For millions of people struggling with depression, traditional antidepressants don’t always provide relief. Fortunately, two groundbreaking treatments – Transcranial Magnetic Stimulation (TMS) and Spravato (esketamine nasal spray) – are changing the landscape of mental health care. Whether you’re a patient, provider, or simply curious, understanding how these therapies work and what they treat can open new doors to healing.
What Is TMS?
Transcranial Magnetic Stimulation is a non-invasive procedure that uses magnetic pulses to stimulate specific areas of the brain – particularly the prefrontal cortex, which is often underactive in people with depression. Unlike medications, TMS doesn’t flood the body with chemicals. Instead, it gently nudges the brain toward healthier activity patterns.
Conditions Treated with TMS:
- Major Depressive Disorder (MDD)
- Treatment-Resistant Depression (TRD)
- Anxiety Disorders
- Post-Traumatic Stress Disorder (PTSD)
- Obsessive-Compulsive Disorder (OCD)
- Migraines and chronic pain (in some off-label cases)
What to Expect:
TMS is typically administered five times a week for four to six weeks. Sessions are short, painless, and require no sedation – patients can drive themselves home and resume normal activities immediately.
Effectiveness:
Studies show that 50–60% of patients experience significant improvement, and about one-third achieve full remission. For many, TMS offers long-term benefits, especially when paired with maintenance sessions.
What Is Spravato?
Spravato is a fast-acting nasal spray derived from esketamine, a compound related to ketamine. It works by targeting glutamate receptors in the brain, promoting rapid neuroplasticity and mood stabilization. Unlike TMS, Spravato is a pharmaceutical treatment – but it’s administered in a controlled clinical setting with close monitoring.
FDA Approvals:
Spravato is specifically approved for:
- Treatment-Resistant Depression (TRD)
- Major Depressive Disorder with acute suicidal ideation or behavior
What to Expect:
Treatment begins with twice-weekly sessions for four weeks, followed by a tapering maintenance phase. Patients are monitored for about two hours after each dose due to potential side effects like dissociation or dizziness.
Effectiveness:
Spravato can deliver relief within hours or days—especially valuable for patients in crisis. Clinical trials show that nearly half of patients experience a 50% reduction in symptoms within the first few sessions. It also significantly reduces relapse risk in patients who achieve remission.
Why Combine TMS and Spravato?
While each treatment is powerful on its own, combining TMS and Spravato can offer synergistic benefits. TMS provides gradual, sustained improvement through brain stimulation, while Spravato delivers rapid relief via chemical modulation. Together, they target different pathways in the brain, offering a more comprehensive approach for severe or refractory cases.
Final Thoughts
Depression is complex, and no single treatment works for everyone. But with options like TMS and Spravato, patients now have access to innovative therapies that go beyond the limitations of traditional antidepressants. Whether you’re seeking long-term stability or immediate relief, these treatments offer real hope – and real results.