When standard antidepressants do not deliver the improvement you need, you might want to consider different options. If you are considering Spravato® or transcranial magnetic stimulation (TMS) therapy, understanding what each treatment is and how it works can help you make an informed choice about mental health treatment.
Spravato®, also known as esketamine, is an FDA-approved nasal spray for adults with treatment-resistant depression or depressive symptoms with suicidal thoughts or actions. You typically use it alongside an oral antidepressant. It acts on the glutamate system, which can rapidly increase synaptic activity in mood-related circuits, leading some people to notice early shifts in outlook or energy.
You self-administer the esketamine nasal spray therapy under clinician supervision, then rest in a quiet room while your team monitors your comfort and blood pressure. Most visits include a two-hour observation period because short-lived effects (such as feeling light-headed or detached) can occur. You arrange a ride home and plan a low-key evening. You will typically visit twice weekly for four weeks, then adopt a maintenance regimen if you find it beneficial.
During TMS therapy, a clinician places a small, non-invasive coil on your scalp. It delivers magnetic pulses that stimulate specific brain regions involved in mood regulation. Our mental health clinicians calibrate this targeted stimulation to your motor threshold and repeat it in brief sequences that, over the course of treatment, can help strengthen healthier communication patterns in relevant circuits.
Unlike Spravato®, TMS is a non-medication mental health treatment. You sit comfortably while a clinician positions the coil. Sessions generally last about 20 minutes, and you remain awake, without anesthesia or systemic medication effects. Most people return to their daily routine immediately after. A typical course is five sessions per week for four to six weeks. Depending on your response, this initial treatment regimen is sometimes followed by reduced frequency of visits or a maintenance treatment plan.
Both of these evidence-based options can integrate with traditional therapy and lifestyle support. The best choice depends on your medical history, preferences, available time, and response to past treatments.
Spravato® modulates glutamate signaling via esketamine; TMS therapy directly stimulates cortical targets with magnetic pulses.
Spravato® may produce earlier improvements for some; TMS therapy builds gradually over your course of treatment.
Spravato® requires in-clinic dosing plus approximately two hours of observation; TMS therapy visits are shorter and typically have no post-visit restrictions.
Spravato® may cause temporary dizziness, altered perception, or increased blood pressure; TMS therapy may cause scalp-tapping sensations or a mild headache that usually eases with adjustment.
Spravato® is designed to work alongside your oral antidepressant; TMS therapy can stand alone or combine with your usual medication, which we may modify, depending on your treatment plan.
You will need a ride home and a calm evening after a Spravato® treatment, whereas you can generally drive and carry on with routine daily activities after TMS therapy.
Medical history, blood pressure, and certain medical conditions guide Spravato® suitability; metal implants or a history of seizures may require special review for TMS therapy.
Insurance criteria differ. You improve your chance of approval for both interventions when you document prior treatments and track your symptoms over time.
There is no single approach to mental health treatment that works for everyone. A candid conversation about Spravato® vs. TMS therapy will help you decide which approach feels best for you. Bring your questions to your discussion, along with your typical weekly schedule. We will discuss what progress means to you and create a treatment plan that fits your life.
Call us today to schedule your discussion.
Right Track Medical Group is a physician-led specialty healthcare organization. Our mission is to provide quality, outpatient mental health services for patients in the Southeast.
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Right Track Medical Group inspires hope and enhances the emotional well-being of all those we serve by providing accessible, innovative and physician-led mental healthcare services for children, adolescents and adults. Commercial insurance & private pay options available.
We are in-network with most commercial insurance, such as Blue Cross Blue Shield, Cigna, Aetna, United Healthcare, Medicare, Tricare and many more. Please contact your insurance provider to confirm that we are an in-network service for your plan if you are unsure.
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