New Hope for Those With Depression Disorders

In the past few decades, more and more people have become aware of the importance of mental health treatment. Just twenty years ago, seeing a therapist would have been considered taboo in many communities. Now, Gen-Z discusses symptoms of anxiety the way previous generations shared about favorite foods or music. This newfound openness allows those who suffered in silence to find help and acceptance. It also means there are more innovations in medical treatment for mental health challenges, like depression and anxiety.

For those who deal daily with mental health symptoms, this is a huge relief. For some, though, it hasn’t been as helpful. A 2021 study, published in the Journal of Clinical Psychiatry, found that some 2.8 million Americans suffered from treatment resistant depression (TRD) at that time. Depressive symptoms are defined as treatment resistant when at least two antidepressants don’t improve a patient’s symptoms. Some patients try medication after medication, coming up empty time and again. This has led many to feel frustrated, hopeless, and helpless. For psychiatrists who want to help their patients, it’s frustrating as well. That’s why many researchers are exploring other options. Relatively new innovations in the realm of depression treatment include ketamine, Transcranial Magnetic Stimulation (TMS), and now, a nasal spray called Spravato.

How Spravato is Different

Until recently, most antidepressants worked in a similar way. Whether you’re taking Lexapro, Zoloft, or Prozac, you’re taking a drug known as an SSRI (Selective Serotonin Reuptake Inhibitor). All of these medications for depression essentially work by keeping levels of a neurotransmitter called serotonin steady so that messages between brain cells will flow freely. This works wonderfully for many patients whose struggle is with low or fluctuating levels of serotonin. For others, it does not. Spravato works on an entirely different neurotransmitter system. Instead of impacting serotonin, Spravato increases glutamate levels in the brain. Having more glutamate, a neurostimulator which supports a variety of neuroplasticity mechanisms, is crucial for better memory and mood regulation.

Is Spravato the Same as Ketamine?

Also known as esketamine, Spravato is often confused with the more well-known drug ketamine. Spravato is one form of ketamine, but there are a few key differences that make Spravato more accessible for patients with treatment resistant depression. First, ketamine is often not covered by insurance. Psychology Today called the coverage of ketamine by major insurers, “spotty at best,” explaining that many companies call the use of this drug investigative. Spravato, on the other hand, is covered by almost all insurers. Both ketamine and Spravato are safe and work quickly, and both need to be taken under the supervision of a medical professional. They both can cause side effects including hallucinations, visual and sensory distortions, and a general feeling of being “on a trip” for a period of up to two hours.  However, unlike ketamine, Spravato has been evaluated and deemed safe and effective for treatment resistant depression by the FDA.

Live Better Today

“To have tried everything and to know he’s not getting better, that was very difficult,” says Allison, a Pikeville, KY mom whose son has TRD. Her son’s depression was so paralyzing that, despite having been a straight A student, he found himself almost failing in his senior year of high school. Despite trying seven drugs, Allison’s son continued to deteriorate, eventually attempting to take his own life. Around that time, Spravato was approved by the FDA and he began esketamine treatment. “After a few weeks, his symptoms began to improve,” says Allison, “He became interested in gardening and cooking. He’s doing so much better, working in a restaurant, aspiring to go to chef school.” The whole family has been transformed because Spravato, along with an oral antidepressant, are allowing Allison’s son to live his life to the fullest.

One of the major benefits of taking esketamine for treatment resistant depression is how quickly it works. Instead of waiting a few weeks for an SSRI to kick in, if it works at all, patients who use Spravato have reported feeling better within the first week of treatment. “Let’s say somebody has had depression, with or without anxiety, for years or even decades. Early on, their doctor tried them on two, or three, or even a handful of meds. At this point, they still have depression, they still have anxiety and have just accepted that. I want that person not to accept that,” says Dr. Aaron Albert of the Center for Brain Stimulation in Wilmington, NC. This is a common approach among psychiatrists who want to help their patients find relief. Since the FDA approved Spravato for use in 2019, many psychiatrists have explored the benefits of the drug and have found it to be a lifesaving option for their patients.

To learn more about how Spravato can help you or your loved one, visit The Center for Brain Stimulation,  a Wilmington, NC medical treatment center. The Center’s team of professionals work to treat severe depression, OCD, anxiety, and other clinically diagnosed psychiatric or mental health conditions.