TMS vs. Spravato: Which Treatment is Right for You?
In this guide, we’ll compare how they work, their benefits, side effects, and who they’re best suited for. Plus, we’ll help you find certified clinics offering TMS and Spravato near you with MDDCare.
Searching for the most effective treatment for depression can be very overwhelming. When traditional antidepressants and therapy aren’t relieving symptoms, innovative treatments like Transcranial Magnetic Stimulation (TMS) and Spravato (esketamine) offer new hope. These treatments have been shown to help patients who have not had success with traditional treatment approaches. We will break down how TMS and Spravato work to allow you to find the best depression treatment for you.
How Each Treatment Works
TMS Therapy: This is a non-invasive treatment that uses magnetic pulses to target underactive areas in the brain responsible for mood regulation. This treatment targets the prefrontal cortex and helps activate neurons and promote neuroplasticity, resorting to healthy brain activity.
Spravato: Treatment is given through a nasal spray, which contains esketamine, a derivative of ketamine. Esketamine increases the levels of glutamate, the largest chemical messenger in the brain, to promote rapid symptom relief and improve mood.
Effectiveness: What Does Research Say?
Studies have shown that both TMS and Spravato are effective for treatment-resistant depression:
- TMS: According to research published by Harvard Health, approximately 50-60% of patients experience significant symptom improvement. Additionally, about one-third of those patients achieved full remission. The effects of TMS are long-lasting, especially after completing a full treatment course and proper maintenance thereafter.
- Spravato: Studies cited by the FDA indicate that many patients experience noticeable symptom relief within hours or days. Clinical trials have shown that around 40-50% of patients achieve a 50% reduction in symptoms by the second or third session.
TMS provides more gradual but sustainable improvements, while Spravato offers more rapid relief, making it a potential option for people in urgent need of relief.
Who Is a Good Candidate?
- TMS is Best for:
- Patients seeking a non-drug and non-invasive treatment
- Those who can commit to a structured treatment schedule
- Patients with mild to moderate depression
- Spravato is Best for:
- Patients with severe depression who need rapid symptom relief
- Those who have tried at least two antidepressants with no improvement
- Patients comfortable with in-clinic administration and monitoring
Treatment Process and Time Commitment
TMS: Sessions are usually 5 days a week for 4 to 6 weeks. Each session lasts about 20 to 40 minutes and requires no downtime.
Spravato: Patients begin with 2 sessions a week for 4 weeks, and then transition to weekly or bi-weekly treatments. Each visit takes about 2 hours to allow for monitoring after treatment.
Side Effects and Risks
TMS: Side effects are usually mild and may include headaches, scalp discomfort, or lightheadedness. Serious side effects like seizures are rare.
Spravato: Common side effects are dizziness, nausea, dissociation, and increased blood pressure. Because of these potential side effects, patients must remain under medical supervision after treatment.
Cost and Insurance Coverage
TMS Therapy
- FDA-approved and covered by many insurance providers, though coverage varies.
- Therapy is typically covered for patients who have tried and failed at least one antidepressant.
- Out-of-pocket costs can be significant for a full course of treatment.
Spravato
- FDA-approved and covered by several insurance providers, but coverage details differ.
- Often requires proof of failure on at least two antidepressants before coverage is approved.
- Often has lower out-of-pocket costs due to wider insurance coverage.
Which Treatment Is Right For You?
Choosing between TMS and Spravato depends on factors like:
- How quickly you need relief (Spravato works faster, but TMS has lasting effects)
- Whether you prefer a medication-free approach (TMS is drug-free)
- Insurance and financial considerations (Costs can vary based on insurance coverage)
Both TMS therapy and Spravato offer hope to those who have not responded to traditional treatments. Consult with a specialist to determine the best treatment for your needs. Find expert care and compare treatments at MDDCare.com.