Irvine adults with treatment-resistant depression can receive FDA-approved Spravato® nasal spray at the BrainHealth Solutions clinic in Costa Mesa, next to John Wayne Airport on the Irvine border. Every dose is supervised by a psychiatric team led by Dr. Robert Bota and Spravato® specialist Dr. Dragos Serseni.
Spravato® (esketamine) is an FDA-approved prescription nasal spray for adults with treatment-resistant depression and for major depression with suicidal thoughts. Instead of acting on serotonin like most antidepressants, it works through the brain’s glutamate system, which is why it can help people who have not improved on standard medications and why some notice change within hours or days rather than weeks. It is given only in a certified clinic under medical supervision and is never sent home with you.
Esketamine blocks NMDA receptors, which increases glutamate signalling and encourages new synaptic connections in mood-regulating areas of the brain. Because this mechanism differs from SSRIs and SNRIs, earlier medication failures do not predict that Spravato® will fail.
You give yourself the spray in the clinic, then remain for at least two hours while your blood pressure and alertness are monitored. Any dissociative effects tend to peak within the first hour and resolve before you go home.
Treatment begins twice a week for four weeks, moves to weekly, then settles into weekly or every-other-week maintenance. Spravato® is always paired with an oral antidepressant, and your psychiatrist manages both.
Spravato® is approved only under a REMS safety program, so it can be given only in a certified clinic with monitoring, never at home. At BrainHealth Solutions the program is led by Dr. Dragos Serseni, whose focus is treatment-resistant depression and neuromodulation, inside a practice that also offers TMS and SAINT®. All Spravato® visits take place at the practice’s single office, 3151 Airway Ave, Bldg R, Costa Mesa, CA 92626, about 10 to 20 minutes from most of Irvine. That short trip matters: during the first month you visit twice a week, and someone has to drive you home every time.
Leave your name, contact information and a callback time. The team checks the usual eligibility criterion, two or more antidepressants without adequate relief, and explains the visit schedule.
Your psychiatrist reviews your symptoms, past medication trials, medical history and blood pressure, and decides whether Spravato® is appropriate. Insurance authorization starts here.
You learn what the monitoring period involves and arrange a ride home. As the label requires, you avoid food for two hours and liquids for 30 minutes before each visit.
You self-administer the nasal spray in a quiet room while the care team monitors you. Each visit lasts at least two hours from dose to discharge.
Twice weekly for the first month, then weekly, then an individualized maintenance schedule. Symptom scales track your response, and your psychiatrist adjusts your oral antidepressant as needed.
Within about 40 minutes of dosing, most patients feel detached, dizzy or notice altered perception. These effects usually fade within one to two hours. The room is kept calm and the team checks on you throughout.
Your blood pressure is taken before dosing and again about 40 minutes afterward, because esketamine can raise it temporarily. You leave only once your readings and alertness are back to baseline.
You cannot drive until the next day, so every visit needs a ride. Since the clinic is a short drive from Irvine, a partner or family member can often drop you off and return, and many patients book visits so the rest of the day can be spent resting at home. Visits are scheduled within weekday hours, 8:30 AM to 5:00 PM.
The Spravato® schedule follows the FDA label:
Spravato® side effects are expected and short-lived, and they are the reason treatment happens under supervision. Most resolve before you leave the clinic.
Common during the monitoring period
Because of sedation and dissociation, you must not drive or operate machinery until after a restful night’s sleep.
Less common
Your evaluation screens for these risks, and a clinician is present for every dose.
In the clinical trials that led to approval, roughly half of patients with treatment-resistant depression responded to Spravato® combined with an oral antidepressant, with some improvement measurable within 24 hours. Longer-term studies show that continuing maintenance dosing lowers the relapse rate compared with stopping.
Everyone responds differently. BrainHealth Solutions tracks symptom scales at each phase, and if Spravato® is not working by the end of induction, the same team can move you to TMS or SAINT® without a referral elsewhere.
Spravato® may be appropriate for Irvine adults who:
Spravato® is not appropriate for people with aneurysmal vascular disease, arteriovenous malformation, a history of intracerebral hemorrhage, or during pregnancy. Uncontrolled blood pressure must be managed first.
Alternatives we offer when Spravato® is not the fit
For Irvine patients who have worked through several antidepressants, Spravato® offers a new mechanism without starting from scratch, and a clinic near enough that twice-weekly visits stay manageable. Patients say the doctor “talks to you, and takes his time on every visit,” which matters when each visit lasts two hours.
Esketamine acts on glutamate, not serotonin, so it can help when several SSRIs or SNRIs have not.
Some patients notice change within days, and the twice-weekly first month gives a clear picture of your response.
The clinic is about 10 to 20 minutes from most of Irvine, which keeps the twice-weekly induction phase and the ride home practical for you and your driver.
Every dose is monitored, so side effects are handled in the room rather than at home.
Dr. Dragos Serseni leads the Spravato® program at BrainHealth Solutions with a focus on treatment-resistant depression.
If Spravato® is not enough, TMS, SAINT®, medication management and psychotherapy are available from the same team.
Spravato® is one of the few treatments FDA-approved specifically for treatment-resistant depression, and one of the few that can act within days. If you have tried two or more medications and are weighing esketamine against TMS, the screening call compares both for your situation, because BrainHealth Solutions offers each of them and has no reason to steer you toward one.
Without insurance, Spravato® at the BrainHealth Solutions clinic ranges from $600 to $1,200 per session, depending on dosage and clinical monitoring requirements. Total cost is higher during the first month, when visits are twice weekly, and comes down once treatment tapers to maintenance. Many insurance plans cover Spravato® for treatment-resistant depression, and the manufacturer offers savings programs for eligible commercially insured patients. We quote only after confirming your plan’s coverage.
Insurance and financing
BrainHealth Solutions accepts insurance and self-pay. Many major plans are accepted, including Medicare and Anthem, and CareCredit financing spreads self-pay costs over monthly payments. Submit your plan through the insurance-check form on our site, or ask on your 15-minute screening call, and our team confirms what your plan covers before you commit to anything.
Dr. Robert Bota, MD, MSG, DFAPA is a board-certified psychiatrist and Distinguished Fellow of the American Psychiatric Association. He trained in TMS at Harvard University and the University of South Carolina, founded and directed the first TMS program at UC Irvine, and has authored more than 60 peer-reviewed publications.
Dr. Bota has been principal investigator on more than 20 clinical trials in depression, schizophrenia, PTSD and Alzheimer’s disease, and the practice participates in brain-imaging research with Kernel neurotechnology. Treatment plans are informed by that research and reviewed as your symptoms change.
Care at BrainHealth Solutions is delivered by a team that includes psychiatrists Dr. Tina Allee and Dr. Mahtab K. Yousefi (child and adolescent care in English and Farsi), Spravato® specialist Dr. Dragos Serseni, TMS technician Anna Venezio and office manager Peter Bota.
Many plans are accepted, including Medicare and Anthem, and CareCredit financing is available for self-pay. One parent wrote that the team “even helped get insurance coverage when others said it wasn’t possible.” Use the insurance check on our site or ask on your screening call.
We serve Irvine patients, but BrainHealth Solutions has no office in Irvine. Spravato® is given at our only clinic, 3151 Airway Ave, Bldg R, Costa Mesa, beside John Wayne Airport and about 10 to 20 minutes from most of Irvine.
A family member or friend you arrange in advance. You cannot drive until the next day after any Spravato® dose. Because the clinic is close to Irvine, many drivers drop patients off and come back at the end of the two-hour monitoring period.
Each visit needs at least two hours in the clinic plus time to rest afterward, so many Irvine patients book visits later in the clinic’s weekday hours and plan the remainder of that day at home. The schedule eases to weekly after the first month.
No. Spravato® is esketamine, an FDA-approved nasal spray given under a REMS safety program and often covered by insurance. IV ketamine is used off-label for depression and is rarely covered. BrainHealth Solutions offers Spravato®.
Yes. Spravato® is approved for use together with an oral antidepressant, and your psychiatrist manages both.
Many commercial plans and Medicare cover it for treatment-resistant depression, usually after documentation of two failed antidepressant trials. Many plans are accepted at BrainHealth Solutions, and the team handles authorization.
The same practice offers TMS and the accelerated SAINT® protocol, so a non-response leads to the next option with the same clinical team rather than a new search.
Schedule a 15-minute screening call with BrainHealth Solutions to find out whether Spravato® is the right next step, at a supervised clinic a short drive from Irvine.
BrainHealth Solutions, 3151 Airway Ave, Bldg R, Costa Mesa, CA 92626 · (949) 441-5542 · Monday to Friday, 8:30 AM to 5:00 PM. Same-day appointments may be available. The screening call asks only for your name, contact information and a callback time; there are no long intake forms before you speak with us.
