Spravato is the first FDA-approved form of intranasal ketamine to rapidly relieve treatment-resistant depression. Clarus Health is San Francisco's premier Spravato center.
Spravato is a transformational, FDA-approved treatment for:
Learn more about the difference between Spravato and IV ketamine therapy for mental health and chronic pain.
We accept Aetna, Medical, United Healthcare, Cigna, Medicare, Anthem Blue Cross Blue Shield, and Blue Cross Blue Shield of California insurances for Spravato.
Your Path Forward
Three intentional steps — each designed around your history, your coverage, and your healing.
Step One
We start by getting to know you and cutting through the complexity. Your provider conducts a clinical evaluation to confirm Spravato is right for you, while our team handles insurance verification and prior authorization — so you can focus on healing, not paperwork.
Step Two
Administered as a nasal spray in our calming, monitored office environment, each Spravato session is a dedicated two hours for your mind to begin resetting. Our team is with you throughout — ensuring comfort, safety, and the space to let the treatment work.
Step Three
Spravato works through a consistent cadence of sessions that taper over time as your brain stabilizes. We track your progress at every visit and adjust your protocol as needed — keeping you supported through every phase of your recovery.
Begin your journey today
With a doctor always on-site, you're in the safest hands
Dr. Anthony Kaveh is a Stanford and Harvard-trained physician who has guided hundreds of patients in restoring their inner healing capacity to rediscover meaning and purpose as part of their holistic healing journey. He works with Dr. Sneha Shrestha to help deliver the highest quality Spravato experience.
Learn from our expert physicians about IV ketamine therapy for depression, anxiety, chronic pain, and PTSD.
Spravato can only be administered at a certified treatment center. The FDA requires it under the REMS program, so it is never dispensed to take home. Clarus Health is a certified Spravato provider in downtown San Francisco:
Clarus Health
450 Sutter Street, Suite 1504
San Francisco, CA 94108
415-237-3007
We are in the Sutter–Stockton corridor near Union Square, convenient to BART and Muni, and we treat patients from across the Bay Area including Marin, Alameda, San Mateo, and Santa Clara counties. Contact us to schedule a free 15-minute consultation.
Because Spravato is FDA-approved, most major insurance plans cover it - including Medicare, Medi-Cal, and commercial insurers - for patients who meet the criteria for treatment-resistant depression or major depressive disorder with suicidal ideation. At our San Francisco clinic we accept Aetna, United Healthcare, Cigna, Medicare, Anthem Blue Cross Blue Shield, and Blue Cross Blue Shield of California for Spravato.
Every plan requires prior authorization, which generally takes anywhere from a few days to a few weeks. We verify your benefits and handle that paperwork before your first session, so you receive a clear out-of-pocket estimate before committing to treatment. This is the main practical advantage of Spravato over IV ketamine, which is used off-label and rarely covered.
Spravato is approved for adults with treatment-resistant depression, generally meaning depression that has not responded adequately to at least two antidepressants, and for adults with major depressive disorder with suicidal ideation. As of 2025 it is also the first and only monotherapy approved for treatment-resistant depression, so eligible patients no longer need a daily oral antidepressant alongside it. Most insurers require documentation of those earlier medication trials as part of prior authorization.
It is not appropriate for everyone. Patients with uncontrolled high blood pressure, aneurysmal vascular disease, a history of psychosis, or active substance use disorder are generally not candidates. Our San Francisco intake evaluation, conducted by our physician team, identifies any contraindications before treatment begins.
Most patients experience a temporary dissociative state — a sense of floating, detachment from surroundings, altered perception of time, or dreamlike thinking. It usually begins within minutes and fades well within the two-hour monitoring window you spend in a private room at our San Francisco office.
You will not be able to drive afterward and should arrange a ride home. Many patients use the hours following a session for quiet reflection or journaling, which our integration therapy team can guide.
Not quite. Spravato is esketamine, one half of the ketamine molecule, delivered as a nasal spray. The ketamine used in IV infusions is the full compound. Both act on NMDA receptors and trigger neuroplasticity.
The practical differences matter more than the chemistry. Spravato is FDA-approved and usually insurance-covered, but its approval is limited to depression. IV ketamine is used off-label and rarely covered, but it can address anxiety, PTSD, chronic pain, and addiction, with faster onset and higher bioavailability. Our San Francisco clinic offers both and recommends based on your diagnosis, coverage, and goals — we cover the tradeoffs in detail in our guide to IV versus nasal ketamine.
Considerably faster than conventional antidepressants, which typically need four to six weeks. Clinical trials show rapid, clinically meaningful reductions in depression symptoms within hours of the first dose, and most patients who respond do so within the first one to four sessions.
That speed is why Spravato received a second FDA approval specifically for major depressive disorder with suicidal ideation, where improvement within 24 hours matters most.
In a head-to-head trial against one of the most common alternatives for treatment-resistant depression, Spravato produced significantly higher remission rates at eight weeks, with benefits sustained through 32 weeks.
That said, the best option depends on your full clinical picture. At our San Francisco clinic we also offer stellate ganglion block, genomic testing to guide medication selection, and hormone optimization, since untreated hormonal or metabolic issues frequently sustain depression that looks purely psychiatric.
Treatment follows a tapering schedule rather than a fixed number. The induction phase is twice weekly for roughly the first four weeks, then once weekly, then every one to two weeks for maintenance as your response stabilizes.
Staying on maintenance matters: patients who reach remission and continue treatment see a substantially lower risk of relapse than those who stop. Your San Francisco provider reassesses at every visit and adjusts your protocol accordingly.
The most common are dissociation, dizziness, nausea, temporarily elevated blood pressure, sedation, and headache. Nearly all resolve within the two-hour monitoring period, and your clinical provider manages them in real time.
Spravato carries a boxed warning for sedation, dissociation, and abuse potential, which is precisely why it must be administered in a certified clinic under supervision rather than taken at home. Across nearly six years of real-world use, its safety profile has remained consistent with what clinical trials predicted.
Spravato is a Schedule III controlled substance and carries a boxed warning for abuse and misuse, so the concern is a fair one. The risk is managed structurally rather than left to chance.
The medication is never dispensed for you to take home. You self-administer it in the clinic under direct supervision and are monitored for two hours afterward. These requirements exist under the FDA's REMS program specifically to prevent misuse, and every session at our San Francisco clinic is supervised by a licensed clinical provider.
