New nasal spray can help treat depression, may be covered by insurance

HOUSTON – Ketamine is a common anesthesia drug that has been found helpful for people suffering from migraines, chronic pain and treatment-resistant depression. The biggest downside is it's very expensive. Each treatment costs between $350 and $1,000.

It's given through an IV and typically needed a couple times a month.

Now, a nose spray version of this treatment is FDA-approved, making it easier for insurance companies to allow some patients to get this new spray for a lot cheaper.

Bellaire patient Rich Guerra said it's better than any treatment he's ever tried before.

In Guerra's battle with depression, he's been suicidal, hospitalized, tried 15 different antidepressants, even endured electric shock therapy.

"That was very traumatic," Guerra said.

Rich has tried the IV with Ketamine before but said without insurance help, it's too expensive to maintain regular treatments. Plus, it doesn't last very long.

However, a nose spray called Spravato may be working to free him from severe symptoms.

"I had low expectations, I didn't understand what it was, in my mind I thought it was going to be weaker than Ketamine I've been taking but for me, it seemed fantastic. I immediately felt the effects," Guerra said.

According to his psychiatrist, Dr. Sandyha Prashad, Spravato works better for some patients because it hits a different receptor in the brain.

"What that means also is that you receive results really fast. People will often see suicidality diminish almost immediately and depression symptoms to get better within days rather than weeks that they typically see with traditional antidepressants," Prashad explained.

She said insurance will cover Spravato, but patients have to be eligible for this treatment.

"This is not a first-line treatment for depression, this is for patients who have tried at least two medications and have severe depression and are considered treatment-resistant," Prashad said.

Rich started using this twice weekly for four weeks and then went down to once a week.

Since it's a regulated drug, patients must wait in the office for two hours after using it to be observed. But he and the doctor feel it's already improved his quality of life.

"I'm amazed that I can actually be in front of a camera and do this because, I'm still working on self-esteem, and other issues, like I said it's never going to be perfect but the fact that I'm willing to work on these things is amazing even to me," Guerra said.

Spravato is not available everywhere, patients and clinics have to get certified before they can start this routine. You can learn more about being REM certified at

Local doctors may have a waitlist even if you do get REM certified, but to find a clinic near you, visit