Spravato is a nasal spray derived from ketamine. The medicine is a breakthrough in depression therapy, providing an alternative, rapid-acting treatment for when conventional antidepressants don’t work.
Last year, some critical studies were published on Spravato. As a relatively new treatment, research teams are continuing to explore its long-term benefits, safety, and potential uses beyond treatment-resistant depression.
Real-world Effectiveness of Spravato in Hospital and Clinical Settings
One of the most important contributions from the past year is the INTEGRATE study. This observational study assessed how adult patients with treatment-resistant depression (TRD) responded to Spravato when used in real-world settings. These types of studies are essential for determining whether medicines produce the same results in patients when used outside clinical trials.
The depression symptoms of 200 patients were assesed, using the clinical judgement of their psychiatric doctor. Results showed that 80% of patients achieved meaningful improvement or full remission of depressive symptoms during their first few weeks of treatment. Among those who entered long-term treatment, 90% maintained response or remission.
Comparing Which Antidepressants Work Best With Spravato
According to FDA guidelines, Spravato must be used in combination with an oral antidepressant. A new study suggests that Spravato may work better with serotonin-norepinephrine reuptake inhibitors (SNRI) classes of antidepressants compared to selective serotonin reuptake inhibitors (SSRI).
In an analysis of over 55,000 adults with TRD, researchers compared two types of antidepressant combinations. One group used Spravato with an SSRI, and the other took Spravato with an SNRI.
For both groups, Spravato helped reduce depressive symptoms, and serious events during the course of treatment were rare. However, there were a few incidences of deaths, hospitalizations, suicide attempts, and depression relapses, which are common in large-scale depression studies. These events were more associated with the Spravato and SSRI group compared to those who used SNRIs.
Spravato Monotherapy — Is It Effective Without an Oral Antidepressant?
Despite clinical guidelines, Spravato may still offer relief, even when used without an antidepressant.
In the TRD4005 monotherapy trial, 378 patients with TRD received either Spravato or a placebo, without using antidepressants. After four weeks, those treated with Spravato showed a significant reduction in depression symptoms. Many patients noticed improvement within 24 hours, and the side effects were similar to those seen when Spravato is used alongside an antidepressant.
These results are promising for clinical populations who can’t use antidepressants because of things like allergies or increased sensitivity to their side effects.
Esketamine and Postpartum Depression
Postpartum depression (PPD) affects a significant proportion of new mothers — impacting not only the parent’s well-being, but also bonding, family dynamics, and long-term child development.
Esketamine, the active ingredient in Spravato, could offer hope for women at risk of PPD. As an anesthetic, using esketamine could potentially help prevent depressive symptoms from occurring after birth. In a randomized clinical trial, women who received a low dose of intravenous (IV) esketamine after cesarean delivery were less likely to develop PPD compared to women who didn’t receive esketamine.
Future studies may look to investigate whether using Spravato could help women who already have PPD symptoms.
Spravato May Improve Work Productivity and Daily Functioning
Depression, especially TRD, often affects more than mood: it impairs functioning at work, leading to financial instability, reduces productivity, and makes day-to-day functioning more difficult.
A 2025 study, ESCAPE-TRD work productivity study, found that people with TRD who used Spravato with an antidepressant had more productivity at work compared to those who just used an antidepressant. Spravato patients had fewer missed days, reduced presenteeism (working while unwell), and better overall functioning. These gains translated into substantial cost savings to both the employer and society.
How Spravato Works: New Insights Into Its Mechanism
Though there are some ideas about how Spravato works in depression treatment, it’s mechanisms aren’t fully understood.
To study its effects, one group of researchers used brain organoids, which are tiny lab-grown models of the human brain. They showed that esketamine changes how brain cells use energy, affecting both metabolism and communication between cells. This suggests that its effects on brain activity may be linked to how cells produce and use energy.
In another study, researchers tested esketamine’s effects on the brain’s of mice. They found esketamine reduced inflammation, and supported neuroplasticity, the ability for brain cells to form connections. The researchers discovered that these benefits work through a specific pathway in the brain called NF-α1/CREB — when this pathway was blocked, esketamine’s protective effects disappeared.
Spravato Treatment in Texas
NeuroGlow is a registered Spravato provider with three conveniently located clinics across North Texas. We offer personalized, compassionate care while following strict FDA guidelines to ensure your safety and well-being throughout treatment. Our team stays up to date on the latest Spravato research and developments to provide the best care possible.
If you or a loved one is struggling with depression that hasn’t responded to traditional antidepressants, Spravato may be the solution you need.
Contact our team today to learn more.
Considering Spravato in DFW? NeuroGlow is in-network with most major insurers, including TRICARE, and offers Spravato at REMS-certified clinics across Dallas–Fort Worth. See if Spravato is right for you or call 469-218-4410.
