SPRAVATO® (esketamine) CIII Treatment in Bozeman, Montana

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You are not alone and help is available.

If you’ve tried multiple antidepressants without relief, Sub Rosa Therapy offers a treatment that works differently. SPRAVATO is an FDA-approved medication for treatment-resistant depression, administered on-site in a calm, supportive mental health environment.

Our team works closely with you to determine if this treatment fits your needs, and provides integration support throughout the process with the help of your therapist. Many clients also benefit from additional support through our Psychedelic Preparation & Integration Therapy services, which can help you process insights and experiences that may arise during SPRAVATO® treatment.

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What is SPRAVATO?

SPRAVATO® (esketamine) CIII is a nasal spray used as monotherapy or with an oral antidepressant to treat:

  • Treatment-resistant depression (TRD) in adults

  • Depressive symptoms in adults with major depressive disorder (MDD) and acute suicidal ideation or behavior

SPRAVATO® is only available through a REMS certified treatment center and must be administered under medical supervision.

Spravato nasal spray device at Sub Rosa in Bozeman

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What to expect from a Spravato® treatment in Bozeman, MT

We understand that trying something new can feel overwhelming. At Sub Rosa, SPRAVATO® sessions are conducted in a quiet, private room with attentive staff present throughout. We offer:

  • Initial psychiatric evaluation, mental health and medical screening

  • Support with the SPRAVATO® Savings Program and insurance authorization

  • Compassionate medical monitoring from our medical team

  • Psychedelic Preparation & Integration Therapy with a Sub Rosa therapist or coordination with an outside counselor

Set, Setting, Safety & Integration

At Sub Rosa Therapy, SPRAVATO® treatment is not approached as a medication-only intervention. We believe that preparation, environment, therapeutic support, and integration are important components of meaningful mental health care.

During SPRAVATO® sessions, clients are supported in a calm, private therapeutic setting with trained staff present throughout the experience. Sessions include ongoing medical monitoring focused on safety and comfort, along with opportunities for reflection, grounding, and emotional support throughout the experience.

Because meaningful change often continues beyond the treatment session itself, integration support is strongly encouraged. Sub Rosa therapists can provide Psychedelic Preparation & Integration Therapy directly, or our team can help coordinate care with outside counselors when appropriate. We view SPRAVATO®, psychiatric care, and psychotherapy as interconnected parts of a larger healing process rather than isolated services.

Learn more about our philosophy of set and setting in psychedelic care: More Than Medicine: The Importance of Set and Setting in Ketamine-Assisted Psychotherapy (KAP)

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Spravato® Frequently Asked Questions

  • Spravato® (esketamine) is a fast-acting antidepressant derived from ketamine and is FDA-approved for treatment-resistant depression and depression with suicidal ideation.

    Check out our blog post: Is Esketamine a Psychedelic? Understanding the Differences Between Esketamine and Classic Psychedelics

  • Spravato® is a prescription medicine used in adults 18 or older to treat depressive symptoms associated with either of the following diagnoses:

    • Treatment-Resistant Depression (TRD), with or without an oral antidepressant

      • Diagnostic criteria for TRD requires failure of 2 or more trials of different classes of antidepressants of adequate duration and dose (4-6 weeks)

    • Major Depressive Disorder (MDD) with acute suicidal ideation, in conjunction with an oral antidepressant.

    Diagnostic requirements of Spravato vary by insurance. Contact us to see whether you meet the specific criteria for your insurance plan. 

    Not eligible for Spravato? Ketamine-assisted therapy (KAT) may be a fit for you.

  • Spravato® (esketamine) is a nasal spray that is self-administered under direct supervision of an onsite medical provider. Following administration, you must remain under supervision by the medical provider for two hours.

    At Sub Rosa Therapy,we believe that set, setting, and psychedelic integration counseling are essential in Spravato and ketamine-assisted therapy treatment. All Spravato sessions are monitored by a psychedelic-informed staff member, to hold space for those undergoing esketamine.

    Check out our blog post: More Than Medicine: The Clinical Setting Advantage in Ketamine-Assisted Therapy

  • Common side effects of Spravato® usually resolve within a few hours and may include:

    • Dissociation

    • Dizziness

    • Nausea

    • Increased light sensitivity

    • Drowsiness

    • Change in blood pressure

    Sub Rosa Therapy abides by Spravato® Risk Evaluation and Mitigation Strategy (REMS) guidelines, meaning an onsite medical provider will monitor 2 hours following self-administration, monitoring vitals before, during, and after treatment.

  • Following initial prior authorization by insurance, Spravato® treatment is scheduled twice a week during weeks 1-4 in the induction phase, followed by maintenance treatment once weekly during weeks 5-8, and then every 2 weeks or once weekly from week 9 forward. Evidence of therapeutic benefit is evaluated at the end of the induction phase to determine the need for continued treatment.

  • Spravato is an FDA-approved treatment for depression that’s covered by many insurance plans in Montana, including:

    Sub Rosa Therapy offers support in setting up and navigating the Spravato® Savings Program for all eligible commercially insured clients.

    All Spravato treatments require prior authorization. Our billing team will help you navigate the approval process. Not sure if your plan covers Spravato? Contact us — we’re happy to verify your benefits.

SPRAVATO® (esketamine) CIII Treatments in Bozeman, Montana | FAQ

Important Safety Information for SPRAVATO®

  • WARNING: SEDATION; DISSOCIATION; ABUSE AND MISUSE; AND SUICIDAL THOUGHTS AND BEHAVIORS
    SPRAVATO® may cause sedation and dissociation. Patients must be monitored for at least two hours after administration. SPRAVATO® is associated with abuse and misuse. SPRAVATO® is only available through a restricted program called the SPRAVATO® REMS. Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors. SPRAVATO® is not approved for use in pediatric patients.

    • The effectiveness of SPRAVATO® in preventing suicide or in reducing suicidal ideation or behavior has not been demonstrated.

    • SPRAVATO® is not approved as an anesthetic agent. Its safety and effectiveness for anesthetic use have not been established.

  • SPRAVATO® is contraindicated in patients with:

    • Aneurysmal vascular disease (e.g., thoracic and abdominal aorta, intracranial, peripheral arterial vessels) or arteriovenous malformation

    • A history of intracerebral hemorrhage

    • Hypersensitivity to esketamine, ketamine, or any of the excipients

  • SPRAVATO® is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS), due to the risks of serious adverse outcomes from sedation, dissociation, respiratory depression, and abuse/misuse.

    Requirements include:

    • Administered only in certified healthcare settings

    • Patient enrollment in the REMS program

    • Direct observation by a healthcare provider and monitoring for at least 2 hours after each dose

  • To view the full Prescribing Information, including additional warnings, precautions, and clinical data:

    View Full Prescribing Information