What is TMS? TMS for Depression Defined - Active Recovery TMS in OR and WA

Spravato for treatment resistant depression

Spravato (esketamine) is the first prescription nasal spray for adults with treatment resistant depression or symptoms of major depressive disorder (MDD), taken alongside an oral antidepressant. 

How effective is spravato for depression?

Clinical studies found that:

  • Participants with treatment-resistant depression who took Spravato plus an oral antidepressant had a reduction in depressive symptoms at four weeks compared to those who received a placebo plus an oral antidepressant. 
  • Participants with MDD with suicidal thoughts or actions who took Spravato plus an oral antidepressant improved depression symptoms 24 hours after the spray was administered. 

Who is spravato for?

Spravato is prescribed for adults who

  • Have treatment-resistant depression (defined as not having experienced sufficient relief from two or more antidepressants)
  • Experienced major depressive disorder with suicidal thoughts or actions

Treatment with Spravato may be recommended if you’re unable t receive transcranial magnetic stimulation (TMS) due to a metal implant in your head or another condition that can make TMS unsuitable.

Do not take spravato if you:

  • Have blood vessel (aneurysmal vascular) disease (including in the brain, chest, abdominal aorta, arms, and legs)
  • Have abnormal connection between your veins and arteries (arteriovenous malformation)
  • Have a history of bleeding in the brain
  • Are allergic to esketamine, ketamine, or other ingredients in Spravato

Insurance Coverage

Active Recovery TMS will help with the insurance process and advocate for patients. Because Spravato requires a prescription, we will work with a Janssen CarePath Coordinator and the patient in order to navigate the insurance coverage. Active Recovery TMS is in-network with most major commercial insurance plans. 

Once you and your healthcare provider have decided that Spravato is right for you, Janssen CarePath will help you find the resources you may need to get started and stay on track. 

A Janssen CarePath Care Coordinator can explain potential out-of-pocket costs and identify cost and support options that may help with managing your out-of-pocket costs — whether you have commercial or private health insurance, government coverage such as Medicare or Medicade, or have no insurance coverage. 

What is involved in spravato depression treatment?

Spravato is only approved for use at a certified doctor’s office or clinic. You take the nasal spray yourself, while a healthcare provider supervises you. Spravato is taken twice a week for the first four weeks, once a week for a month and then after the eight-week treatment, your provider will reduce your treatment further if appropriate. 

Because there is a risk of sedation and dissociation, you must be monitored for at least two hours after receiving a dose. A caregiver or family member must drive you home after your appointment.  

What are possible side effects of spravato?

The most common side effects of Spravato when taken alongside an antidepressant include:

  • Feeling disconnected from yourself, your thoughts, feelings, and things around you
  • Increased blood pressure
  • Sleepiness

If these common side effects occur, they usually happen right after taking Spravato and go away the same day.

Your healthcare provider will discuss side effects in more detail during your evaluation. 

How to get started

If you would like the schedule a free consultation in order to learn more about Spravato or our other services, please fill out our form below. A member from our clinics will help connect you within one business day.

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Our Partners

At Active Recovery TMS, we have partnered with the leading TMS manufacturers, including NeuroStar Advanced Therapy and BrainsWay, to bring the latest in technology to our patients. This means we can offer several types of TMS treatment: BrainsWay’s dTMS and NeuroStar Advanced Therapy.

With Deep TMS (dTMS) magnetic pulses travel more deeply, allowing the therapy to stimulate more parts of the brain and provide broader stimulation of the targeted region of the brain involved in MDD, the dorsolateral prefrontal cortex. NeuroStar’s rTMS treatment protocol has recently been redesigned to reduce treatment time to just under 20 minutes with some variation from patient to patient. To read more about this technology, visit our Device Partners page.