When traditional treatments for depression and mood disorders don’t provide relief, many people feel stuck in a cycle of frustration and hopelessness. If you’ve been struggling with treatment-resistant depression (TRD) or major depressive disorder with suicidal thoughts, you may have come across Spravato (esketamine) as a potential treatment option.
But how do you know if Spravato is the right choice for you? Understanding who qualifies for this innovative therapy and how it works can help you make an informed decision about your mental health treatment.
Who is Eligible for Spravato?
Spravato isn’t for everyone—it is specifically designed for individuals with severe, persistent depression that hasn’t improved with standard treatments. Here are the key eligibility criteria:
- Diagnosis of Treatment-Resistant Depression (TRD) – You may qualify if you have tried at least two different antidepressants at adequate doses without significant improvement.
- Major Depressive Disorder (MDD) with Suicidal Thoughts – If you experience frequent, severe depressive episodes that include suicidal ideation, Spravato may be recommended to stabilize your condition.
- Currently, Taking an Oral Antidepressant – Spravato is not a standalone treatment. It must be used in combination with an oral antidepressant (such as an SSRI or SNRI) for the best results.
- Medically Cleared for Treatment – Some health conditions may make Spravato unsafe, including uncontrolled high blood pressure, a history of substance abuse, or certain cardiovascular issues. A thorough medical evaluation will determine if you’re a good candidate.
Who Can Benefit the Most from Spravato?
Not all depression is the same. Some individuals may see life-changing improvements with Spravato, while others may need a different treatment approach. The following groups are most likely to benefit from this therapy:
Individuals Who Have Exhausted Traditional Antidepressants
Many people with depression go through multiple medication trials with little or no success. If you’ve tried at least two antidepressants for a sufficient duration and still experience debilitating symptoms, Spravato may offer an alternative path to relief.
Unlike traditional antidepressants that target serotonin and norepinephrine, Spravato acts on the glutamate system, which plays a key role in mood regulation, synaptic connections, and neural plasticity. This different mechanism may be more effective for those who haven’t responded to conventional medications.
Those Experiencing Suicidal Thoughts or Severe Episodes
For individuals with frequent suicidal ideation, Spravato has been shown to work rapidly, often producing relief within hours or days—unlike oral antidepressants that take weeks to show effects. This makes it a crucial option for those in crisis or at high risk.
Patients Seeking a Fast-Acting Treatment
If you need urgent symptom relief, Spravato may be beneficial. While standard antidepressants take weeks to adjust neurotransmitter levels, Spravato’s effects begin within hours by stimulating new neural connections and rapidly altering brain function.
Many patients report that they feel lighter, more hopeful, and mentally clearer within the first few treatments, which can be a game-changer for those who have been stuck in a deep depressive state.
Those Who Want a Non-Traditional Approach
Some individuals prefer to avoid daily medications due to side effects, difficulty adhering to a schedule, or a desire for a different approach to treatment. Since Spravato is administered as a nasal spray in a clinical setting, it offers a structured, supervised treatment plan without the need for daily pills.
People Looking for Long-Term Stability
Spravato doesn’t just offer short-term relief—many patients experience sustained improvement in mood and function over time. By rebuilding neural pathways and enhancing brain plasticity, it may help prevent future depressive episodes when used consistently alongside therapy and medication.
Who Should Avoid Spravato?
While Spravato is a powerful treatment, it’s not suitable for everyone. You may not be a good candidate if you:
- Have a history of substance abuse – Esketamine has the potential for misuse, so individuals with active addiction issues may need to explore alternative treatments.
- Have uncontrolled high blood pressure or heart disease – Spravato can temporarily raise blood pressure, making it unsafe for those with severe hypertension or cardiovascular conditions.
- Pregnant or Breastfeeding – There is limited research on how Spravato affects fetal development, so it is generally not recommended during pregnancy or while nursing.
- Have certain psychiatric conditions – If you have bipolar disorder with a history of manic episodes, psychosis, or schizophrenia, Spravato may worsen symptoms and should be used cautiously.
What to Expect if You Choose Spravato
If you and your doctor decide that Spravato is right for you, here’s what the treatment process looks like:
- Initial phase: Treatment is administered twice a week for the first four weeks in a clinical setting. Each session involves nasal spray administration followed by a monitoring period of two hours to ensure safety.
- Maintenance phase: After the initial period, the frequency of treatments gradually decreases to once weekly or biweekly based on your response.
- Continued care: Spravato works best when combined with therapy and lifestyle changes. Ongoing counseling, medication management, and self-care strategies play a crucial role in sustaining the benefits.
Final Thoughts
If you’ve been battling severe, persistent depression and haven’t found relief with traditional treatments, Spravato may be a life-changing option. It’s fast-acting, effective, and offers new hope for individuals struggling with treatment-resistant depression and suicidal thoughts.
However, Spravato isn’t a one-size-fits-all solution. It’s essential to consult with a qualified mental health provider to assess whether it’s the right treatment for your unique situation. With the right approach, you can take control of your mental health and move toward a brighter, more stable future.
