Indication 1
Treatment-Resistant Depression (TRD)
In adults — as monotherapy or in conjunction with an oral antidepressant. TRD generally means inadequate response to at least two antidepressants in the current episode.
A Texas Patient & Provider Resource
Understanding SPRAVATO® treatment in Texas.
Clear, independent information about SPRAVATO® (esketamine) — an FDA-approved nasal spray for adults with treatment-resistant depression. Find certified clinics, understand the pharmacy process, and navigate insurance in Texas.
The basics
What is SPRAVATO®?
SPRAVATO® (esketamine) is a prescription nasal spray and a Schedule III controlled substance, manufactured by Janssen (a Johnson & Johnson company).
Esketamine is the S-enantiomer of ketamine — a distinct, separately FDA-approved medication. It is a non-competitive NMDA-receptor antagonist, a fundamentally different mechanism than traditional oral antidepressants, and is considered rapid-acting (improvement was seen as early as 24 hours in clinical trials).
SPRAVATO® is not the same as ketamine and is administered only in certified healthcare settings under the FDA's REMS program.
FDA-approved uses
What it's approved to treat
Indication 2
MDD with Acute Suicidal Ideation or Behavior
Depressive symptoms in adults with major depressive disorder (MDD) who have acute suicidal ideation or behavior — in conjunction with an oral antidepressant.
Limitations of use: SPRAVATO® is not approved as an anesthetic. Effectiveness in preventing suicide or reducing suicidal ideation or behavior has not been demonstrated. Not approved for pediatric use.
Rapid-acting
Improvement seen as early as 24 hours in clinical trials.
In-clinic only
Administered exclusively in REMS-certified healthcare settings.
Not at retail
Cannot be picked up at a pharmacy or taken home.
New in 2025
FDA approved SPRAVATO® as the first standalone (monotherapy) treatment for treatment-resistant depression.
Previously approved only as an add-on to an oral antidepressant for TRD, the January 2025 approval allows SPRAVATO® to be used on its own — a meaningful option for patients who can't tolerate additional oral antidepressants.
Statewide coverage
SPRAVATO® treatment across Texas
From Houston, Dallas–Fort Worth, Austin and San Antonio to El Paso, the Panhandle, the Permian Basin, the Rio Grande Valley and East Texas — explore an interactive map of 60+ verified SPRAVATO® clinic listings across 20+ Texas cities.
Open the full map →Certified SPRAVATO® clinic locationSome metros have multiple clinics — number on each pin = clinics in that area. Hover or tap a pin for the list.
Explore the guide
Pharmacies
Why SPRAVATO® can't be picked up at retail — and how it actually gets to the clinic.
Clinics
What a treatment visit looks like, plus a directory of certified Texas clinics.
Resources
FDA indications, the boxed warning, and authoritative links for patients and providers.
News & Insurance
Latest approvals and a clear walk-through of Texas coverage, prior auth, and savings programs.
Ready to find a certified clinic?
Browse 60+ REMS-certified SPRAVATO® clinic listings across 20+ Texas cities — from Houston, Dallas and Austin to El Paso, the Rio Grande Valley and East Texas.
Browse Texas clinicsIf you're in crisis, call or text 988 — the Suicide & Crisis Lifeline.