Esketamine Treatment: Everything You Need to Know for Better Mental Health

Esketamine is a medication that has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of depression, particularly treatment-resistant depression (TRD). It is a form of ketamine, which is an anesthetic agent used for decades in medical settings. Esketamine is administered intranasally as a nasal spray and acts as a rapid-acting antidepressant.  

One of the key advantages of esketamine is its rapid onset of action. Unlike traditional antidepressant medications that may take weeks or even months to alleviate depressive symptoms, esketamine can produce a noticeable improvement in mood within hours or days. This rapid response can be crucial for individuals experiencing severe depression or those who have not responded to other treatments.  

For individuals who have not responded well to traditional antidepressants or have experienced intolerable side effects, esketamine provides an alternative treatment option. It expands the range of possibilities for managing depression, particularly in cases where other treatments have been unsuccessful.

Esketamine is an NMDA receptor antagonist, meaning it blocks the activity of a specific receptor in the brain called the N-methyl-D-aspartate (NMDA) receptor. By modulating this receptor, esketamine influences the release of certain neurotransmitters, such as glutamate, which is involved in mood regulation.

Esketamine is primarily used in the treatment of depression. It is specifically approved for treatment-resistant depression, which is defined as depression that has not responded adequately to at least two previous antidepressant treatments.

Esketamine is administered as a nasal spray under the supervision of a healthcare professional in a clinical setting. The nasal spray allows for quick absorption of the medication through the nasal passages into the bloodstream and then to the brain.

Esketamine treatment typically involves two phases: induction and maintenance. During the induction phase, patients receive esketamine twice weekly for the first four weeks, followed by a gradual reduction in frequency. In the maintenance phase, the frequency of esketamine administration is adjusted based on the individual’s response and clinical judgment.

Esketamine treatment requires close monitoring due to potential side effects and safety concerns. Patients are required to remain under observation at the treatment site for about two hours. To ensure patient safety, healthcare professionals monitor blood pressure and pulse before and after treatment.

Common side effects of esketamine can include dissociation (a sense of detachment from surroundings), dizziness, sedation, increased blood pressure, and increased heart rate. These effects are generally temporary and resolve soon after treatment. Serious side effects, though rare, can occur and should be discussed with the prescribing physician.

Esketamine is typically used as part of a comprehensive treatment approach for depression, which may include psychotherapy, medication, and other therapeutic interventions. It is important to note that esketamine is not a stand-alone treatment for depression but is used in conjunction with other treatments.

Esketamine treatment is only available through certified treatment centers or clinics. It is important to consult with a qualified psychiatrist or healthcare professional to assess the suitability of esketamine treatment and to determine the most appropriate treatment plan for an individual’s specific needs.

It’s crucial to consult with a healthcare professional to discuss the potential benefits, risks, and considerations of esketamine treatment, and to determine if it is an appropriate option based on an individual’s unique circumstances and treatment history.

Lamia Abdouni, PMHNP

Lamia Abdouni,
PMHNP-BC

My name is Lamia Abdouni, and I am a board certified Psychiatric Mental Health Nurse Practitioner with a background in both family and psychiatric nursing. I became a Registered Nurse in 2007 after earning my nursing degree from Mercy College of Northwest Ohio. In 2016, I obtained my Family Nurse Practitioner degree from Walden University, and in 2019, I earned my Psychiatric Mental Health Nurse Practitioner degree from Binghamton University. I have been working in the field of mental health since 2014.

I specialize in the evaluation and treatment of a wide range of psychiatric disorders, with a particular focus on depression, anxiety disorders, and trauma-related conditions. I consider myself an interventional healthcare provider and believe in utilizing comprehensive treatment approaches tailored to each individual’s needs. My areas of focus include higher levels of care such as Partial Hospitalization Programs (PHP), Intensive Outpatient Programs (IOP), and residential treatment. I also have a strong interest and focus in innovative psychiatric treatments, including Transcranial Magnetic Stimulation (TMS) and ketamine therapy.

I chose this profession because I have always been passionate about helping people navigate some of the most challenging periods of their lives. I believe that mental health care requires compassion, understanding, and a commitment to finding effective, individualized solutions. The most rewarding part of my work is witnessing patients regain hope, improve their quality of life, and achieve meaningful progress in their mental health journey.

Outside of work, I enjoy swimming, roller skating, and strength training. These activities help me maintain balance, resilience, and energy, allowing me to continue providing thoughtful and compassionate care to my clients.

Danielle Siragusa, LSCW

Danielle Siragusa,
VP of Behavioral Health, LCSW

Danielle Siragusa, LCSW, is a behavioral health leader with a strong track record of building and scaling high-impact clinical programs. As Vice President of Behavioral Health, she brings a unique blend of clinical expertise, operational strategy, and people-centered leadership to her work, with a focus on delivering accessible, high-quality care.

Danielle began her career as a clinician, which continues to shape her leadership approach today. As a Licensed Clinical Social Worker, she has extensive experience working with individuals and families across a range of behavioral health needs. Her clinical foundation allows her to design programs that are not only evidence-based, but also practical, compassionate, and responsive to the real-world needs of clients and providers.

Throughout her career, Danielle has held progressive leadership roles, where she has led multidisciplinary teams, developed integrated care models, and overseen complex behavioral health operations. She is known for her ability to translate vision into execution, whether that’s launching new service lines, optimizing clinical workflows, or driving system-wide improvements in quality, access, and outcomes. Her operational strengths include program development, financial and performance management, regulatory compliance, and building scalable infrastructure to support growth.

A collaborative and mission-driven leader, Danielle is passionate about developing high-performing teams and fostering a culture of accountability, innovation, and continuous improvement. She values strong partnerships, both internally and across communities, and is committed to advancing behavioral health solutions that are sustainable, impactful, and person-centered.

Jeremy Edwards

Jeremy Edwards, DNP, PMHNP-BC

My name is Jeremy Edwards, I am board-certified Psychiatric Mental Health Nurse Practitioner with over 15 years of experience in the behavioral health field, working across a wide range of settings including schools, group homes, residential treatment centers, outpatient clinics, and inpatient hospitals. I earned my Bachelor’s degree in Psychology from the University of Colorado, followed by a Bachelor of Science in Nursing and a Doctorate of Nursing Practice degree from Creighton University.
 
My passion for mental health care is deeply rooted in my own life experiences. Having overcome significant adversity, I was inspired to become part of the solution and to support others on their healing journeys. I take great pride and joy in helping individuals discover their strengths and reach their full potential. I strongly believe that each patient’s journey is unique, and I am committed to meeting patients where they are. Through collaboration, empathy, and patient-centered care, I work with each individual to develop a personalized treatment plan that supports growth, resilience, and long-term well-being.
Barbara Reed

Barbara Reed,
MSN, RN, PMHNP-BC

My name is Barbara Reed, MSN, RN, PMHNP-BC, and I am a Psychiatric Mental Health Nurse Practitioner at Synergy Mental Health & Wellness in Rockwall, Texas. I earned my Master of Science in Nursing from Saint Louis University in 2014, building upon earlier years of service as a Hospital Corpsman in the United States Naval Reserve.

I specialize in anxiety, depression, trauma, OCD, and mood disorders, working primarily with adults, and veterans. My approach to care is collaborative, holistic, and strengths-focused, and I often use medication management, CBT-informed strategies, motivational interviewing, and supportive therapy to support my clients.

I chose this profession because I believe every person deserves compassionate, dignified, and scientifically grounded mental health care, and I find it most rewarding to partner with clients in their healing journey—helping them rediscover stability, confidence, and the ability to thrive in their daily lives.

Outside of work, I enjoy cooking, learning new things, staying active with my family, staying current with psychiatric research, and attending AANP Health Policy Conferences, and I believe these activities help me stay balanced and energized to support my clients.

Ngozi Theresa Onyia

Theresa Ngozi Onyia,
MSN, APRN, PMHNP-BC

My name is Theresa Ngozi Onyia, and I am a Family and Psychiatric Nurse Practitioner at Synergy Mental Health & Wellness Integrated in Rockwall, Texas. I earned my Master’s and post-master’s degrees from Walden University and hold certifications in Family/Psychiatric Nurse Practitioner with AANP and ANCC.

I specialize in anxiety, depression, trauma, adolescent care, working primarily with adults, teens, families, veterans. My approach to care is patient-centered, collaborative, evidence-based, and strengths-focused, and I often use CBT, DBT, mindfulness-based interventions to support my clients.

I chose this profession because I believe in the uniqueness of every patient and, thus, the importance of individualized patient needs and care. My goal is to apply the uniqueness of each patient to their treatment recommendations to address their health issues best for a greater outcome. Each patient deserves the most optimal mental well-being.

Alejandra Vasquez

Alejandra Vasquez, PMHNP-BC

Meet Alejandra Vasquez, a dedicated board-certified Psychiatric-Mental Health Nurse Practitioner passionate about providing holistic and trauma-informed care to individuals across the lifespan. She earned her Master of Science in Nursing from Northern Arizona University and brings years of experience in psychiatric nursing, including crisis stabilization, detox and recovery, inpatient, and outpatient community mental health.

Alejandra has a special interest in supporting young adults as they navigate life transitions and mental health challenges. Her integrative and collaborative approach blends evidence-based psychopharmacology, psychotherapy, and lifestyle interventions to promote emotional balance, recovery, and wellness. Guided by compassion, empowerment, and education, Alejandra strives to create a safe and supportive environment where patients feel heard, valued, and actively involved in their care, helping them build resilience and achieve lasting wellness.

Outside of her clinical work, Alejandra values mindfulness, connection, and balance in her own life. She believes that healing is a journey best supported by compassion, self-awareness, and collaboration. Her passion for mental health stems from witnessing the profound impact of empathy and strength of resilience, inspiring her to walk alongside patients as they build meaningful, fulfilling lives.

Dr. Andrea Raby,

Dr. Andrea Raby, M.D.,

Dr. Andrea Raby is a diplomate of the American Board of Psychiatry and Neurology in General Psychiatry, holding additional certifications in Tele-Mental Health and Medication Assisted Treatment (MAT). Her educational journey commenced with a Psychology and Chemistry Undergraduate degree at Arizona State University, where she was a distinguished member of the Honors College. Dr. Raby furthered her medical training at the University of North Texas Health Science Center and completed her residency at Maricopa Integrated Health/County Hospital.

With over fifteen years of clinical experience in both community and hospital-based psychiatry, Dr. Raby brings a wealth of expertise to our team. Her commitment to the field is demonstrated through her provision of forensic evaluations and court testimonies. Currently serving as an Inpatient Attending at Valley Hospital, she showcases her broad proficiency in both inpatient and outpatient settings.

Beyond her professional endeavors, Dr. Raby’s life is enriched by her love for family, including her five children, and her dedication to endurance running. Her commitment to excellence and passion for improving lives make her an integral part of our exceptional team of psychiatrists at Synergy Mental Health and Wellness Integrated. We eagerly anticipate the privilege of serving you and guiding you on your journey to mental well-being. Your path to healing and hope begins with us.

Dr. Fariba Pfitzner, M.D.,

Dr. Fariba Pfitzner, M.D.,

Dr. Fariba Pfitzner is a distinguished board-certified psychiatrist specializing in adult, child, and adolescent psychiatry. Her illustrious career began with medical training at Ludwig-Maximillian University School of Medicine in Munich, Germany, laying the foundation for her impressive expertise. Driven by a commitment to continuous learning, she pursued a residency in adult psychiatry and a two-year subspecialty fellowship program in Child and Adolescent Psychiatry at the University of Rochester in Rochester, NY.

Dr. Pfitzner’s professional journey includes a pivotal role as the Director of the Adolescent Inpatient Unit at the Arizona State Hospital. With extensive experience in community mental health clinics, she provided psychiatric services within a multidisciplinary team, fostering collaborative and comprehensive care. Dr. Pfitzner’s treatment approach emphasizes teamwork, involving patients, families, and other healthcare providers in the decision-making process.

Fluent in several languages, Dr. Pfitzner has earned a strong reputation in the Valley, where her contributions significantly support the Adolescent Intensive Outpatient Program at Synergy Mental Health and Wellness Integrated. Her dedication to teamwork and collaborative care reflects her commitment to providing exceptional psychiatric services and enhancing the well-being of her patients.

Dr. Bahar Altaha, M.D.,

Dr. Bahar Altaha, M.D.,

Dr. Bahar Altaha is an esteemed member of the Synergy Mental Health and Wellness Integrated team, bringing with her a triple board certification in General Psychiatry, Child and Adolescent Psychiatry, and Psychosomatic Medicine. With a diverse medical background that encompasses training at the University of Hamburg School of Medicine in Germany, she has refined her expertise in Internal Medicine at Johns Hopkins Hospital and in General Adult and Child-Adolescent Psychiatry at West Virginia University.

Dr. Altaha’s accomplishments are noteworthy, including the receipt of the Community Service Award for Outstanding Leadership from the WVU Department of Behavioral Medicine and Psychiatry. Her influence extends to both national and international psychiatric spheres, contributing to publications such as the Sage Encyclopedia of Abnormal and Clinical Psychology and Current Psychology. Dr. Altaha’s multilingual abilities, encompassing English, German, Farsi, and French, significantly enhance her capacity to provide exceptional care to our patients. Her wealth of experience and dedication underscores our commitment to delivering comprehensive and outstanding mental health care at Synergy Mental Health and Wellness Integrated.

Victoria Emanuelson, MPAS, PA-C,

Victoria Emanuelson, MPAS, PA-C,

Meet Victoria Emanuelson, a nationally certified Physician Assistant, whose expertise enriches our team. Victoria’s professional journey took her from Stephens College in Columbia, Missouri, to the vibrant Phoenix area. Throughout her training, she acquired invaluable experience working with diverse patient populations across various clinical and geographic settings.

Passionate about patient care, Victoria specializes in serving individuals aged 17 and older. Her comprehensive services encompass psychiatric assessments, diagnoses, treatment plans, and medication management. Proudly affiliated with the American Academy of Physician Assistants and the Arizona State Association of Physician Assistants, Victoria is recognized for her empathy and collaborative approach to patient care. She places a special emphasis on patient education and strives to enhance the overall quality of life for those under her care. Welcome to the compassionate and dedicated support provided by Victoria Emanuelson, where your well-being is at the forefront of her commitment.

Jose A. Rodriguez, PMHNP-BC,

Jose A. Rodriguez, PMHNP-BC,

Meet Jose A. Rodriguez, a dedicated board-certified Psychiatric Mental Health Nurse Practitioner. Jose earned his Bachelor of Science in Nursing from Oregon Health & Science University in 2013, followed by a Master of Science in Nursing with a specialization in Psychiatric Mental Health in 2021 from Frontier Nursing University.

Specializing in treating patients across their lifespan, Jose is particularly passionate about supporting military veterans dealing with PTSD, depression, anxiety, and substance abuse. With 9 years of experience as a critical care nurse and crisis nurse in Boise, Idaho, and a total of 20 years in the United States Army Infantry, including six years in active duty, Jose brings a unique and comprehensive perspective to his practice.

Jose is an Army Infantry Combat Veteran and retired Honorably as a Sergeant First Class from the United States Army after 20 years of faithful service.  He spent time in the Middle East, Korea, and numerous places in the United States.

Not only does Jose provide evidence based pharmacological therapies to help patients struggling with their mental health, but he also utilizes a patient centered approach which individualizes the plan of care to the patient.

Samantha Willen, DNP, PMHNP-BC,

Samantha Willen, DNP, PMHNP-BC,

My name is Samantha Willen, and I am a Psychiatric Nurse Practitioner at SMHWI. I earned my Doctor of Nursing Practice from the University of Arizona and am board certified in Psychiatric-Mental Health.

I specialize in anxiety, depression, and substance use disorders, working primarily with adults with co-occurring disorders. My approach to care is collaborative and strengths-focused, emphasizing each client’s unique resilience and capacity for growth. I often use cognitive-behavioral therapy (CBT), and mindfulness-based interventions to help clients build insight and develop practical coping skills.

I chose this profession because I have a family member who struggled with mental health challenges, and that experience showed me how important compassion and understanding are in the healing process. I find it most rewarding to build meaningful relationships with my clients and help them feel better and more hopeful about their lives.

Outside of work, I enjoy spending time with my husband and two daughters, and indulging in my guilty pleasure of watching Bravo shows.

Angela Ross, MS, LPC,

Angela Ross, MS, LPC,

Angela Ross, MS, LPC, is a Licensed Professional Counselor and a proud Arizona native. She earned her Master’s degree in Professional Counseling from Grand Canyon University in 2020. Angela has extensive experience working with individuals facing mental health challenges in both outpatient and inpatient settings. She specializes in working with adolescents, adults, and families, utilizing a variety of therapeutic approaches, including CBT, DBT, EMDR, motivational interviewing, and solution-focused therapy.

With a robust background in both individual and group counseling, Angela creates a supportive, collaborative space where clients feel safe to engage in meaningful self-exploration and growth. Her authentic and non-judgmental approach fosters strong therapeutic relationships, empowering clients to reach their full potential.

Outside of her professional work, Angela enjoys spending time outdoors, embracing the serenity and beauty of nature. She is deeply committed to helping individuals enhance their well-being, guiding them toward greater clarity, fulfillment, and overall quality of life.

Dafna Oz, LCSW,

Dafna Oz, LCSW,

My name is Dafna Oz and I am a Licensed Clinical Social Worker at Synergy Mental Health & Wellness Integrated. I earned my Master of Social Work from the University of New England and hold certifications EMDR and couple’s counseling.

I specialize in anxiety, depression, trauma and working primarily with adults. My approach to care is working together as a team to navigate challenges and achieve a healthier life, and I often use CBT, DBT, motivational interviewing interventions to support my clients.

I chose this profession because of my deep belief in compassion, resilience and the power of human connection, and I find it most rewarding to witness my client’s growth and healing, seeing them gain insight, strength and hope as they create positive changes in their lives.

Outside of work, I enjoy music, exploring new places and spending time with my family. and I believe these activities help me stay balanced and energized to support my clients.

Dr. Roland Segal, M.D., Managing Partner, Scottsdale Psychiatrist

Dr. Roland Segal, a distinguished psychiatrist, holds the role of Managing Partner and MD Psychiatrist at Synergy Mental Health and Wellness Integrated. Graduating from the University of Arizona, College of Medicine, he pursued his general psychiatry training at Banner Good Samaritan Medical Center in Phoenix, Arizona. Dr. Segal further refined his skills through a forensic psychiatry fellowship at the University of Southern California, Keck School of Medicine.

Dr. Segal has more than 10 years of clinical, administrative, executive and forensic experience. With double board certification in General and Forensic Psychiatry, Dr. Segal brings a wealth of knowledge and experience to our team. He served as the Chief Medical Officer at Valley Hospital in Phoenix, Arizona, president of the Arizona Psychiatric Society, chair of the legislative committee and a member of multiple state and national boards, committees and organizations. Dr. Segal is a clinical assistant professor of psychiatry at the University of Arizona, College of Medicine, where he regularly teaches medical students and residents.

Dr. Segal serves as a psychiatry expert consultant for a number of superior and regional courts including Salt River, Maricopa and Yuma County; city governments including Phoenix, Lake Havasu and Mesa; and organizations including the United Postal Service, Social Security Administration, Immigration Health Services, US Department of Justice and the Department of Homeland Security.
Dr. Segal values objectivity, morality, ethics, mindfulness, and cultural awareness in a diverse society.

Dr. Segal’s unwavering commitment to comprehensive psychiatric care serves as a testament to his dedication to enhancing the lives of his patients across the state of Arizona and beyond.

Dr. Ehab Abdallah, M.D., psychiatric physician profile

Dr. Ehab Abdallah, M.D., Managing Partner, Psychiatrist

Dr. Ehab Abdallah serves as the Managing Partner and MD Psychiatrist at Synergy Mental Health and Wellness Integrated. A distinguished professional, he earned his medical degree from Alexandria University in Alexandria, Egypt, and completed his psychiatry residency training at West Virginia University. Dr. Abdallah holds triple board certifications in General Psychiatry, Consultation-Liaison (Psychosomatic) Psychiatry, and Addiction Psychiatry and Medicine.

An expert in addiction medicine, Dr. Abdallah is experienced in treating psychiatric illness for those with complex medical and psychiatric conditions. Dr. Abdallah is an invaluable asset to our team with a commitment to providing quality care that is reflected in his unwavering dedication to the well-being of his patients.

Dr. Abdallah is also fellow of the American Psychiatric Association and a clinical assistant professor of psychiatry with the University of Arizona where he teaches medical students and residents.