Spravato®, an esketamine nasal spray, has demonstrated notable success rates in treating treatment-resistant depression. However, outcomes vary depending on the treatment phase and study parameters. Real-world data from a retrospective study in Spain showed that approximately 80% of patients with treatment-resistant major depressive disorder achieved response or remission during the induction phase, with the Spravato® success rate increasing to 90% during the maintenance phase. Other studies have reported remission rates of 37-40% and response rates of 48-60% after the first month of treatment.
In comparative trials, patients undergoing Spravato® treatment were 1.54 times more likely to achieve remission after eight weeks compared to those receiving quetiapine extended-release, with remission rates of 27.1% versus 17.6%. The variation in reported Spravato® success rates reflects different definitions of response and remission, diverse patient populations, and whether the data comes from controlled clinical trials or real-world clinical settings. Spravato still requires administration under the supervision of a healthcare provider in certified treatment centers.
How Effective Is Spravato® for Treatment-Resistant Depression?
Spravato® has proven to be an effective treatment option for adults with treatment-resistant depression (TRD), showing meaningful improvements where traditional antidepressants have failed. In clinical trials, nasal esketamine appears to provide significant short-term symptom improvement in TRD, with only transient and mild-to-moderate side effects commonly being reported. One particularly noteworthy aspect is the medication’s rapid onset of action, with some patients experiencing reduced depression symptoms in as little as 24 hours.
The long-term effectiveness of Spravato® also demonstrates promising durability for sustained symptom management. In a long-term open-label safety study spanning 5.1 years, remission rates were 36.3% at induction endpoints and 49.6% during optimization and maintenance phases. These outcomes are particularly significant given that TRD affects approximately one-third of adults with depression, and after trying their third oral antidepressant, approximately 86% of patients do not achieve remission.
Does Spravato® Work for Everyone?
No, Spravato® does not work for everyone with treatment-resistant depression, as the patient information states that not all patients will respond to Spravato®. Healthcare providers evaluate symptoms over the four-week course of treatment to determine if there has been satisfactory improvement.
While the medication has shown promising results, with studies indicating that roughly 30-50% of patients may not experience substantial improvement. Individual response to the effectiveness of Ketamine-assisted therapy varies based on multiple factors, including depression history, previous treatments tried, current health status, and any existing medical conditions.
The variability in patient response is a crucial consideration when determining whether Spravato is an appropriate treatment option. Interestingly, some research has found that patients with prior electroconvulsive therapy (ECT) actually had higher response rates to Spravato® compared to those without prior ECT (53.3% versus 31.8%), suggesting that certain patient populations may benefit more than others.
For patients who don’t respond within the initial treatment period, healthcare providers will reassess whether continuing Spravato® therapy is warranted or if alternative treatment approaches should be explored. This underscores the importance of Spravato® treatment, which requires ongoing monitoring in a certified healthcare setting, enabling providers to track individual responses and adjust treatment plans accordingly.
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How Long Does It Take for Spravato® to Start Working?
Spravato® stands out from traditional antidepressants due to its remarkably rapid onset of action. In clinical studies, many people who received Spravato® treatment experienced improved depression symptoms within four hours of taking the drug, and this effect can occur within hours, often within 24 hours, leading to symptom relief and improved mood. This quick response time is dramatically different from conventional antidepressants like SSRIs, which typically require several weeks to produce noticeable improvements in depressive symptoms.
However, it’s essential to understand that while some patients may experience initial relief within hours or days, the full therapeutic benefits of Spravato® develop over time with continued treatment. Some may find significant improvements within the first month, while others might require ongoing treatment to maintain their benefits. The treatment protocol works in these stages:
- Repeated doses of Spravato® strengthen connections between nerve cells through neuroplasticity, as Spravato® stimulates the production of proteins that support this process.
- The typical treatment protocol starts with twice-weekly sessions during the initial four-week induction phase.
- Healthcare providers assess the patient’s response and determine whether to continue with less frequent maintenance dosing to sustain the therapeutic effects.
Can Spravato® Be Used with Other Mental Health Therapies to Improve Results?
Yes, Spravato® can and should be used in combination with other mental health therapies to optimize treatment outcomes. By FDA requirement, Spravato® must be administered in conjunction with an oral antidepressant, establishing a foundational multimodal approach to treatment. Its effectiveness can be enhanced by:
- Combining Spravato® with psychotherapy appears to enhance overall outcomes by addressing multiple dimensions of depression simultaneously.
- Combining Spravato® with therapeutic interventions such as Cognitive-Behavioral Therapy can help patients address other issues contributing to their depression, improve coping mechanisms, and reinforce positive behavioral changes.
- Psychotherapy helps patients develop lasting coping strategies, address underlying psychological issues, and maintain gains over time.
This combination provides both immediate symptom relief and long-term coping strategies, creating a comprehensive treatment approach for individuals with treatment-resistant depression.
Key Takeaways on the Spravato® Success Rate
- Spravato® shows strong effectiveness for treatment-resistant depression, with real-world studies demonstrating that 80-90% of patients achieve response or remission during the treatment phase.
- The medication works remarkably fast compared to conventional antidepressants, with many patients experiencing improved depression symptoms within 4–24 hours of the first dose.
- Spravato® is not effective for everyone, with approximately 30-50% of patients not experiencing substantial improvement.
- Long-term effectiveness is promising for those who respond, with 76% of patients in one study remaining in treatment for two years or longer, and maintenance phase remission rates reaching nearly 50%, indicating sustained benefits with continued use.
- Spravato® works best as part of a comprehensive treatment approach, requiring combination with an oral antidepressant by FDA mandate, and showing enhanced outcomes when paired with psychotherapy.
The impressive Spravato® success rate has led more patients to consider this therapy for those struggling with treatment-resistant depression and post-traumatic stress disorder (PTSD). If you or someone you know is seeking personalized and compassionate outpatient care for mental health, reach out to Moment of Clarity at 949-625-0564. Our team is dedicated to providing customized treatment plans that cater to your unique needs and support your recovery journey. We can also discuss the admission process and how insurance pays for Spravato® treatment.
Resources
- Spravatohcp.com –SPRAVATO® + oral AD is proven to provide rapid and superior improvement in depressive symptoms at Day 281
- National Library of Medicine –Intranasal Esketamine (SpravatoTM) for Use in Treatment-Resistant Depression In Conjunction With an Oral Antidepressant
- ScienceDirect –Efficacy of Esketamine among patients with treatment-resistant depression in a ‘real world’ healthcare setting in Israel
- National Library of Medicine –Long-term safety and maintenance of response with esketamine nasal spray in participants with treatment-resistant depression: interim results of the SUSTAIN-3 study
