Spravato for anxiety

The limits

Spravato is not approved for anxiety disorders and insurers exclude it for anxiety alone. Its approved use is treatment-resistant depression, and anxiety symptoms are common in that population. Esketamine trials show that anxious depression responds about as well as non-anxious depression. See the coverage hub, the Spravato hub, and the coverage checker.

If anxiety is the main problem

Generalized anxiety, panic and social anxiety respond to psychotherapy and SSRIs or SNRIs in most people, and the interventional options are not established for them. If you have failed several treatments and also meet depression criteria, Spravato may be appropriate; the authorization is for depression.

What to expect

Dissociation and a brief rise in anxiety during dosing are common and usually settle within an hour. Clinics prepare anxious patients for this and can adjust the environment.

Coverage and cost

Covered under the depression criteria only. See Spravato coverage and ketamine therapy for anxiety.