Spravato (esketamine) Treatment
When the heavy fog of a depressive episode persists despite your best efforts, it is easy to feel like you have run out of options. For many individuals, traditional antidepressant medications provide a start, but not a solution. If you have tried two or more antidepressants without finding relief, you may be dealing with Treatment-Resistant Depression (TRD).
At OPMHS (Optimum Mental Health Services), we provide Advanced Depression Care specifically designed for those with treatment-resistant depression. We are more than just a standard clinic for depression treatment; we are major depressive disorder specialists dedicated to providing the next generation of relief through SPRAVATO® (esketamine) and integrated brain stimulation therapies.
What is Spravato (esketamine)?
Our FDA-approved nasal spray is prescribed for treatment-resistant depression. Unlike oral antidepressants, which can take several weeks to months to work, the effects of this advanced therapy are typically felt within days, unlocking a pathway to healing for patients who have not responded to oral antidepressants and/or other augmentative therapies alone. This treatment is the first new option approved for depression by the Federal Drug Administration (FDA) in decades. It is specially designed for those suffering from Treatment Resistant Depression (TRD). If you are currently diagnosed with depression and have not responded well to at least two different oral antidepressants, you may qualify for this therapy. This medication is derived from a well-known anesthetic that has been used in hospitals since the 1970s. Its help in alleviating symptoms of depression is a more recent discovery. This nasal spray for depression is unique in that it is self-administered in an office setting under the supervision of a healthcare provider
What is Treatment-Resistant Depression? (TRD Meaning)
In clinical terms, TRD refers to a specific type of Major Depressive Disorder (MDD) that does not respond adequately to standard traditional treatment and medication interventions.
Treatment-resistant depression is more common than many realize, affecting approximately one-third of adults living with MDD. In the US alone, that is 1%-4% of the population. If you are struggling with medication-resistant depression, it may be a sign that your brain’s neural pathways require a different therapeutic mechanism—specifically one that targets the glutamate system rather than just serotonin or norepinephrine.
Is Spravato (esketamine) right for you?
Frequently Asked Questions About TRD and MDD
Treatment-Resistant Depression is a clinical diagnosis for individuals with Major Depressive Disorder who have not achieved remission after two or more adequate trials of antidepressant treatment. It suggests that the brain requires advanced interventions, such as intranasal esketamine or brain stimulation, to break the cycle of resistance.
Like anything else, there are potential side effects associated with treatment. Side effects will usually lessen with each session as your body adjusts to the medication. Some things to expect include nausea, drowsiness, headaches, dizziness, feelings of intoxication, and increased blood pressure. You can read more about potential contraindications or side effects in the Medication Guide linked at the bottom of the page. Some patients also can experience more extreme side effects, including hallucinations and feeling disconnected from themselves and their surroundings. Therefore, it is vital for treatment to be done in a safe and controlled environment where the patient can be monitored.
For the first four weeks, you can expect to come into the office twice weekly for treatment. During weeks 5 to 8 of treatment, you can expect to come in once weekly. For week 9 and after, depending on the efficacy/rate of remission, the patient and provider will determine if they should remain weekly or titrate down to biweekly.
Patients in this treatment program should expect to be at the office for a minimum of two hours on a treatment day. You will have your blood pressure taken prior to administration, halfway through treatment, and then one last time at the end. Staff will monitor you throughout your treatment period. Patients will need to have a ride home from treatment and should not drive or operate heavy machinery until having a restful night’s sleep.
The treatment is given as a spray through the nose. Each device contains a specific dose for each nostril. The dosing is determined by your provider during your first treatment; after that, you and your provider may decide whether to continue with the initial dose or to increase it.
Most major insurance plans provide coverage for Spravato® (esketamine) when it is prescribed for treatment-resistant depression or major depressive disorder with suicidal thoughts. Coverage requirements can vary depending on your specific insurance plan. Our team manages the entire insurance authorization process for you—including benefits verification and prior authorization—so you can focus on preparing for treatment rather than dealing with paperwork. We’ll also discuss any potential out-of-pocket costs with you before starting care, so there are no surprises.
