Treatment-resistant depression (TRD) is a challenging condition where traditional antidepressant medications fail to alleviate symptoms. This can leave patients feeling hopeless, disconnected, and stuck. Fortunately, medical advancements have introduced new treatment options, including Spravato, a groundbreaking therapy offering hope for those who haven’t found relief through conventional means. Learn how Spravato works, what to expect during treatment, and why it might be the right option for you.
What is Treatment-Resistant Depression?
Before exploring Spravato further, it’s important to understand treatment-resistant depression. TRD refers to a form of major depressive disorder (MDD) that doesn’t improve even after trying two or more antidepressant treatments. This type of depression is particularly frustrating and debilitating, as it often seems that no matter what approach you take, symptoms persist. In these cases, traditional treatments like selective serotonin reuptake inhibitors (SSRIs) and psychotherapy fail to provide sufficient relief.
What Is Spravato?
A lack of response to standard depression therapies highlights the need for alternative treatments like Spravato, which works differently than typical antidepressants. Spravato is the brand name for esketamine, a nasal spray approved by the FDA specifically for treating TRD.
Esketamine is derived from ketamine, a well-known anesthetic that has shown remarkable effectiveness in treating depression. Unlike oral antidepressants, which often take weeks or even months to start working, Spravato produces rapid improvements in depressive symptoms, often providing relief within a few hours or days after treatment.
Spravato is used in conjunction with an oral antidepressant and is administered under a healthcare provider’s close supervision. This ensures the safest, most effective treatment possible and allows medical professionals to monitor the patient for potential side effects.
How Does Spravato Work?
Traditional antidepressants primarily target serotonin and norepinephrine in the brain. However, these treatments don’t work for everyone. Spravato offers a different approach by targeting the N-methyl-D-aspartate (NMDA) receptors in the brain, which are involved in mood regulation and cognitive functions.
The medication’s interaction with these receptors helps restore the balance of certain neurotransmitters, promoting the growth of new neural connections. This unique mechanism helps reduce depressive symptoms in treatment-resistant cases, and it works faster than many traditional antidepressants.
The Spravato Treatment Process
Spravato treatment involves several stages, beginning with an initial assessment by a healthcare provider to determine if the therapy is suitable for you. Here’s what to expect once treatment begins.
Initial Phase
During the first four weeks, patients typically receive Spravato twice a week. Each session lasts about two hours, including preparation, administration, and observation time.
The nasal spray is self-administered under medical supervision in a healthcare setting. Your blood pressure will be checked before administration, as Spravato can cause increased blood pressure.
After administering the spray, you’ll rest in a comfortable, quiet room. The medication often causes temporary side effects like dissociation or sedation, so you’ll need to arrange to have someone drive you home.
Induction Phase
After the initial phase, Spravato treatment tapers off. A typical schedule involves administering the medication once a week for the next month, then every two weeks or as needed, based on your response. Throughout the process, you’ll continue taking your oral antidepressant as prescribed.
Ongoing Monitoring
Your healthcare provider will monitor your progress regularly, adjusting the treatment plan if necessary to ensure you receive the maximum benefit with the fewest adverse effects.
Spravato Side Effects
As with any medication, Spravato can cause side effects. The most common ones include:
- Dissociation: This is a sense of detachment from reality, where patients feel disconnected from their surroundings or themselves. The feeling is temporary and fades shortly after treatment.
- Sedation: Many patients experience drowsiness or fatigue during and after treatment. Monitoring is required for about two hours following administration.
- Dizziness: Some individuals report feeling lightheaded, which typically subsides shortly after treatment.
- Nausea: This common but short-term side effect is often mild and resolves on its own.
- Increased blood pressure: Spravato can cause a temporary spike in blood pressure, another reason patients are monitored before and after treatment.
Spravato is only available through a restricted program known as the Spravato Risk Evaluation and Mitigation Strategy (REMS). This program ensures that the medication is administered safely and that patients are fully informed about the treatment’s potential side effects and benefits.
Is Spravato Right for You?
Spravato offers a promising alternative for individuals with TRD who have not found relief from other treatments. It works differently from traditional antidepressants, making it an option for those who need a new approach. However, it’s not suitable for everyone. This treatment is generally only recommended for adults who have not responded to at least two other antidepressants.
Spravato may not be right for you if you have a history of substance abuse, as it carries some risk of misuse. Those with uncontrolled high blood pressure are also not good candidates. In addition, people with certain medical conditions, such as brain aneurysms or recent heart issues, should discuss these risks with their doctor before starting treatment.
Spravato is used in conjunction with an oral antidepressant and requires close medical supervision during each session. If you’re open to trying a new method and can commit to the structured, monitored treatment process, Spravato may provide the relief you seek. However, it’s essential to have a thorough discussion with your healthcare provider to weigh the benefits and risks based on your specific health history.
Take the Next Step with Mindwell Urgent Care
Living with treatment-resistant depression is challenging, to say the least. At Mindwell Urgent Care, we are committed to helping you find a treatment that will work for you. With same-day and next-day urgent care appointments offered throughout Texas, and telepsychiatric visits available everywhere else, our experienced team is ready to guide you on your depression treatment journey. If you’re struggling with TRD and want to learn more about how Spravato could help, don’t hesitate to reach out. Let’s find a path forward together.