How many spravato treatments are in the induction phase?

Spravato Induction Phase Basics

Spravato (esketamine nasal spray) treats treatment-resistant depression in adults, combined with an oral antidepressant. The FDA-approved dosing regimen splits treatment into an induction phase followed by maintenance. Induction builds initial response quickly.[1]

How Many Treatments in Induction

The induction phase lasts 4 weeks with twice-weekly dosing, totaling 8 treatments. Each session involves 2 nasal sprays (28 mg per device, up to 84 mg total per dose) under medical supervision, with 1-hour monitoring afterward.[1][2]

Why Twice-Weekly During Induction

This schedule targets rapid symptom relief, as esketamine's effects peak within hours but wane quickly. Studies showed twice-weekly dosing improved MADRS scores faster than placebo in phase 3 trials.[2]

Transition to Maintenance

After 4 weeks (8 doses), patients shift to once-weekly for week 5, then every 2 weeks or weekly based on response. Remission often occurs by week 4 in responders.[1]

Common Patient Questions on Scheduling

• Missed dose? Resume at next scheduled time; do not double up.
  
• Duration varies? No—fixed 4-week induction for all approved uses (TRD or MDD with suicidal ideation).
  
• Duration for suicidal ideation? Same 8-dose induction, but with urgent symptom monitoring.[1][2]
  
  [1]: FDA Spravato Label
  [2]: Spravato.com Dosing