2 clinics shown
Dr. David Kalkstein operates a psychiatric practice in Rehoboth Beach, located on John J Williams Highway. The practice provides psychiatric evaluations and medication management for adults. Specific treatment modalities such as TMS, esketamine, or ketamine therapy are not detailed in available information; patients should contact the office to confirm whether these procedural treatments are offered or if referrals to other providers are available.
Nicole Sachs LCSW operates a psychotherapy practice in Rehoboth Beach, located on Lake Avenue. The practice focuses on individual therapy for adults dealing with chronic pain and related psychological factors. Specific treatment modalities beyond traditional talk therapy are not detailed in available information; patients seeking TMS, ketamine, or esketamine services should contact the office to confirm whether those treatments are offered or if referrals to other providers are available.
Spravato is the brand name for esketamine, an FDA-approved nasal spray for treatment-resistant depression and major depressive disorder with suicidal ideation. It's derived from ketamine and works on the brain's glutamate system — a different mechanism than traditional antidepressants like SSRIs.
Treatment is administered only at REMS-certified clinics under direct medical supervision. Patients self-administer the spray under a clinician's guidance, then remain at the clinic for at least two hours of monitoring after each dose. The induction phase typically involves twice-weekly sessions for four weeks, followed by weekly or biweekly maintenance dosing depending on response.
Many patients report meaningful symptom improvement within the first one to two weeks — substantially faster than the 4 to 8 weeks typical of oral antidepressants. Spravato is taken alongside an oral antidepressant, not as a replacement.
The most common side effects are dissociation, dizziness, sedation, and elevated blood pressure during and shortly after dosing. These typically resolve within the two-hour monitoring window. Patients cannot drive on the day of treatment.
Most commercial insurance and Medicare cover Spravato for treatment-resistant depression with prior authorization. Clinics offering Spravato in our directory hold active REMS certification and are staffed to provide the required in-clinic monitoring period.