When should my child see a psychiatrist vs. a therapist?

A therapist helps children work through emotions, behavioral challenges, and life changes through talk therapy. A psychiatrist is a medical doctor who can diagnose complex mental health conditions and prescribe medication. If your child has been in therapy but still struggles, or if a professional has suggested medication might help, it's time to see a psychiatrist.

Can my child see both a psychiatrist and therapist?

Yes, this is common and often recommended. A psychiatrist manages medication and monitors its effectiveness, while a therapist provides ongoing talk therapy and coping strategies. This team approach offers comprehensive mental health care.

What mental health conditions require a child psychiatrist?

Conditions that often benefit from psychiatric care include ADHD, severe anxiety or depression, bipolar disorder, OCD, treatment-resistant depression, and any condition where medication may be helpful.

How do I find a child psychiatrist in Charlotte, NC?

Pediatric & Family Behavioral Health (PFBHNC) in Charlotte offers comprehensive psychiatric care for children, adolescents, and adults. Located at 10420 Park Rd, Suite 300, the practice accepts most major insurance plans.

SPRAVATO® in Charlotte, NC

Javier Santos Cubina MD
Feb 24
4 min read

A monitored, evidence based option for treatment resistant depression at Pediatric & Family Behavioral Health

Quick Answer

SPRAVATO® (esketamine) is an FDA approved prescription treatment for certain adults with treatment resistant depression and major depressive disorder. It is administered as a nasal spray in a certified medical setting with on site monitoring after each dose. At PFBH in Charlotte, NC, SPRAVATO® is offered through Interventional Psychiatry with individualized planning and coordinated care.

Depression affects millions of people worldwide. Many people improve with traditional antidepressants, but some do not experience adequate relief. For those individuals, SPRAVATO® (esketamine) offers an additional, evidence based option when other approaches have fallen short.

At Pediatric & Family Behavioral Health in Charlotte, North Carolina, SPRAVATO® is provided through our Interventional Psychiatry services for adults with Treatment Resistant Depression (TRD) and Major Depressive Disorder (MDD), including depressive symptoms associated with acute suicidal thoughts or behaviors.

What Is SPRAVATO®?

SPRAVATO® is a prescription medication approved by the U.S. Food and Drug Administration (FDA). Unlike many standard antidepressants that primarily target serotonin and related neurotransmitters, SPRAVATO® works on the brain’s glutamate system, a pathway involved in mood regulation, learning, and neural connectivity. Some patients experience symptom improvement within hours or days. Response varies, and treatment decisions are made with your psychiatric provider.

Rapid Acting Relief for Severe Depression

Traditional antidepressants can take several weeks to produce noticeable results. SPRAVATO® offers a faster acting, biologically distinct approach for some patients. This can be especially meaningful for individuals with severe symptoms or suicidal ideation. Your clinician will help determine if this approach fits your history, symptoms, and safety needs.

What to Expect During SPRAVATO® Treatment

SPRAVATO® is administered as a nasal spray in a certified medical setting and is always provided under direct supervision. After dosing, patients remain in office for monitoring because short term side effects can occur. These may include dizziness, dissociation, nausea, sleepiness, or temporary increases in blood pressure.

For safety reasons, SPRAVATO® is not taken at home. It is often used alongside an oral antidepressant as part of a structured treatment plan. Your provider will review your medication regimen and discuss options based on current guidance and your needs.

Transportation and Visit Length

Patients are not permitted to drive themselves to or from appointments on treatment days. You will need to arrange transportation in advance through a family member, friend, or rideshare service.

Most visits last about two hours or longer. This includes medication administration and post dose monitoring. Our team provides care in a calm, supportive outpatient environment with a focus on comfort and safety throughout each session.

SPRAVATO® Treatment Timeline
Induction phase: Treatment often begins with twice weekly sessions for the first four weeks. Maintenance phase: If treatment is helpful, visit frequency is gradually reduced. Many patients transition to weekly or every other week sessions based on response and clinical progress. Your psychiatric provider will assess symptoms regularly and adjust the schedule to keep care personalized and appropriate.

Who Is a Candidate for SPRAVATO®?

You may be a candidate for SPRAVATO® treatment in Charlotte, NC if you:

Have been diagnosed with Treatment Resistant Depression or Major Depressive Disorder
Have tried two or more antidepressant medications without adequate improvement
Continue to experience moderate to severe depressive symptoms
Can participate in monitored, in office treatment sessions
Have ongoing psychiatric support as part of a comprehensive care plan

A thorough psychiatric evaluation is required to determine whether SPRAVATO® is safe and appropriate for you.

Clinical Outcomes and What Results Can Look Like

Clinical studies and real world experience suggest that many people with treatment resistant depression can experience meaningful symptom reduction with SPRAVATO® when combined with a comprehensive care plan. Reported response rates vary across studies and settings. Some sources cite significant symptom reduction for many patients, with remission in a smaller portion of treated individuals. Your provider will review what these numbers mean in context and will focus on your individual goals and progress over time.

Insurance and Cost Planning

SPRAVATO® is covered by many major insurance plans. Our team works with patients to verify benefits and support the prior authorization process when required. Patient assistance programs may also help reduce out of pocket costs for eligible individuals. Coverage and costs vary, so we will review practical details before treatment begins.

Why Choose Pediatric & Family Behavioral Health for SPRAVATO® Treatment

Interventional psychiatry requires careful screening, consistent monitoring, and a team that can support both the biology of depression and the day to day realities of recovery. At PFBH, SPRAVATO® treatment is delivered by an experienced psychiatric team in a supervised outpatient setting. We provide clear education on what to expect, coordinate care with your existing treatment team when helpful, and track progress throughout induction and maintenance. Our goal is a plan that fits your needs, supports safety, and makes treatment feel manageable.

When to Seek Help Immediately

Go to the nearest emergency room or seek urgent help if you have thoughts of harming yourself or someone else, feel unable to keep yourself safe, or experience a sudden and severe change in mood or behavior.

Crisis support: 988 Suicide & Crisis Lifeline (call or text 988)

Ready to Explore SPRAVATO® in Charlotte?

If you have tried multiple antidepressants without enough relief, a consultation can help clarify whether SPRAVATO® may be appropriate. Our team will review your history, answer questions, and outline next steps.

Schedule a Consultation

Key Takeaways

SPRAVATO® is an FDA approved prescription option for certain adults with treatment resistant depression and major depressive disorder
It is administered in a certified clinic with on site monitoring and is not taken at home
Most visits last about two hours or longer, and you need a ride home on treatment days
Treatment often begins twice weekly, then transitions to a maintenance schedule based on response
PFBH provides supervised, coordinated care through Interventional Psychiatry in Charlotte, NC

About the Author

Dr. Javier Santos-Cubiñá, MD is a triple board certified psychiatrist in Adult Psychiatry, Child and Adolescent Psychiatry, and Consultation Liaison Psychiatry. He and the experienced team at Pediatric & Family Behavioral Health provide evidence based depression care in Charlotte, North Carolina, including Interventional Psychiatry services for adults.

Location: 10420 Park Rd, Suite 300, Charlotte, NC 28210