SPRAVATO® in Rockwall, TX
If antidepressants haven’t brought your depression under control, Spravato (esketamine) may be the next step. Delivered as a nasal spray in our certified Rockwall clinic under the supervision of Dr. Ryan H. Hashem, MD.
Now accepting new Spravato patients · Insurance covered for most
What Is Spravato
A different mechanism, for depression that hasn’t responded to antidepressants
Traditional antidepressants work on serotonin, norepinephrine, or dopamine. For a lot of people, that’s enough. For roughly one in three, it isn’t. You’ve tried the pills. Maybe you’ve tried therapy on top of that. And depression is still shaping every day.
Spravato (esketamine) is different. It acts on the glutamate system, a separate pathway in the brain that traditional antidepressants don’t reach. That’s why it can help when other medications haven’t. It’s delivered as a nasal spray in our certified Rockwall clinic, and it’s FDA-approved for two indications: adults with treatment-resistant depression, and adults with major depression who are experiencing acute suicidal thoughts.
Because Spravato is a REMS-controlled medication, every dose has to be given in a certified clinic under staff observation. That’s us. You’ll spend about two hours per session at 810 E Ralph Hall Pkwy in Rockwall, where our clinical team monitors you the entire time. Spravato is always taken alongside an oral antidepressant, not as a replacement.
Not sure if Spravato is right for you? Call (469) 707-9603. Dr. Hashem and our team will review your history and lay out what’s realistic, before you commit to anything.
Your Spravato physician
Interventional psychiatry led by a physician who takes the whole picture seriously
Every Spravato candidate at our Rockwall clinic is evaluated by Dr. Ryan H. Hashem, our board-certified Medical Director. He has specialty training in interventional psychiatry, including Spravato, TMS, and IV ketamine, and he’ll give you a straight read on whether Spravato is likely to help before you commit to the first dose. Every session is supervised by the same clinical team managing your medication and follow-up care.
How a Spravato Session Works
What actually happens on treatment day
Because Spravato is a REMS-controlled medication, every session is standardized and monitored. Here’s the flow.
Ready to talk?
Start a Rockwall Spravato consultation
Fill out the form and someone from our team will follow up to see if Spravato is a fit and, if so, verify your insurance and start prior authorization before you schedule anything. No commitment.
Your information is confidential and HIPAA-secure.
Who Spravato Is For
FDA-approved indications, and when to consider it
Spravato isn’t a first-line treatment. It’s designed for depression that hasn’t responded to standard care, and it’s always given alongside an oral antidepressant.
Treatment-Resistant Depression
Adults with major depression that hasn’t responded to at least two different antidepressants tried at adequate dose and duration. This is what Spravato was designed for.
Learn more about depression treatmentMajor Depression with Acute Suicidal Ideation
For adults with major depressive disorder who are experiencing acute suicidal thoughts or behavior. Spravato works quickly in this indication and is used alongside standard care.
Talk to our team todayPaired with an oral antidepressant
Spravato is always given alongside a daily oral antidepressant. Our psychiatric team manages both together, so your medication plan actually holds together.
See our psychiatric servicesNot sure between Spravato and TMS?
Both are strong options for treatment-resistant depression. TMS is drug-free and drives yourself home; Spravato is faster onset but requires a ride and 2-hour monitoring. Dr. Hashem helps you weigh what fits your history.
Compare TMS in RockwallSpravato isn’t right for everyone. It’s not appropriate during pregnancy, with certain cardiovascular conditions, or for patients with a history of psychosis. Our Rockwall team also offers TMS therapy and IV ketamine for patients who aren’t Spravato candidates. Call (469) 707-9603 to talk through the options.
Why SMHWI Rockwall
A certified Spravato clinic inside an integrated psychiatric practice
Spravato works best when it’s part of a coordinated plan. At our Rockwall clinic, the same team supervising your sessions also manages your medications and monitors your progress.
REMS-certified site
Every Spravato dose is delivered in a REMS-certified clinic. Ours is here in Rockwall, physician-supervised.
One team, one plan
Your Spravato provider is the same practice managing your antidepressant and follow-up care.
Close to home
Right off I-30 at Ralph Hall Parkway. No Dallas commute for a 2-hour session.
Insurance handled
We verify benefits, secure prior auth, and confirm your out-of-pocket cost before your first dose.
How Spravato Compares
Spravato vs. IV ketamine
Both come from the same molecule family. They’re not the same treatment. Here’s the honest side-by-side, so you can weigh it with your psychiatrist.
Your Rockwall care team
Real, named providers behind your Spravato treatment
Spravato at SMHWI Rockwall is physician-led and coordinated with the psychiatric nurse practitioners and therapists who make up your day-to-day care.
Physician Leadership
Psychiatric Nurse Practitioners
Insurance & Cost
Spravato is covered by most insurance plans
For most adults with treatment-resistant depression, insurance covers most of the cost. Coverage typically requires documentation that at least two antidepressants didn’t work. Prior authorization is almost always required, and our team handles it.
Frequently Asked Questions
Spravato at SMHWI Rockwall
Yes. Our Rockwall clinic at 810 E Ralph Hall Pkwy, Ste 140 is a certified Spravato treatment center. Every session happens here, in-clinic, under the supervision of Dr. Ryan H. Hashem, MD.
Spravato is FDA-approved for two indications: adults with treatment-resistant depression (major depression that hasn’t responded to at least two antidepressants), and adults with major depression dealing with acute suicidal thoughts. It’s always taken alongside an oral antidepressant.
Spravato is esketamine, a specific piece of the ketamine molecule, delivered as a nasal spray and FDA-approved for treatment-resistant depression. It’s covered by most insurance. IV ketamine is a related but different medication, given as an infusion, used off-label, and usually not covered.
For most adults with treatment-resistant depression, yes. Major commercial plans, Medicare, Tricare, and many Texas Medicaid plans cover Spravato when medical necessity is met. Prior authorization is almost always required. Our team handles that before your first session.
About two hours per session. The nasal spray is self-administered under staff observation. Then you’re monitored for at least two hours by trained clinical staff before being released. Because Spravato can cause sedation and dissociation, you can’t drive yourself home.
During induction (weeks 1–4), sessions are usually twice weekly. During initial maintenance (weeks 5–9), sessions move to once weekly. From week ten forward, most patients transition to sessions every one to two weeks.
The most common effects are dissociation, dizziness, nausea, sedation, and a temporary rise in blood pressure, all monitored by our clinical staff during your session. Most effects fade before you leave. Dr. Hashem reviews your risk profile in detail before recommending it.
Yes. Spravato is designed to be taken alongside a daily oral antidepressant, not as a replacement. Our psychiatric team coordinates both.
Still thinking it over?
A first conversation. That’s all this is.
You’ve read the details. If you’re ready to see whether Spravato fits, our Rockwall team will follow up to verify your insurance and start prior auth before you schedule anything.
Your information is confidential and HIPAA-secure.
Service Area
Serving Rockwall and East DFW
Our Rockwall clinic welcomes Spravato patients from across the East Dallas metro, with easy access from I-30 at Ralph Hall Parkway.
Visit us
Find our Rockwall clinic
Conveniently located on E Ralph Hall Parkway, just off I-30, with easy access from Rockwall, Heath, Rowlett, and the wider East Dallas metro.
SMHWI, Rockwall
Rockwall, TX 75032
Medically reviewed
Reviewed by Ryan H. Hashem, MD
Board-certified psychiatrist and Medical Director of SMHWI Rockwall, TX.
You’ve been living with this long enough
A first conversation is exactly that, a conversation. It’s confidential, we’ll verify your insurance and secure prior authorization before you commit to anything.
In a crisis
Get help right now
SMHWI is an outpatient clinic and cannot respond to emergencies. If you or someone you know is in danger or thinking about suicide, use these free, confidential resources, available 24/7.
- Call 911Life-threatening emergency, or someone at immediate risk of harm.
- Call or text 988Suicide & Crisis Lifeline, 24/7. Chat at 988lifeline.org/chat.
- Dial 988, then press 1Veterans Crisis Line, or text 838255.
- Text HOME to 741741Crisis Text Line, free 24/7 support with a trained counselor.
