Are you considering Spravato for TRD and Suicidal Ideation? This guide explains the first month of treatment, including what happens at your sessions and how you may feel.
Finding a treatment that works for depression can feel like a long and difficult journey. Many people try several different pills and therapies without feeling better. This is often called treatment resistant depression or TRD. If you or a loved one are also dealing with suicidal thoughts, the need for relief becomes even more urgent.
Spravato for TRD and Suicidal Ideation is a newer medical option that works differently than traditional antidepressants. It is a nasal spray that you take under the care of a doctor. The first month of treatment is a very important time. It is called the induction phase. In this post, we will explain what happens during those first four weeks so you can feel prepared and hopeful.
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Understanding Spravato for TRD and Suicidal Ideation
Before we look at the first month, it helps to know what this medication is. Spravato is the brand name for a medicine called esketamine. It is approved by the FDA for adults who have not found relief from at least two other antidepressant medications. It is also approved for adults with major depressive disorder who have active suicidal thoughts or actions.
Traditional antidepressants usually focus on chemicals like serotonin or norepinephrine. These can take many weeks to start working. Spravato for TRD and Suicidal Ideation targets a different chemical in the brain called glutamate. By doing this, it helps the brain create new connections between cells. This can lead to faster relief for some people.
You can learn more about how this works on our service page about esketamine.
Getting Ready for Your First Appointment
The process starts before you ever use the nasal spray. At the Maryland Spravato and TMS Center, we begin with a thorough evaluation. We want to make sure this treatment is safe and right for you. This evaluation can be done in person at our offices in Laurel, Maryland or Alexandria, Virginia. We also offer telehealth evaluations for patients in Maryland, Virginia, and Washington D.C.
Once you are approved for treatment, you will need to plan for your session days. Here are some things to keep in mind.
- You must have a ride home. You cannot drive or operate machinery until the next day after a restful sleep.
- Do not eat for at least two hours before your treatment.
- Do not drink liquids for at least 30 minutes before your treatment. This helps prevent nausea.
- Wear comfortable clothes and bring something relaxing, like music or a book.
Week 1. Starting the Journey
During the first week of using Spravato for TRD and Suicidal Ideation, you will usually have two treatment sessions. Each session lasts about two hours. You will stay at our clinic during this time so our medical team can monitor you.
When you arrive, a staff member will check your blood pressure. Then you will use the nasal spray device yourself while a professional watches. Depending on your dose, you might use two or three devices with five minutes between each one.
The most common things people feel during the first week are.
- Dissociation. This is a feeling of being disconnected from your body or the room. It often feels like a dream.
- Dizziness or a lightheaded feeling.
- Nausea.
- A temporary rise in blood pressure.
These effects usually peak about 40 minutes after taking the medicine and go away by the time the two hour session is over.
Weeks 2 and 3. Building Progress
In the second and third weeks, you will continue coming in twice a week. Your doctor will talk to you about how you are feeling. They might adjust your dose based on your results and how well you handle the medicine.
For many people, this is when they start to notice small changes. You might feel a little more energy or find it slightly easier to get through your daily tasks. If you are using Spravato for TRD and Suicidal Ideation, your care team will pay close attention to your mood and safety.
It is important to keep taking your daily oral antidepressant as prescribed. Spravato is meant to be used along with your regular medicine, not instead of it. For more details on what a typical session looks like, you can click here.
Week 4. Evaluating the Results
By the end of the first month, you have completed the most intense part of the treatment. At this point, your doctor will do a formal evaluation of your progress. They will look at how your symptoms of depression and suicidal thoughts have changed.
If the treatment is helping, you will move into the maintenance phase. This means you will come in less often. In the second month, most patients only need to visit once a week. Over time, your doctor may suggest coming in every two weeks or even less frequently.
The goal of the first four weeks is to jumpstart your recovery. While everyone reacts differently, many clinical studies show significant improvement in symptoms by the end of this first month. Organizations like the National Institute of Mental Health (NIMH) often provide resources for understanding these types of clinical outcomes.
Staying Safe and Supported
Your safety is our top priority. Because Spravato can cause sedation or dissociation, it can only be given in a certified medical office. This is part of a safety program called REMS. This ensures that you are monitored by experts who can help if you have any side effects.
We also encourage you to stay in close contact with your therapist or other mental health providers. While Spravato helps with brain chemistry, talking through your feelings is a vital part of getting better. If you ever feel like your symptoms are getting worse, you should contact your doctor or a crisis line immediately.
Why Choose Maryland Spravato and TMS Center
We know that seeking help for treatment resistant depression takes courage. Our team in Laurel and Alexandria is dedicated to providing a calm and supportive environment. We focus on the latest medical treatments to help people who feel like they have run out of options.
We serve patients across the local area, including those in Maryland, Northern Virginia, and Washington D.C. Whether you need an in person treatment or a telehealth evaluation, we are here to guide you through every step of the process.
Summary and Next Steps
The first four weeks of using Spravato for TRD and Suicidal Ideation are a time of change and observation. By coming in twice a week, you give your brain the best chance to respond to the medication. Most side effects are short lived and happen right at the clinic where we can support you.
If you are tired of waiting for traditional antidepressants to work, this could be the step that makes a difference. You do not have to carry the burden of depression alone.
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