Spravato, also known as esketamine, is an FDA-approved medication designed for treatment-resistant depression. It is administered as a nasal spray under the supervision of a healthcare professional. Esketamine is the S-enantiomer of ketamine, meaning that it is a more potent form of the drug that can be provided at lower doses. Unlike traditional ketamine, which is typically given intravenously, esketamine is easier to administer under medical supervision. Spravato targets the brain’s glutamate receptors, which are believed to affect mood regulation. This treatment option is particularly beneficial for individuals who have not responded well to traditional medications. The duration of its effects can vary, but it typically lasts a few days.
TMS therapy is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in specific brain regions. It is primarily used to address depression symptoms but can also be effective for other mental health conditions, such as anxiety and obsessive-compulsive disorder. Unlike Spravato, TMS therapy does not involve medication and is considered a safe and well-tolerated treatment option. It is administered in an outpatient setting over several sessions, each lasting around 30 minutes.
Due to the more intense psychedelic-like reactions to Spravato, patients require much closer medical supervision and monitoring after taking it. TMS therapy does not alter consciousness or perception, allowing people to return to normal activity immediately.
TMS therapy for depression typically involves 20-30 sessions over 4-6 weeks. After the initial treatment course, maintenance TMS is sometimes recommended – usually one session per month or per week over 6-12 months to sustain the antidepressant effect. In comparison, Spravato usually starts with the induction phase – two sessions per week for 1-4 weeks alongside an oral antidepressant. After this initial step, the frequency is reduced to once weekly for weeks 5-8. Maintenance may continue at a reduced frequency in people who have responded well. In summary, the initial phase for TMS is shorter at 4-6 weeks, whereas Spravato usually takes around two months. Both treatments may involve a maintenance period of monthly or weekly sessions to prevent relapse of depressive symptoms. Depending on the patient’s needs and response, the maintenance phase can last 6-12 months or longer for either TMS or Spravato.
The cost of Spravato medication varies based on the patient’s condition and needs, so it is best to consult a doctor for accurate pricing. Insurance coverage is also possible. After receiving price quotes from their providers and discussing potential reimbursements, patients can calculate the financial differences between TMS and Spravato.
TMS therapy is typically suitable for patients with major depressive disorder. It is also generally safe for most people, including older adults. The only absolute contraindications are having metallic objects near the head or certain neurological conditions, such as seizures. TMS does not interact with medications.
TMS therapy is suitable for a broader population of patients with depression, whereas Spravato has stricter inclusion criteria, monitoring requirements, and risk factors that would exclude certain people. Healthcare providers conduct suitability assessments to determine which treatment option is better for each individual’s needs and medical history.
