A New Path Forward:
Spravato Treatment
For millions of Americans struggling with treatment-resistant depression, hope has often felt elusive. Traditional antidepressants, while effective for many, leave approximately one-third of patients without adequate relief. However, a groundbreaking treatment called Spravato is changing the landscape of depression care, offering new possibilities for those who have felt trapped by their condition.
What Is Spravato?
Spravato is an FDA-approved nasal spray containing esketamine, a derivative of the anesthetic ketamine. Unlike traditional antidepressants that can take weeks to show effects, Spravato can rapidly reduce depressive symptoms, often within hours or days of the first dose.
Most remarkably, in January 2025, Spravato became the first and only monotherapy approved for adults with treatment-resistant depression. This historic approval means that for the first time, patients can receive Spravato as a standalone treatment, not just in combination with oral antidepressants.
A Different Approach to Brain Chemistry
What makes Spravato revolutionary is how it works. While conventional antidepressants increase levels of chemicals like serotonin, norepinephrine and dopamine, esketamine works differently by increasing levels of glutamate, the most abundant chemical messenger in the brain.
Spravato targets the NMDA receptor, which differs from traditional antidepressants that primarily act on serotonin, norepinephrine, or dopamine pathways. This unique mechanism allows it to immediately impact brain cells, offering relief from depressive symptoms within hours rather than the typical 4-6 week wait for traditional medications to take effect.
Who Can Benefit from Spravato?
Spravato is specifically designed for people facing the most challenging forms of depression:
Treatment-Resistant Depression (TRD): This means you’ve tried at least two other antidepressants (for at least six weeks each) and haven’t experienced remission or at least a 50% improvement in mood. Approximately one-third of adults with major depressive disorder will not respond to oral antidepressants alone and are considered to have treatment-resistant depression.
Major Depressive Disorder with Acute Suicidal Ideation: Spravato is also used together with an antidepressant taken by mouth, to treat depressive symptoms in patients with major depressive disorder with suicidal ideation or behavior. Esketamine is the only drug besides lithium that’s proven to decrease suicidal thoughts.
The Treatment Experience
Let’s be honest, starting therapy can feel nerve-wracking. You might be wondering what you’ll talk about, whether you’ll like your therapist, or if it’s really going to help.
Supervised Administration:
Spravato must be administered in a clinic setting under doctor supervision. You remain in the clinic under doctor observation until potential side effects have passed. You’ll stay at the facility for at least 2 hours after you receive your dose.
Simple Process:
With the nasal spray, you give yourself three doses, spaced five minutes apart, under doctor supervision. Do not eat for at least 2 hours and do not drink at least 30 minutes before using this medicine.
Treatment Schedule:
Usually, the treatment is given twice a week for the first month, and then if it is successful it is continued at decreased frequency in a maintenance phase for a few weeks or months.
Rapid Results and Real Hope
The speed of Spravato’s effects sets it apart from all other depression treatments. Clinical data shows SPRAVATO alone led to rapid and superior improvement in depressive symptoms compared to placebo as early as 24 hours.
For patients who have cycled through multiple medications without success, this rapid action can be life-changing. For people who haven’t had success with other antidepressants, esketamine gives them the chance to see what it’s like to not have depression. It gives them hope that they can feel better with the right treatment.
Important Safety Considerations
Spravato is a controlled substance and requires careful monitoring:
- Supervised Treatment Only: Spravato treatment is used only in a healthcare setting. You will not be able to use this medicine at home
- Transportation: You will need someone to drive you home after using Spravato treatment
- Side Effects: This medicine may make you drowsy, confused, or have problems with thinking clearly
- Monitoring: Patients must be monitored by a healthcare provider for at least 2 hours
The Bigger Picture
Major depressive disorder affects an estimated 21 million adults in the U.S., with nearly half of the economic burden attributable to treatment-resistant depression. After trying their third oral antidepressant, approximately 86% of patients do not achieve remission.
Spravato represents more than just another treatment option, it’s a paradigm shift that acknowledges the urgent need for rapid, effective interventions for severe depression. This innovative treatment option provides hope to individuals who have not found relief from other depression treatments.
Take the Next Step Towards a More Organized and Focused Life
Give us a call:
- West Des Moines: (515) 500-6082
- Sioux Falls: (605) 573-2000
Email us:
- West Des Moines: intake@mwihealth.org
- Sioux Falls: office@mwihealth.org
Visit Our Offices:
MWI Health – West Des Moines, IA
3737 Woodland Ave, Ste 410
West Des Moines, IA 50266
MWI Health – Sioux Falls, SD
4308 S Arway Drive
Sioux Falls, SD 57106
Your Questions, Answered
How quickly will I feel better?
This varies by person, but Spravato works faster than traditional antidepressants. Some people notice improvements within 24 hours. Others may take a few weeks to see significant changes.
What’s remarkable is that in clinical trials, people continued to improve over time, with the greatest benefits often seen at 4 weeks.
Will my insurance cover it?
Most insurance plans do cover Spravato for treatment-resistant depression. Because it’s FDA-approved and administered in a medical setting, insurance companies typically recognize it as a medically necessary treatment.
We can help verify your benefits and work with your insurance company to understand your coverage.
What if it doesn't work for me?
Not everyone responds to Spravato, just like not everyone responds to traditional antidepressants. However, the response rates are encouraging – especially for people who haven’t found relief with other treatments.
If Spravato doesn’t work for you, we’ll work together to explore other options. The fact that you tried it doesn’t close any doors; it just gives us more information about how your depression responds to different treatments.
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Find new hope. Spravato for TRD at MWI Health: Sioux Falls and West Des Moines.
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