SPRAVATO® Treatment for Depression: An In-Depth Look at a Cutting-Edge Option

Treatment-resistant depression (TRD) affects millions of people worldwide, leading many to seek alternative treatment options when traditional antidepressants fail. SPRAVATO, a nasal spray treatment for TRD, offers a promising solution to treat depressive symptoms.

To better understand this powerful treatment option, we speak with Psychiatric Mental Health Nurse Practitioner (PMHNP) Ron Tyree of Sozo Centers to explore what SPRAVATO treatment entails, how it compares to other treatments, and who might benefit from it.

Do you think SPRAVATO treatment could help you? Reach out to the experts at Sozo and schedule an appointment today.

What is SPRAVATO Treatment?

SPRAVATO (esketamine) nasal spray is a unique treatment option specifically designed for people with treatment-resistant depression. It’s the only FDA-approved nasal spray medication for TRD and has proven effective where traditional antidepressants fall short.

As Sozo Centers Tyree explains, “SPRAVATO is the only nasal spray treatment used for treatment-resistant depression. Treatment-resistant depression is defined as anyone who has taken two or more oral antidepressants and had an inadequate response.” This definition is key, as the FDA requires that patients trying SPRAVATO must have previously failed to see results with at least two other oral antidepressants.

This nasal spray works differently than traditional antidepressants. SPRAVATO targets the NMDA receptor in the brain, offering faster relief than typical serotonin-based medications, which can take weeks to show effects. Many patients report feeling relief within hours, rather than waiting several weeks for improvement.

SPRAVATO vs. Ketamine Infusion: Is There a Difference?

Ketamine infusion therapy has gained popularity for its effectiveness in treating severe depression, but how does it compare to SPRAVATO? Both treatments involve esketamine, a derivative of ketamine, but the method of administration and regulatory oversight differ.

“While both SPRAVATO and ketamine infusion use esketamine, SPRAVATO is a nasal spray, self-administered under medical supervision. Ketamine infusion, on the other hand, is delivered intravenously,” says Tyree. “The biggest difference is that SPRAVATO must be administered in a REMS-certified treatment center, while ketamine infusion does not have the same strict guidelines.”

Another key difference is dosing. With SPRAVATO, the nasal spray is given in doses over five-minute intervals, typically starting at 54 mg and going up to 84 mg. “With ketamine infusion, doses are delivered more consistently through an IV,” adds Tyree. However, both treatments have been shown to improve depression symptoms quickly, giving patients new hope when other treatments have failed.

Who Should Consider SPRAVATO and Who Should Avoid It?

Not everyone is a candidate for SPRAVATO treatment. Understanding who should and should not take this medication is essential for safety and effectiveness.

The primary criteria for SPRAVATO are clear: “Any individual who has taken two oral antidepressants and experienced an inadequate response meets the criteria for SPRAVATO,” Tyree explains. However, there are also contraindications to consider. For example, anyone with a history of aneurysms or certain types of strokes should avoid SPRAVATO. “Anyone with a history of aneurysm, stroke, or malformations should not take this medication,” emphasizes Tyree.

It’s important to have a thorough discussion with your healthcare provider to determine whether SPRAVATO is appropriate for your condition.

Can SPRAVATO Be Taken With Other Depression Medications?

Unlike some treatments for major depressive disorder that require patients to stop taking other medications, SPRAVATO is designed to be used in conjunction with an oral antidepressant. “The FDA requires that SPRAVATO be taken alongside an oral antidepressant. You must already be on an oral antidepressant to qualify for SPRAVATO treatment,” Tyree clarifies. This means that SPRAVATO is not a standalone treatment, but a complement to existing medication regimens, offering an extra layer of support for those with treatment-resistant depression.

This dual approach allows patients to maintain their existing treatment plan while adding a new, fast-acting solution.

How is SPRAVATO Administered?

While SPRAVATO is self-administered, it cannot be taken at home. “SPRAVATO is self-administered but under the supervision of staff at a REMS-certified treatment center,” explains Tyree. The patient sprays the medication into each nostril in a carefully controlled environment.

The process typically takes about 10 minutes, with the doses administered in intervals. “The first dose is usually 54 mg, and after that, patients can receive up to 84 mg,” Tyree adds. Following administration, patients must stay in the treatment center for monitoring, usually for two hours. This is to ensure safety, especially since SPRAVATO can cause side effects like dizziness or increases in blood pressure.

What Are the Side Effects of SPRAVATO?

Like any medication, SPRAVATO comes with potential side effects. The most common include dizziness, sedation, and dissociation. Dissociation, described by Tyree as “feeling disconnected, with arms feeling longer or shorter,” can be unsettling but typically subsides quickly.

“The good thing about SPRAVATO is that the side effects come on quickly but also subside quickly. In my clinical experience, the most intense side effects last about 20 minutes, and they are usually resolved within two hours,” Tyree reassures. Patients are monitored during this time to ensure their safety and to manage any uncomfortable symptoms that arise.

Blood pressure monitoring is also a critical part of the process, as SPRAVATO can cause spikes in blood pressure during treatment.

How Long Does SPRAVATO Treatment Last?

SPRAVATO treatment is not a one-time solution. Patients typically undergo a series of treatments over a period of several weeks to achieve lasting results. “The minimum time requirement for a treatment session is two hours, but the full treatment course can span several weeks or months,” Tyree affirms.

One patient story highlights the gradual nature of the treatment. “We had a female patient who had suffered from depression for over 40 years and had suicidal thoughts almost daily. After her first SPRAVATO treatment, her suicidal thoughts stopped, but it took about four to five months before her depression significantly improved,” Tyree recalls. SPRAVATO is effective, but it requires commitment and consistency.

Additional Ways to Manage Depression While on SPRAVATO

SPRAVATO treatment is just one part of managing depression, and lifestyle changes can also make a significant difference. “When I talk to my patients, we always discuss lifestyle changes. Improving diet, increasing exercise, and encouraging social interactions are important steps,” Tyree advises.

However, these lifestyle changes often become more achievable as the patient begins to feel relief from their depression. “Once they start to feel better, we can work together to make these positive changes,” he adds.

A holistic approach to mental health can provide the best outcomes, combining medication, therapy, and lifestyle adjustments.

SPRAVATO Treatment at SOZO

Here at Sozo, we proudly offer SPRAVATO as a groundbreaking treatment option. For those with treatment-resistant depression, SPRAVATO provides fast relief where traditional antidepressants have failed. By working in tandem with oral antidepressants and administered in a controlled setting, SPRAVATO allows patients to treat depression and take control of their mental health in a new and effective way.

Whether you’re exploring SPRAVATO for yourself or a loved one, understanding how it works and who can benefit is the first step toward finding the right treatment path.

Do you think SPRAVATO treatment could help you? Reach out to the experts at Sozo and schedule an appointment today.