SPRAVATO® (Esketamine) Evaluation & Treatment in El Dorado Hills
REMS-certified clinic offering FDA-approved SPRAVATO nasal spray for adults with treatment-resistant depression. Comprehensive evaluation, insurance navigation, and on-site monitoring by REMS-certified psychiatric providers.
REMS-Certified Treatment Center
2-Hour On-Site Monitoring
Board-Certified Provider
Most Insurance Plans Accepted
Free insurance verification
Same-week appointments available
Serving El Dorado Hills, Folsom & Sacramento area
What Is SPRAVATO® (Esketamine)?
SPRAVATO is an FDA-approved nasal spray for adults with treatment-resistant depression (TRD) and for depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior. It works differently than traditional antidepressants by targeting the glutamate system in the brain.
FDA-Approved Indications:
Treatment-resistant depression (TRD) in adults—used with or without an oral antidepressant
Depressive symptoms in adults with MDD with acute suicidal ideation or behavior—used with an oral antidepressant
How SPRAVATO Works
Targets NMDA receptors in the brain's glutamate system
Different mechanism than traditional antidepressants
Can provide rapid relief—many patients notice improvement within days to weeks
Self-administered nasal spray under medical supervision
Used alongside (or without) oral antidepressants
What Makes It Different
Rapid onset of action compared to traditional medications
Effective for patients who haven't responded to other treatments
Administered in a controlled, monitored clinical setting
Part of the REMS program ensuring patient safety
Covered by most major insurance plans for eligible patients
Am I Eligible for SPRAVATO?
SPRAVATO is specifically approved for adults who meet certain criteria. Our evaluation process determines if this treatment is appropriate for your unique situation.
You May Be Eligible If:
You're an adult (18+) with major depressive disorder
You've tried at least two antidepressants without adequate improvement
Each medication was taken at adequate doses for at least 6 weeks
You did not experience at least 50% improvement in symptoms
You're willing to be monitored on-site for 2 hours after each dose
What We'll Evaluate:
Your complete treatment history
Current medications and their effectiveness
Medical conditions that may affect eligibility
Your treatment goals and expectations
Insurance coverage and authorization requirements
Whether SPRAVATO is the best option for you
Important Safety Information:
SPRAVATO is not appropriate for everyone. You should not take SPRAVATO if you have blood vessel disease, arteriovenous malformation, history of brain bleeding, or are allergic to esketamine or ketamine. A comprehensive medical evaluation is required before starting treatment.
Book Your Free SPRAVATO Consultation
Choose a time for a 15‑minute phone consultation with our El Dorado Hills team. We’ll talk through what you’ve tried, your goals, and whether a full SPRAVATO evaluation or another advanced treatment is a good next step.
Review your depression history and previous treatment
Discuss how SPRAVATO treatments work in our clinic
Go over safety, schedule, and insurance basics
This call is for adults 18+ and is informational only. It does not guarantee that SPRAVATO or any specific treatment will be recommended or prescribed, and it is not monitored for emergencies. If you are in crisis or thinking about harming yourself, please call 988 or go to the nearest emergency room.
Prefer to book by phone?
Call us at (279) 280-0020
Your SPRAVATO Treatment Journey
From evaluation to ongoing treatment, we guide you through every step with clear communication and compassionate care.
Initial Consultation
Schedule a consultation with our psychiatric team to discuss your history and determine if SPRAVATO evaluation is appropriate.
Comprehensive Evaluation
Complete psychiatric assessment, medical history review, and eligibility screening. We handle insurance verification and prior authorization.
Treatment Initiation
Begin SPRAVATO in our REMS-certified clinic. Twice-weekly sessions for the first 4 weeks, with 2-hour on-site monitoring after each dose.
Ongoing Care
Transition to weekly, then maintenance dosing based on your response. Continuous progress tracking and care coordination.
Typical Treatment Schedule:
Weeks 1-4: Twice weekly sessions (8 treatments)
Weeks 5-8: Once weekly sessions (4 treatments)
Week 9+: Maintenance dosing—weekly or every-other-week based on response
Each session: Self-administration under supervision + 2-hour monitoring period
Safety & On-Site Monitoring
As a REMS-certified treatment center, we follow strict safety protocols to ensure your wellbeing throughout treatment.
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REMS-Certified Facility
Our clinic meets all FDA requirements for SPRAVATO administration, including staff training, monitoring equipment, and emergency protocols.
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Medical Supervision
Certified psychiatric providers oversee every treatment. Healthcare staff monitor you continuously during the 2-hour observation period.
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Vital Sign Monitoring
Blood pressure, heart rate, and other vitals are checked before, during, and after each dose to ensure safety and detect any concerns immediately.
What to Expect During Treatment:
Common side effects include feeling disconnected from yourself, dizziness, nausea, sleepiness, spinning sensation, and anxiety. These typically occur right after taking SPRAVATO and resolve the same day. You cannot drive or operate machinery after treatment—you'll need someone to drive you home. Most patients return to normal activities the next day.
Meet Your SPRAVATO Treatment Team
REMS-certified psychiatric providers with specialized training in interventional treatments for treatment-resistant depression.
Michael C. Hoaglin, MD
Founder & Interventional Psychiatrist
Dr. Hoaglin is an interventional psychiatrist with training from Duke University Hospital and the Perelman School of Medicine at UPenn. With a background in emergency medicine and biomedical engineering, he brings a precision-medicine approach to psychiatric care. He has treated over 3,000 patients and specializes in advanced treatments for treatment-resistant conditions.
Linda Rushing, PMHNP
Psychiatric Mental Health Nurse Practitioner
Linda is a board-certified PMHNP serving our El Dorado Hills location. She holds an MSN from Purdue University Global and an MPH from UC Berkeley. With extensive experience in medication management and patient safety protocols, Linda provides compassionate, evidence-based psychiatric care and SPRAVATO treatment oversight.
What Our Patients Say
Real experiences from patients who found relief through advanced treatment at Gut Feelings.
★★★★★
"After nearly 20 years of disappointing psychiatric providers, I recognize that Dr. Mike is exceptional. Unlike every psychiatrist I've had, he hasn't given up on me. He told me we're working towards 'complete remission'—something I never thought possible. His compassionate demeanor is calming, and he makes himself available outside office hours."
— Elizabeth L.
★★★★★
"Dr. Hoaglin saved my life. After being misdiagnosed and put on the wrong medications, I was suicidal. He correctly identified what was happening and adjusted my treatment. A few months later, it was like a switch flipped—my anxiety, depression, and procrastination were completely gone. I feel like myself again."
— Gizem T.
Frequently Asked Questions About SPRAVATO
How quickly does SPRAVATO work?
Many patients notice improvement in depressive symptoms within days to weeks of starting treatment. This is significantly faster than traditional antidepressants, which can take 4-8 weeks or longer. However, individual response varies, and the full treatment course (12+ sessions) is recommended for optimal results.
Will my insurance cover SPRAVATO treatment?
Most major insurance plans cover SPRAVATO for treatment-resistant depression, including Blue Shield of California, Aetna PPO, Medicare, and Tricare. Prior authorization is required. Our team handles all insurance verification, authorization paperwork, and appeals if needed. We'll provide a clear cost estimate before you begin treatment.
What are the side effects of SPRAVATO?
The most common side effects include dissociation (feeling disconnected), dizziness, nausea, sleepiness, and increased blood pressure. These typically occur during or shortly after administration and resolve within hours. Serious side effects are rare but can include sedation, respiratory depression, and abuse potential—which is why treatment occurs in a monitored clinical setting with a 2-hour observation period.
How long does each SPRAVATO session take?
The nasal spray administration itself takes about 5 minutes (you'll use two devices, 5 minutes apart). However, you must remain in our clinic for at least 2 hours after administration for monitoring. Plan for approximately 2.5-3 hours total per visit. You cannot drive yourself home after treatment.
Can I continue my current antidepressant medications?
Yes. SPRAVATO is typically used alongside an oral antidepressant (though it can be used alone for TRD). We'll review all your current medications during evaluation to ensure there are no contraindications. Do not stop or change any medications without consulting your provider.
What if SPRAVATO doesn't work for me?
While SPRAVATO has high response rates for treatment-resistant depression, it doesn't work for everyone. If you don't respond adequately, we have other advanced treatment options including TMS therapy, IV ketamine, and other interventional approaches. We'll work with you to find the most effective treatment for your specific situation.
Is SPRAVATO the same as ketamine?
SPRAVATO (esketamine) is derived from ketamine but is not identical. Esketamine is the S-enantiomer of ketamine and is FDA-approved specifically for treatment-resistant depression. It's administered as a nasal spray in a REMS-certified setting. IV ketamine is a different formulation used off-label for depression. Both can be effective; the choice depends on your specific needs, insurance coverage, and clinical situation.
Insurance & Payment
We accept most major insurance plans and handle all authorization paperwork on your behalf.
Blue Shield of California
Aetna PPO
Medicare
Tricare
And Many Others
What We Handle For You:
Complete insurance verification before your first appointment
Prior authorization submission and follow-up
Appeals if initial authorization is denied
Clear cost estimates before treatment begins
Billing and claims submission
Payment plan options if needed
Don't see your insurance listed? Contact us - we can often work with out-of-network benefits or help you understand your coverage options.
Ready to Explore SPRAVATO Treatment?
If antidepressants haven't been enough, SPRAVATO may offer the relief you've been looking for. Our El Dorado Hills team is here to answer your questions, verify your insurance, and determine if this FDA-approved treatment is right for you.
✓ Free 15-minute consultation | ✓ Insurance verification included | ✓ REMS-certified providers
Gut Feelings Psychosomatic Medicine
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Important Safety Information: SPRAVATO® is a registered trademark of Janssen Pharmaceuticals, Inc. This website provides educational information only and does not constitute medical advice. SPRAVATO has risks including sedation, dissociation, abuse potential, and increased blood pressure. It is only available through a restricted REMS program. Individual results may vary. All treatments require evaluation by a qualified healthcare provider.
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