Key Takeaways
- SPRAVATO® (esketamine) works on a completely different brain pathway than traditional antidepressants like SSRIs.
- Traditional antidepressants target serotonin and can take weeks to show an effect, while SPRAVATO® targets the brain's glutamate system and can bring relief within hours or days.
- SPRAVATO® is a nasal spray that must be given in a certified clinical setting, with monitoring for at least two hours after each dose.
- SPRAVATO® is generally reserved for adults with treatment-resistant depression, meaning standard antidepressants haven't provided enough relief.
- Foundation Psychiatry offers SPRAVATO® treatment for patients in Atlanta who haven't found success with traditional medication.
- If you're wondering whether SPRAVATO® could be right for you, schedule an appointment with Foundation Psychiatry to discuss your candidacy.
How SPRAVATO® Treatment Works Differently Than Traditional Antidepressants
If you've tried antidepressants without much luck, it can help to understand that SPRAVATO® isn't just a stronger version of what you've already taken. It's a fundamentally different type of medication, and that difference is exactly why it can help people who haven't responded to standard treatment.
Traditional antidepressants, such as SSRIs and SNRIs, primarily work by increasing levels of serotonin or norepinephrine in the brain. These are chemical messengers involved in mood regulation. Because the brain needs time to adjust to these changes, most traditional antidepressants take several weeks to produce a noticeable effect.
SPRAVATO® (esketamine) works on a different system entirely. According to Cleveland Primecare, rather than targeting serotonin like most antidepressants, SPRAVATO® targets the NMDA receptor, a part of the brain's glutamate system, to promote rapid improvements in mood, often within hours to days.
Glutamate is the brain's most abundant chemical messenger, and this different mechanism is part of why SPRAVATO® can help people who haven't responded to serotonin-based medications.
| Traditional Antidepressants (SSRIs/SNRIs) | SPRAVATO® (Esketamine) | |
|---|---|---|
| Primary target | Serotonin and norepinephrine | Glutamate system (NMDA receptor) |
| Time to notice relief | Several weeks | Often within hours to days |
| How it's taken | Daily pill at home | Nasal spray, administered in-office |
| Monitoring required | Routine follow-up visits | Direct supervision, at least 2 hours post-dose |
| Typical candidate | First-line depression treatment | Treatment-resistant depression |
What Happens During an In-Office SPRAVATO® Session
Because esketamine carries risks of sedation and dissociation, along with a potential for misuse, it must be given in a clinical setting where a healthcare provider can monitor the patient for at least two hours after the dose, according to the Cleveland Clinic. You cannot take SPRAVATO® home with you the way you would a daily antidepressant.
A typical visit at Foundation Psychiatry looks like this:
- You self-administer the nasal spray under the direct supervision of a member of the clinical team.
- Your care team monitors you in the office for the required observation period.
- You're not permitted to drive yourself home the day of treatment, so plan for a ride in advance.
- Sessions are typically scheduled multiple times per week during the initial phase of treatment, then spaced out further as you progress.
Is SPRAVATO® Right for You?
SPRAVATO® is generally considered for adults with treatment-resistant depression, meaning standard antidepressants haven't provided enough relief despite adequate trials. According to Mayo Clinic, esketamine nasal spray is intended for patients who have previously received at least two antidepressant treatments that did not work well. It's typically used in combination with an oral antidepressant, not as a standalone replacement.
Foundation Psychiatry's team reviews your treatment history, current symptoms, and any relevant medical conditions before determining candidacy. Not everyone is a fit for SPRAVATO®, which is exactly why this evaluation matters.
Ready to Explore Ketamine Therapy for Depression?
If traditional antidepressants haven't relieved your depression, SPRAVATO® offers a different path forward, one built on a completely different mechanism designed for exactly this situation. Foundation Psychiatry's team can walk you through what to expect and help determine whether esketamine nasal spray fits your treatment history.
Schedule an appointment with Foundation Psychiatry to discuss SPRAVATO® treatment and find out if it's the right next step for your depression care.
Frequently Asked Questions
How is Spravato different from regular antidepressants?
Regular antidepressants target serotonin and norepinephrine and typically take weeks to work. SPRAVATO® targets the brain's glutamate system through the NMDA receptor and can bring relief within hours or days for some patients.
Do I have to stay at the office after taking Spravato?
Yes. Because of the risk of sedation and dissociation, you're required to stay under clinical observation for at least two hours after each dose, and you'll need someone else to drive you home.
Is Spravato a replacement for my current antidepressant?
Usually not. SPRAVATO® is typically prescribed alongside an oral antidepressant, not as a substitute for it.
Who is a good candidate for esketamine nasal spray?
SPRAVATO® is generally intended for adults with treatment-resistant depression who have already tried at least two standard antidepressants without adequate relief. A full evaluation with a psychiatric provider determines candidacy.
How quickly does Spravato work compared to other depression treatments?
Many patients notice improvement within hours to days, compared to the several weeks it often takes for traditional antidepressants to take effect.
