How Old Do You Have to Be for Spravato® Treatment?

If you're exploring Spravato® (esketamine) treatment for depression, one of the most common questions patients and caregivers ask is:

“How old do you have to be to receive Spravato treatment?”

Understanding age eligibility is an important part of evaluating whether Spravato® is a possibility for you or someone you care about. In this article, we’ll explain the official age requirements, how they apply in real clinical settings, and what options exist if someone doesn’t meet those age criteria.

Official FDA Age Requirement for Spravato®

Spravato® (esketamine), a nasal spray used alongside an oral antidepressant, is FDA-approved for:

• Adults ages 18 and older

• For treatment of treatment-resistant depression (TRD)

• And for major depressive disorder (MDD) with acute suicidal ideation or behavior

This means that, based on current FDA approval, patients must be at least 18 years old to receive Spravato® treatment.

There is no FDA approval for Spravato® in individuals under 18, and younger age groups are not currently eligible for this specific treatment.

Why Age Matters

The FDA’s approval process considers:

• Safety data

• Clinical trial populations

• Long-term effects

• Developmental physiology

Spravato® was studied and approved based on research in adults, so there is not yet sufficient evidence for its safe and effective use in adolescents or children.

Because of these safety considerations and the lack of controlled clinical data for younger patients, Spravato® is not prescribed for those under age 18.

How Age Eligibility Is Determined for Spravato®

Spravato® (esketamine) is an FDA-approved treatment with strict safety and prescribing requirements. It is approved for use in adults with specific diagnoses, and its administration is governed by a federally mandated safety program.

Spravato® is only provided through the REMS (Risk Evaluation and Mitigation Strategy) program, which means:

• It can only be administered at certified treatment centers

• Patients must meet FDA-defined eligibility criteria

• Each treatment occurs under direct medical supervision

• Age requirements are built directly into these safety protocols

Because of these safeguards, Spravato® is not prescribed outside of its approved age indications, and treatment decisions are made carefully based on current FDA guidance and patient safety considerations.

If someone is under 18 or does not meet eligibility criteria, clinicians focus on other evidence-based treatment options that are appropriate for that individual’s age and clinical needs.

What Options Are There for Teens and Young Adults?

If someone under 18 is struggling with depression or treatment-resistant symptoms, there are evidence-based care options that may be considered:

• Psychotherapy (CBT, DBT, family therapy)

• Medication evaluation and management with a child/adolescent psychiatrist

• Lifestyle and behavioral interventions (sleep, routine, activity)

• School-based support services

• Referral to pediatric mental health specialists

These providers are experienced with younger age groups and can guide developmentally appropriate care.

How Age and Eligibility Are Determined in Clinic

When you undergo an evaluation for Spravato® or any advanced treatment, clinicians consider:

• Your chronological age (18+ for Spravato®)

• Your psychiatric history history

• Prior treatments and responses

• Medical history (heart, brain, blood pressure, etc.)

• Safety and monitoring requirements

Age is one part of a larger eligibility assessment — but it is a firm requirement for Spravato®.

Frequently Asked Age Questions

Can someone in their early 20s or mid-20s get Spravato®?

Yes — as long as they meet other clinical criteria and are 18 or older.

Is Spravato® recommended for older adults (60+)?

Spravato® can be considered for older adults if they meet eligibility criteria. Age alone (beyond being 18+) is not a disqualifier, though medical evaluation and monitoring are critical.

Conclusion

The minimum age to receive Spravato® treatment is 18 years old, based on current FDA approval and safety data. Individuals younger than this are not currently eligible for Spravato®, and alternate depression care approaches should be discussed with a qualified child or adolescent mental health provider.

If you are 18 or older and considering next-step treatment options for depression that have not improved with traditional therapy or medications, a psychiatric evaluation can help determine whether Spravato® is appropriate for you.

At Aurora Wellness, we provide comprehensive psychiatric care — including evaluation, medication management, and advanced treatment options like Spravato® for eligible adults in Brooklyn and White Plains. If you’d like to explore whether Spravato® might be right for you, we can help guide that conversation in a supportive, clinical setting.