For some adults living with depression, even the best treatments can fall short. You may try several antidepressants, follow every step of your provider’s plan, and still feel little change. When that happens, it’s natural to wonder if anything can truly help.
Spravato® (esketamine) offers a new way forward for people whose depression has been difficult to treat. Available at select Northeast Health Services (NEHS) locations, Spravato® is the first FDA-approved nasal spray for adults who have not found relief from two or more antidepressants. It works differently from traditional medications, often helping people feel better within hours or days rather than weeks.¹
Why some depression is harder to treat
Depression is complex. For about one in three adults, standard antidepressants that target serotonin and norepinephrine do not provide enough relief.² These medications adjust the brain’s “chemical messengers,” which can improve mood over time. But for some people, those pathways simply are not responsive enough.
This is called difficult-to-treat depression, meaning symptoms continue even after trying at least two antidepressants at the right dose and duration.²
When depression does not respond to traditional treatment, another type of therapy may be needed, one that acts on a different system in the brain.
How Spravato® works differently
Spravato® contains esketamine, a form of ketamine that is taken as a nasal spray under medical supervision. What makes it different from traditional antidepressants is the part of the brain it targets. Instead of focusing on serotonin or norepinephrine, Spravato® acts on glutamate, the brain’s main communication chemical.³
The role of glutamate in the brain
Think of glutamate as the “messenger” that helps brain cells stay in touch. It keeps different parts of the brain connected, especially those involved in mood, memory, and motivation. When these signals weaken, depression can make the brain feel like it is stuck in slow motion.
Spravato® helps get that communication moving again. Many people describe it as if their brain has been rebooted after being frozen for a long time.
How Spravato® helps the brain reconnect
Spravato® works by:
- Triggering more glutamate activity, which wakes up areas of the brain that have been quiet during depression.
- Encouraging new brain connections, helping clients feel more flexible and emotionally responsive.
- Supporting long-term brain health through better communication between mood-regulating regions.
By reactivating these pathways, Spravato® helps lift the weight of depression and restore balance. Many clients begin to notice small but meaningful shifts, such as more energy, clearer thinking, or renewed interest in daily life, after just a few treatments.³
What makes Spravato® fast-acting
Traditional antidepressants often take four to six weeks to work because they gradually adjust brain chemistry over time. Spravato® takes a different route. By acting directly on glutamate receptors, it helps restore communication in the brain more quickly.
The difference you might feel
Some people begin to notice a lift in mood within a day of their first treatment. For others, changes build steadily over the first few weeks. Clients who continue treatment often find that their symptoms stay more stable and are less likely to return.3
The timing is personal. There is no single pattern, but many people describe feeling lighter or more themselves again after years of feeling weighed down.
What to expect during treatment
Spravato® is given only in certified healthcare settings as part of the FDA’s Risk Evaluation and Mitigation Strategy (REMS) program. At NEHS, sessions take place in a calm and supportive environment designed to help clients feel comfortable and cared for throughout the process.
Typical treatment schedule
- Weeks 1–4: Two treatments per week (induction phase)
- Weeks 5–8: One treatment per week
- Ongoing: Weekly or every other week, depending on how you feel and respond
What happens in a session
Each appointment includes:
- Self-administration of the nasal spray with guidance from a healthcare provider
- Observation and monitoring for at least two hours, including regular check-ins and blood pressure readings
- Recovery time, where clients rest quietly, listen to music, or read
- Post-treatment care, since driving or operating machinery is not allowed until the next day after restful sleep
This supervised process allows clients to relax while the medication takes effect in a safe and supportive setting.
Possible side effects and safety
Spravato® can cause temporary side effects such as dizziness, nausea, feeling detached from one’s surroundings (dissociation), or sleepiness. These effects usually appear soon after taking the medication and fade the same day.³
Less common effects may include:
- Mild increases in blood pressure
- Brief changes in perception or sensation
- Headache or fatigue after treatment
Because of these possibilities, all clients stay in the treatment space for at least two hours. Every session is guided by experienced professionals who are there to monitor your comfort and well-being.³
Who can benefit from Spravato®?
Spravato® is designed for adults who:
- Have not improved after trying at least two antidepressants
- Experience major depressive disorder with suicidal thoughts or behaviors when used alongside an oral antidepressant³
Before starting treatment, NEHS providers complete a full medical and psychiatric evaluation to decide whether Spravato® is the right option. This includes reviewing cardiovascular health, medications, and overall mental health history. The goal is to help clients find the treatment plan that best fits their needs.
Why Spravato® matters in depression care
For decades, most antidepressant therapies focused on the same chemical systems. Spravato® represents a new way of understanding depression, one that focuses on repairing the brain’s connections rather than only adjusting its chemistry.
The impact of innovation
- Broader reach: Works for clients who have not responded to standard treatments
- Faster relief: Offers improvement within hours or days
- Ongoing research: Continues to shape future approaches to depression care
Since its approval, more than 140,000 people worldwide have received Spravato®.¹ Many describe it as a turning point after years of frustration with standard medications.
While Spravato® is not right for everyone, it represents a meaningful step forward. It offers a faster, biologically distinct way to relieve symptoms and gives clients who have felt hopeless a reason to believe that change is possible again.
At Northeast Health Services, this treatment reflects our broader mission to provide accessible, innovative, and compassionate care that helps people live well.
Spravato® treatment at Northeast Health Services
If you have tried multiple medications without lasting improvement, Spravato® could be an important next step. At Northeast Health Services, certified providers deliver this treatment in a supportive, medically supervised environment designed to promote comfort and peace of mind.
For new clients, please click here to schedule an appointment. For existing clients, please click here and find your office location to contact your office directly.
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