What Is the Newest Treatment for Treatment-Resistant Depression
The journey to find effective treatment for depression can often be a long and discouraging process. Some people respond well to antidepressants, while many others cannot seem to improve their symptoms despite trying numerous medications. This situation is known as Treatment-Resistant Depression (TRD), which affects millions of people and leaves them feeling hopeless and out of options when it comes to finding any relief.
Luckily, newer treatments are offering hope to those with TRD. One of the most exciting treatments is Spravato (esketamine), a nasal spray FDA-approved in 2019. Alongside Transcranial Magnetic Stimulation (TMS), which has been available for longer, Spravato is helping to expand what’s possible in depression treatment.
Spravato: A Breakthrough In Depression Treatment
Spravato is the first treatment in years to work in a fundamentally different way than standard antidepressants. Typical antidepressants, like SSRIs and SNRIs, target serotonin or norepinephrine, two brain chemicals that regulate mood. In contrast, Spravato acts on the NMDA receptor, which is the receptor linked to the neurotransmitter glutamate. Switching to this different pathway, Spravato can produce effects much faster and more powerful for many patients with TRD.
Spravato is not a standard prescription you can just pick up from your local pharmacy, it is a special medication given in a clinic under medical supervision. Patients self-administer the nasal spray and then are kept for observation for a couple hours, during which a provider watches for potential side effects like dizziness and dissociation. Treatment is a series of sessions, generally given alongside an oral antidepressant.
Benefits of Spravato for Patients
One of the most exciting features of Spravato is the time it takes to show its effect. While traditional antidepressants usually take several weeks to see changes, many patients report improvements in their mood within hours or days of treatment. Clinical trials have demonstrated that Spravato is able to lessen the signs of depression in people who have not had good results with trying several different medications.
For people that have spent years feeling stuck in their depression, Spravato offers patients a new chance at finding relief. The treatment helps relieve depressive symptoms and improves daily functioning, thus making it easier for patients to return to their jobs, relationships, and self-care.
How it Compares to TMS
While Spravato is the latest FDA-approved treatment for TRD, it is not the only possibility. TMS has been FDA-cleared as an option since 2008 and has a proven record of helping patients who have not benefited from taking medication.
TMS uses a magnetic pulse to activate regions of the brain that influence one’s mood. TMS is non-invasive, does not require anesthesia, and is generally very tolerable with few side effects. Similar to Spravato, TMS requires an in-office visit and is provided over a series of visits.
The main distinction is that Spravato is a medication, whereas TMS is a device-based therapy. The rapid onset of Spravato may be the most suitable for some patients, while others may opt for the non-medication path that TMS offers. In most cases, providers will assist and help patients weigh the pros and cons of each option to decide which is the right path forward for their specific needs.
Insurance Coverage and Requirements
Due to their success, both Spravato and TMS have progressively been covered by insurance to a large extent. Nevertheless, there are often special requirements that you must satisfy in order to be covered. Typical criteria might include:
- Diagnosis of major depressive disorder
- Non-responsiveness to at least two different antidepressant medications
- Documentation from your doctor about the history of your treatment
- In some instances, prior authorization from your insurance provider is needed before starting therapy
Every insurance plan varies, so you should call your insurance company to get the details of your coverage.
The Bottom Line
Treatment-resistant depression can feel impossible to handle, but new options are changing what recovery looks like today. Spravato represents one of the newest and most innovative options available today, providing rapid relief for those in search of results outside of traditional medications. In addition to Spravato, TMS has been established as another viable treatment option, providing patients the opportunity for multiple evidence-based treatment choices.
If you are exploring these options, consider talking with your physician or checking with your insurance to see if your specific treatment will be covered. Remember, you don’t have to navigate the search alone. MDDCare makes it easy to find clinics in your area that offer Spravato or TMS in your insurance network.