Spravato treatment for Pompano Beach — REMS-certified, insurance-covered TRD care.

RECO Integrated Psychiatry is a REMS-certified Spravato site 18 miles and 28 minutes north of Pompano Beach on I-95. Induction dosing runs twice weekly for four weeks with the required two-hour in-office monitoring window, and the office handles REMS enrollment, insurance prior authorization, and concurrent oral antidepressant management as part of a single treatment plan. Clients from Cresthaven, Lighthouse Point, Sea Ranch Lakes, and Hillsboro Shores travel a single I-95 corridor with predictable drive time across the twelve-week induction and consolidation phase.

From Pompano Beach, the drive to RECO Integrated Psychiatry’s Delray Beach office runs 18 miles north on I-95 — about 28 minutes outside rush hour. For clients in Cresthaven, Lighthouse Point, Sea Ranch Lakes, or Hillsboro Shores, that distance provides useful clinical separation from local routines while keeping care inside the same South Florida catchment. RECO is a REMS-certified Spravato site delivering esketamine under the FDA-required monitoring protocol for treatment-resistant major depressive disorder and for major depressive disorder with acute suicidal ideation.

Spravato and the REMS protocol — what treatment actually looks like

Spravato (esketamine) is a nasal spray self-administered in the office under nursing supervision. Standard TRD dosing is 56 mg at the first session and 84 mg thereafter, adjusted downward only for tolerability. The device delivers 28 mg per spray; the client sits upright, self-administers under direct observation, and remains in the monitoring room for the two-hour post-dose window.

Blood pressure is checked at 40 minutes because transient hypertension is expected — systolic increases of roughly 40 mmHg and diastolic increases of 25 mmHg are common in the first hour and typically resolve without intervention. Dissociative symptoms are assessed with the Clinician-Administered Dissociative States Scale (CADSS), sedation with the Modified Observer’s Assessment of Alertness/Sedation. Depression severity is tracked at intervals with the PHQ-9.

REMS registration and dispensing documentation are handled by the office. Clients cannot drive after a session — a ride home is mandatory. Food is restricted for two hours prior and fluids for 30 minutes prior to reduce the most common transient side effect, nausea. The Spravato room is set up specifically for the monitoring window: reclining chair, low light, headphones and eye covers available on request.

The induction and maintenance schedule

For TRD, induction is twice weekly for four weeks — eight sessions — followed by weekly dosing for four weeks and then every one to two weeks based on response. For major depressive disorder with acute suicidal ideation, dosing runs twice weekly for four weeks with a separate maintenance decision made in coordination with the treating psychiatrist. RECO’s Spravato treatment program is structured around fixed weekly slots so the schedule stays predictable across the twelve-week induction and consolidation phase.

Most clients report an initial mood shift within the first week of induction — sleep normalization, reduced rumination, brief windows of emotional flexibility. Sustained response consolidates across the eight-session induction. Non-response at four weeks is a genuine clinical signal: the psychiatrist reassesses dosing, oral antidepressant coverage, and differential diagnosis (bipolar spectrum, comorbid PTSD, thyroid dysfunction, unrecognized substance use) before continuing.

Discontinuation is a taper, not an abrupt stop. Maintenance intervals are stretched gradually — every two weeks, every three weeks, monthly — with PHQ-9 tracking at each visit. Relapse rates rise when the oral antidepressant is discontinued concurrently, so oral coverage is maintained through and beyond the Spravato taper.

Spravato with an oral antidepressant, not instead of one

The FDA approval for esketamine is specifically as an adjunct to an oral antidepressant, not as monotherapy. Clients arriving on a partial-response SSRI such as sertraline, escitalopram, or fluoxetine typically continue that medication through the Spravato course. Clients on an SNRI — venlafaxine or duloxetine — do the same. The oral agent provides sustained baseline coverage between esketamine sessions.

For clients who meet the standard TRD definition (inadequate response to two or more adequate antidepressant trials), the psychiatrist may start or switch an oral agent at the same time as beginning Spravato. Options include augmentation with aripiprazole or quetiapine, a switch across SSRI/SNRI class, or lithium augmentation where the history supports it. This is medication management done in parallel with esketamine, not in isolation from it.

RECO’s psychiatry team handles the concurrent oral medication as part of the treatment plan. Prescriptions, dose adjustments, and side-effect management are integrated into the same weekly touchpoints as Spravato dosing rather than farmed out to an outside prescriber.

Spravato versus IV ketamine and how we choose

Spravato and IV ketamine are related but not interchangeable. Spravato (esketamine) is FDA-approved for TRD and for MDD with acute suicidal ideation; IV ketamine is used off-label for depression and remains cash-pay at most centers. Insurance coverage is the practical difference — Spravato is reimbursed by most commercial plans with documented TRD, IV ketamine typically is not.

Dosing structure differs. Spravato is fixed at 56 mg or 84 mg intranasal, with adjustment limited to tolerability. IV ketamine uses weight-based dosing (typically 0.5 mg/kg over 40 minutes) with response-based titration across sessions. Monitoring windows are similar in duration: Spravato mandates two hours post-dose; IV ketamine runs about two hours end-to-end for the infusion and recovery.

The choice at RECO is driven by insurance coverage, prior treatment history, and schedule constraint. Clients with insurance and documented TRD start with Spravato because the financial and evidentiary case is stronger. Clients who did not respond to Spravato or who have specific reasons to prefer titration may consider IV ketamine separately. The psychiatrist walks through both at the initial consultation without pushing a modality the client did not ask about.

What to expect on your first visit

The first visit is a full psychiatric evaluation, not a same-day dosing appointment. The intake covers current symptoms, prior medication trials (name, dose, duration, response), psychiatric history, medical history, substance use screen, and family psychiatric history. Baseline PHQ-9 and GAD-7 are administered; the ASRS is added when adult ADHD is on the differential. The psychiatrist confirms the TRD diagnosis or the acute suicidality indication and reviews REMS enrollment paperwork.

If Spravato is the right modality, the first dosing session is scheduled within one to two weeks — the interval covers insurance prior authorization and pharmacy delivery through the REMS-restricted distribution channel. Clients are asked to arrange a ride home for every dosing day; this is non-negotiable under the REMS protocol.

Insurance and admissions from Pompano Beach

RECO is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS behavioral health plans. Spravato is billed under the medical benefit at most plans rather than the pharmacy benefit, which means the office handles prior authorization directly. Documentation typically includes two prior antidepressant trials with dose, duration, and PHQ-9 response — the standard TRD criteria.

For Pompano Beach clients, the logistics are straightforward. The office is 18 miles up I-95 from central Pompano — 28 minutes off rush hour, closer to 40 during peak. Twice-weekly induction appointments are scheduled at consistent times to make the drive predictable. Clients from Lighthouse Point and Hillsboro Shores sit inside 20 miles; Cresthaven and Sea Ranch Lakes are on the same corridor. Initial consultations are typically available within one to two weeks, and self-referrals are accepted directly.

Serving residents of: Cresthaven, Lighthouse Point, Sea Ranch Lakes, Hillsboro Shores.