Spravato (esketamine) is a prescription nasal spray approved by the FDA to treat treatment-resistant depression (TRD) and major depressive disorder with suicidal thoughts or actions. It’s used when traditional antidepressants have not provided sufficient relief.
How It Works:
Spravato contains esketamine, a form of ketamine, which affects a brain receptor called the NMDA receptor (N-methyl-D-aspartate). By blocking this receptor, Spravato helps increase the levels of glutamate, a neurotransmitter that plays a key role in mood regulation, memory, and learning.
This surge in glutamate promotes the growth of new connections between brain cells (synapses), which is believed to restore normal communication in brain circuits involved in mood and emotional processing.
Why It’s Different:
Unlike traditional antidepressants (which target serotonin, norepinephrine, or dopamine and often take 4–6 weeks to work), Spravato acts on a different brain system and can begin to relieve symptoms within hours to a few days.
How It’s Given:
Spravato is not taken at home. It must be administered in a certified healthcare setting under medical supervision due to potential side effects like:
- Dissociation (feeling disconnected from your body or thoughts)
- Drowsiness
- Elevated blood pressure
Each session includes a two-hour observation period after taking the nasal spray. It’s used alongside a daily oral antidepressant for best results.
Summary:
Spravato works by enhancing brain plasticity and improving communication between neurons. Its fast-acting effects and unique mechanism make it a valuable option for people who haven’t responded to other depression treatments.