Depression can feel like it takes away your energy, your joy, and even your hope for the future. For many adults, standard antidepressants are not enough to bring meaningful relief. At Northeast Health Services (NEHS), we believe that no one should feel stuck without options. That is why we offer Spravato® (esketamine) nasal spray at select locations. Spravato® works differently than traditional antidepressants, often bringing improvement in symptoms within hours or days. For people who have lived with depression that has been difficult to treat, it represents a real opportunity to reclaim stability and find relief. Since its approval, more than 140,000 people worldwide have received Spravato®, and its use continues to grow.¹ 

What is Spravato®? 

Spravato® is an FDA-approved nasal spray for adults with difficult-to-treat depression. It contains esketamine, a form of ketamine, and is delivered through the nose for fast absorption into the brain. Unlike traditional antidepressants that target serotonin or norepinephrine, Spravato® works on glutamate pathways by blocking NMDA receptors. This unique process helps it act faster than many oral medications, with some people noticing changes in mood within hours or days rather than weeks.² 

Spravato® can be prescribed alone or in combination with oral antidepressants depending on the treatment plan made by your provider. 

Understanding difficult-to-treat depression 

• About 7 million adults in the U.S. live with depression that does not improve with standard medications.¹ 
• Difficult-to-treat depression means symptoms continue even after trying at least two antidepressants at the right dose and duration.¹ 
• Remission rates drop below 14% once three different medication trials have failed.¹ 

Two of the most common are transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT). TMS is a noninvasive treatment that uses magnetic pulses to stimulate mood-related areas of the brain, with no anesthesia required and little to no recovery time. At NEHS, we offer NeuroStar® TMS at select locations, giving clients access to this proven, noninvasive option close to home. ECT, on the other hand, involves controlled electrical currents under anesthesia to trigger brief seizures, which can be highly effective but is generally reserved for more severe cases. 

Spravato® adds another option, working differently than either medications or brain stimulation techniques. 

How Spravato® works 

Spravato® changes brain chemistry in ways that set it apart from other treatments: 

• Blocks NMDA receptors, which increases glutamate release. 
• Encourages neuroplasticity by activating pathways that strengthen brain connections. 
• Acts quickly, sometimes improving symptoms within 24 hours.² 
• Works internally, unlike brain stimulation therapies that act from the outside. 

Treatment administration and schedule 

Spravato® can only be given in certified health care centers through the FDA’s REMS (Risk Evaluation and Mitigation Strategy) program. At NEHS, treatment is delivered in a calm, supportive setting. 

• Induction phase: Two sessions per week during the first four weeks. 
• Maintenance phase: Weekly or biweekly, depending on your response. 
• During a session: Clients self-administer the nasal spray under supervision, then remain for a two-hour monitoring period. 
• After treatment: Transportation home is required, since side effects can temporarily affect alertness.² 

Clinical effectiveness and results 

Spravato® is different because it works fast. Clinical trials showed many people experienced meaningful improvement in their symptoms within 24 hours of the first dose. For some, these benefits lasted up to 28 days. Longer studies also found that clients who stayed on Spravato® were less likely to relapse than those who stopped.² 

In practice, people who had tried and failed multiple antidepressants reported not only better mood, but also an improved ability to take part in everyday activities. For many, Spravato® restored hope where other treatments had not. 

Are you a candidate? 

Spravato® is meant for adults who have not improved after trying at least two antidepressants. It is also approved for adults with major depressive disorder and acute suicidal thoughts, when combined with an oral antidepressant.² 

Before treatment, providers complete a full medical and psychiatric evaluation, including review of cardiovascular and respiratory health, substance use, and current medications. This helps determine if Spravato® is safe and appropriate. 

A new path forward 

Spravato® is a major step forward in the treatment of depression that has been difficult to manage with traditional medications. With its rapid results, careful monitoring, and proven effectiveness, it offers a new path for adults who have struggled to find relief. At NEHS, certified providers are here to deliver Spravato® in a safe, supportive setting.