Spravato® vs TMS: Which Depression Treatment is Right for You?

Spravato® vs TMS: Which Depression Treatment is Right for You?

Innovative therapies are offering new hope for those struggling with treatment-resistant depression (TRD). Two such therapies, Spravato® and Transcranial Magnetic Stimulation (TMS), have gained significant attention for their potential to help patients who haven't found relief through traditional methods. Both FDA-approved, these treatments represent a new frontier in mental health care.

 Spravato, a nasal spray form of esketamine, and TMS, a non-invasive brain stimulation technique, have shown promising results in treating depression. However, they work in different ways and may be suitable for different individuals. Understanding the differences between Spravato and TMS can help you and your healthcare provider determine which therapy might be more appropriate for your unique situation.

 

How Spravato Works

Spravato, an FDA-approved treatment for depression, utilizes esketamine, a derivative of ketamine, to address symptoms that have resisted other forms of therapy. This innovative approach offers hope for many struggling with persistent depression. Most patients experience only short-lasting, minimal side effects, making it a well-tolerated option for those seeking relief.

The mechanism of action sets Spravato apart from traditional antidepressants that affect chemicals in the brain:

  • It targets the glutamate system in the brain by blocking NMDA receptors.
  • This action is believed to promote the growth of new neural connections.

One of the most notable aspects of Spravato is its rapid-acting nature. Unlike conventional antidepressants that may take weeks to show effects, some patients report experiencing relief within hours or days of Spravato treatment.

At Stella, safety is a top priority with Spravto administration. The treatment is given as a nasal spray in a clinical setting under careful medical supervision. This ensures proper usage and allows for immediate response to any side effects.

The typical Spravato treatment plan follows a structured schedule:

  • Induction Phase: Twice-weekly treatments for 4 weeks
  • Optimization Phase: Once-weekly treatments for 4 weeks
  • Maintenance Phase: Once every 2 weeks 
  • Ongoing Maintenance Phase: Once every 3-4 weeks if needed

This tailored approach allows healthcare professionals to adjust the treatment to each patient's needs, optimizing the potential for positive outcomes.

 

How TMS Works

Transcranial Magnetic Stimulation is a non-invasive treatment that harnesses the power of magnetic fields to stimulate specific areas of the brain associated with mood regulation. This FDA-approved therapy has shown promising results in treating depression, especially for those who haven't responded well to traditional treatments.

At the core of TMS therapy is a sophisticated mechanism:

  • A magnetic coil is placed on the patient's scalp.
  • This coil generates short pulses of magnetic fields.
  • These pulses induce small electric currents in targeted brain regions.
  • The currents activate neurons, potentially improving mood regulation.

TMS primarily focuses on the prefrontal cortex, an area of the brain often linked to mood disorders. This targeted approach allows for precise treatment without affecting the entire brain.


One of the advantages of TMS is its non-invasive nature. Patients don't need to undergo surgery or receive implants, making it a comfortable option for many. At Stella clinics, TMS is administered using the NeuroStar machine, known for its efficacy and extensive research backing.

 
A typical TMS treatment course involves:

  • 36 sessions over 4-6 weeks
  • Each session lasts about 20-40 minutes
  • 5 sessions per week during the initial phase

Some clinics offer accelerated TMS protocols for faster results. During treatment, patients remain awake and can usually resume daily activities immediately after each session, making TMS an attractive option for many seeking depression relief.

 

 

Outcome Comparison: Spravato vs. TMS

When undergoing treatment for depression, understanding what improvement looks like can be invaluable. Both Spravato and TMS have shown promising results in helping patients reclaim their lives from the grip of depression.

For Spravato patients, success often manifests as:

  • Reduction in recurring negative thought patterns
  • Increased optimism and self-confidence
  • Improved ability to cope with stress and anxiety
  • Enhanced capacity to enjoy life activities 

TMS patients frequently report:

  • Improved overall mood
  • Increased energy levels
  • Better sleep quality
  • Enhanced cognitive function

 Both treatments aim to help patients return to normal functioning and improve their quality of life. Success can vary from person to person, with some experiencing rapid changes and others noticing gradual improvements. Regular check-ins with your Stella care advocate team help track progress and adjust treatment as needed.

 

Efficacy Comparison

When considering Spravato vs TMS, it's important to look at their effectiveness in treating depression: 

Spravato Efficacy

  • Approximately 75% of Stella's patients show a significant reduction in depression scores (PHQ-9) after treatment
  • May provide rapid relief, with some patients experiencing improvements within hours or days

TMS Efficacy

Onset of Effects

  • Spravato: May provide relief within hours to days for some patients
  • TMS: Effects typically develop over several weeks of treatment

 Both treatments may require maintenance sessions to sustain improvements, with schedules tailored to individual needs.

 

Ideal Candidates: Who May Benefit from Spravato or TMS?

  • Spravato is primarily designed for individuals with TRD or MDD who haven't responded to at least two different antidepressants, particularly those experiencing suicidal thoughts or actions.
  •  TMS is FDA-cleared for the following conditions: 
    • Major Depressive Disorder (MDD)
    • Anxious Depression
    • Obsessive-Compulsive Disorder (OCD)

TMS is often considered for individuals who prefer a non-medication approach or haven't responded well to antidepressants.

Both treatments have specific contraindications. A thorough evaluation by a mental health professional is essential to determine the most appropriate option for your situation.

 

About Stella

Stella is a leading trauma care clinic committed to providing innovative and effective treatments for depression, anxiety, and PTSD. Our mission is to offer hope and healing to those who have struggled to find relief through traditional methods. At Stella, we combine cutting-edge biological interventions with compassionate psychological support to address the root causes of mental health challenges. 


Our comprehensive range of services includes: 

This diverse array of treatment options allows us to tailor our approach to each individual's unique needs and experiences. If you're seeking a path to recovery and renewed well-being, we encourage you to reach out to our caring team. At Stella, we're here to support you on your journey to better mental health.

 


 

 

 

 

Frequently Asked Questions (FAQs)


Is Insurance More Likely to Cover Spravato or TMS?

Insurance coverage varies by provider and plan. Both Spravato and TMS are FDA-approved for depression treatment, increasing the likelihood of coverage. Coverage and out-of-pocket costs can vary significantly depending on your specific insurance plan. It's best to check with your insurance provider and Stella's care team for specific coverage details and potential costs.

 

How Long Do the Effects of Spravato and TMS Last?


The duration of effects can vary. Some patients may experience long-lasting benefits from both treatments, while others may require maintenance sessions. Spravato effects may be more immediate but might require ongoing treatment. TMS effects often build over time and may last for several months to a year after a full course of treatment.

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