How Does Spravato Treatment Work for Depression?

When first-line treatments do not bring relief from depression, Spravato® treatment (esketamine) offers new hope. Unlike traditional antidepressants, Spravato treatment focuses on different brain pathways linked to mood and motivation. It is an innovative way to manage symptoms and improve well-being for those with major depressive disorder or treatment-resistant depression.

What is Spravato treatment?

Spravato is the brand name for esketamine, a form of ketamine that is approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression. Prescribed by psychiatrists, it is administered as a nasal spray under medical supervision. Patients typically use Spravato in combination with an oral antidepressant to enhance results and ensure comprehensive care.

Traditional antidepressants typically take several weeks to start working, which can be discouraging for those who have tried two or more medications with little to no symptom relief. However, Spravato treatment can begin working within hours or days. This faster response provides relief for those experiencing severe or long-standing depression that has not improved with prior treatment.

When to consider Spravato treatment

A psychiatrist typically recommends Spravato treatment after a patient with depression has not experienced sufficient relief from at least two traditional antidepressants. This is also known as treatment-resistant depression (TRD). Common signs that it might be time to ask a psychiatrist about Spravato:

• Severe feelings of sadness and hopelessness
• Self-harm ideation or behavior
• Suicidal ideation or behavior
• Intolerance to side effects from traditional antidepressants
• Reduced ability to experience pleasure (anhedonia)
• Higher number of depressive episodes

Spravato can begin working within days, providing faster stabilization and helping patients regain focus and motivation. For those living with chronic or treatment-resistant depression, this approach offers a safe, supervised, and evidence-based path toward restoring balance and improving mental well-being.

How Spravato works in the brain

Since Spravato affects the brain differently, it can be effective even if antidepressants have been ineffective. More specifically, instead of acting on serotonin or dopamine pathways, esketamine influences the N-methyl-D-aspartate (NMDA) receptor, a component of the glutamate system. Glutamate is one of the brain's most productive neurotransmitters and helps with learning, memory, and mood regulation.

By interacting with the NMDA receptor, Spravato helps restore balance in brain circuits that may have become disrupted by treatment-resistant depression. This action improves neural connectivity and supports the brain's ability to form new communication pathways. This process is known as neuroplasticity. As a result, patients often experience improved mood, clearer thinking, and a renewed sense of long-term emotional stability.

A closer look at the treatment process

Spravato treatment is always conducted under the supervision of a psychiatrist, either in their office or at a medical treatment center, to ensure patient safety. Regardless of the location, each Spravato session follows a structured process meant to ensure comfort, safety, and optimal results. Here is what the process looks like step by step:

Initial evaluation

Before starting Spravato treatment, the psychiatrist reviews medical history, current medications, and mental health goals. This evaluation determines whether Spravato is appropriate and safe for the patient. Ideal candidates for Spravato treatment include:

• Adults over the age of 18
• Diagnosed with major depressive disorder or treatment-resistant depression
• Already taking an oral antidepressant
• No history of psychotic disorders
• No history of substance abuse
• No history of certain medical conditions (e.g., uncontrolled hypertension, intracerebral hemorrhage, or cardiovascular disease)

Supervised administration

During each treatment session, the patient will self-administer the nasal spray under medical supervision. The psychiatrist will determine the appropriate dosage based on the patient's needs and response to treatment.

Monitoring period

After administration, the patient will remain in the office for observation, typically for about two hours. During this time, the experienced medical staff monitors their blood pressure, heart rate, and overall response to the treatment. Due to the effect of Spravato on the central nervous system, it needs to be administered in a controlled environment. This precaution allows the medical team to monitor the patient for potential side effects, such as dizziness, mild dissociation, or increased blood pressure. Even if these effects occur, they are usually temporary and resolve within a few hours after the end of the session.

Follow-up

Once the session is complete, the patient is released to go home. Follow-up visits are scheduled to assess progress and adjust the treatment plan as needed. Most Spravato treatment schedules begin with twice-weekly sessions for the first month, followed by a gradual tapering to weekly or bi-weekly visits. The psychiatrist will use the follow-up appointments to monitor the patient's progress and response to determine the frequency of treatment sessions.

Explore a new era in depression treatment

Spravato® treatment comes as a major advancement in addressing symptoms of major depressive disorder and treatment-resistant depression. For those who have struggled to find relief, this approach offers renewed hope and an effective way to manage their symptoms. If you are interested in learning more about Spravato or would like to find out whether you are a candidate, please reach out to our Myrtle Beach office today to schedule a consultation.

Request an appointment here: https://mb.futurepsychsolutions.com or call Future Psych Ketamine Clinics at (843) 788-9718 for an appointment in our Myrtle Beach office.

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