Today the U.S. Department of Veterans Affairs (VA) announced its health care providers will now be able to offer the newly approved Spravato nasal spray for treatment-resistant depression.

The treatment will be made available to Veterans based on their individual medical needs combined with providers’ clinical assessments.

The move follows the March 5 Food and Drug Administration (FDA) approval of Spravato (esketamine) nasal spray. Spravato was approved for use in conjunction with an oral antidepressant for the treatment of treatment-resistant depression in adults.

“We’re pleased to be able to expand options for Veterans with depression who have not responded to other treatments,” said VA Secretary Robert Wilkie. “It reflects our commitment to seek new ways to provide the best health care available for our nation’s Veterans.”

Spravato will be available through a restricted distribution system under an FDA-approved Risk Evaluation and Mitigation Strategy (REMS). The purpose of the REMS is to mitigate the risks of serious adverse outcomes and the potential abuse and misuse of Spravato.

VA health care providers will monitor Veterans for serious adverse outcomes, such as sedation and difficulty with attention, judgment and thinking (dissociation), abuse and misuse, worsening of depression and suicidal thoughts and behaviors.

Veterans will self-administer Spravato nasal spray under the direct observation of a health care provider in a certified medical facility, and then must be monitored by a health care provider for at least two hours after receiving their dose. Spravato cannot be dispensed directly to Veterans for use at home.

For additional information on access to Mental Health Support for Veterans, visit VA Mental Health. Veterans in immediate crisis may call the Veterans Crisis Line at 800-273-8255 and press 1, text to 838255 or chat online at Veterans Crisis Line.

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Published on Mar. 19, 2019

Estimated reading time is 1.5 min.

Views to date: 158


  1. William L Hopkins April 14, 2019 at 3:57 pm

    So peacetime volunteers don’t get a “thank you for your service” ? And, you tell a war veteran with PTSD he deserves no more attention than you?

  2. Pamela S Lee April 6, 2019 at 12:30 am

    What ARE the ‘eligibility’ requirements? They’ve been treating me for depression for +33 years now. Do I qualify?

  3. Kevin Gikk March 27, 2019 at 6:56 pm

    As a Viet Nam Vet who has been antidepressant resistant for over six years. How do I become eligible for the new Spravato medication?

  4. Tommy V Parker March 27, 2019 at 10:34 am

    My mental health provider was told by Fayetteville Veterans Administration pharmacy that Spravato inhaler has not been approved for treatment. Can you provide any helpful information about procurement. Veteran: Tommy V Parker e-mail: (redacted)

  5. Barry Bell March 26, 2019 at 4:34 am

    So the patient has to go to the VA every time he needs a dose? Ridiculous.

  6. William Zally March 25, 2019 at 6:19 pm

    Dear Fellow Brother and Sister Veterans,

    I have the same question as regarding Madelyn Sandall. When will non-wartime yet be able to receive benefits as those who served during war time dates. Please read the following we are not asking for something we haven’t earned.

    The I issue I’ve been trying to get assistance with for years. Perhaps someone knows what to do and who to contact.

    I am 100% Total and Permanent disabled veteran. In 2015 I inquired with the local VA and after severs detailed discussions with them I was informed I qualified for the real estate tax exemption prior to the purchase of our home.

    After I purchased our new home for my family and put the paper work through their office and I was informed to my gut wrenching surprise that I did not qualify because I have service times that do not fall into combat time.

    My question to them after going through local and state and federal representatives that all passed it to each other, that I made financial decisions based on your assurances that I indeed qualified for the program. VA Administrator said they were sorry we made a mistake. A mistake that I calculated in how much I had to spend on a home. They were relatively new to their position and gave out wrong information. They go home at the end of the day as normal and live their lives and I have $400 a month more in expenses.

    I was told by several representatives that there is paper work in the channel to change that to all 100% T&P disabled veterans regardless of service dates. I would like to know where the change to any service member that is 100% T&P with a Service Connected disability stands as far as being approved. So far it has cost me over $20,000 in Real Estate Taxes that I was informed I would be exempt from.

    This has taken a toll on my resources and has caused me undue hardship and anxiety for me and my family.

    I am a bit confused about how to value the service of a serviceman or woman. If a U.S. Serviceman or Servicewoman working as a dental assistant or working in the motor pool became 100% T&P after 1990 which is considered wartime without ever leaving the United States they would qualify for this benefit.

    I have many friends that are 30 year combat veterans. I am very proud of them and very thankful for their service. Some of them I served with and they were able to continue their career that extended into war time / combat service years. I could not because of my Service Connected Disabilities.

    This is the problem that needs to be addressed and dealt with whether in Congress, the Secretary of Veterans Administration or President of the United States.

    I planned I making a career in the U.S Navy. I was injured while serving my country on a ballistic missile submarine. At that time, we were the front line, deployed for up to three months and we were at alert wartime status and readiness to launch our missiles during each patrol. We were actively hunted by Soviet Hunter Killer Attack Submarines.

    With the pending financial collapse of the Soviet Union which would lead to the total collapse and dissolution of the Soviet Union, tensions were very high. History has shown time and time again that economic issues had lead to more and more conflicts and war.

    I am no hero by any measure, but I served my country with honor and distinction as noted in my Service Record. I volunteered for Submarine Duty to deter and protect our great nation from nuclear war and I was ready and willing to fight and die for my country if necessary. I still feel the same way today.

    If I were not injured I would have had a long great career in the Navy and if the injury occurred while during a certain time period I would qualify for this benefit. Something is not right here.

    I completed college in under 4 years but could not re enter the Navy as an officer due to the severity of my disability. I tried to make a career out of the service but my disability continued to worsen and now I can no longer be gainfully employed due to my service connected disabilities.

    I really would like some assistance and guidance with this matter.

    Very Respectfully, William

  7. W H Rappaport March 22, 2019 at 4:40 pm

    How about cannabis?

  8. Dollie Backman March 22, 2019 at 2:46 pm

    Funny I read all this WONDERFUL STUFF yet I called the White House 800 number SUPPOSEDLY manned 24/7 with responses within days. That’s a TOTAL bunch of crap. I called with SPECIFIC DEFICIENCIES that affects ALL VETERANS here in Fayetteville as well as other VA’s. Haven’t heard a peep from anyone. Print all the pretty while the bad just gets worse!

  9. Madelyn Sandall March 22, 2019 at 12:52 pm

    When will the VA recognize non wartime veterans as equal to those during wartime. Not the veteran who VOLUNTEERED to serve that there was no war?

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