New Directions Mental Health is dedicated to supporting your mental health. If you are experiencing suicidal thoughts, we encourage you to reach out for immediate support through your local crisis services by dialing 988, contacting your local emergency services, or visiting your local emergency room.

When you’re living with depression that doesn’t seem to get better—no matter how many medications you’ve tried—it can feel frustrating, confusing, and lonely. But you are not alone. Many people face treatment-resistant depression (TRD), and there are newer options that might help. One of these is Spravato® treatment. New Directions Mental Health supports clients across Southwestern Pennsylvania with personalized care, including therapy, psychiatric medication management, and innovative treatment options like Spravato®.

What is Spravato®?

Spravato® is the brand name for esketamine, a medication given as a nasal spray. It’s FDA-approved for adults with treatment-resistant depression and for those with major depressive disorder who experience suicidal thoughts. Spravato® is always given in a clinic, where a trained healthcare professional supervises you.

What makes Spravato® different is how quickly it can work. Some people feel better within hours or days, compared to the weeks or months it can take for traditional antidepressants to show results.

How do antidepressants work?

Antidepressants are often the first step in treating depression. These medications work by changing the levels of certain chemicals in the brain, such as serotonin or norepinephrine. Some of the most common antidepressants include:

• SSRIs
• SNRIs
• Tricyclic antidepressants and MAOIs (older types, less commonly used)

While many people benefit from these medications, others may not experience enough relief, even after trying multiple options.

Spravato® vs. antidepressants: Key differences

If you’ve tried more than one antidepressant and still feel no relief, your provider might bring up the option of Spravato® vs. antidepressants. Here’s how they differ in real-world terms:

• How they’re taken: Most antidepressants are pills taken at home. Spravato® is a nasal spray that is only taken in a clinic.
• How they work: Antidepressants target brain chemicals like serotonin. Spravato® targets glutamate, a different brain chemical linked to mood and emotion.
• How fast they work: Antidepressants usually take four to six weeks to start working. Spravato® may provide relief in as little as a few hours or days.
• Treatment process: Antidepressants can be taken alone or with therapy. Spravato® is always used with an oral antidepressant and regular follow-up care.

Both can be effective, but they work differently and are used for different stages of depression treatment.

The benefits of esketamine

One of the biggest benefits of esketamine is that it gives people hope when nothing else has worked. Many people report:

• Feeling emotional relief faster than with other medications
• Reduced suicidal thoughts during crises
• A stronger ability to focus during therapy
• More energy to reconnect with loved ones and routines

Because Spravato® is given at a clinic, each session includes time for monitoring and rest. Your dedicated care team will support and guide you at every step of your journey, helping you feel cared for.

Is Spravato® right for me?

Spravato® is not a first-line treatment—it’s designed for people who have already tried at least two different antidepressants without success. If you’re feeling stuck, exhausted, or unsure what else to try, Spravato® treatment might be worth exploring.

You may be a good candidate if:

• You’ve tried multiple antidepressants with little or no relief
• Your depression symptoms are intense and long-lasting
• You’ve experienced thoughts of self-harm or suicide
• You’re open to exploring a new treatment with support from your provider

Your psychiatric provider will help you weigh the pros and cons and make a treatment plan that fits your goals and health history.

What to expect during treatment

Spravato® treatments usually start with twice-weekly sessions, then taper down over time. Each appointment includes:

• A quiet space for you to self-administer the nasal spray
• Monitoring by trained staff for about two hours after treatment
• Ongoing check-ins to track your symptoms and safety
• Support from your provider to adjust treatment if needed

Spravato® is used alongside your current oral antidepressant as part of your care plan.

Find a depression treatment plan that suits you

Choosing between Spravato® vs. antidepressants isn’t about which one is “better”—it’s about what’s best for you. Some people respond well to traditional medications. Others need a different approach to find relief. That’s okay.

What matters most is finding a care plan that gives you hope and helps you feel like yourself again. New Directions Mental Health is here to support you with options, not just answers. Call us today at 724.374.7414 to learn more about Spravato® treatment and whether it could be the right fit for you.

For new clients, please click here to schedule an appointment. For existing clients, please click here and find your office location to contact your office directly.