Spravato (esketamine) ยท Long Beach
Spravato, administered in office, under direct observation.
Spravato (esketamine) is an FDA-approved nasal spray for certain adults with treatment-resistant depression, or with major depressive disorder and acute suicidal ideation or behavior. It is a controlled, closely monitored treatment, not a take-home medication. As of October 2026, Dr. Samer Roumani, D.O., is certified under the FDA's Spravato REMS Program to administer it at our Long Beach clinic.
- In the office Never taken at home
- At least two hours Monitored after every dose
- Nasal spray Under direct observation
- REMS-certified Dr. Samer Roumani, D.O.
The medication
What Spravato is, and what it isn't
Spravato (esketamine) is a nasal spray derived from ketamine, delivered as a prescription medication under a Risk Evaluation and Mitigation Strategy (REMS) the FDA requires because of its sedation, dissociation, and misuse risks. It is not a standalone treatment: the FDA approval for treatment-resistant depression allows it as monotherapy or alongside an oral antidepressant, and the acute-suicidal-ideation indication requires it be used together with an oral antidepressant.
Spravato is different from the ketamine infusions offered at some clinics, which use a different formulation and are not FDA-approved for depression. Spravato's approval, dosing, and REMS requirements are specific to the esketamine nasal spray product.
An honest limit worth knowing
The FDA has not demonstrated that Spravato prevents suicide or reduces suicidal ideation or behavior, even though one of its approved uses is for depression with acute suicidal ideation. It is approved to treat the depressive symptoms in that population, used alongside an oral antidepressant, not as a treatment for suicidality itself. If you are in crisis right now, call or text 988 or call 911; this page is not a substitute for emergency care.
Who it's for
Who it's for
Spravato is approved for adults in two situations:
- Treatment-resistant depression, generally meaning depression that has not responded to at least two different antidepressants at adequate doses.
- Major depressive disorder with acute suicidal ideation or behavior, used together with an oral antidepressant.
Whether Spravato is appropriate depends on your full history: prior medication trials, current symptoms, medical conditions, substance use history, and safety. A clinical evaluation, not a self-assessment, determines fit.
Your visit
What a treatment visit involves
- Plan your ride home
- Treatment in the office
- Monitoring after every dose
You cannot pick up Spravato from a pharmacy and take it home. Certified pharmacies ship it only to certified healthcare sites like ours, and it is administered on-site, never self-administered at home.
Plan for the appointment to take at least two to three hours including monitoring time. You will need someone else to drive you home; you should not drive, operate machinery, or make important decisions for the rest of the day, since judgment and alertness can be affected.
A typical course involves an induction phase of more frequent sessions, followed by a maintenance phase with sessions spaced further apart, individualized to how you respond. Your clinician reviews progress and adjusts the plan with you along the way.
Your care team
Part of a coordinated plan, not a standalone fix
Spravato is used alongside the rest of your care, not instead of it. For treatment-resistant depression, it may be combined with an oral antidepressant or used as the primary treatment after a careful evaluation; for the acute-suicidal-ideation indication, an oral antidepressant is required alongside it. Many patients also continue talk therapy and ongoing medication management with our team.
Our care team includes Dr. Samer Roumani, D.O., Medical Director and the REMS-certified provider for Spravato at our Long Beach clinic, and Richard Perez, PMHNP-BC. Coverage and out-of-pocket cost depend on your plan; we verify insurance benefits and explain what to expect before a course begins rather than after.
Your next step
Ask whether Spravato fits your history.
The first step is a conversation about what you've already tried and what you're experiencing now. We'll explain the REMS process, what a visit involves, and what we need to check before scheduling.