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Spravato vs. Traditional Antidepressants: What Sets This Treatment Apart?

May 15, 2023

Depression is a complex mental health condition that affects millions of people worldwide, and finding the right treatment can be challenging. Traditional antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), have been the cornerstone of depression treatment for decades. However, not everyone responds positively to these medications, leaving some individuals with treatment-resistant depression (TRD) and major depressive disorder (MDD) accompanied by acute suicidal ideation or behavior. In recent years, Spravato has emerged as a promising alternative to conventional antidepressants. In this blog post, we will compare Spravato with traditional antidepressants, highlighting the unique features that set this innovative treatment apart.

Understanding Spravato

Spravato is the brand name for esketamine, a medication derived from ketamine, an anesthetic used in medical and veterinary settings. In March 2019, the U.S. Food and Drug Administration (FDA) approved Spravato as a treatment for TRD and MDD with acute suicidal ideation or behavior. Unlike traditional oral antidepressants, Spravato is administered as a nasal spray, providing a more accessible and less invasive treatment option.

The Mechanism of Action: NMDA Receptor Modulation

One key difference between Spravato and traditional antidepressants is their mechanism of action. Traditional antidepressants, such as SSRIs and SNRIs, primarily work by increasing the availability of serotonin and/or norepinephrine in the brain. While these neurotransmitters play a vital role in mood regulation, not all individuals with depression respond positively to these medications.

Spravato, on the other hand, targets the N-methyl-D-aspartate (NMDA) receptor, a type of glutamate receptor found in nerve cells. By blocking the NMDA receptor, esketamine helps restore the balance of neurotransmitters in the brain, potentially alleviating depressive symptoms in individuals who have not responded to conventional treatments.

Rapid Onset of Action

Another significant difference between Spravato and traditional antidepressants is the speed at which they take effect. Traditional antidepressants often require weeks, or even months, of consistent use before patients experience noticeable improvements in their symptoms. In contrast, Spravato has demonstrated rapid-acting effects, with some patients reporting significant mood improvements within hours of their first treatment. This rapid onset of action can be particularly beneficial for those experiencing severe depressive episodes or suicidal thoughts.

Administration and Monitoring

While traditional antidepressants are typically taken daily in pill form, Spravato is administered as a nasal spray under the supervision of a certified healthcare professional. Patients receive treatment in an office or clinic setting and are monitored during treatment and for at least two hours after administration to ensure safety due to the potential for temporary side effects such as dizziness, disorientation, and elevated blood pressure.

Potential Side Effects and Cost

Spravato is not without its drawbacks. Some potential side effects can include nausea, vomiting, dizziness, and dissociation (a temporary sensation of being disconnected from reality). Additionally, Spravato can be quite expensive, and insurance coverage may vary, so it’s crucial to explore financial options and consider potential out-of-pocket expenses before committing to treatment.


Spravato represents a unique and innovative approach to treating depression, offering hope to those who have struggled to find relief through traditional antidepressants. Its distinct mechanism of action, rapid onset of effects, and alternative method of administration set it apart from conventional treatments. If you are considering Spravato as a treatment option, consult with your healthcare provider to determine the best course of action based on your individual needs and circumstances.


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