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What Is Spravato® and Who Might Benefit? (Melissa Bell, APRN)

faith0445
Sep 2
2 min read

If you've struggled with depression and feel like you've "tried everything," you're not alone. Many people with depression improve with traditional antidepressants, therapy, or a combination of both. However, some continue to experience significant symptoms despite multiple treatment attempts. This is known as treatment-resistant depression (TRD).

One newer treatment option that has offered hope to many individuals is Spravato® (esketamine).



How Is Spravato Different?

Most traditional antidepressants work by affecting serotonin, norepinephrine, or dopamine—brain chemicals involved in mood regulation. While these medications can be very effective, they often take several weeks to begin working.

Spravato works differently. It targets a brain chemical called glutamate, which plays an important role in communication between brain cells. Researchers believe that by affecting glutamate pathways, Spravato helps the brain create and strengthen connections that may have been disrupted by depression.

Because of this unique mechanism, some people notice improvement much faster than they experienced with traditional antidepressants.


What Does Treatment Involve?

Spravato is administered as a nasal spray in a medical office under supervision.

Treatment requires a time commitment because patients must remain in the office for monitoring after each dose.

A typical schedule includes:

  • Twice-weekly treatments for the first 4 weeks

  • Once-weekly treatments for the next month

  • Maintenance treatments every 1–2 weeks for those who continue to benefit

Most appointments last about 2 hours, including observation time.

Because Spravato can temporarily cause dizziness, sleepiness, or changes in perception, patients cannot drive themselves home after treatment and must arrange transportation.


Who Is an Ideal Candidate?

Spravato may be a good option for adults who:

  • Have major depressive disorder that has not adequately improved with multiple antidepressant trials

  • Continue to experience significant depression despite therapy and medication

  • Are looking for an evidence-based treatment beyond traditional antidepressants

  • Can commit to regular office visits and post-treatment monitoring

Spravato is not the right fit for everyone, which is why a thorough evaluation is important before starting treatment.


A Message of Hope

Living with treatment-resistant depression can feel exhausting and discouraging. Many people begin to wonder if they'll ever feel better. While no treatment works for everyone, Spravato has provided meaningful relief for many individuals who previously felt stuck.

If you have been struggling despite multiple treatment attempts, it may be worth discussing whether Spravato could be an appropriate option for you. New treatments continue to expand what's possible in depression care, and hope remains even when previous treatments have fallen short.


Melissa Bell, APRN, MSN, FNP-C, PMHNP-BC Christian Perspective Counseling



Spravato® is FDA-approved for treatment-resistant depression and certain adults with major depressive disorder and acute suicidal thoughts or behaviors. Individual results vary, and a consultation is needed to determine eligibility.

 
 
 

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