Spravato vs. Traditional Antidepressants: What’s the Difference?

Do you struggle with depression? If so, you’ve most likely tried oral antidepressants to manage your symptoms. But for some people, antidepressants alone don’t help them feel better. If that sounds familiar, you may have heard of Spravato and wondered what it is, how it works differently from traditional antidepressants, and whether it’s right for you. In this article, we will break down how Spravato differs from traditional antidepressants, how each works, and what to consider if you’re exploring your treatment options.

How Traditional Antidepressants Work

Traditional antidepressants, such as SSRIs, or selective serotonin reuptake inhibitors, are usually the first line of treatment for major depressive disorder. These work by adjusting the levels of brain chemicals such as serotonin and norepinephrine to help improve mood over time. People can find significant relief with antidepressants, but 1 in 3 individuals don’t get enough relief, even after trying multiple medications. This is called treatment-resistant depression.

How Quickly Do Antidepressants Work?

SSRIs usually take 4 to 8 weeks to show noticeable effects. For some, it can take even longer to build up in the system and start relieving symptoms. It is not unusual for patients to try multiple medications or adjust their dosage before feeling better. The waiting period to find what works for each individual can be difficult, especially for those who have severe depressive symptoms. 

What Is Spravato?

Spravato (esketamine) is an FDA-approved option for adults with treatment-resistant depression. Spravato is a nasal spray that is given under medical supervision at a certified clinic. It targets glutamate, instead of serotonin, and this different pathway allows it to work faster and help people who have not found help from antidepressants. Treatment usually starts with twice a week for four weeks and then becomes weekly or bi-weekly after that. After each treatment, you stay in the clinic for two hours to monitor for short-term side effects. 

How Quickly Does Spravato Work?

For many patients, Spravato starts showing effects within hours or days. Targeting the glutamate system allows it to offer much faster relief. This is especially important for patients with severe symptoms who have not responded to traditional medications or those who have suicidal thoughts. However, it is important to note that not everyone experiences immediate relief from Spravato, and the nasal spray is still usually given alongside an oral antidepressant. But for many, the faster relief Spravato offers is a major advantage. 

Potential Side Effects

The most common side effects from traditional antidepressants include:

• Weight gain
• Insomnia or drowsiness
• Nausea
• Sweating
• Anxiety
• Sexual dysfunction

The most commonly reported side effects of Spravato are:

• Dissociation
• Dizziness/lightheadedness 
• Nausea 
• Increased blood pressure
• Drowsiness

Because Spravato works differently, most side effects are usually short-term and fade away within a few hours after treatment.

Who Might Be a Good Candidate?

It may be worth exploring Spravato if:

• You have not found success with antidepressants and have tried multiple medications without relief
• If you’ve had long-term or severe depression
• If you experience suicidal thoughts

Of course, you will need to be evaluated by a mental health provider to determine if Spravato is a good fit for you.

Cost and Insurance Coverage

Most traditional antidepressants are low-cost and widely covered by insurance or available as generics. Spravato is more expensive and usually needs prior approval from your insurance. However, many insurers cover Spravato for those who meet the criteria, like trying at least two other antidepressants first with no relief.

Is One Better Than the Other?

Spravato and traditional antidepressants both attempt to alleviate depression, but in different ways, on different timelines, and affect each individual differently. The most crucial thing is understanding where you are on your treatment path. If at any point you have felt stuck on your treatment journey, it may be time to explore a different option. Spravato is a new possibility for those who have treatment-resistant depression and may offer relief that may have felt out of reach before.

Talk to your doctor or a mental health professional about your treatment history and whether Spravato may be a good option for you. Visit MDDCare.com to get more information and find a local clinic today.