Living with depression that doesn’t seem to get better no matter how many medications you’ve tried can feel frustrating, confusing, and lonely. However, new innovations in depression treatment, such as Spravato®, can offer new hope to people with difficult-to-treat depression.
What Is Spravato®?
Spravato® is the brand name for esketamine, a nasal spray that has been 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 and monitors your symptoms after administration.
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 inhibiting the “reuptake” of certain neurotransmitters, allowing them to be processed and used. Most medications target the neurotransmitters serotonin and norepinephrine, which are both responsible for mood and energy levels.
Some of the most common antidepressants include:
- Selective serotonin reuptake inhibitors (SSRIs), including fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro)
- Selective norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta), venlafaxine (Effexor XR), and desvenlafaxine (Pristiqu)
- Atypical antidepressants, like buproprion (Wellbutrin)
- Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), both of which can be effective but are less commonly used due to more side effects and potential interactions with other medications.
- 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 haven’t found relief from depression symptoms, your psychiatric provider may suggest a different approach, such as Spravato®. This works differently than regular antidepressants, focusing on glutamate instead of serotonin or norepinephrine.
Here’s how Spravato® works differently from other antidepressants:
- How they’re taken: Most antidepressants are pills taken at home. Spravato® is a nasal spray that is only administered in a clinic.
- How they work: Antidepressants target brain chemicals like serotonin. Spravato® targets glutamate, a different neurotransmitter linked to mood, energy, and emotion.
- How fast they work: Antidepressants usually take four to six weeks before someone feels their effects. 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 usually combined with an oral antidepressant and regular follow-up care.
- Who they’re for: Spravato® is cleared by insurance companies specifically for difficult-to-treat depression, so it’s typically saved for after someone has tried at least two other antidepressant medications.
The Benefits of Esketamine for Depression
One of the biggest benefits of esketamine is that it gives people hope when other options haven’t worked. Many people report:
- Feeling emotional relief faster than with other medications
- Reduced suicidal thoughts
- Improved ability to express and connect with emotions and implement coping skills
- More energy to reconnect with loved ones and get back to routines
Because Spravato® is given at a clinic, each session includes two hours of monitoring and rest. Your dedicated care team will support and guide you at every step of your journey.
The Biggest Pro: Quick Relief
The most tangible difference for many people experiencing hard-to-treat depression is how quickly Spravato® starts to take effect. Most medications can take a few months to really start feeling any difference, while Spravato® works within days or even hours for many clients.
Is Spravato® Right for Me?
Spravato® is not a first-line treatment. It’s designed (and cleared by insurance companies) 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 for Spravato® if:
- You’ve tried multiple antidepressants with little or no relief
- Your depression symptoms are intense and long-lasting
- 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. And if Spravato® isn’t a good fit, our providers can talk you through other options, such as TMS for depression.
What to Expect During Spravato® Sessions
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 with the guidance of a specialized clinician
- 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 typically used alongside your current oral antidepressant as part of your broader depression care plan.
Get Comprehensive Depression Treatment at New Directions Mental Health
Choosing between Spravato® vs. antidepressants isn’t about which one is “better,” it’s about what’s best for each individual. Some people respond well to traditional medications. Others need a different approach to find relief. We’re here to ensure you’re getting the care that’s actually going to move the needle on how you feel.
We’re ready to help you determine your best depression treatment options in the greater Pittsburgh area. Call us today at [Direct[ to learn more about Spravato® treatment and whether it could be the right fit for you, or schedule your first appointment with us now.
