Spravato® Plus | Best Fit Counseling & Psychiatry

Spravato (esketamine) nasal spray device, 28 mg

Spravato® contains esketamine, one of the two molecular forms of ketamine.

Insurance covered & FDA-approved

Introducing Spravato® (esketamine) for Depression.
A transformational approach to healing from depression.

Spravato® (esketamine) is an FDA-approved prescription nasal spray, related to ketamine but not the same as the ketamine used in IV infusion clinics. It's a specific, tightly regulated formulation that's only available through certified providers like Best Fit.

When traditional antidepressants haven't worked, Spravato® offers a different path forward. It works in a unique way to help the brain build new connections and may support lasting healing.

For many people, Spravato® can be a life-changing step toward feeling better, reconnecting with themselves, and moving forward.

Science-Driven

Spravato treatment grounded in research and clinical practice.

Proven Effective

78% validated positive outcomes, with 21,150 patients served across 44 years of integrated care.

Safe & Precise

Spravato treatment provided with careful dosing and clinical monitoring.

Comfort-Focused

A supportive, patient-first treatment experience with Telehealth options anywhere in Michigan.

Affordable

99% use insurance, with an average cost of $24 per session (2025).

How does ketamine work?

Chronic depression can affect the brain, making you feel heavy, numb, disconnected, and stuck.

Ketamine works differently from traditional antidepressants. It may help the brain build new connections between nerve cells and strengthen existing ones, supporting the brain’s natural ability to heal and adapt.

The result? A chance to break free from the cycle of depression, see life differently, and reconnect with hope, joy, and yourself again.

"Ketamine is transformational. In my career, there's never been anything like it." — Terry Dunivin, LMSW, Director of BFC&P

Are You Eligible for Spravato®?

You've been diagnosed with depression
You've tried at least two different antidepressant medications
Those medications haven't brought lasting relief
Or you're experiencing suicidal thoughts and depression

Spravato® is FDA-approved for treatment-resistant depression and for major depressive disorder with suicidal thoughts or actions. Our psychiatrists may also consider ketamine-based treatment for other conditions, such as PTSD, on a case-by-case basis when clinically appropriate.

Get Started Now

Insurance plans we commonly see cover Spravato®:

Coverage varies by plan. We recommend confirming
your specific benefits with us before you begin treatment.

Educational resource

Yale Medicine's Overview of the Power and Effectiveness of Ketamine and Spravato.

Watch on YouTube for captions and transcript options

Our Spravato® Plus Process

At Best Fit Counseling & Psychiatry, our approach to mental health combines the strengths of psychiatry and therapy to provide comprehensive care. We focus on integrating medication management, psychotherapy, and holistic wellness strategies to address the unique needs of each individual.

Initial Consultation

A thorough assessment to determine suitability for Spravato® Plus, including medical history review, treatment expectations, and discussion of mental health goals.

Preparation

Pre-session guidance and support to ensure you're mentally and physically prepared for treatment, promoting a safe, focused, and effective treatment journey.

Medication

Self-administered Spravato® (esketamine) nasal spray under direct clinical supervision, aimed at providing rapid relief from depression, suicidal ideation, anxiety, PTSD, and others.

Integrated Neurotherapy

A comprehensive approach that brings together advanced neurotherapeutic treatments and personalized care to support meaningful, lasting change.

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Where treatment happens

A Medication Room Designed for Your Comfort

Your treatment experience should feel calm, private, and supported from the moment you arrive. Our medication rooms are thoughtfully designed around the needs of each patient, with comfortable seating, adjustable lighting, and the small comforts that can make your time here feel easier.

We believe your environment matters. That's why we've created a space where you can settle in, relax, and feel supported while your medication takes effect—with thoughtful details available throughout your visit.

A Best Fit medication room with a leather recliner, side chair, and a window with natural light — Comfortable recliners, adjustable lighting, calming music, and noise-canceling headphones create a restful space for your treatment.

A Best Fit medication room with recliners, a side table, and comfort amenities — Water, mints, tissues, hand sanitizer, and other thoughtful essentials are available whenever you need them.

A Best Fit medication room with recliners, calming artwork, and a temperature control unit — Adjustable temperature, weighted blankets, and carefully chosen surroundings help you create a comfortable treatment experience.

Every detail is intentional. Your comfort is not an extra—it's part of the experience.

Where treatment happens

Our Ann Arbor Office

Because it's an in-office, REMS-monitored medication, every Spravato® Plus visit takes place here, not by telehealth.

5331 Plymouth Road, Ann Arbor, Michigan 48105, US
Main Hotline: (734) 412-7300
Free on-site parking, with accessible entry

Conveniently located in Ann Arbor for patients in nearby communities: Belleville, Canton, Chelsea, Dexter, Dundee, Grass Lake, Hamburg, Manchester, Milan, Pinckney, Plymouth, Saline, South Lyon, Tecumseh, Whitmore Lake, and Ypsilanti, Michigan.

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Frequently asked questions

Spravato® Treatment, Explained

Spravato® is FDA-approved for adults with treatment-resistant depression (depression that hasn't responded to at least two other antidepressants) and for adults with major depressive disorder who have suicidal thoughts or actions. Our team will review your history to determine whether you're a candidate.

Spravato® is approved for treatment-resistant depression and for major depressive disorder with suicidal thoughts or behavior. In practice, that often looks like a persistent low mood, loss of interest in things you used to enjoy, disrupted sleep or appetite, low energy, trouble concentrating, feelings of guilt or hopelessness, and, in some cases, suicidal thinking, especially after at least two other antidepressants and talk therapy haven't brought lasting relief.

You'll self-administer the nasal spray under the supervision of our clinical staff, then remain in our office for a required monitoring period. Counseling sessions are scheduled separately from treatment visits, not on the same day.

Best Fit follows the FDA-approved protocol. In sequence, here's how often you'll come in:

Introduction phase: twice weekly for 4 weeks
Optimization phase: once weekly for 4 weeks
Maintenance phase: once every 2 weeks
Ongoing maintenance phase: once every 3–4 weeks, once your mood is stable

There's no fixed end date built into the protocol; it's designed to escalate and then taper based on how you respond. Many patients continue in the once-every-3-to-4-week maintenance phase for an extended period once their mood is stable, and your psychiatrist reassesses with you along the way to decide what makes sense for your situation.

It starts with an intake evaluation with one of our providers to confirm you meet the clinical criteria, based on your psychiatric history and your specific insurance plan's requirements. Most plans require prior authorization before treatment can begin, and our team handles that paperwork for you once your evaluation is complete.

Yes. Spravato® (esketamine) has been FDA-approved since March 2019, for treatment-resistant depression and, more recently, for major depressive disorder with suicidal thoughts or behavior.

Many insurance plans cover Spravato® for patients who meet clinical criteria, typically after prior authorization. Coverage and out-of-pocket costs vary by plan, so we recommend confirming your specific benefits with us before you begin treatment.

No. In our Spravato® Plus program, Spravato® is delivered alongside ongoing psychiatric care and counseling, not as a replacement for either.

No. Spravato® Plus requires a real commitment: 12 visits upfront before your first evaluation. It's the start of a coordinated plan with counseling and support built in, not a one-time treatment.

Traditional antidepressants can take weeks to work and only manage symptoms. Spravato® works through a different pathway and can create change more rapidly.

Therapy alone can be slow going for treatment-resistant depression. Spravato® can open a window that helps that work land faster.

TMS requires many more in-office sessions with equipment worn on the head. Spravato® visits are shorter and don't require any device.

IV ketamine requires an IV line. Spravato® is a nasal spray with fewer side effects and the largest research base of any ketamine-based option.

Refer a patient for
Spravato®

You Know Your Patient. We Know Spravato®.

We partner with your practice to provide specialized Spravato® treatment, so your patients receive expert care without losing the continuity and guidance you provide.

Refer a Patient

What We Handle

Complex treatment planning for patients who have not responded adequately to multiple antidepressant trials
Spravato® treatment and required monitoring, including the structured induction process
Prior authorization and insurance navigation, handled by our team
Clear communication with referring providers, so you remain informed without having to manage every detail

You stay involved in your patient's care. We take care of the complexity that requires a dedicated treatment program.

Blog: Ketamine vs. Spravato® Blog: Does ketamine therapy work? Treatment-resistant depression

Heal the Brain. Rebuild Your Life.

Request an appointment and our team will walk through your history and treatment options together.

Are We the Right Fit?

For too many people, depression feels like a life sentence.