What is Spravato®?

Most people living with depression find relief from their symptoms from standard treatments like psychotherapy and antidepressants. However, for some, symptoms linger despite trying multiple therapies and medication combinations. If you or your loved one feel stuck after exhausting all other options, you may want to explore newer treatments like Spravato®.

Spravato is an FDA-approved nasal spray for adults with treatment-resistant depression (TRD) and major depressive disorder (MDD) with suicidal thoughts or behaviors. Unlike conventional antidepressants, Spravato can ease symptoms within hours. 

Our highly trained psychiatrists at NYC Psychiatric Associates in the Murray Hill neighborhood of New York City, New York, use the most advanced treatments available to help our patients regain a sense of hope and stability. We offer in-office Spravato therapy for individuals who haven’t experienced meaningful improvements with other depression treatments.

In this blog, we explain how Spravato works, who might benefit, and what to expect if you’re considering this innovative treatment.

What is Spravato?

Spravato is a medication for people who can’t get relief from their depression symptoms using traditional depression treatments. It’s a nasal spray that contains eskatmine, a derivative of ketamine that’s been shown in clinical studies to rapidly reduce depressive symptoms and suicidal thoughts at low doses.  

While ketamine itself isn’t FDA-approved for depression, Spravato is specifically approved for this purpose when administered under strict medical supervision to ensure safety and effectiveness.

How does Spravato work?

Most antidepressants work by increasing levels of specific neurotransmitters such as serotonin, dopamine, and norepinephrine, which are chemicals involved in regulating mood. Spravato’s target is different.

Esketamine targets the brain’s glutamate system, which plays a key role in learning, memory, and emotional processing. By interacting with specific glutamate receptors, Spravato enhances communication between brain cells and promotes the formation of new neural connections. This rapid increase in neural flexibility, often referred to as neuroplasticity, may explain why many patients experience faster symptom relief.

Researchers believe this mechanism helps the brain be more adaptive when responding to emotional information, providing relief that other treatments don’t. 

Who might benefit 

Spravato is FDA-approved to treat only people with TRD and MDD with suicidal thoughts or actions. 

Our doctors conduct a comprehensive psychiatric evaluation before making any treatment recommendations. If you have MDD with suicidal thoughts or actions, we may recommend Spravato immediately.

Otherwise, we must first confirm a diagnosis of TRD and that you’ve tried other therapies without success.

What to expect from treatment

Spravato is only given at our office due to the potential for serious side effects, including sleepiness, anxiety, and dissociation. We closely monitor you during and after your session for your safety.

Treatment typically follows three phases: 

• Induction phase: Two treatments a week for four weeks
• Optimizing phase: One treatment a week for four weeks
• Maintenance phase: One treatment every two weeks

You may continue your other depression therapies and medications while on Spravato. The duration of treatment depends on results, but Spravato is approved for long-term use and can be part of your ongoing depression management plan. 

If traditional treatment hasn't lifted your low mood, don’t lose hope. Schedule an appointment with our team to learn more about Spravato and how it might work for you. 

Call or click today to schedule your consultation. We offer same-day appointments so you can feel better sooner.