment itself.
Do I have to keep taking my antidepressant?
Not always. Since January 2025, SPRAVATO has been approved for treatment-resistant depression on its own or together with an oral antidepressant. For depression with suicidal thoughts or actions, it is used with an oral antidepressant. At Labyrinth, SPRAVATO is given either on its own or with an oral antidepressant, whichever is right for you, and your psychiatrist decides what to continue.
Can I drive after a SPRAVATO treatment?
No. You need a ride home, and you should not drive or operate machinery until the next day after a restful night's sleep.
How long do people stay on SPRAVATO?
The first eight weeks follow a set schedule. After that, visits are weekly or every two weeks, and the goal is the least frequent schedule that keeps you well. How long treatment continues is decided with your psychiatrist.
Where can I get SPRAVATO near me in Union County?
Labyrinth Psychiatry Group and TMS Center gives SPRAVATO at 11 Commerce Drive, Lobby Floor, Cranford, NJ 07016. Call 908-336-1187 or send a request to start with an evaluation.