Depression treatment has changed significantly over the past decade. For patients with treatment-resistant depression, new therapies are offering relief when traditional medications haven’t worked.
One of the most important of these treatments is Spravato (esketamine nasal spray). Approved by the FDA in 2019, Spravato has helped many patients experience rapid improvement in severe depression symptoms.
But one question patients often ask is:
What happens after the initial treatment phase?
Research shows that Spravato isn’t just helpful for short-term relief. With the right treatment plan, it can also play an important role in maintaining remission and reducing the risk of relapse.
Spravato is a prescription nasal spray that contains esketamine, a compound related to ketamine. Unlike traditional antidepressants, which typically work on serotonin or norepinephrine, Spravato acts on the brain’s glutamate system.
Glutamate is the most abundant neurotransmitter in the brain and plays a key role in how brain cells communicate.
When Spravato activates this system, it helps stimulate neuroplasticity, the brain’s ability to form new connections between neurons.
For people with depression, especially long-lasting depression, these communication pathways can become weakened or disrupted. By helping restore these connections, Spravato can reduce symptoms such as:
Many patients begin noticing improvements within hours or days, rather than the weeks often required for traditional antidepressants.
Spravato is typically prescribed for adults with treatment-resistant depression (TRD). This means a patient has tried at least two antidepressant medications without adequate improvement.
It may also be used in certain cases of major depressive disorder with suicidal thoughts or behaviors, when rapid symptom relief is especially important.
Because Spravato is a powerful medication, it must be administered in a certified treatment center under medical supervision.
Unlike IV ketamine, Spravato is delivered as a nasal spray.
Patients self-administer the medication under the supervision of a healthcare provider while seated comfortably in a treatment room. After the dose is given, patients remain in the clinic for observation for about two hours so clinicians can monitor blood pressure and ensure safety.
Spravato is always used alongside an oral antidepressant, which helps support longer-term stability.
Speaking of risks, like any medication, Spravato nasal spray has potential side effects. Some patients have reported experiences of dissociation, an increase in blood pressure, or even suicidal thoughts. This emphasizes the importance of undergoing treatment in a certified healthcare setting where mitigation strategies and risk evaluation are paramount.
Treatment usually occurs in phases.
Patients receive Spravato twice per week, allowing the medication to begin stabilizing mood symptoms.
Treatment frequency decreases to once per week as symptoms begin to improve.
Sessions often move to every two weeks or once per month, depending on the patient’s response.
This long-term schedule is important. Depression is a chronic condition for many people, and maintenance treatment helps prevent symptoms from returning.
When considering Spravato therapy or any depression treatment, it’s vital to consult a healthcare provider. Their expertise will guide you, ensuring your mental health journey is both effective and safe. As more patients turn to options beyond traditional antidepressants, treatments like Spravato offer a beacon of hope, ensuring a brighter future free from the shackles of depressive symptoms.
Reach out to our team in Cleveland or Columbus today to get started on your healing journey or visit our Spravato frequently asked questions page for more information. We look forward to fighting this battle with you!
The most important long-term goal of depression treatment is remission, a state where symptoms are minimal or absent and daily functioning improves.
Clinical studies have shown that patients who continue maintenance treatment with Spravato are significantly less likely to relapse than those who discontinue treatment.
Long-term benefits may include:
Many patients also report that continued treatment allows them to better engage in therapy, relationships, and healthy routines, which further supports recovery.
Because Spravato affects brain signaling rapidly, it must be administered in a certified healthcare setting.
Some patients experience temporary side effects such as:
These effects usually resolve within a few hours after treatment. Monitoring in the clinic ensures that patients remain safe and comfortable during the process.
Clinicians also regularly evaluate each patient’s progress and adjust the treatment schedule as needed.
One of the biggest challenges in depression care is relapse. Even after symptoms improve, depression can return if treatment stops too quickly.
Maintenance Spravato therapy helps reduce this risk by continuing to support the brain’s neural communication systems.
When combined with ongoing psychiatric care, such as ketamine-assisted psychotherapy or counseling, as well as healthy lifestyle habits, Spravato can become part of a long-term strategy for sustained mental health stability.
At New Pathways Clinic, Spravato treatment is delivered in a structured, supportive environment designed to help patients feel safe and comfortable throughout the process.
Our team carefully evaluates each patient to determine whether esketamine therapy is appropriate and then develops a treatment plan tailored to the individual’s needs.
For many patients living with treatment-resistant depression, Spravato offers something that once seemed out of reach: the possibility of lasting relief.
If traditional antidepressants haven’t provided the relief you need, Spravato may be worth exploring.
Our team at New Pathways Clinic provides Spravato treatment in Cleveland (at both west and east locations), Columbus, and Cincinnati, helping patients access advanced depression therapies in a safe clinical setting.
