Now In-Network With BCBS Texas, United Healthcare & Cigna! 

An New Form of Treatment

Spravato Ketamine Nasal Spray Treatment In Austin Texas

Learn more about the Spravato treatment process.

Nepenthe Wellness Center is proud to be in-network with the following insurance carriers:

               

Complete the following to learn more about your insurance benefits!

Because esketamine is a pseudo psychedelic treatment for depression, during your experience you may experience lucid dreaming, time distortion or nausea. Your Provider will assist you throughout your treatment. 

Your blood pressure will be checked prior to your treatment starting, 40 minutes after it starts, and again before you leave.

After treatment, you may feel groggy or woozy. You may not drive after treatment, so you’ll need someone to drive you home.

Because esketamine is a pseudo psychedelic treatment for depression, during your experience you may experience lucid dreaming, time distortion or nausea. Your Provider will assist you throughout your treatment. 

Your blood pressure will be checked prior to your treatment starting, 40 minutes after it starts, and again before you leave.

After treatment, you may feel groggy or woozy. You may not drive after treatment, so you’ll need someone to drive you home.

Nicole's Story

Spravato® helped Nicole’s treatment-resistant depression. Now, she’s resuming her education and sharing her story.

Allison’s Story

Allison’s son tried many oral antidepressants without relief. Now, because of Spravato®,
Allison’s son is starting to feel like himself again.

Getting Started
Consultation

You will meet with our Care Coordinator virtually to discuss the process, collect your health history and verify your insurance benefits.

Once your insurance benefits are confirmed and all your intake forms are completed you are ready for your first appointment with your prescribing Provider.

First Appointment

Your first appointment will be in person with your prescribing Provider. Your Provider will discuss your Spravato treatment in further detail, review your health history, medication list and answer any last minute questions you may have.

Once all your questions are answered your Provider will enroll you in the REMS program and create a protocol specific to you.

Day of Treatment

You must arrive with a trusted adult that will drive you home after treatment. We recommend you wear comfortable clothing. We will provide you with pillows and a blanket, but if there is a specific comfort item you require, please bring it with you. 

Your experience will last between 60-90 minutes, but you must remain at the clinic for two hours for monitoring. 

Your Treatment Schedule

Weeks 1 to 4: Spravato is administered twice a week for eight doses.

Weeks 5 to 8: Once weekly

Week 9 and after: Every 2 weeks or once weekly*

*Dosing frequency will be individualized to the least frequent dosing to maintain remission/respon

Spravato® shows significant promise in treating depression in conjunction with an oral antidepressant.

Learn More About Our Billing Process

At Nepenthe Wellness Center, we prioritize transparency and convenience when it comes to billing for ketamine treatment. Our streamlined process ensures that patients receive the care they need without unnecessary financial stress.

Direct Billing to Insurance Carriers

We handle the billing process directly with your insurance carrier for the covered portion of your treatment. This means you don’t have to worry about submitting claims or dealing with complex paperwork.

Patient Responsibility for Remaining Balance

While we bill insurance for the covered portion, there may be additional costs not covered by your insurance plan. Our billing specialist will work closely with you to clearly communicate any out-of-pocket expenses you may incur.

Verification of Insurance Benefits

Prior to your first appointment, our dedicated billing specialist will work with you to verify your insurance benefits. This ensures that you have a clear understanding of your coverage and any potential financial responsibility

Good Faith Estimate

Based on the information gathered during the verification process, our billing specialist will provide you with a good faith estimate of the cost of treatment. This estimate will outline the expected out-of-pocket expenses, allowing you to plan accordingly.

Assistance with Authorization Requirements

If your insurance carrier requires authorization for ketamine treatment, our team will assist in obtaining the necessary documentation to ensure a seamless process.

Clear Communication Throughout

We believe in open communication regarding financial matters. Our team is available to address any questions or concerns you may have about the billing process.

Our goal is to make your experience at Nepenthe Wellness Center as smooth and worry-free as possible. Rest assured, our billing specialist is here to guide you through every step, ensuring you have a clear understanding of the financial aspect of your treatment.

The Process Of Getting Started with Our Spravato Ketamine Nasal Spray®

Which Treatment is Right for Me?

So, which is the best treatment for TRD or MDD, Spravato or IV ketamine? Ultimately, the decision will depend on a variety of factors, including the severity of the disorder, the patient’s medical history, and their financial situation. It is important to consult with a doctor to discuss which option is best for your individual needs.

Spravato is the only FDA approved option, and is often covered by insurance. This makes it the preferred choice for many people seeking treatment. It is administered twice a week, over the course of four weeks, with a followup appointment after the four weeks have passed. Spravato is a fastacting treatment and can have positive effects on symptoms within hours.

Both Spravato and IV ketamine are administered by a medical professional in a medical setting, such as a clinic or hospital. IV ketamine is an off-label treatment for severe depression, and is usually administered in twice-weekly sessions for several weeks. It is also given to the patient intravenously, instead of through a nasal spray.

While IV ketamine is not FDA approved and is not typically covered by insurance, it is a highly effective treatment option, and patients can experience symptom relief within days.

Although you have the option to choose between ketamine infusions or Spravato® as a treatment- it is important to recognize which medication can be more beneficial when addressing specific diagnosis.

Let’s dive into the details of both ketamine and esketamine, in terms of administration, dosage, bioavailability, administration time-frame, medication conjunction, treatment time frame, and insurance coverage.
KETAMINE IV INFUSION SPRAVATO
Administration Ketamine is administered through an IV infusion over an hour. Spravato is self-administered in two to three successive intranasal sprays administered in five-minute increments.
Dosage The dose is determined by weight and titrated over the series of six infusions based on the patient’s comfort and vitals. Spravato comes in two doses 56mg and 84mg. Your healthcare provider will select the appropriate dose based on your response to the treatment.
Bioavailability The bioavailability of IV ketamine is 100%. Esketamine has a bioavailability of approximately 50%. Things such as clogged nasal passages and swallowing part of the medication can affect the the bioavailability.
Administration Time-Frame Ketamine is administered in six treatments over the course of two to four weeks. Maintenance infusions are often needed, and the frequency is individualized based on the response of the patient. Weeks 1 to 4: Spravato is administered twice a week for eight doses. Weeks 5 to 8: Once weekly Week 9 and after: Every 2 weeks or once weekly* *Dosing frequency will be individualized to the least frequent dosing to maintain remission/response.
Medication Conjunction Ketamine can be administered in conjunction or as a single treatment for clients with MDD. Spravato must be given in conjunction with an oral antidepressant.
Treatment Time IV ketamine infusions last for an hour, but we recommend booking yourself for 90 minutes to give you time to recover. Spravato is a minimum of 2 hours after the initial dose is administered.
Insurance Coverage Currently, insurance does not pay for the cost of ketamine treatment. Your insurance provider may however reimburse you once treatment is received. Your insurance may cover the cost of Spravato. Your responsibility could be as little as $10 for each dose.
Diagnosis Treated Major Depressive Disorder Obsessive Disorders PTSD Anxiety Disorders Neuropathic pains FDA approved for major depressive  disorder

Spravato® can cause serious side effects, including:

  • Sedation and dissociation. Spravato® may cause sleepiness (sedition), fainting, dizziness, spinning sensation, anxiety, or feeling disconnected from yourself, your thoughts, feelings, space and time (dissociation).
    • Tell your healthcare provider right away if you feel like you cannot stay awake or if you feel like you are going to pass out.
    • Your healthcare provider must monitor you for serious side effects for at least 2 hours after taking Spravato®. Your healthcare provider will decide when you are ready to leave the healthcare setting.
  • Abuse and misuse. There is a risk for abuse and physical and psychological dependence with Spravato® treatment. Your healthcare provider should check you for signs of abuse and dependence before and during your treatment with Spravato®.
    • Tell your healthcare provider if you have ever abused or been depended on alcohol, prescription medicines or street drugs.
    • Your healthcare provider can tell you more about the differences between physical and psychological dependence and drug addiction.
  • Spravato® Risk Evaluation and Mitigation Strategy (REMS)
    • Because of the risks for sedation, dissociation, and abuse and misuse, SPRAVATO® is only available through a restricted program called the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program. SPRAVATO® can only be administered at healthcare settings certified in the SPRAVATO® REMS Program. Patients treated in outpatient healthcare settings (e.g., medical offices and clinics) must be enrolled in the program.
  • Increased risk of suicidal thoughts and actions.
    • Antidepressant medicines may increase suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed.
  • SPRAVATO® is not for use in children
    • Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a higher risk of having suicidal thoughts or actions. These include people who have (or have a family history of) depression or a history of suicidal thoughts or actions.
  • How can I watch for and try to prevent suicidal thoughts and actions in myself or a family member?
    • Pay close attention to any changes, especially sudden changes, in mood, behavior, thoughts, or feelings, or if you develop suicidal thoughts or actions.
    • Tell your healthcare provider right away if you have any new or sudden changes in mood, behavior, thoughts, or feelings.
    • Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you have concerns about symptoms.
  • Tell your healthcare provider right away if you or your family member have any of the following symptoms, especially if they are new, worse, or worry you:
    • suicide attempts
    • thoughts about suicide or dying
    • worsening depression
    • other unusual changes in behavior or mood
  • Do not take Spravato® if you:
    • have blood vessel (aneurysmal vascular) disease (including in the brain, chest, abdominal aorta, arms and legs)
    • have an abnormal connection between your veins and arteries (arteriovenous malformation)
    • have a history of bleeding in the brain
    • are allergic to esketamine, ketamine, or any of the other ingredients in Spravato® 
    • If you are not sure if you have any of the above conditions, talk to your healthcare provider before taking Spravato®

Before you take Spravato®, tell your healthcare provider about all of your medical conditions, including if you:

    • have heart or brain problems, including:
      • high blood pressure (hypertension)
      • slow or fast heartbeats that cause shortness of breath, chest pain, lightheadedness, or fainting
      • history of heart attack
      • history of stroke
      • heart valve disease or heart failure
      • history of brain injury or any condition where there is increased pressure in the brain
      • have liver problems
      • have ever had a condition called “psychosis” (see, feel, or hear things that are not there, or believe in things that are not true).
      • are pregnant or plan to become pregnant. SPRAVATO® may harm your baby. You should not take SPRAVATO® if you are pregnant.

Tell your healthcare provider right away if you become pregnant during treatment with SPRAVATO®.

If you are able to become pregnant, talk to your healthcare provider about methods to prevent pregnancy during treatment with SPRAVATO®.

    • There is a pregnancy registry for women who are exposed to SPRAVATO® during pregnancy. The purpose of the registry is to collect information about the health of women exposed to SPRAVATO® and their baby. If you become pregnant during treatment with SPRAVATO®, talk to your healthcare provider about registering with the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or online at https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/antidepressants/
  • are breastfeeding or plan to breastfeed. You should not breastfeed during treatment with SPRAVATO®

Tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Taking SPRAVATO® with certain medicine may cause side effects.

Especially tell your healthcare provider if you take central nervous system (CNS) depressants, psychostimulants, or monoamine oxidase inhibitors (MAOIs) medicines. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

How will I take SPRAVATO®?

  • You will take SPRAVATO® nasal spray yourself, under the supervision of a healthcare provider in a healthcare setting. Your healthcare provider will show you how to use the SPRAVATO® nasal spray device.
  • Your healthcare provider will tell you how much SPRAVATO® you will take and when you will take it.
  • Follow your SPRAVATO® treatment schedule exactly as your healthcare provider tells you to.
  • During and after each use of the SPRAVATO® nasal spray device, you will be checked by a healthcare provider who will decide when you are ready to leave the healthcare setting.
  • You will need to plan for a caregiver or family member to drive you home after taking SPRAVATO®.
  • If you miss a SPRAVATO® treatment, your healthcare provider may change your dose and treatment schedule.
  • Some people taking SPRAVATO® get nausea and vomiting. You should not eat for at least 2 hours before taking SPRAVATO® and not drink liquids at least 30 minutes before taking SPRAVATO®.
  • If you take a nasal corticosteroid or nasal decongestant medicine take these medicines at least 1 hour before taking SPRAVATO®.

What should I avoid while taking SPRAVATO®?

Do not drive, operate machinery, or do anything where you need to be completely alert after taking SPRAVATO®. Do not take part in these activities until the next day following a restful sleep. See “What is the most important information I should know about SPRAVATO®?”

What are the possible side effects of SPRAVATO®?

SPRAVATO® may cause serious side effects including:

  • See “What is the most important information I should know about SPRAVATO®?”
  • Increased blood pressure. SPRAVATO® can cause a temporary increase in your blood pressure that may last for about 4 hours after taking a dose. Your healthcare provider will check your blood pressure before taking SPRAVATO® and for at least 2 hours after you take SPRAVATO®. Tell your healthcare provider right away if you get chest pain, shortness of breath, sudden severe headache, change in vision, or seizures after taking SPRAVATO®.
  • Problems with thinking clearly. Tell your healthcare provider if you have problems thinking or remembering.
  • Bladder problems. Tell your healthcare provider if you develop trouble urinating, such as a frequent or urgent need to urinate, pain when urinating, or urinating frequently at night.

The most common side effects of SPRAVATO® when used along with an antidepressant taken by mouth include:

  • feeling disconnected from yourself, your thoughts, feelings and things around you
  • dizziness
  • nausea
  • feeling sleepy
  • spinning sensation
  • decreased feeling of sensitivity (numbness)
  • feeling anxious
  • lack of energy
  • increased blood pressure
  • vomiting
  • feeling drunk
  • feeling very happy or excited

If these common side effects occur, they usually happen right after taking SPRAVATO® and go away the same day.

These are not all the possible side effects of SPRAVATO®.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Please see full Prescribing Information, including Boxed WARNINGS, and Medication Guide for SPRAVATO® and discuss any questions you may have with your healthcare provider.

FAQ

Frequently Asked Questions About Ketamine - Spravato

SPRAVATO™ is a prescription medicine, used along with an antidepressant taken by mouth, for treatment-resistant depression (TRD) in adults.
SPRAVATO™ is not for use as a medicine to prevent or relieve pain (anesthetic). It is not known if SPRAVATO™ is safe or eff­ective as an anesthetic medicine.
It is not known if SPRAVATO™ is safe and e­ffective in children.

With the success of ketamine seen across the nation the creation of an FDA approved treatment was inevitable. In 2019 a nasal spray, Esketamine also known as Spravato was approved for the treatment of TRD.

With the addition of this new medication patients now have the option to utilize either ketamine or esketamine treatments for their depression.

You will take SPRAVATO™ nasal spray yourself, under the supervision of a healthcare provider in a healthcare setting. Your healthcare provider will show you how to use the SPRAVATO™ nasal spray device.

Your healthcare provider will tell you how much SPRAVATO™ you will take and when you will take it.

Follow your SPRAVATO™ treatment schedule exactly as your healthcare provider tells you to.

During and after each use of the SPRAVATO™ nasal spray device, you will be checked by a healthcare provider who will decide when you are ready to leave the healthcare setting.

You will need to plan for a caregiver or family member to drive you home after taking SPRAVATO™.

If you miss a SPRAVATO™ treatment, your healthcare provider may change your dose and treatment schedule.

Some people taking SPRAVATO™ get nausea and vomiting. You should not eat for at least 2 hours before taking SPRAVATO™ and not drink liquids at least 30 minutes before taking SPRAVATO™.

If you take a nasal corticosteroid or nasal decongestant medicine take these medicines at least 1 hour before taking SPRAVATO™.

SPRAVATO™ may cause serious side effects including:

  • Increased blood pressure. SPRAVATO™ can cause a temporary increase in your blood pressure that may last for about 4 hours after taking a dose. Your healthcare provider will check your blood pressure before taking SPRAVATO™ and for at least 2 hours after you take SPRAVATO™. Tell your healthcare provider right away if you get chest pain, shortness of breath, sudden severe headache, change in vision, or seizures after taking SPRAVATO™.
  • Problems with thinking clearly. Tell your healthcare provider if you have problems thinking or remembering.
  • Bladder problems. Tell your healthcare provider if you develop trouble urinating, such as a frequent or urgent need to urinate, pain when urinating, or urinating frequently at night.

The most common side effects of SPRAVATO™ when used along with an antidepressant taken by mouth include: dissociation, dizziness, nausea, sedation, spinning sensation, reduced sense of touch and sensation, anxiety, lack of energy, increased blood pressure, vomiting, and feeling drunk.
These are not all the possible side effects of SPRAVATO™.

Spravato is more often than not covered by insurance providers; however, its always best to double check with your insurance company

Spravato® can cause serious side effects, including:

  • Sedation and dissociation. Spravato® may cause sleepiness (sedition), fainting, dizziness, spinning sensation, anxiety, or feeling disconnected from yourself, your thoughts, feelings, space and time (dissociation).
    • Tell your healthcare provider right away if you feel like you cannot stay awake or if you feel like you are going to pass out.
    • Your healthcare provider must monitor you for serious side effects for at least 2 hours after taking Spravato®. Your healthcare provider will decide when you are ready to leave the healthcare setting.
  • Abuse and misuse. There is a risk for abuse and physical and psychological dependence with Spravato® treatment. Your healthcare provider should check you for signs of abuse and dependence before and during your treatment with Spravato®.
    • Tell your healthcare provider if you have ever abused or been depended on alcohol, prescription medicines or street drugs.
    • Your healthcare provider can tell you more about the differences between physical and psychological dependence and drug addiction.
  • Spravato® Risk Evaluation and Mitigation Strategy (REMS)
    • Because of the risks for sedation, dissociation, and abuse and misuse, SPRAVATO® is only available through a restricted program called the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program. SPRAVATO® can only be administered at healthcare settings certified in the SPRAVATO® REMS Program. Patients treated in outpatient healthcare settings (e.g., medical offices and clinics) must be enrolled in the program.
  • Increased risk of suicidal thoughts and actions.
    • Antidepressant medicines may increase suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed.
  • SPRAVATO® is not for use in children
    • Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a higher risk of having suicidal thoughts or actions. These include people who have (or have a family history of) depression or a history of suicidal thoughts or actions.
  • How can I watch for and try to prevent suicidal thoughts and actions in myself or a family member?
    • Pay close attention to any changes, especially sudden changes, in mood, behavior, thoughts, or feelings, or if you develop suicidal thoughts or actions.
    • Tell your healthcare provider right away if you have any new or sudden changes in mood, behavior, thoughts, or feelings.
    • Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you have concerns about symptoms.
  • Tell your healthcare provider right away if you or your family member have any of the following symptoms, especially if they are new, worse, or worry you:
    • suicide attempts
    • thoughts about suicide or dying
    • worsening depression
    • other unusual changes in behavior or mood
  • Do not take Spravato® if you:
    • have blood vessel (aneurysmal vascular) disease (including in the brain, chest, abdominal aorta, arms and legs)
    • have an abnormal connection between your veins and arteries (arteriovenous malformation)
    • have a history of bleeding in the brain
    • are allergic to esketamine, ketamine, or any of the other ingredients in Spravato® 
    • If you are not sure if you have any of the above conditions, talk to your healthcare provider before taking Spravato®

Before you take Spravato®, tell your healthcare provider about all of your medical conditions, including if you:

    • have heart or brain problems, including:
      • high blood pressure (hypertension)
      • slow or fast heartbeats that cause shortness of breath, chest pain, lightheadedness, or fainting
      • history of heart attack
      • history of stroke
      • heart valve disease or heart failure
      • history of brain injury or any condition where there is increased pressure in the brain
      • have liver problems
      • have ever had a condition called “psychosis” (see, feel, or hear things that are not there, or believe in things that are not true).
      • are pregnant or plan to become pregnant. SPRAVATO® may harm your baby. You should not take SPRAVATO® if you are pregnant.

Tell your healthcare provider right away if you become pregnant during treatment with SPRAVATO®.

If you are able to become pregnant, talk to your healthcare provider about methods to prevent pregnancy during treatment with SPRAVATO®.

    • There is a pregnancy registry for women who are exposed to SPRAVATO® during pregnancy. The purpose of the registry is to collect information about the health of women exposed to SPRAVATO® and their baby. If you become pregnant during treatment with SPRAVATO®, talk to your healthcare provider about registering with the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or online at https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/antidepressants/
  • are breastfeeding or plan to breastfeed. You should not breastfeed during treatment with SPRAVATO®

Tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Taking SPRAVATO® with certain medicine may cause side effects.

Especially tell your healthcare provider if you take central nervous system (CNS) depressants, psychostimulants, or monoamine oxidase inhibitors (MAOIs) medicines. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

How will I take SPRAVATO®?

  • You will take SPRAVATO® nasal spray yourself, under the supervision of a healthcare provider in a healthcare setting. Your healthcare provider will show you how to use the SPRAVATO® nasal spray device.
  • Your healthcare provider will tell you how much SPRAVATO® you will take and when you will take it.
  • Follow your SPRAVATO® treatment schedule exactly as your healthcare provider tells you to.
  • During and after each use of the SPRAVATO® nasal spray device, you will be checked by a healthcare provider who will decide when you are ready to leave the healthcare setting.
  • You will need to plan for a caregiver or family member to drive you home after taking SPRAVATO®.
  • If you miss a SPRAVATO® treatment, your healthcare provider may change your dose and treatment schedule.
  • Some people taking SPRAVATO® get nausea and vomiting. You should not eat for at least 2 hours before taking SPRAVATO® and not drink liquids at least 30 minutes before taking SPRAVATO®.
  • If you take a nasal corticosteroid or nasal decongestant medicine take these medicines at least 1 hour before taking SPRAVATO®.

What should I avoid while taking SPRAVATO®?

Do not drive, operate machinery, or do anything where you need to be completely alert after taking SPRAVATO®. Do not take part in these activities until the next day following a restful sleep. See “What is the most important information I should know about SPRAVATO®?”

What are the possible side effects of SPRAVATO®?

SPRAVATO® may cause serious side effects including:

  • See “What is the most important information I should know about SPRAVATO®?”
  • Increased blood pressure. SPRAVATO® can cause a temporary increase in your blood pressure that may last for about 4 hours after taking a dose. Your healthcare provider will check your blood pressure before taking SPRAVATO® and for at least 2 hours after you take SPRAVATO®. Tell your healthcare provider right away if you get chest pain, shortness of breath, sudden severe headache, change in vision, or seizures after taking SPRAVATO®.
  • Problems with thinking clearly. Tell your healthcare provider if you have problems thinking or remembering.
  • Bladder problems. Tell your healthcare provider if you develop trouble urinating, such as a frequent or urgent need to urinate, pain when urinating, or urinating frequently at night.

The most common side effects of SPRAVATO® when used along with an antidepressant taken by mouth include:

  • feeling disconnected from yourself, your thoughts, feelings and things around you
  • dizziness
  • nausea
  • feeling sleepy
  • spinning sensation
  • decreased feeling of sensitivity (numbness)
  • feeling anxious
  • lack of energy
  • increased blood pressure
  • vomiting
  • feeling drunk
  • feeling very happy or excited

If these common side effects occur, they usually happen right after taking SPRAVATO® and go away the same day.

These are not all the possible side effects of SPRAVATO®.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Please see full Prescribing Information, including Boxed WARNINGS, and Medication Guide for SPRAVATO® and discuss any questions you may have with your healthcare provider.