HomeBlogConditionsTipsSpravato for Anxiety Relief: How It Works and Who Can Benefit

Spravato for Anxiety Relief: How It Works and Who Can Benefit

Today, there is a rising use of Spravato (esketamine) in treating mental health disorders. It has shown great promise in treating conditions like depression, and given the neurobiological overlap with anxiety disorders, it is important to explore Spravato as a treatment option for anxiety.

What is Spravato?

A prescription version of ketamine called esketamine (brand name Spravato) was approved in 2019 by the FDA for use in patients with depression. It works as a nasal spray that is administered in a controlled environment overseen by approved facilities. 

Spravato and Its Mechanism of Action for Anxiety Relief

Studies indicate that long-term depression results in a shrinkage of the hippocampus by up to 20%, which damages learning and memory. This directly impacts the glutamate receptors at the end of nerve cells responsible for communication. 

Chronic stress, which could also result from an anxiety disorder, causes this damage to the glutamate receptors. Still, Spravato has been shown to regrow those connections and improve communication in the brain, overcoming these symptoms.

  • Studies show that 35.6% and 46.1% of participants who use Spravato go into remission.
  • 70% of patients have at least a 50% reduction in symptoms with Spravato.
  • Studies indicate that 62% of patients have better social functioning, 53% of patients have a better quality of life, 41% of patients have a better ability to work, 30% of patients are better equipped to meet their own basic needs, and 34% of patients saw general improvements in their overall health with Spravato. 

The study above speaks highly to the efficacy of Spravato for anxiety, particularly the way in which it improves social function and the ability to take care of yourself and to perform better at work, all of which are often negatively influenced by anxiety disorders. 

spravato for anxiety

Efficacy of Spravato in Treating Anxiety

Right now, Spravato is not FDA-approved to treat anxiety disorders, but doctors can choose to prescribe it anyway. This is called “off-label,” where a doctor prescribes a medication to treat a condition that is not labeled for treatment. 

Does Spravato help with anxiety?

Research findings have yet to investigate the use of Spravato for anxiety alone because this is an off-label use of the medication. However, limited studies that have focused on the use of Spravato for one of the FDA-approved treatments, treatment-resistant depression, have tangentially studied anxiety symptoms and Spravato’s anxiety efficacy for those who, within the study, had depression and anxiety disorder.

One systematic review concluded there was insufficient data to confirm the efficacy of Spravato and anxiety treatment. Another, however, found that Spravato produced significant reductions in depression, and those with anxiety saw slightly higher improvement. 

Given the fact that depression and anxiety are often generated from similar areas in the dorsolateral prefrontal cortex, it stands to reason that medication that is approved by the FDA to treat depression, particularly treatment-resistant depression, could also play a role in managing anxiety disorders.

Who Can Benefit from Spravato?

Anyone who has struggled with an anxiety disorder, co-occurring anxiety and depression disorders, or who hasn’t responded well to other treatments can possibly benefit from Spravato. Suitable candidates for Spravato include:

  1. Those who do not have existing heart conditions
  2. Those who are not pregnant
  3. Those who are not breastfeeding
  4. Those who do not have liver problems
  5. Those who do not have brain problems like a history of intracerebral hemorrhage
spravato for anxiety

Which types of anxiety disorders respond best

Some anxiety disorders may respond better to Spravato treatment than others. 

Generalized Anxiety Disorder

Generalized anxiety disorder is characterized by persistent and difficult-to-control anxiety that, in some, might relate to real issues in everyday life but, in others, might relate to perceived issues, real or not. It can be difficult to stay focused and balance your mood, and it can cause significant pain or headaches that have no apparent cause.

It’s not uncommon for people with generalized anxiety disorder to have serious impairments in their everyday function as a direct result. Around 4% of the population struggles with generalized anxiety disorder, and of those, 1% have severe symptoms.  

Social Anxiety Disorder

Social anxiety disorder is a type of anxiety disorder characterized by fear of being embarrassed or laughed at when in social situations. This can make it difficult for people to befriend others, speak in public, or even attend social outings. Around 7% of the population has a social anxiety disorder, and of those, an additional 2% experience severe social anxiety that can coexist with symptoms of depression or panic attacks.

Generalized anxiety disorder and social anxiety disorder are both conditions that may respond better to Spravato anxiety treatment because traditional treatments include antidepressant medications. Antidepressants are often combined with therapy specifically for anxiety. Given the efficacy of Spravato entreating and depression symptoms, it stands to reason that that efficacy would translate to generalized and social anxiety disorders in particular. 

Benefits of Spravato Over Other Treatments

Physical side effects are limited to things like headaches, nausea, and vomiting. Some of the most common side effects, though, being a nasal spray, simply have to do with nasal discomfort and a runny nose. This is significantly reduced compared to the side effects of traditional antidepressants or anti-anxiety medications.

The administration is fast and simple. When you go to a qualified facility for Spravato anxiety treatment, the doctor will show you how to use the nasal spray. You’ll use it on yourself in front of him and then remain for 2 hours under observation. However, it offers immediate relief from many symptoms. This, too, is a significant improvement over traditional medication, which is used in conjunction with therapy and can take several months to result in any changes.

Moreover, it is covered by many insurance providers, which makes it just as feasible and potentially affordable as other treatment options. 


Spravato offers significant relief for those who struggle with depression and, by extension, has the potential to help those with anxiety as well. Patients who have not responded to other treatments would do well to consider the use of Spravato for anxiety. Consult with a healthcare provider to evaluate if this is a suitable treatment option.

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