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The esketamine pathway at Dokotela
Supervised esketamine (Spravato®) for adults with treatment-resistant depression, at our Sydney clinic from January 2027.
Short on time? Download the referral sheet below.
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Who it's for
Adults with moderate to severe depression that hasn't responded to two or more adequate antidepressant trials in the current episode. Used alongside an oral antidepressant. A Dokotela psychiatrist confirms suitability.
Treatment schedule
Twice weekly for weeks 1–4, weekly for weeks 5–8, then weekly or fortnightly. Response is reviewed after induction and at least every six months.
Prescribing and PBS
Schedule 8. In NSW only psychiatrists can prescribe it for treatment-resistant depression, so GPs refer rather than prescribe. Under the PBS it's given under supervision at an accredited centre, and the prescribing psychiatrist treats the patient. Patients can't drive until the next day.
If you're a GP
GPs can't prescribe esketamine. Refer suitable patients to a Dokotela psychiatrist and we'll keep you updated throughout.
How to referHow the pathway works
Suitability is your clinical decision. Send a referral through any of the channels below.
A Dokotela psychiatrist oversees prescribing and treatment. Our team contacts the patient, books their sessions and coordinates pharmacy supply.
Dose administered, monitoring observations and patient-reported outcomes. Adverse events are communicated promptly.
What the clinic provides
The patient self-administers under direct nurse supervision, with a blood pressure check before each dose.
Blood pressure, sedation and dissociation are monitored until the patient is clinically stable, for up to two hours.
Pharmacy supply, scheduling and review recalls are handled by our team.
How to refer
Monday to Friday, 9am – 5pm AEST
- Current oral antidepressant
- Antidepressant trials, dose and duration
- BP and cardiovascular history
- Substance use history
- Pregnancy and contraception, if relevant
- Patient contact details
For Australian health professionals only. Does not replace the full product information (TGA).
Email a referral
Clinician FAQs
No. Clinicians who prescribe and administer the treatment complete the manufacturer's training.
No. Esketamine is used together with an oral antidepressant.
Fee details will be published here before the clinic opens.
Dokotela Specialists, Westfield Tower 1, 520 Oxford Street, Bondi Junction NSW 2022.
Call (02) 8003 7668 and ask for the clinical team, Monday to Friday, 9am to 5pm AEST.
We are here to help.
Clinical questions?
Call (02) 8003 7668 and ask for the clinical team, Monday to Friday, 9am to 5pm AEST.
