SPRAVATO® for Treatment-Resistant Depression

Depression can make it difficult to handle life’s everyday responsibilities. Many patients know they need treatment but struggle to pursue it. It’s a frustrating cycle that becomes more stressful when treatment fails to provide the results you need.

SPRAVATO® — a nasal spray that compounds with your antidepressants to relieve symptoms when other methods leave you without results.

What Is Treatment-Resistant Depression?

While many patients find relief through counseling or medication, some find that the standard methods fail to eliminate depression symptoms. Patients who have tried depression treatment options like antidepressants and counseling to little avail experience a condition called treatment-resistant depression (TRD).


SPRAVATO® helped Nicole’s treatment-resistant
depression. Now, she’s resuming her education
and sharing her story.

Navigating TRD

Various strategies attempt to mitigate TRD. Some are more successful than others. The most common ways medical professionals suggest handling TRD are:

  • Allowing more time for the medication to take effect.
  • Increasing the dosage.
  • Switching to a new antidepressant.
  • Stacking another antidepressant.
  • Trying a medication that treats another condition.
  • Undergoing pharmacogenetic tests.
  • Psychotherapy and other forms of counseling.
  • Medical procedures.

While finding real relief from TRD can be a difficult process, some methods have proven to be effective in clinical trials. Thomas Care Clinic offers a treatment approach that combines with your current medication for great effects — SPRAVATO®


SPRAVATO® is a nasal spray that the FDA approved to treat adults with TRD. The spray operates in conjuncture with your other antidepressants and treatment approaches to provide fast relief and work toward the long-term reduction of symptoms.

SPRAVATO® spray contains esketamine, a variant of the anesthetic ketamine. Professionals note that esketamine targets the N-methyl-D-aspartate (NMDA) receptor and increases levels of glutamate, the brain’s most chemical message carrier.

The FDA classifies SPRAVATO®  as a Schedule III drug, so treatment must occur under professional supervision in a certified Risk Evaluation and Mitigation Strategies (REMS) center.

The Treatment Process

When you pursue SPRAVATO® treatment with Thomas Care Clinic, you’ll visit our certified treatment center. Our medical professionals here will oversee the process and ensure your safety. You’ll take three doses of SPRAVATO® nasal spray a few minutes apart. The esketamine will work its way into your bloodstream, where it can provide rapid relief from your symptoms and enhance your other medication’s effects.

We’ll keep you in the office for a couple of hours, as you may experience some disorienting side effects. SPRAVATO® is an outpatient treatment, so you’ll be free to return home after the observation period. However, side effects may persist for hours after the treatment. You will not be able to drive or operate machinery until the next day.

You’ll receive SPRAVATO® treatment twice a week during your first month, once a week during the second month then once every week or two in the following months. Continue to take your other antidepressants according to your healthcare provider’s recommendations during your treatment period.

Benefits of SPRAVATO®

Patients choose SPRAVATO® because it provides unique benefits over other medications. For one, you’ll experience immediate symptom relief, as well as long-term benefits. A clinical trial showed that SPRAVATO® patients experienced improvements at the four-week mark compared to the placebo group. Another significant benefit is that esketamine is safer than ketamine for depression treatment. Esketamine is a more potent ketamine variant that a healthcare provider can administer in smaller doses for positive results.

Side Effects

SPRAVATO® might result in a few side effects during and after treatment. Patients may experience feelings of dissociation, or disconnection from their thoughts, feelings and experience. Other common symptoms include dizziness, increased blood pressure, nausea, feeling tired or drunk, numbness or low sensitivity, anxiety, sluggishness or elation.

You’ll receive SPRAVATO® treatment twice a week during your first month, once a week during the second month then once every week or two in the following months. Continue to take your other antidepressants according to your healthcare providers recommendations during your treatment period.

What Makes SPRAVATO® Different from Other Treatment Plans?

Researchers are still working to understand the science behind the benefits of SPRAVATO®. Other antidepressants increase serotonin, dopamine, norepinephrine and similar natural transmitters. The esketamine in SPRAVATO® is thought to increase glutamate levels while also inhibiting the brain’s N-methyl-D-aspartate (NMDA) receptors.

Esketamine functions similarly to ketamine but features a different treatment method. While doctors administer ketamine intravenously, esketamine is a nasal spray. Ketamine is FDA-approved as an anesthetic but has no current clearance as a depression treatment. This FDA approval means there is more existing research on its benefits and safety as a treatment for TRD, and there is more potential for future studies.

Could SPRAVATO® Work for Me?

SPRAVATO® treatment may be a viable path forward if you experience treatment-resistant depression. Clinical trials show that SPRAVATO® treatment resulted in lower depression after four weeks among the control group than the placebo group. Clinical trials also show that SPRAVATO patients were less likely to see their symptoms return after 16 weeks. Patients in these studies continued to take other antidepressants during the process.

Consult with your healthcare provider to see if SPRAVATO® is right for you. You should not take SPRAVATO® if you have a ketamine or esketamine allergy, blood vessel disease or connection abnormality or a history of brain hemorrhages.

Patients who are pregnant, breastfeeding or plan to become pregnant should not take SPRAVATO®.  Inform your doctor immediately if you become pregnant during the treatment period.

Make an Appointment

SPRAVATO® (esketamine) CIII nasal spray has made a significant difference in patients’ lives, and it may help you find the relief you need. We encourage you to request an appointment with Thomas Care Clinic to speak with a medical professional about SPRAVATO® as a remedy for your treatment-resistant depression.