Understanding the Science Behind a Breakthrough Depression Treatment
For many people living with depression, traditional antidepressants like SSRIs and SNRIs offer relief. But for those with treatment-resistant depression (TRD), who’ve tried multiple medications without success, these standard approaches may not be enough.
Enter Spravato®, a nasal spray medication that works differently than other depression treatments.
In this post, we’ll explain how Spravato® works, what sets it apart, and why it may be an option worth considering if other medications haven’t helped.
You can also learn more on our Spravato® treatment page.
What Are Traditional Antidepressants?
Most common antidepressants fall into two categories: SSRIs (like Prozac® or Zoloft®) and SNRIs (like Effexor® or Cymbalta®). These medications work by increasing the levels of serotonin, norepinephrine, or dopamine in the brain.
But for those with treatment-resistant depression (TRD), who’ve tried multiple medications without success, these standard approaches may not be enough.
How Is Spravato® Different?
Spravato® (esketamine) takes a different approach. It targets the brain’s glutamate system, which plays a key role in learning, memory, and mood regulation. Glutamate is the most abundant neurotransmitter in the brain and is involved in the formation of neural connections.
Here’s how it compares:
|
Feature |
Traditional Antidepressants |
Spravato® |
|
Chemical Pathway |
Serotonin, norepinephrine |
Glutamate (via NMDA receptor) |
|
Time to Effect |
4–6 weeks |
Can begin in days or weeks |
|
Administration |
Daily pill |
Nasal spray, 2x/week (initially) |
|
Monitoring |
Self-administered |
In-clinic supervision required |
|
FDA Approval for TRD |
No |
Yes |
Spravato® is used alongside a traditional oral antidepressant but offers a new mechanism of action that may “wake up” areas of the brain that aren’t responding to other meds.
Spravato® is always used in combination with an oral antidepressant and is administered under medical supervision.
Why Target the Glutamate System?
Glutamate is critical for neuroplasticity. It supports the brain’s ability to adapt, learn, and form new pathways. By targeting glutamate, Spravato® may help restore communication between brain regions involved in mood regulation.
This mechanism is especially important for patients whose symptoms have not responded to serotonin-based medications. It gives the brain another route to recovery.
What Patients Report Experiencing
Although every patient responds differently, many describe:
- Feeling more emotionally present or less “numb”
- Reduction in suicidal thoughts
- Increased clarity, motivation, or energy
- Improvement that begins within the first few weeks of treatment
Side effects may include dizziness, nausea, or dissociation. To ensure safety, the medication is only administered in a REMS-certified clinic under supervision.
To learn more about the safety process, visit our blog: Why Spravato® Must Be Administered Under Clinical Supervision.
Is Spravato® the Same as Ketamine?
Spravato® and IV ketamine are similar in some ways, but they are not the same. Both treatments are based on ketamine, a compound that affects the brain’s glutamate system, which plays a role in mood regulation. This makes them different from traditional antidepressants that target serotonin.
Spravato® is made from esketamine, one part of the ketamine molecule. It’s given as a nasal spray in a medical office that follows strict safety protocols. IV ketamine includes both parts of the ketamine molecule and is usually delivered by infusion in a clinic.
The biggest differences are in the formulation, how the treatment is given, and how each one is regulated.
You can read more in our post: Is Spravato® Right for You? Comparing TMS, Ketamine, and Spravato®.
Could Spravato® Work for You?
If you’ve tried at least two antidepressants without improvement, Spravato® may be a next step. At Compassionate Psychiatric Services, we offer Spravato® treatment at our Frisco and Southlake locations. We’ll guide you through the evaluation, insurance process, and personalized treatment plan.
Therapy can also play a key role in long-term improvement. We offer individual therapy through our licensed therapists and counselors, which can be used alongside medication-based care.
Learn More Before Starting
For a breakdown of what to expect, how sessions are structured, and insurance FAQs, read our post: Starting Spravato®? Here’s What to Know About Insurance, Side Effects, and Safety
Book a Consultation
Spravato® offers a new option for those who feel like they’ve tried everything.
Contact our Frisco or Southlake office to schedule your consultation and learn whether this breakthrough treatment is right for you.
