Esketamine (Spravato®) Treatment at AwareHub
- Specialist-led assessment for treatment suitability
- Delivered in a controlled clinical setting
- May be considered for people experiencing treatment-resistant depression
- Part of a broader treatment plan
A treatment option for people with treatment-resistant depression
At AwareHub, we provide psychiatrist-led assessment and treatment for people experiencing treatment-resistant depression, including the use of esketamine (Spravato®) where clinically appropriate.
Esketamine is a TGA-approved medication used alongside an oral antidepressant for adults whose depression has not adequately responded to standard treatments. It represents an important option for people who continue to experience significant symptoms despite multiple treatment trials.
What is esketamine (Spravato®)?
Esketamine is a nasal spray medication derived from ketamine and is approved in Australia for treatment-resistant depression under strict clinical and safety protocols.
Unlike traditional antidepressants, which primarily act on serotonin and noradrenaline systems, esketamine works on the brain’s glutamate pathway. This different mechanism of action may help improve mood and cognitive flexibility in people who have not benefited from other treatments.
Esketamine is administered in-clinic, under medical supervision, as part of a structured treatment program.
Ketamine and esketamine – what’s the difference?
Ketamine has a long history of use in medicine as an anaesthetic. In recent years, research has explored its potential antidepressant effects at much lower doses.
Ketamine may be used off-label in some psychiatric settings, but it is not TGA-approved for the treatment of depression.
Esketamine (Spravato®) is a specifically formulated, TGA-approved medication with established protocols for use in treatment-resistant depression.
At AwareHub, our focus is on evidence-based, regulated treatments, which is why esketamine is the primary ketamine-based therapy we discuss and offer within our service framework.
Who may be suitable for esketamine treatment?
Esketamine may be considered for adults who:
- Have a diagnosis of major depressive disorder
- Have not responded adequately to at least two antidepressant treatments
- Continue to experience significant functional impairment due to depression
- Are able to attend in-clinic treatment sessions and monitoring
What do we mean by treatment-resistant depression (TRD)?
Treatment-resistant depression (TRD) generally refers to depression that has not responded adequately to at least two different antidepressant treatments, taken at an appropriate dose and for an adequate duration.
TRD does not mean that improvement is not possible. Rather, it indicates that additional or alternative treatment approaches may need to be considered under specialist psychiatric care.
Suitability is determined through a comprehensive psychiatric assessment, taking into account your mental health history, current treatments, medical background, and overall goals of care.
Esketamine is not appropriate for everyone, and careful screening is essential.
What does treatment at AwareHub involve?
Esketamine treatment at AwareHub is delivered within a structured, psychiatrist-led program, prioritising safety, monitoring, and continuity of care.
Your treatment typically includes:
- A detailed psychiatric assessment to confirm eligibility
- Collaborative treatment planning with your psychiatrist
- Supervised administration of esketamine in-clinic
- Monitoring during and after each session, in line with safety requirements
- Ongoing review of progress, side effects, and overall response
- Integration with other treatments such as psychotherapy and medication management, where appropriate
Safety and monitoring
Esketamine can cause short-term effects such as dissociation, dizziness, nausea, or changes in blood pressure. For this reason, treatment is always provided in a controlled clinical environment with medical and nursing oversight.
At AwareHub, we place strong emphasis on:
- Informed consent
- Careful monitoring during each session
- Individualised risk assessment
- Clear communication with your broader treating team (e.g. GP, psychologist), with your consent
Your safety and well-being are central to every stage of care.
Esketamine as part of a broader treatment plan
Esketamine is not a standalone solution. At AwareHub, it is offered as part of a broader, integrated mental health treatment approach which may include ongoing psychiatric care, evidence-based psychological therapies and support for comorbid conditions.
Our aim is not just symptom reduction, but meaningful improvement in functioning and quality of life.
What to Expect with Esketamine (Spravato®) Treatment at AwareHub
Esketamine treatment at AwareHub is delivered in a structured, supervised clinical setting, with safety, comfort, and continuity of care as priorities.
Before treatment
Before starting esketamine, you will have a comprehensive psychiatric assessment to review your mental health history, confirm eligibility, assess medical factors, and discuss risks, benefits, and alternatives.
If treatment proceeds, our psychiatrist will develop an individualised treatment plan and explain the recommended schedule.
On the day of treatment
Esketamine is administered as a nasal spray in the clinic. You will remain in the clinic for approximately 2 hours, under the observation and monitoring of our nursing team.
During and after treatment
Some people experience temporary effects such as dissociation, dizziness, fatigue, or nausea. These effects usually resolve within a few hours.
You will not be able to drive on the day of treatment and will need to arrange transport home.
After you go home
Most people return to their usual baseline later the same day or by the following day. You will be advised to rest and avoid driving, alcohol, or making important decisions until the next day.
Treatment course and follow-up
Esketamine is delivered as a course of treatment, with frequency adjusted over time depending on response and clinical need.
A typical treatment pathway may include:
- An initial phase over the first 4 weeks, often involving up to two treatments per week
- A consolidation phase over the following 4 weeks, commonly involving weekly treatment
- Ongoing or maintenance treatment, where sessions may be spaced weekly or fortnightly if treatment continues
The exact number and frequency of treatments is individualised and reviewed regularly.
Referrals and next steps
If you are interested in exploring whether esketamine treatment may be appropriate for you, the first step is an assessment with one of our psychiatrists. To discuss suitability, the referral process, costs, or to book an appointment, please contact AwareHub via email (details below) or call 1300 029 273.
If you have a referral from your GP or psychiatrist, please email it to TMS@awarehub.com.au or bundabergtms@awarehub.com.au (Bundaberg clients).
Cost of treatment
Esketamine (Spravato®) has been listed on the Pharmaceutical Benefits Scheme (PBS). This means that eligible Australians with treatment-resistant depression may access the medication at a subsidised cost.
Under the PBS, the medication costs $31.60 per dose, or $7.70 per dose for concession card holders (subject to eligibility and PBS criteria).
In addition to the PBS medication cost, AwareHub charges an additional clinic fee to cover in-clinic monitoring, nursing care, and medical supervision required for safe administration.
Some organisations, such as DVA or WorkCover, may contribute to or cover part of the overall treatment costs, depending on individual circumstances.
We recommend contacting us to discuss your individual circumstances, clinic fees, and any Medicare eligibility that may apply.
Disclaimer
AwareHub does not advertise prescription medicines to the public and provides this information solely to support informed discussions between patients and clinicians.
Spravato® is a registered trademark of Janssen-Cilag Pty Ltd (a Johnson & Johnson company).
Esketamine (Spravato®) is a prescription-only medication approved for the treatment of treatment-resistant depression when used under specialist psychiatric care and medical supervision.
As with any medication, esketamine may cause side effects, including temporary dissociation, sedation, nausea, or changes in blood pressure. Patients are monitored in the clinic following each treatment session in accordance with clinical guidelines.
The information on this page is general and does not replace individual medical advice. Please refer to the Consumer Medicines Information (CMI) and discuss with your psychiatrist or doctor whether this treatment is suitable for you.
Ketamine is a prescription-only medicine. It cannot be advertised directly to consumers. Any reference on this website is for informational purposes only and does not constitute promotion of a therapeutic good. Individual responses to medical treatments vary. No outcomes, improvements, or benefits are guaranteed.
How novel treatments help treat resistant depression
Video courtesy of Yale Medicine
These novel depression treatments are not suitable for everyone. It is important to discuss the various options with your treating psychiatrist and GP. AwareHub will oversee your depression treatment in the clinic, but your primary care will remain the responsibility of your treating doctor.
Please note that many newer depression treatments are privately funded and do attract any Medicare rebates. Costs involved include the treatment sessions, doctor’s and psychologist’s appointments, medication cost and dispensing fees.
