What is treatment-resistant depression?
Depression usually responds well to selective serotonin reuptake inhibitors (SSRI), which are first-line treatments for depression; or to other common pharmacological treatments, like serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, or atypical antidepressants. In certain cases, however, depression does not respond to conventional antidepressants. The term treatment-resistant depression refers to cases that do not respond to adequate treatment—typically two or more trials of antidepressants.
What is Spravato and how does it work?
Spravato is a prescription nasal spray containing Esketamine, an isomer of ketamine. It has been approved by the FDA for treatment-resistant depression and for depression with suicidal thoughts or actions.
How does Esketamine help with depression?
Esketamine is an NMDAR antagonist. In other words, it blocks the action of NMDAR, which is a glutamate receptor. Glutamate is an important signaling molecule. Glutamate abnormalities (e.g., abnormal connections between brain cells) have been implicated in depression. So, Spravato targets the glutamate system. Traditional antidepressants, in contrast, target the dopamine, norepinephrine, and particularly, the serotonin systems.
Spravato for depression
Spravato offers hope to people with depression who have not responded to traditional antidepressants and those who have depression with suicidal ideation or behavior. Indeed, according to an article in Expert Review of Neurotherapeutics, the “discovery of ketamine’s fast and robust antidepressant actions is the greatest advance in the depression research field in the last 60 years.” At Harbor Psychiatry & Mental Health, our goal is to help our patients recover from depression and live their best life. So, if you have depression, come and see us. We are a certified Spravato treatment center in Southern California and are proud to offer you this new, powerful medication for depression. Our expert health care team is ready to consult and customize the appropriate treatment plan for your needs, so call us today.