Who Can Prescribe Spravato?

Spravato (esketamine) is a prescription medication, but that doesn’t mean all psychiatrists can offer it. So exactly who can prescribe Spravato? The answer: A  Risk Evaluation and Mitigation Strategies (REMS)-certified provider can write an esketamine prescription. Continue reading to learn what the REMS program is and how to find a certified treatment center. 

Quick answers

• REMS certification signals that a prescribing provider or practice has met FDA safety guidelines to prescribe and administer a certain drug. There are multiple treatments that require this certification, including Spravato.  
• Psychiatrists and psychiatric-mental health nurse practitioners (PMHNPs) are the most likely to be REMS-certified for Spravato, though other healthcare providers can be certified to prescribe this medication as well. 

Which providers are certified to prescribe Spravato?

“In order to become a REMS certified provider of Spravato, a clinic has to go through a lot of different processes to make sure that it's doing everything in a safe, legal, and consistent way,” says Carlene MacMillan MD, FCTMSS, DFAACAP, co-founder at Radial and board-certified psychiatrist. REMS certification requirements are determined by the FDA. 

This certification applies to both the clinic and prescribing provider. Multiple provider types can be certified to prescribe Spravato for FDA approved purposes, such as treatment-resistant depression. The most common include:

• Psychiatrists: The most common, prescribing psychiatrists must be individually REMS-certified. Not all psychiatrists are designated as such, so it’s worth researching a provider before discussing Spravato with them.
• PMHNPs: Psychiatric mental health nurse practitioners (PMHNP) are fully qualified to prescribe and supervise, if REMS-certified.
• Other specialists: Dr. MacMillan mentions that other providers who prescribe medications, especially for mental health, can become REMS-certified for Spravato.

Any healthcare providers who are not REMS-certified, including therapists and counselors, cannot prescribe Spravato. They can, however, write a Spravato referral to a REMS-certified colleague, such as the team at Radial. 

How to find a REMS-certified Spravato provider

“We always love referrals from other clinicians, but people can go right onto the Spravato directory online and find certified providers near them,” says Dr. MacMillan, “No referral is usually needed.”

The SPRAVATO® REMS locator that Dr. MacMillan referred to allows you to search providers and REMS-certified clinics in your local area. It also offers contact information, such as a number to call. 

When calling a REMS-certified clinic, you might ask:

• Is your clinic REMS-certified to administer Spravato?
• How do you evaluate new patients for Spravato treatment?
• What does the administration process look like at your clinic?

For those in New York City, South Carolina, Tennessee, Illinois, or Missouri, Radial is a REMS-certified Spravato clinic to consider. 

Disclaimer: One medical reviewer listed on this article, Steve Harvey, MD, is a paid speaker for Johnson & Johnson, the manufacturer of Spravato.

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