When people hear about Spravato, it is usually in the context of depression treatment. But what if your main struggle is anxiety? Can Spravato help with that too?
Spravato is currently used to help people with treatment-resistant depression, and in some cases, adults with major depressive disorder who also have suicidal thoughts or behaviors. Although there are promising signs that Spravato can also help with anxiety, the research is not yet conclusive, which means the FDA has not approved it for use in cases of anxiety.
If you have been dealing with overwhelming anxiety, you will not find Spravato listed as a standard treatment in the guidelines.
Even though Spravato is not FDA-approved for anxiety, some providers and researchers are exploring how it may affect anxiety symptoms. There is early evidence that medications working on similar pathways in the brain, such as ketamine, can sometimes bring relief to people with severe anxiety. That said, studies are still ongoing, and we do not have the same level of evidence for anxiety as we do for depression.
Because of its potential for treating anxiety, some providers consider using Spravato for off-label purposes. Off-label does not mean unsafe; it just means that the FDA has not officially approved that particular use. Doctors sometimes prescribe medications off-label when other treatments have not worked, but it is always a careful, case-by-case decision.
Getting FDA approval requires a large amount of clinical trial data. Companies must run studies that prove a medication is safe and effective for a specific condition. Right now, Spravato has the strongest evidence for treatment-resistant depression, not anxiety. Until large, well-designed studies are completed, the FDA cannot add anxiety to the official label.
If you are struggling with anxiety, the first-line treatments are usually therapy, especially cognitive behavioral therapy, lifestyle changes, and traditional medications such as SSRIs or SNRIs. For some people, these work very well. For others, they may not be enough. That is when specialists may start looking into newer or less traditional options, sometimes including off-label treatments such as Spravato.
Right now, Spravato is not approved for anxiety. Its official use is for treatment-resistant depression and certain cases of depression with suicidal thoughts. That does not mean it will never be an option for anxiety. More research needs to be done before it can be considered a standard treatment.
If anxiety is your main struggle, the best step is to talk openly with a provider who understands both anxiety disorders and newer treatment options. They can help you weigh the pros and cons and determine the appropriate treatment for you.