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Nasal Esketamine

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Hope419 offers the only FDA-approved ketamine based psychadelic treatment for depression. FDA approved in March of 2019 and used in the Hope419 practice since June of 2021, nasal esketamine is used for treatment resistant depression as well as for acute suicidal ideation and behavior.

The Process

Treatment Course



As a new patient, a clinician will meet with you to do a full psychiatric assessment and determine if Spravato is the right choice for you. For current patients, Esketamine is easily discussed by asking your clinician. All patients receiving Esketamine treatment must be enrolled in a monitoring program and this will be discussed on the day of consutlation.



On the day of treatment you will avoid eating for two hours prior to treatment. You will get a ride to the office and plan to stay for two hours of monitoring. For your safety, your blood pressure will be checked prior to treatment, 40 minutes after the start and at the end.


Stage One

Stage one is weeks 1-4. During these weeks it is recommended to receive Esketamine treatment twice per week. The Esketamine treatment coordinator will work with you and your transportation schedule as well as determining which location is most convenient.


Stage Three

Stage three is anytime beyond 8 weeks. You will work with your medical team to determine if once per week or once every other week is best for your symptoms, and lifestyle needs. Treatment duration is indefinite at this stage and is best determined by you and your medical team. 


Insurance Investigation

When the decision is made to proceed with Esketamine, your clinician will submit a referral to the Esketamine treatment coordinator. The treatment coordinator and your clinician work together to enroll you, with your consent in the REMS monitoring program.  She then works with our local delivery pharmacy to investigate insurance benefits.


Going Home

After two hours, and if the medical team has cleared you to return home you will be released to the care of your driver. Your driver will sign you out of the office. That evening you will not be able to drive, but many do return to a normal level of functioning otherwise.


Stage Two

Stage two is weeks 5-8. During these weeks it is recommended to receive Esketamine treatment once per week. The Esketamine treatment coordinator will work with you to determine what day of the week works best for your lifestyle.


Learn More

The following topics can provide more information on the science  and further detail on nasal ketamine based treatment of depression. 

Esketamine, REMS

Esketamine, More Information

Esketamine, The science

Cat and Working


If you are interested in nasal esketamine and would like to schedule a consultation, complete the form below. We will be in touch within 1-3 business days.

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