Depression is a complex mental health condition that affects millions of people worldwide, and for some, traditional treatment options like antidepressants and therapy are not enough to alleviate symptoms. This subset of patients is often diagnosed with treatment-resistant depression (TRD), which means they have not responded to at least two different forms of antidepressant treatment. Fortunately, advancements in mental health therapies have led to innovative approaches that offer new hope for those with TRD. Two such options are Transcranial Magnetic Stimulation (TMS) and Spravato (esketamine) therapy. Both are FDA-approved treatments available at Bella Vida TMS, offering patients more choices in their path to recovery.
What is Transcranial Magnetic Stimulation (TMS)?
Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment that uses magnetic fields to stimulate nerve cells in specific areas of the brain that are involved in mood regulation. TMS is particularly effective in targeting the prefrontal cortex, the region associated with emotional control and mood disorders like depression. TMS is an outpatient procedure that does not require anesthesia, and patients remain awake and alert during the session.
FDA Approval and Research on TMS
TMS was approved by the U.S. Food and Drug Administration (FDA) in 2008 for the treatment of major depressive disorder (MDD), specifically in cases where patients had not responded to traditional antidepressants. Since its approval, numerous studies have validated TMS as a safe and effective treatment for TRD. Research has shown that TMS significantly reduces depression symptoms for a large percentage of patients, with some experiencing long-term relief. A notable benefit of TMS is its ability to offer sustained results after treatment, with some patients continuing to improve or maintain their progress months after their sessions end.
What is Spravato (Esketamine) Therapy?
Spravato (esketamine) is a nasal spray medication derived from ketamine, a drug long known for its anesthetic and dissociative properties. Esketamine, a more potent version of ketamine, was specifically developed to target treatment-resistant depression. Unlike oral antidepressants, which can take weeks to produce effects, Spravato works quickly—often within hours or days—by targeting the NMDA receptor in the brain. This receptor plays a crucial role in synaptic plasticity and neurotransmitter function, both of which are essential in mood regulation.
FDA Approval and Research on Spravato
In 2019, Spravato received FDA approval for adults with treatment-resistant depression, making it the first new type of antidepressant in decades. The approval came after extensive clinical trials showed that patients taking Spravato, along with an oral antidepressant, experienced significantly greater improvements in their depression symptoms compared to those taking a placebo. The rapid onset of relief, often within 24 to 48 hours, is one of the most striking differences between Spravato and traditional treatments. This fast-acting nature can be life-saving for individuals in crisis or those who have been suffering for long periods.
Spravato is administered in a clinical setting under the supervision of a healthcare provider, and patients are monitored for at least two hours after receiving the treatment due to the potential for side effects such as dizziness, dissociation, and blood pressure changes. Unlike TMS, which does not have psychoactive effects, Spravato’s dissociative effects can alter perception and require patients to rest after administration.
Key Differences Between TMS and Spravato
1. Method of Action:
– TMS uses magnetic fields to stimulate specific brain regions related to depression. It physically alters brain activity by enhancing neuroplasticity and increasing connectivity in areas like the prefrontal cortex.
– Spravato, on the other hand, works through chemical means by targeting the brain’s NMDA receptors, which affect neurotransmitter levels and enhance synaptic plasticity, allowing for rapid changes in mood.
2. Invasiveness:
– TMS is completely non-invasive and requires no medications or anesthesia. Patients simply sit in a chair while the TMS device is applied to their head, and there are few side effects.
– Spravato involves taking a medication nasally, followed by a two-hour observation period in a clinical setting. The psychoactive nature of the drug means patients may experience altered states of perception, unlike the neutral experience during TMS.
3. Speed of Results:
– TMS is effective but requires a series of sessions over several weeks to achieve the desired results. Most patients begin to see improvement after 4-6 weeks of daily or frequent sessions.
– Spravato offers a much faster response, with many patients reporting relief from depression symptoms within hours or days. This makes it particularly useful for those experiencing acute depressive episodes.
4. Side Effects:
– TMS is associated with minimal side effects, such as mild headaches or scalp discomfort, which typically subside after the first few treatments.
– Spravato may cause dizziness, dissociation, or increased blood pressure during and immediately after treatment. Because of these potential effects, patients must be monitored in the clinic for a couple of hours post-treatment.
5. Insurance Coverage:
– TMS is increasingly being covered by insurance, especially when other treatment options have failed. However, coverage varies depending on the provider.
– Spravato is covered by most insurance plans, making it a more accessible option for patients looking for an alternative to traditional antidepressants. Bella Vida TMS helps patients navigate their insurance options to ensure they get the coverage they need for either treatment.
Bella Vida TMS: Offering Both TMS and Spravato
At Bella Vida TMS, we are proud to offer both TMS and Spravato as FDA-approved treatment options for individuals struggling with treatment-resistant depression. We understand that no two patients are the same, and we work with each individual to develop a personalized treatment plan that best suits their needs. For those who have not found success with oral medications or traditional therapies, TMS and Spravato provide alternative paths to relief. By offering both options, we can tailor care to each patient’s unique situation, ensuring the highest likelihood of success in overcoming depression.
Our compassionate team is dedicated to guiding patients through every step of their treatment journey. Whether it’s the precision and non-invasiveness of TMS or the fast-acting relief of Spravato, Bella Vida TMS offers the latest in mental health treatment technology to help patients reclaim their lives and move toward a brighter future.
External Reference links
- Neuropsychiatric Disease and Treatment – Effects of repetitive transcranial magnetic stimulation on clinical, social, and cognitive performance in postpartum depression
- National Library of Medicine ( NIH) – Cognitive Enhancement in Neurological and Psychiatric Disorders Using Transcranial Magnetic Stimulation (TMS): A Review of Modalities, Potential Mechanisms and Future Implications
- Transcranial magnetic stimulation for treatment of major depression during pregnancy: a review
- U.S. Food & Drug Administration – FDA approves new nasal spray medication for treatment-resistant depression; available only at a certified doctor’s office or clinic
- Biomarkers in Neuropsychiatry – Benefits and risks of esketamine nasal spray continuation in treatment-resistant depression
