Brattleboro Retreat

The Brattleboro Retreat in Brattleboro, Vermont offers esketamine (Spravato) therapy through its Specialty Medication Clinic for adults with treatment-resistant depression and major depressive disorder with acute suicidal ideation. Spravato is an FDA-approved nasal spray used along with an oral antidepressant, working by increasing glutamate to strengthen connections between brain cells, with relief often coming within hours rather than the weeks conventional antidepressants can take.

The nasal spray is self-administered under healthcare provider supervision, followed by a two-hour observation period in a private room with blood pressure monitoring. Treatment runs twice weekly for four weeks, then weekly for four weeks, before progress is evaluated for possible maintenance care. Patients arrange a ride home after each session.

A private, not-for-profit psychiatric hospital, the Brattleboro Retreat requires a referral from a licensed clinician. The program currently accepts BCBS VT, Medicare, and VT Medicaid.