How Spravato® Differs from Traditional Antidepressants

Aug 29, 2022
  How Spravato® Differs from Traditional Antidepressants
A challenge in the treatment of depression is finding an effective medication at the right dosage. Not all antidepressants work for all patients. Spravato® represents a new direction in the treatment of depression.

It’s estimated that about 21 million Americans experience a major depressive episode each year, over 8% of the country’s adult population. Primary treatment paths for depression include psychotherapy and antidepressant medications. 

An issue with treating depression is the wide response that patients show, particularly with the effects of medication. Nearly one-third of depression sufferers who take two or more drugs for their condition without significant improvement to their symptoms. This is called treatment-resistant depression (TRD). 

Psychiatric nurse practitioner Nola Ayoola-Yussuf and the team at Potomac Shores Mental Health and Wellness recommend Spravato®, an esketamine-based nasal spray as an add-on medication for our patients with TRD. 

The mechanism of depression

Neurotransmitters are the brain’s messengers, chemicals used to communicate within the synapses of your brain. Abnormalities in the specific neurotransmitters serotonin, dopamine, and norepinephrine appear in the brains of those with depression. 

Two additional neurotransmitters, called GABA and glutamate, regulate mood and higher-level thinking. Abnormalities with these messengers is another change associated with depression. As a patient with depression, you may have irregularities occurring with any or all of these neurotransmitters.

How Spravato differs from traditional antidepressants

Conventional treatment of depression uses several types of antidepressant drugs. Though they may work in different ways, they all typically work by inhibiting the breakdown of serotonin, dopamine, and norepinephrine. Although these antidepressants work well for some people, those with TRD don’t see much change. 

This is where Spravato comes in. Its active ingredient is esketamine, derived from the anesthetic ketamine, which is used in hospitals as a general anesthetic that has a low negative impact on patient vital signs. Ketamine isn’t approved as an antidepressant by the Food and Drug Administration (FDA), but it’s commonly used off label as part of a mood-boosting intravenous (IV) infusion. 

Spravato was designed specifically for antidepressant use since it targets the NMDA receptors in the brain. Though the precise activity of Spravato isn’t understood, the NMDA receptors respond to glutamate and GABA,  two neurotransmitters that are unaffected by conventional anesthetics.  

Spravato is typically prescribed alongside a conventional antidepressant. This means that both groups of neurotransmitters that go out of balance during depression receive dedicated treatment. Those who respond to an antidepressant regimen, including Spravato, have a better chance at beating their TRD symptoms. 


Conventional antidepressants can sometimes take weeks or months to show results. Spravato reaches maximum concentration in the body very quickly, typically within 40 minutes after treatment. It can help overcome acute major depressive episodes and even with patients who have thoughts of self harm. 

Consult with Potomac Shores Mental Health and Wellness to learn more about Spravato and to see if it’s right for you. Make an appointment today by calling the Woodbridge, Virginia office at 571-492-7954. Depression relief may be closer than you think.