Spravato® (Esketamine)
for Los Angeles, CA Patients
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.
What Is Spravato®?
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.
How Spravato® Works
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® From Los Angeles: Visits, Rides and Supervision
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.
The Spravato® Treatment Process
15-minute screening call
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.
Comprehensive evaluation in Costa Mesa
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.
Preparing for your first dose
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.
Administration under supervision
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.
Ongoing visits and progress reviews
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.
What to Expect
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.
Session
Duration
The Spravato® schedule follows the FDA label, with every visit at the Costa Mesa clinic:
- Each visit: at least 2 hours of in-clinic monitoring after dosing
- Induction: twice weekly for 4 weeks
- Maintenance: weekly for 4 weeks, then weekly or every 2 weeks
- Taken alongside an oral antidepressant managed by your psychiatrist
Potential Side Effects
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
- Dissociation or a feeling of detachment
- Dizziness, sedation or drowsiness
- Nausea
- Temporary increase in blood pressure
- Headache or numbness
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
- Significant blood-pressure elevation, which is why uncontrolled hypertension or certain vascular conditions can exclude a patient
- Bladder irritation symptoms with long-term use, monitored at follow-up
Your evaluation screens for these risks, and every dose is given with a clinician present.
Treatment Effectiveness & Results
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.
Is Spravato® Right for You?
Spravato® at our Costa Mesa clinic may be appropriate for Los Angeles adults who:
- Have tried two or more antidepressants without adequate relief
- Have major depression with suicidal thoughts that needs a fast-acting option
- Have a driver for the round trip and can set aside the time twice a week during induction
- Are willing to continue an oral antidepressant alongside treatment
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
- SAINT® accelerated TMS: five treatment days, one week in Costa Mesa, and you can drive yourself
- TMS therapy for depression and OCD
- Medication management and psychotherapy with the same clinical team
Benefits of Spravato® for Los Angeles Patients
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.
A new mechanism after medication failures
Esketamine works on glutamate, not serotonin, so it can help when several SSRIs or SNRIs have not.
Faster onset than oral antidepressants
Some patients notice change within days. The twice-weekly induction month gives a clear read on response.
Fewer trips than daily TMS
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.
FDA-approved and insurance-recognized
Spravato® is covered by many commercial plans and Medicare for treatment-resistant depression, and the manufacturer offers savings programs for eligible commercially insured patients.
Run by a dedicated specialist
Dr. Dragos Serseni leads the Spravato® program at BrainHealth Solutions with a focus on treatment-resistant depression, and every dose is supervised.
Part of a complete depression practice
If Spravato® is not enough, TMS, SAINT®, medication management and psychotherapy are available from the same team.
For Treatment-Resistant Depression
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.
Cost of Spravato® for
Los Angeles, CA Patients
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.
Why Patients Trust BrainHealth Solutions
A psychiatrist who built UC Irvine's first TMS program
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.
Research-driven care, not a franchise protocol
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.
A clinical team, not a single provider
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.
Insurance help that patients talk about
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.
Frequently Asked Questions
Is Spravato® the same as ketamine infusions?
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®.
Do you have a Spravato® clinic in Los Angeles?
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.
Can I drive myself back to Los Angeles after a dose?
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.
How often would I need to come to Costa Mesa?
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.
Can I keep taking my antidepressant?
Yes. Spravato® is approved for use together with an oral antidepressant, and your psychiatrist manages both.
Is Spravato® covered by insurance?
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.
What if Spravato® does not work for me?
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.
Take the First Step Toward Relief
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.
