For many people, depression simply doesn’t improve with antidepressants. When that happens, it can feel frustrating and hard to know where to turn next. SPRAVATO® (esketamine) was developed for people who haven’t responded to traditional treatment options. By working differently in the brain, it offers another possibility when traditional medications haven’t helped.

What Is SPRAVATO® (esketamine) and How Does It Work?

Most traditional antidepressants, like SSRIs or SNRIs, influence chemical messengers like serotonin or norepinephrine. These medications can change the lives of many, but some people need a different path to relieve their depression. Additionally, antidepressants have to be taken every day and usually take several weeks to start seeing effects. For some people, it takes many tries before finding one that works for them. If that’s your experience, it is natural to feel discouraged and unsure about what to do next.

SPRAVATO® (esketamine) acts in a different way in the brain by targeting the glutamate system. Glutamate is the most abundant excitatory neurotransmitter and plays a large role in mood regulation and neural communication. It specifically targets the NMDA receptor to promote changes in the brain’s functioning and improve neural connections between neurons that have been underactive. For some patients, this different mechanism means they may notice changes sooner than with traditional antidepressants, sometimes within days rather than weeks.

SPRAVATO® (esketamine) is a prescription nasal spray approved for adults with major depressive disorder, specifically for people with Treatment-Resistant Depression (TRD). This means you have not responded to at least two antidepressant medications. It’s also approved for people with MDD who have severe depressive symptoms accompanied by suicidal thoughts or behavior. 

Who Might Benefit from SPRAVATO® (esketamine)?

SPRAVATO® (esketamine) is often considered when depression has continued after standard treatments. It may be worth learning more about if you’ve been diagnosed with major depressive disorder and haven’t experienced meaningful relief after trying more than one antidepressant. You should consider SPRAVATO® (esketamine) if your symptoms continue to affect your everyday life, work, relationships, and motivation. 

What the Clinical Evidence Shows

When depression hasn’t improved with standard treatments, it’s understandable to want clear, reliable evidence before considering something new. Especially when you’ve already invested significant time, energy, and hope into other treatments.

The FDA granted approval to SPRAVATO® (esketamine) following thorough clinical trials and research. In an FDA-reviewed trial, patients who received SPRAVATO® (esketamine) experienced faster improvement in depressive symptoms compared to those who received a placebo. Statistically significant results showed changes seen in as little as 24 hours and lasting through four weeks. After just four weeks, 22.5% of patients achieved remission, compared to 7.6% of those on placebo. These results are especially meaningful for people who continue to struggle to find relief through standard approaches.

What To Expect During Treatment

SPRAVATO® (esketamine) is given in a clinic under supervision. Knowing what a session will look like ahead of time can make the process feel less intimidating. The general treatment process includes:

1. Pre-Dose Evaluation

Before each session, your provider will go over your symptoms, overall health, and any past side effects from previous treatments. This helps to ensure safety and determine your dosage plan. Your provider will also determine whether you should take SPRAVATO® (esketamine) alone or alongside an oral antidepressant.

2. Nasal Spray Administration

Under supervision, you will self-administer the nasal spray according to your assigned dose and schedule.

3. Observation Period

After treatment, you will have to stay for approximately two hours so that our clinical team can monitor your blood pressure, breathing, and general reaction. Monitoring is important as SPRAVATO® (esketamine) can temporarily cause reactions like dizziness, nausea, and dissociation. Because these side effects are possible, you can’t drive after treatment and must have an adult take you home. 

We know the structure can feel unfamiliar at first, but many patients find that their nerves ease after the initial session and they find it reassuring once they see how calm and supportive our environment is.

Phases of SPRAVATO® (esketamine) Treatment

Most SPRAVATO® (esketamine) treatment plans will follow this structure: 

• Induction Phase: For weeks 1 through 4, sessions will occur two times per week. 

• Maintenance Phase: For weeks 5 through 8, sessions will occur once per week. From week 9 onward, sessions may be reduced to once a week or once every two weeks. Your provider will decide the best schedule to maintain long-term stability.

Remember that SPRAVATO® (esketamine) is not an overnight solution. You will need to commit to going to regularly scheduled sessions. Progress may feel gradual, but even small changes can signal that the brain is beginning to respond.

Safety and Monitoring

It’s completely understandable to have concerns about safety when you’re thinking of taking a new medication. SPRAVATO® (esketamine) has a very well-established safety profile not only through clinical trials but also through real-world use, with its structure designed with patient safety in mind. 

Because SPRAVATO® (esketamine) can have temporary effects, like dissociation, sleepiness, and changes in blood pressure, it’s only available through a special safety program called the REMS (Risk Evaluation and Mitigation Strategy) program. Every SPRAVATO® (esketamine) session occurs in our certified clinic with trained professionals present throughout your visit. They will be there to help you navigate any potential side effects or uncertainties during treatment. You are never expected to navigate the process alone.

This monitoring isn’t meant to make you feel worried. Rather, it’s meant to provide support and ensure your safety, particularly if you experience anything that feels strange or uncomfortable. Care providers will be there to perform routine check-ins and monitor your response. Most patients find comfort in knowing they have time to rest and that help is immediately available if needed.

SPRAVATO® (esketamine) at Deep Centered in Austin

SPRAVATO® (esketamine) is currently available at Deep Centered Mental Health’s Austin clinic. We provide a calm, welcoming environment where you can take the time to talk through your options with clinicians who truly understand how difficult living with depression can be.

If you’d like to learn more or start a conversation about SPRAVATO® (esketamine), we encourage you to submit a form here and our team will reach out to schedule an appointment, or call 512-894-9598 to schedule an appointment.

Let’s take the next step together.