Boston’s density of academic medical centers and teaching hospitals means many patients arrive at our clinics already well-versed in their diagnosis and treatment history — what they’re often looking for is a next step after oral antidepressants haven’t closed the gap. Spravato® (esketamine), an FDA-approved nasal spray administered under clinical supervision, is that next step for adults across Back Bay, Cambridge, Brookline, and the wider Boston area.
Where conventional antidepressants work gradually by adjusting serotonin or norepinephrine, Spravato takes aim at NMDA receptors within the glutamate system — an entirely different route into the brain’s mood circuitry. It’s prescribed alongside a continuing oral antidepressant rather than as a replacement, and that combination is what allows some patients to notice change sooner than they would from oral medication alone. Dosing is adjusted over time as our Boston clinicians track each patient’s response.
Federal REMS requirements govern exactly how Spravato can be delivered: only within certified facilities, only under the direct observation of a licensed provider during self-administration, and always followed by a minimum two-hour monitoring period to track blood pressure and screen for sedation or dissociation before a patient leaves.
Our clinics are positioned for easy access from Back Bay, Cambridge, and Brookline, with several locations reachable via the T’s Green Line or a short drive from I-93 and the Massachusetts Turnpike. Sessions run more frequently in the early weeks of treatment, and our coordinators plan around that front-loaded schedule rather than academic calendars or standard office hours. Every visit ends the same way, though — with a ride arranged, since driving home isn’t an option after dosing.
Adults across Greater Boston come to us after standard antidepressant therapy hasn’t provided lasting relief, and we offer Spravato as an FDA-regulated option to build on that existing care rather than replace it. Conditions we treat include:
Your first appointment includes a detailed psychiatric and medical evaluation, which our clinical team uses to confirm candidacy and design a dosing schedule specific to you.
A licensed provider will be with you the entire time you self-administer the nasal spray in a private treatment room. From there, you’re required to stay on-site for at least two hours while staff monitor your blood pressure and check for effects like dizziness or a dissociative feeling. Once you’ve been cleared, you’ll head home with whoever you’ve arranged to drive you.
It often is. A number of our patients keep seeing their existing therapist throughout Spravato treatment, and our clinical team is happy to stay in contact with that provider. If you don’t currently have one, we can point you toward mental health professionals in the Boston area.
Dissociation, dizziness, drowsiness, and short-term increases in blood pressure are the effects clinical staff watch most closely during your observation window. Nausea and mild headache turn up occasionally in the hours after a session, and both are generally short-lived.
Most patients move from the more frequent induction schedule into a maintenance phase with longer gaps between sessions, though exactly how long depends on how symptoms have responded. We check in on that schedule regularly and adjust the spacing based on what we’re seeing.
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