Among patients with major depressive disorder (MDD), 30.9% have treatment-resistant depression (TRD). That means their condition has not improved after two trials of antidepressant drugs. This group is twice as likely to attempt suicide than their peers who respond to treatment, and their relapse rates is 80%.
Researchers have been urgently looking for alternative depression treatments for over 30 years. Talk therapy and oral antidepressants are the two main types of treatment that have been widely available — until recently.
There is a new nasal spray for depression symptoms, and plenty of TRD patients have experienced positive results. It’s called Spravato (esketamine), and we offer this treatment at Active Path Mental Health.
How most depression treatments work
Until now, there has never been a nasal spray for depression that delivers effective results. There are two main classes of oral antidepressants: SSRIs and SNRIs. These medications target the neurotransmitters serotonin and norepinephrine, respectively. Several of these antidepressants have been developed over the years. But because they are so similar, none have proven effective for the large group of patients with resistance to these chemicals.
Transcranial magnetic stimulation (TMS) offered something different for TRD patients in 2014. It’s not a drug, but rather a noninvasive treatment that uses pulses of magnetic energy to stimulate a specific area of the brain associated with mood regulation, promoting brain activity. We offer TMS at Active Path Mental Health, but it’s not for everyone. Patients with a metal implant in their head can’t receive TMS, and other conditions can raise the risk of side effects.
For some people with other health issues besides depression, the nasal spray delivery system can make Spravato a less viable treatment option. For instance, patients with respiratory or heart conditions may not be able to take this type of treatment. On the other hand, a depression nasal spray may be a better option for patients who can’t do TMS treatments. You can discuss any potential risks with our team during your free consultation.
How Spravato is different
Most oral antidepressants work in a similar way: They treat depression by increasing levels of certain neurotransmitters. If a patient has tried three of these medications to treat their depression, the chances of success with another one fall to only 6.9%. But Spravato works differently: Its active ingredient esketamine targets the NMDA receptor. Spravato increases levels of glutamate in the brain, which is the most plentiful neurotransmitter.
Other antidepressants are pills or tablets taken daily. Spravato is the first nasal spray for depression, so this new delivery system sets it apart. Patients must stay at the treatment center to be monitored for two hours after taking it. Most patients feel sleepy, dissociated, dizzy or nauseous. The good news is that side effects are usually minor and go away within 24 hours. Even better, many patients enjoy pleasant feelings of deep relaxation during treatment — and depression symptoms usually lessen in weeks instead of years.
What to expect before, during and after Spravato treatments
The first step is to speak with your doctor and one of our providers. Once you’ve determined that Spravato is right for you, you’ll need to make a recovery plan for your treatment days. Patients aren’t allowed to drive after taking Spravato, so we ask that you arrange for a friend or a loved one to pick you up after each treatment session. Most people want to go home and get a full night’s sleep.
You may want to bring some personal items with you, for instance, a blanket or pillow, to Active Path Mental Health so your experience will be more comfortable. If calming music or videos are helpful for you, you can bring headphones or small electronics.
You’ll start with two treatments per week for the first four weeks, then drop down to weekly sessions for four weeks. The duration of treatments varies, so you’ll work with your healthcare provider to create a maintenance plan for the rest of your Spravato treatments.
Try Spravato nasal spray for your depression symptoms at Active Path Mental Health
We want to help even more people with TRD by offering innovative depression treatments like Spravato.
All of our care providers and technicians are dedicated to helping patients have the most comfortable, transformative experiences with these new treatment methods.
Are you curious about trying Spravato? Contact our team today for more information or to schedule an initial appointment.
