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July 1, 2026Depression affects many people, and for some, standard antidepressants simply do not work. Spravato offers a different option. Approved by the FDA, this nasal spray treatment provides relief for patients with treatment-resistant depression. Understanding how it works can help patients make a more informed decision about their mental health care. Here is more information on this treatment, including its benefits and eligibility requirements:
What Is Spravato?
Spravato is the brand name for esketamine, a nasal spray medication approved by the FDA. It is specifically designed for adults with treatment-resistant depression (TRD). Unlike traditional antidepressants taken daily at home, Spravato is administered in a certified healthcare setting under direct medical supervision. The medication is derived from ketamine, an anesthetic that affects brain chemistry. Spravato is not a standalone treatment; it is prescribed alongside an oral antidepressant as part of a broader treatment plan.
How Does It Work?
Most traditional antidepressants target serotonin, dopamine, or norepinephrine, which helps relieve symptoms for some individuals. Spravato takes a different approach by acting on the brain’s glutamate system, specifically the NMDA (N-methyl-D-aspartate) receptors. This mechanism enables it to produce rapid changes in brain signaling that standard antidepressants cannot replicate, and it may improve a patient’s quality of life.
Treatment follows a structured schedule. During the first month, patients typically receive Spravato twice weekly. Frequency then decreases to once weekly, and eventually once every one to two weeks for maintenance. This phased approach allows the clinical team to monitor response, adjusting care accordingly.
What Are the Benefits?
Spravato offers several benefits for patients with depression, particularly those with treatment-resistant forms of the condition.
- Rapid Action: Patients may experience a reduction in depressive symptoms within hours or days of the initial treatment.
- Alternative for Treatment-resistant Depression: Spravato provides a viable option for patients who have not found relief with standard treatments.
- Sustained Effects: Patients who continue with Spravato maintenance treatment may experience longer periods of remission.
For patients experiencing acute suicidal ideation, the rapid response of Spravato can be significant.
Who Is Eligible?
Eligibility for Spravato is defined by specific clinical criteria, which were established by the FDA. Adults diagnosed with treatment-resistant depression who have not responded to at least two different oral antidepressants are among the primary candidates. Adults with major depressive disorder who display active suicidal ideation with intent or behavior may also qualify for Spravato treatment, and a psychiatrist will determine eligibility.
Certain medical conditions and medications may affect candidacy; patients with a history of psychosis, uncontrolled hypertension, or specific cardiovascular conditions require careful evaluation before starting treatment. A prescribing psychiatrist will review a patient’s full medical history, current medications, and prior treatment responses, enabling appropriate medical intervention. The treatment is designed specifically for cases where other interventions have not produced adequate results.
Visit a Psychiatry Clinic Today
Spravato helps treat depression, particularly for patients who have not found relief through conventional medications. Its distinct mechanism, rapid onset, and supervised administration make it a valuable option, and a licensed psychiatrist can assess your history, confirm eligibility, and outline a treatment plan tailored to your needs. If you or someone you know is living with treatment-resistant depression or experiencing suicidal ideation, speak with a psychiatry professional.




