Dosing and Administration SMDD

SPRAVATO® (esketamine) dosing and administration

Actor portrayal.

TRD=treatment-resistant depression in adults.

MDSI=depressive symptoms in adults with MDD with acute suicidal ideation or behavior.

AE=adverse event.

TEAE=treatment-emergent adverse effect.

8 doses over 4 weeks to treat depressive symptoms in adults with MDSI1

rapid reduction of depressive symptoms

 All patients in the clinical studies received comprehensive standard-of-care (SOC) treatment, including an initial inpatient hospitalization and a newly initiated or optimized oral antidepressant (AD) therapy (AD monotherapy or AD plus augmentation) as determined by the investigator

 After 4 weeks of treatment with SPRAVATO®, evidence of therapeutic benefit should be evaluated to determine need for continued treatment. Treatment beyond 4 weeks has not been systematically evaluated

 Dosage may be reduced to 56 mg twice weekly based on tolerability

Depressive symptoms in adults with MDD with acute suicidal ideation or behavior administration

SPRAVATO® should be self-administered by the patient under the supervision of a healthcare provider in a certified SPRAVATO® treatment center.1

Treatment-resistant depression administration

Read the full Dosing & Administration Guide before training and supervising patients.

Please see “Dosing and Administration” and “Instructions for Use” in the full Prescribing Information.

Post-administration observation and discharge

observation and discharg

Healthcare providers are required to observe patients for at least 2 hours.

 Because of the possibility of delayed or prolonged sedation or dissociation in some cases, patients should be monitored by a healthcare provider for at least 2 hours following each treatment

observation and discharge

Patients will require transportation from the treatment center.

 Caution patients that SPRAVATO® may impair their ability to drive, and not to engage in potentially hazardous activities requiring complete mental alertness and motor coordination, such as driving a motor vehicle or operating machinery, until the next day after a restful sleep


Next: Start patients on SPRAVATO®

Learn more


1. SPRAVATO® [Prescribing Information]. Titusville, NJ: Janssen Pharmaceutials, Inc. July 2020.

2. Al-Harbi KS. Treatment-resistant depression: therapeutic trends, challenges, and future directions. Patient Prefer and Adherence. 2012;6:369-388.