What Does Spravato Do?

For people with Major Depressive Disorder (MDD), it can take weeks or even months for standard antidepressants to show their effects. Spravato (esketamine) offers a different approach. While antidepressants mainly influence serotonin and norepinephrine, Spravato impacts the brain through the glutamate system. Spravato, which is administered as a nasal spray, is most suitable for patients with treatment-resistant depression or those experiencing acute suicidal ideation.

How Spravato Works in the Brain

Spravato targets the NMDA receptors that are part of the glutamate signaling. This is important, as glutamate is the most abundant excitatory neurotransmitter in the brain, responsible for things like learning, mood regulation, memory, and neural growth. When Spravato is administered: 

• Synaptic plasticity is enhanced: The brain’s ability to grow, adapt, and form new connections is improved.
• New neural connections form: The areas related to mood and stress processing work more efficiently.
• Overactive depressive pathways quiet: This can help reduce negative overactivity in areas of the brain associated with negative thought cycles.

This delivery of treatment is the main reason why many patients can feel relief within days or even hours, instead of weeks. This mechanism is also why Spravato is a great option for people who have not been responsive to traditional antidepressants or need rapid improvement.

What To Expect During Treatment

Spravato is given to patients in a certified clinic with direct medical supervision:

1. Pre-Dose Evaluation
A clinician assesses your condition, any side effects from previous sessions, and confirms you meet the dosing requirements.

2. Nasal Spray Administration
The clinician will give you instructions and the suitable dose. You will then administer the spray yourself while the clinician assists you. 

3. Observation Period (2 hours)
You will remain in a quiet, comfortable setting after treatment for monitoring. The staff will check your blood pressure, breathing, and responsiveness level. Some patients may feel dissociation, dizziness, or nausea. These are usually brief and will go away within the observation period. Due to these potential side effects, driving is not allowed after treatment, so you will need someone to take you home.

Spravato vs. Traditional Antidepressants

SSRIs, SNRIs, and similar medicines work by changing the amount of serotonin or norepinephrine in the body. The process affects mood but usually takes a few weeks before the effects are felt, and it usually takes trial and error to find the medication that works for you. There are also other side effects that are common while taking antidepressants, such as nausea, fatigue, headaches, or sleep problems.

Rather than relying on the body to slowly increase serotonin levels, Spravato uses a different method. It affects the glutamate system in order to help brain cells communicate more effectively. Spravato helps stimulate the brain to produce new and stronger connections, which leads to faster improvements in mood and motivation.

How Results Develop Over Time

There are usually three phases of Spravato therapy:

Initial Phase (Weeks 1-4)
Treatments are administered twice a week. This phase helps to reset the brain’s communication patterns. Many patients will report experiencing a lightened mood and a reduction of emotional heaviness even after a few sessions.

Optimization Phase (Weeks 5-8)
Sessions are reduced to one per week. The main purpose here is to fine-tune your reaction. Clinicians will check if your improvements will be maintained with fewer sessions or if adjustments need to be made.

Maintenance Phase (Weeks 9-12)
Treatment gradually changes to once weekly or bi-weekly. This phase is meant to maintain your progress and helps to preserve long-term motivation, daily functioning, and resilience. Spravato is not just about giving a quick relief of symptoms, but rather it is designed to gradually strengthen healthier neural pathways over time.

How MDDCare Helps You Navigate Treatment

If you’re exploring Spravato, finding the right clinic is very important. MDDCare helps to simplify the process. On our platform, you can quickly locate certified Spravato clinics throughout the U.S., review treatment options, and compare locations near you. 

We connect you to providers who are ready to help you, whether you are just gathering information or want to make an appointment. 

Explore clinics near you at MDDCare.com and start a conversation with professionals who can help you decide whether Spravato is right for you.