Spravato is indicated for treatment-resistant depression and a major depressive episode with suicidal ideation. Insurance companies generally require prior authorization, which typically includes documentation of treatment-resistant depression and previous trials of antidepressant medications.Ketamine, as a generic medication, has been used for many years for a variety of mental health conditions. It's being used off-label for the treatment of depression, PTSD, anxiety, and many forms of chronic pain.

Treatment-resistant depression is generally defined as depression that has not adequately responded to at least two different antidepressant medications. Insurance requirements for Spravato® vary by plan. Some insurers require the medication trials to have occurred within a specified period, and some also require patients to meet a minimum level of depression severity based on standardized rating scales such as the MADRS or PHQ-9.

Both ketamine and Spravato® can be effective treatments for treatment-resistant depression. Clinical studies of ketamine have reported response rates of approximately 50–70%, although ketamine is used off-label for depression. Spravato® is FDA-approved for treatment-resistant depression, and clinical trials have also shown substantial response rates. In depression research, a “response” generally means a 50% or greater reduction in depressive symptoms. Individual results vary.

Both ketamine and Spravato® are administered in our San Antonio clinic in a clinically supervised setting. Spravato® sessions are required to last at least 120 minutes. Ketamine sessions typically last 90 to 120 minutes.Spravato® is administered as a nasal spray that patients self-administer under clinical supervision. Ketamine is administered by intramuscular injection.Patients receive treatment in private rooms with subdued lighting. We also have big-screen TVs with 4K nature videos. Many patients enjoy watching relaxing scenes, such as waves crashing on a beach, during their session.We encourage patients to bring headphones and create a playlist of music they enjoy.

Our ketamine treatments are administered in a clinical setting under the direction of a licensed medical provider. Klarisana has been providing ketamine treatments since 2015. The doses used in our clinics are far below those used for anesthesia, and patients generally remain conscious and able to communicate during treatment.At the low, medically supervised doses used for depression and PTSD, ketamine carries a low risk of addiction. This is different from the higher recreational doses associated with abuse. Every patient is screened for substance use history before starting treatment, and patients are monitored throughout each treatment session.

Spravato® is covered by most major insurance plans when prior authorization is obtained. Klarisana participates with many major insurance plans.Intramuscular (generic) ketamine may also receive partial insurance coverage, although coverage varies considerably by plan. Our team can review your specific insurance benefits and provide more information about your coverage.

Yes, Klarisana has psychiatric nurse practitioners on staff who are closely involved in the treatment of our patients. While ketamine and Spravato® can work very well, some patients also benefit from oral psychiatric medications as part of their overall treatment plan.We also offer conventional psychiatric medication management for patients who are not interested in or ready for ketamine or Spravato® treatment.Addiitonally we have therapists who provide talk therapy.

Klarisana was founded in 2015 by Carl Bonnett, MD. At the time, there were only a handful of ketamine clinics in the U.S.We are one of the most experienced providers of ketamine treatment in the country. We now operate six clinics across Colorado and Texas and perform more than 12,000 ketamine and Spravato® treatment sessions each year..

Carl Bonnett, MD, is the Founder and Medical Director of Klarisana. Dr. Bonnett graduated from the University of Iowa and completed his emergency medicine residency at Denver Health Medical Center in Denver, Colorado. He has more than two decades of experience working as an emergency physician and extensive experience with ketamine.Dr. Bonnett retired from the Army National Guard after 20 years of service. He deployed four times in support of Operation Enduring Freedom and Operation Iraqi Freedom and has experience administering ketamine in austere, forward-deployed military settings.Dr. Bonnett has published three papers on the use of ketamine for mental health conditions. He is also a founding board member of the American Society of Ketamine Physicians, Psychotherapists & Practitioners.