Esketamine Nasal Spray Program (Spravato®)
Treatment for patients with treatment-resistant depressive disorder
- Covered by your insurance (policy-dependent)
- Immediate start, no waiting lists
Esketamine Nasal Spray Program (Spravato®)
The esketamine nasal spray (Spravato®) treatment program is designed for patients with treatment-resistant depressive disorder for whom previous treatments have been insufficiently effective. The program is tailored individually for each patient, and its duration is determined based on treatment response, clinical judgment, and alignment with the patient.
Magnolia creates optimal conditions to support recovery. Where clinically indicated, additional therapeutic interventions may be applied, such as cognitive behavioural therapy (CBT), Acceptance and Commitment Therapy (ACT), psychodynamic therapy and interpersonal therapy (IPT), appropriate for the treatment of treatment-resistant depression.
The treatment is delivered by a multidisciplinary team of lead clinicians and co-treating professionals.
Within this programme, esketamine nasal spray is used as an integral part of the treatment, in accordance with current guidelines.
Your treatment is covered up to 80% by health insurers (policy-dependent)
Who is this programme intended for
To participate in our programme it is important that you:
- Are an adult (18+)
- Have been diagnosed with treatment-resistant depressive disorder (insufficient response to at least two different antidepressants in adequate dosage and duration)
- Concurrent use of an oral antidepressant during esketamine treatment, as prescribed by the treating physician
- Have additionally tried at least one augmentation strategy without sufficient effect.
After your request for consultation, an intake and screening will follow during which we assess your medical and psychiatric history. If you are eligible, you will be matched with a dedicated treatment team.
For the first time in my life, I can say that I experience calm and a sense of safety in my body, even when I am alone. Before, I only lived in my head, but now I live in the world."
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The ketamine journeys have provided me with a wealth of wisdom and insights. Thanks to the ketamine, I was able to connect with deeply buried pain, but also with my true desires and abilities. Moreover, the ketamine has helped expand my ‘container,’ allowing me to dare to feel and connect—with my true self and with the world around me.
Together with my psychologist from Magnolia, Wiesje, I worked hard on the themes that emerged from my journeys. I have been able to create safety, both at home and in my relationships. For the first time in my life, I can say that I experience calm and a sense of safety in my body, even when I am alone. Additionally, I feel strength. I am better able to sense and protect my boundaries, which finally allows me to maintain a connection with myself. Slowly but surely, I am emerging from my ‘freeze’ mode; frozen energies (emotions) can now, little by little, leave my body. I can connect with my deepest desires and act from that place; step by step, I am letting go of pieces of my long-standing eating disorder, and the dysthymic disorder is making way for life energy, spontaneity, freedom, and self-compassion.
My heartfelt gratitude goes out to the Magnolia team and Menno Oosterhoff for the warm, loving, and skilled guidance throughout my journey. Movement has been sparked on so many levels—emotionally, physically, spiritually, relationally, and in my conscious “being.” The ketamine journeys turned out to be the missing link in my process toward further healing. Magnolia came into my life at exactly the right moment. Thank you for everything!
“Before, I only lived in my head, but now I live in the world.”
Programme structure
The program is individually tailored and includes screening, diagnostics, treatment, and aftercare. The duration of treatment is determined based on treatment response, clinical judgment, and alignment with the patient. Progress is evaluated regularly, and the treatment plan is adjusted where necessary.
Request for consultation
After your request, we schedule a non-binding introductory consultation. During this conversation we explore your treatment request, explain the programme and discuss the medical, practical and financial framework. Together we then determine whether a formal screening is appropriate.
Screening & diagnostics
During screening and diagnostics we carefully assess whether the programme is medically and therapeutically suitable for you and whether you meet the indication criteria for treatment with esketamine. For treatment with esketamine nasal spray, prior authorization from your health insurer is required. Without authorization the programme cannot start. We guide you through this process.
Intake & treatment plan
If the screening indicates that further treatment is appropriate, your case is first discussed in a multidisciplinary meeting. Based on this, an intake consultation follows in which the indication, treatment goals and expectations are carefully aligned. After the intake your personal treatment plan is established. After approval and receipt of the required authorization, treatment can begin.
Treatment cycle
Esketamine treatment on site
In most cases you will receive two esketamine treatments per week during the first four weeks. After this, the frequency is gradually reduced to once per week or once every two weeks, depending on progress and clinical response. Administration takes place under medical supervision, with careful monitoring of safety and effect.
Psychological and Psychiatric Support
Where clinically indicated, additional psychological and psychiatric support may be provided during the treatment trajectory.
This may include consultations with a psychologist and psychiatrist, tailored to the individual needs, treatment response, and clinical course of the patient.
Throughout the treatment trajectory, esketamine treatment is carefully monitored and periodically evaluated with regard to effectiveness, tolerability, and clinical progress.
Start your first treatment immediately after screening
Specialized medical treatment team
Safety and well-being
Insured care (policy-dependent)
Nature, tranquility and privacy
Treatment and guidance during the programme
The esketamine nasal spray programme is primarily aimed at the pharmacological treatment of treatment-resistant depression within a multidisciplinary treatment setting. The trajectory focuses on recovery of depressive symptoms, functioning, and quality of life.
Through the use of esketamine, we work towards symptom reduction, restoration of functioning, and strengthening of the natural recovery capacity.
Throughout the treatment trajectory, esketamine treatment is carefully monitored and periodically evaluated with regard to effectiveness, tolerability, and clinical progress. Where clinically indicated, additional psychological or psychiatric support may be provided.
Psychological treatment
Where clinically indicated, additional psychological support may form part of the treatment trajectory.
Depending on the individual treatment indication, this may focus on:
– Reducing depressive thinking patterns
– Behavioural activation and structuring
– Emotion regulation
– Interpersonal functioning
Additional psychological support may help reinforce the recovery process and consolidate improvements achieved during treatment.
Psychiatric treatment
In addition, consultations with a psychiatrist may take place during the treatment trajectory. During these consultations:
Indication and treatment response are evaluated
Effectiveness and side effects are monitored
Dosage and treatment strategy are adjusted where necessary
Treatment takes place under the medical responsibility of a psychiatrist. Throughout the programme, regular multidisciplinary meetings take place in which progress, treatment response, and treatment policy are evaluated and adjusted where necessary.
Quality assurance
Magnolia Therapy is a member of the Esketamine Nasal Spray Consortium Netherlands (ENC-NL), a national collaboration of clinicians and psychiatrists specialised in the application of esketamine nasal spray within specialist mental healthcare (GGZ).
Within ENC-NL, treatment experiences, safety data and outcomes are shared and discussed, with the aim of continuously improving the quality and careful application of esketamine treatment in the Netherlands.
Binnen ENC-NL worden behandelervaringen, veiligheidsgegevens en uitkomsten gedeeld en
besproken, met als doel de kwaliteit en zorgvuldigheid van esketaminebehandeling in Nederland continu te verbeteren.
Contra-indications
The main contraindications for participation in the program are:
A history of psychosis
Bipolar disorder type I
Acute suicidality
Substance misuse
Severe cardiovascular disease
Pregnancy or breastfeeding
Costs and reimbursement
We believe it is important that the costs of the treatment program are clear and predictable.
The screening is free of charge. Any reimbursement you receive from your health insurer for the screening is to be paid to us. A referral to the specialist mental healthcare (sGGZ) is required to participate.
During the treatment program, we work with a fixed and transparent out-of-pocket contribution.
- For the monthly consultation with the psychiatrist, the out-of-pocket contribution is €50 per month, supplemented by the reimbursement you receive from your health insurer.
- For each treatment with esketamine nasal spray, the out-of-pocket contribution is €50 per session, supplemented by the reimbursement from your health insurer.
The esketamine nasal spray itself is — after approval — fully reimbursed by your health insurer.
Based on a treatment course of approximately 20 sessions over 6 months, the average out-of-pocket contribution comes to around €215 per month.
The level of reimbursement from your health insurer does not affect access to or the content of the treatment.
This number of sessions is based on the standard treatment protocol. In practice, the program is tailored to your individual situation, and the number of sessions may be lower — which would also reduce the overall out-of-pocket contribution.
The treatment plan described above reflects a primarily pharmacological treatment approach.
Where clinically indicated, additional psychological support aimed at strengthening the natural recovery capacity may form part of the treatment trajectory. This additional treatment component may involve a higher out-of-pocket contribution. If appropriate, this will always be discussed with you clearly and transparently in advance.
Throughout the treatment, we continuously assess what is needed and appropriate. Progress is regularly evaluated, and the treatment plan is adjusted where necessary.
If the out-of-pocket contribution presents a barrier, we may — in exceptional cases and after individual assessment — explore the possibility of a reduced monthly contribution.