What’s SPRAVATO®, and How Does It Work?

When traditional antidepressants haven’t helped you, it’s easy to feel discouraged or even hopeless — but take heart, you’re not out of options.

SPRAVATO® is an FDA-approved treatment for adults with treatment-resistant depression and, in certain cases, major depressive disorder with suicidal thoughts or behaviors.

At Hudson Specialty Care Spravato in Cliffside Park, Edison, and Elizabeth, New Jersey, and Brooklyn and Manhattan, New York, we focus on helping patients understand how SPRAVATO® works and whether it’s appropriate for their needs.

What’s SPRAVATO®?

SPRAVATO® is the brand name for esketamine, a prescription nasal spray used alongside an oral antidepressant. It’s designed for adults who’ve tried at least two other antidepressants without sufficient improvement.

Unlike traditional daily pills, SPRAVATO® is administered in a medical setting under supervision. Patients self-administer the nasal spray in the office and remain under observation for a while to ensure safety and comfort.

This structured approach is part of a federally required safety program that helps ensure appropriate monitoring.

Why SPRAVATO® works differently

Most common antidepressants work on serotonin or norepinephrine pathways. SPRAVATO® works through a different system in the brain — the glutamate pathway.

Esketamine targets NMDA receptors, which are involved in mood regulation and neural communication. Research shows that this approach may help restore the connections between brain cells affected by depression.

Because of this different pathway, some patients experience improvement more quickly than with traditional antidepressants.

While scientists continue to study every aspect of how esketamine works, its distinct mechanism is one reason it’s considered a meaningful advancement for certain patients with difficult-to-treat depression.

What SPRAVATO® treatment looks like

SPRAVATO® treatment typically begins with an evaluation to determine eligibility. If it’s appropriate, the initial phase often involves treatments twice per week for several weeks. After that, the frequency may decrease depending on how you respond.

Each visit includes:

Supervised self-administration of the nasal spray
Monitoring for a couple of hours afterward
Ongoing assessment of mood and symptom changes

Temporary side effects, such as dizziness, nausea, or changes in perception, may occur. Patients should arrange for transportation home after each session.

Who may be a good candidate for SPRAVATO®

SPRAVATO® isn’t a first-line treatment. It’s intended for adults who:

Have major depressive disorder
Haven’t improved after trying at least two antidepressants
Continue to experience significant symptoms

At Hudson Specialty Care Spravato, we carefully review each patient’s medical history, treatment history, and current mental health status before recommending this option.

How SPRAVATO® fits into a larger care plan

SPRAVATO® isn’t meant to replace therapy or comprehensive mental health care. Instead, it’s part of a broader treatment strategy.

Many patients continue working with therapists or psychiatrists while receiving SPRAVATO®. Our team coordinates care to ensure treatment remains consistent and patient-centered.

Depression is complex. For some individuals, changing the biological pathway can open doors that previously felt closed. To learn more about SPRAVATO®, call Hudson Specialty Care Spravato or request an appointment online today.