Depression is a mental disorder that can make even simple things feel out of reach. For many, therapy and traditional antidepressants help. For others, they fall short of bringing relief.
What Is Treatment-Resistant Depression?
Treatment-resistant depression (TRD) is a form of major depressive disorder (MDD) in which a patient doesn’t respond adequately to at least two different antidepressant medications. In practice, that means the depressive symptoms persist despite the person doing everything that’s been asked of them, be it therapy, antidepressants, or making lifestyle changes.
Common systems include:
- Persistent low mood that doesn’t lift even during good periods
- Loss of interest in things that once felt meaningful
- Poor concentration and difficulty making decisions
- Physical fatigue that sleep doesn’t resolve
- Social withdrawal and emotional numbness
- In severe cases, suicidal thoughts
Treatment-resistant depression is more common than people think. Roughly 30% of people diagnosed with depression go on to develop it, meaning it’s not a personal failure, but the brain’s chemistry doesn’t respond to serotonin or norepinephrine-based treatments.
What Is Spravato?
Spravato (esketamine) is an innovative treatment option in the form of an FDA-approved nasal spray derived from ketamine. It was developed specifically for treatment-resistant depression. Since it’s an FDA-approved treatment, it’s administered in a clinical setting under the supervision of medical professionals and adhering to strict Risk Evaluation and Mitigation Strategy (REMS) guidelines.
How Spravato Treats Depression
Spravato has emerged as an innovative way to treat depressive symptoms because it works in a fundamentally different way from traditional antidepressants. While SSRIs and SNRIs target serotonin or norepinephrine, Spravato affects glutamate, a key neurotransmitter involved in brain communication.
Spravato blocks NMDA receptors, increasing glutamate activity and stimulating the prefrontal cortex, a brain area responsible for mood regulation that is often underactive in depression disorder. This supports neuroplasticity, which is the brain’s ability to break negative thought patterns and form new connections.
Benefits of Spravato Esketamine Treatment
Spravato has a proven track record of helping people struggling with depression who haven’t gotten relief from other available treatments. Core benefits of Spravato esketamine nasal spray include:
- Rapid onset: Symptom relief can begin within hours to days, as opposed to weeks typically required for SSRIs or SNRIs to take effect.
- Novel mechanism: By targeting the glutamate system instead of serotonin or norepinephrine, Spravato helps patients who haven’t responded to conventional antidepressant pathways.
- FDA-approved treatment: Spravato is FDA-approved for adults with treatment-resistant depression (TRD) and for adults with major depressive disorder (MDD) experiencing acute suicidal ideation.
- Proven efficacy: Clinical trials show significant improvement within 24 hours in adults with suicidal ideation.
- Structured, supervised treatment: Every session takes place in a certified clinical setting with a medical team present, providing a level of safety and support you don’t get with antidepressants.
- Insurance coverage: Spravato is covered by most major insurers, including BCBS, UnitedHealthcare, Aetna, and Cigna, for qualifying diagnoses.
Spravato vs. Traditional Antidepressant Therapy
Here’s how treatment with Spravato compares with traditional antidepressants.
| Treatment | Spravato | SSRIs / SNRIs |
| How It Works | Blocks NDMA receptors and triggers glutamate surge and neuroplasticity | Regulates serotonin or norepinephrine levels |
| Onset of Effects | Hours to days | Several weeks |
| Administration | Nasal spray, in clinic only | Daily oral medication at home |
| Duration of Treatment | Twice weekly for 4 weeks, once weekly for 4 weeks, then maintenance sessions as needed | Several months to years |
| Best Suited For | Treatment-resistant depression and MDD with suicidal ideation | Mild to moderate depression |
| Insurance Coverage | Covered by BCBS, UHC, Aetna, and Cigna | Typically covered |
| Potential Side Effects | Nausea, dizziness, dissociation, and increased blood pressure | Nausea, fatigue, weight gain, and sexual dysfunction |
| Black Box Warning | None | Some antidepressants carry an increased risk of suicide (under 25) |
Who Should Use Spravato?
Spravato is for adults with treatment-resistant depression and adults with MDD who haven’t achieved meaningful relief with antidepressants or therapy. But Spravato is not the right fit for everyone, which is why you should always start with a thorough clinical evaluation. For those who are cleared, it can bring relief that makes moving forward feel possible again.
Spravato Therapy at Kadelyx Treatment Center
At Kadelyx, we take a people-oriented approach, which we practice through the “set and setting” concept. With patients dealing with depression, the idea that the environment in which the treatment happens is just as important as the treatment itself is also clinically relevant.
That’s why Spravato sessions at Kadelyx are done in a clinical space, but one that is calm and thoughtfully designed not to look and feel like a waiting room. You’ll self-administer the treatment in a group setting of up to 6 people at a time with the guidance of our medical team.
When your session ends, you will stay under our care for at least 2 hours, giving you the time to rest and reflect on the experience in whatever way feels right. Our staff will be there to support you throughout.
There’s Still a Way Forward
If depression has been shaping your life instead of you, and conventional methods aren’t helping, it doesn’t mean you’ve reached the end of your options. Spravato is a path worth exploring, and for the right patients, a path forward where they couldn’t see any. At Kadelyx, we offer free consultations to help you decide if this treatment is the right fit for you.
