BrainHealth Solutions offers FDA-approved Spravato® nasal spray for treatment-resistant depression to Los Angeles patients at our Costa Mesa clinic, under the supervision of 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. It acts on the brain’s glutamate system rather than serotonin, which is why it can help people who have not improved on standard antidepressants, and why some patients feel change within hours or days instead of weeks. It is only given in a certified clinic under medical supervision; you cannot take it home.
Esketamine blocks NMDA receptors, which increases glutamate signalling and promotes new synaptic connections in mood-regulating regions. This is a different mechanism from SSRIs and SNRIs, so prior medication failures do not predict failure with Spravato®.
You self-administer the spray in the office, then stay for at least two hours of monitoring while blood pressure and alertness are checked. The dissociative effects that can occur peak in the first hour and resolve before you leave.
Treatment starts twice weekly for four weeks, then weekly, then weekly or every other week in maintenance. Spravato® is taken alongside an oral antidepressant, so your psychiatrist manages both.
Spravato® is approved only under a REMS safety program, which means 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, within a practice that also offers TMS and SAINT®. Every dose is given at our one clinic, 3151 Airway Ave, Bldg R, Costa Mesa, CA 92626; there is no Los Angeles office. Compared with daily TMS, Spravato®’s schedule of two visits a week at first, then weekly or less, is easier to fit around a drive of about an hour each way on the I-405. The catch is that you cannot drive home after a dose, so every visit needs a driver.
Share your name, contact information and a callback time. The team confirms you have tried two or more antidepressants without adequate relief, the usual eligibility criterion, and explains the visit schedule as it looks from Los Angeles.
Your psychiatrist reviews symptoms, prior medication trials, medical history and blood pressure, and decides whether Spravato® is appropriate for major depressive disorder. Insurance authorization begins here.
You learn what the monitoring period involves, arrange a driver for the round trip, and avoid food for two hours and liquids for 30 minutes before each visit, as the label requires.
You self-administer the nasal spray in a quiet room while the care team monitors you. Each visit lasts at least two hours from dosing to discharge.
Twice weekly for the first month, then weekly, then individualized maintenance. Symptom scales track your response and the psychiatrist adjusts your oral antidepressant as needed.
Most patients feel a sense of detachment, dizziness or altered perception within 40 minutes of dosing. It usually fades within one to two hours. The room is kept calm, and the team checks on you throughout.
Blood pressure is measured before dosing and about 40 minutes after, because esketamine can raise it temporarily. You are discharged only when readings and alertness are back to baseline.
You cannot drive until the next day, so a Los Angeles patient needs someone to drive the hour or so home on the I-405. Counting the drive both ways and two hours of monitoring, a visit takes a good part of the day; many patients book a fixed day and time each week with the same driver and plan to rest at home afterward.
The Spravato® schedule follows the FDA label, with every visit at the Costa Mesa clinic:
Spravato® side effects are expected, time-limited and the reason for in-clinic monitoring. Most resolve before you leave the office.
Common during the monitoring period
Because of sedation and dissociation, you must not drive or operate machinery until after a restful night’s sleep, which includes the drive back to Los Angeles.
Less common
Your evaluation screens for these risks, and every dose is given with a clinician present.
In the clinical trials behind approval, roughly half of patients with treatment-resistant depression responded to Spravato® plus an oral antidepressant, with some improvement measurable within 24 hours. Longer-term studies show that continued maintenance dosing lowers the relapse rate compared with stopping.
Response is individual. 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 the one-week SAINT® course without a referral elsewhere.
Spravato® at our Costa Mesa clinic may be appropriate for Los Angeles 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 needs to be managed first.
Alternatives we offer when Spravato® is not the fit
For Los Angeles patients who have tried many antidepressants, Spravato® offers a different mechanism on a schedule that is fewer trips than daily TMS. Patients describe BrainHealth Solutions as a place where the doctor “talks to you, and takes his time on every visit,” which matters when each visit is two hours.
Esketamine works on glutamate, not serotonin, so it can help when several SSRIs or SNRIs have not.
Some patients notice change within days. The twice-weekly induction month gives a clear read on response.
Two visits a week during induction, then weekly or every other week, is a more manageable commute from Los Angeles than five visits a week.
Spravato® is covered by many commercial plans and Medicare for treatment-resistant depression, and the manufacturer offers savings programs for eligible commercially insured patients.
Dr. Dragos Serseni leads the Spravato® program at BrainHealth Solutions with a focus on treatment-resistant depression, and every dose is supervised.
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 been through two or more medications and are weighing esketamine against TMS, the screening call at BrainHealth Solutions compares both for your situation, including how each schedule works from Los Angeles, rather than steering you toward the only one a clinic happens to offer.
Without insurance, Spravato® at BrainHealth Solutions ranges from $600 to $1,200 per session, depending on dosage and clinical monitoring requirements. During the initial phase, which often involves twice-weekly visits for several weeks, total costs are higher before tapering to a maintenance schedule. Many insurance plans cover Spravato® for qualifying patients, and manufacturer savings programs may significantly reduce out-of-pocket costs. Our team reviews your benefits and gives you a clear estimate before your first visit.
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.
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®.
No. BrainHealth Solutions has one clinic, at 3151 Airway Ave, Bldg R, Costa Mesa, beside John Wayne Airport, about an hour south of Los Angeles on the I-405 depending on traffic. Every evaluation and dose happens there.
No. You cannot drive until the following day because of sedation and dissociation, so you need a driver for every visit. Plan the return trip before your first appointment.
Twice a week for the first four weeks, then weekly for four weeks, then weekly or every two weeks in maintenance. Each visit includes at least two hours of monitoring. The clinic is open Monday to Friday, 8:30 AM to 5:00 PM.
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 for your depression, and how the visit schedule would work from Los Angeles.
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.
