Depressive disorders are a very common problem in the United States, impacting at least 1 in 6 people during their lifetime. It’s also a condition that can affect anyone at any time, regardless of background. However, it’s also one of the most treatable mental health disorders, and between 80-90% of people eventually respond to therapeutic interventions.

But what if you don’t?

These cases of depression fall into a different classification of major depressive disorder (MDD): treatment-resistant depression. As you might imagine, this type can be far more challenging to treat, since it doesn’t respond to traditional antidepressant drugs. Unfortunately, recent studies estimate that up to 30.9% of people receiving medication for MDD fall into this classification.

That’s where Spravato® could help.

Eka Oyeka, MSN, APRN, PMHNP-BC, and her team offer a wide range of psychological services at Harmonica Psychiatry in McKinney, Texas. One cutting-edge treatment involves Spravato therapy for treatment-resistant depression.

Spravato basics

If you’ve tried at least two antidepressants without results, our team could suggest Spravato.

Unlike other antidepressant medications, Spravato is a nasal spray that contains esketamine, which is a medication that’s made from ketamine.

You may have heard of ketamine, because it’s a powerful anesthetic that’s made headlines over the years. However, it’s also a highly effective treatment for depression. And, more recently, a more potent version called esketamine earned FDA approval for use as a nasal spray to help people with treatment-resistant depression.

What sets esketamine apart from traditional ketamine is that it requires far less to provide results, and it comes with fewer side effects. However, it’s still a powerful medication that requires treatment in a clinical setting.

Spravato vs. other antidepressants

At first blush, the differences between Spravato and traditional antidepressants may seem obvious. It’s a nasal spray — not an oral medication — and you need to go to a clinic for treatment.

However, there are other differences between Spravato and traditional antidepressants. Traditional antidepressants typically work by increasing the levels of naturally occurring neurotransmitters, such as dopamine, serotonin, and norepinephrine. By increasing the number of these chemicals, the communication between brain cells can increase, which can improve mood.

While esketamine also increases the level of neurotransmitters, it also increases glutamate. When you have more glutamate, there’s a greater impact on more brain cells at once. But why would that matter?

Because it often takes traditional antidepressants several weeks to cause a noticeable difference. With esketamine, you can see results within hours. On top of that, esketamine is one of the few drugs that can decrease suicidal thoughts, whereas some traditional antidepressants can actually increase these types of thoughts in the early stages of treatment.

Finally, clinical studies show esketamine can reduce depression symptoms in many people who don’t respond to other medications.

What to expect from Spravato


If you haven’t responded to at least two traditional antidepressants, we could suggest Spravato.

Spravato treatments are straightforward, since you simply spray the medication up your nose. However, this process takes place under our supervision at Harmonica Psychiatry so we can monitor you for possible side effects, including:

  • Drowsiness
  • Feeling intoxicated
  • Nausea
  • Headache
  • Increased blood pressure

However, these responses often lessen after a few treatments.

Each Spravato appointment takes two hours, and you need a friend, family member, or ride share service to drive you home afterward.

For the best results, we typically recommend a series of Spravato treatments, usually two sessions weekly for 4 weeks, then once weekly. Once complete, you could need regular boosters to maintain your results.

In addition to having Spravato therapy for rapid relief, you also take a traditional antidepressant at the same time to ensure lasting results.

Do you have treatment-resistant depression? Contact Harmonica Psychiatry today to learn more about your treatment options.

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