Prescription medication · NMDA Receptor Antagonist (Nasal Spray)
esketamine
Also sold as Spravato. Spravato is used to treat treatment-resistant depression in adults.
Data updated 2026-05-15
- 15,846
- FDA reportsModerately reported
- 1
- InteractionFew interactions
- $373.45
- Brand price (NADAC)
What the data shows
esketamine (Spravato) is a prescription NMDA Receptor Antagonist (Nasal Spray), reported at a middle-of-the-pack volume (15,846 FDA reports), with 1 documented drug interaction.
Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.
esketamine (Spravato) is a prescription NMDA Receptor Antagonist (Nasal Spray). Spravato is used to treat treatment-resistant depression in adults.
Spravato is a nasal spray medicine used to treat depression. It contains esketamine and affects certain receptors in the brain.
Verify with FDA → · CMS NADAC pricing →
Drug Pricing (NADAC)
Brand Price
$373.45/unit
Generic Available
No
JANSSEN PHARMS
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Spravato is used to treat treatment-resistant depression in adults.
Common side effects
Feeling disconnected from yourself or your surroundings, Dizziness, Nausea
Key warnings
Spravato can cause sleepiness, feeling disconnected, and breathing problems.
The sections below are summarized in plain English from esketamine's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.
How It Works
Spravato is a type of medicine called an NMDA receptor antagonist. It works by affecting certain receptors in the brain. These receptors are involved in regulating mood and emotions.
How to Take It
Spravato is given as a nasal spray by a healthcare provider. You will spray it into your nose. You will be watched for at least 2 hours after each dose. Avoid food for 2 hours and liquids for 30 minutes before taking Spravato. If you use a nasal spray for allergies, use it 1 hour before Spravato.
This is a plain-language summary of esketamine's FDA labeling, not individualized dosing advice. Ask a pharmacist or prescriber before changing how you take this medication.
Pregnancy & Breastfeeding
Spravato may harm an unborn baby. Talk to your doctor about pregnancy planning and birth control. Breastfeeding is not recommended while using Spravato.
This is a plain-language summary of esketamine's FDA labeling, not individualized advice. Ask a pharmacist or prescriber about pregnancy or breastfeeding on this medication.
Missed Dose
Spravato is given by a healthcare provider, so you are unlikely to miss a dose. If you miss an appointment, call your doctor as soon as possible.
This is a plain-language summary of esketamine's FDA labeling, not individualized advice. Ask a pharmacist or prescriber what to do about your specific missed dose.
Storage
Store Spravato at room temperature, between 68° to 77°F.
Side Effects (from patient reports)
Based on 15,846 FDA adverse event reports.
Most-reported reactions
Adverse reactions in FAERS for esketamine, by number of reports
- Feeling disconnected from yourself or your surroundings
Feeling disconnected from yourself or your surroundings
3,351 reports
- Sleepiness
Sleepiness
2,465 reports
- Thoughts of suicide 1,233
Thoughts of suicide
1,233 reports
- Feeling sick to your stomach 876
Feeling sick to your stomach
876 reports
- Feeling sad or hopeless 808
Feeling sad or hopeless
808 reports
- Needing to be in the hospital 702
Needing to be in the hospital
702 reports
- High blood pressure 688
High blood pressure
688 reports
- Feeling worried or nervous 681
Feeling worried or nervous
681 reports
- Throwing up 643
Throwing up
643 reports
- Feeling unsteady 597
Feeling unsteady
597 reports
What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.
Reports over time
Adverse-event reports filed for esketamine each year to the FDA Adverse Event Reporting System (FAERS).
Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.
Where esketamine sits
esketamine has more FDA adverse-event reports than 50% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.
Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is esketamine; the line is the median (50th percentile).
FDA Adverse Event Report Analysis
Detailed analysis of 15,846 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2015–2025.
Total Reports
15,846
Reports Mentioning Death
641
4.0% of reports — not proof of cause
Hospitalization Reports
2,714
Top Indication
Depression
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DISSOCIATION | 3,351 |
| 2 | SEDATION | 2,465 |
| 3 | SUICIDAL IDEATION | 1,233 |
| 5 | NAUSEA | 876 |
| 6 | DEPRESSION | 808 |
| 8 | HOSPITALISATION | 702 |
| 9 | HYPERTENSION | 688 |
| 10 | ANXIETY | 681 |
| 11 | VOMITING | 643 |
| 12 | DIZZINESS | 597 |
| 13 | BLOOD PRESSURE INCREASED | 518 |
| 14 | FEELING ABNORMAL | 455 |
| 16 | HEADACHE | 306 |
| 17 | DEATH | 291 |
| 18 | SUICIDE ATTEMPT | 289 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Spravato can cause sleepiness, feeling disconnected, and breathing problems. You will be monitored for these side effects. Spravato has the potential for abuse and misuse. Spravato may increase suicidal thoughts and behaviors in young adults. Spravato is only available through a special program.
Known Drug Interactions
7.2 Psychostimulants Concomitant use with psychostimulants (e.g., amphetamines, methylphenidate, modafinil, armodafinil) may increase blood pressure [see Warnings and Precautions (5.7) ] .
Mechanism: Taking these two medicines together can cause your blood pressure to go up higher than usual.
What to do: Your healthcare provider should check your blood pressure regularly while you are using both medications.
This is a plain-language summary of interactions documented in FDA labeling, not individualized advice. Ask a pharmacist or prescriber before combining medications.
Common Questions
Can Spravato prevent suicide?
Can I drive after taking Spravato?
What if my blood pressure is high?
Is Spravato safe for children?
What should I avoid before taking Spravato?
Can I take other medicines with Spravato?
How long will I be monitored after taking Spravato?
What if I feel sleepy after taking Spravato?
How is Spravato supplied?
What does Spravato contain?
What are the common side effects of esketamine?
Does esketamine interact with other medications?
What drug class is esketamine?
Is esketamine safe during pregnancy?
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What the FDA Data Shows for esketamine
The FDA label for esketamine (sold under brand names such as Spravato) classifies it as a prescription-only medication in the NMDA Receptor Antagonist (Nasal Spray) class. Spravato is used to treat treatment-resistant depression in adults. Official labeling lists 12 commonly reported side effects, including Feeling disconnected from yourself or your surroundings, Dizziness, Nausea.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 15,846 voluntary reports. The database also lists 1 documented drug interaction derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS.
Report counts do not establish causation, a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice, always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: August 26, 2025
Read our methodology - how this data is sourced, computed, and verified.
Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled and last refreshed May 2026. See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a correction.
All federal data sources used on this page
- FDA Orange Book - approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed - NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) - post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm - standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files - federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database - current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages