If your depression has not improved the way you expected, it can feel exhausting to keep cycling through the same options. You might be asking whether a more targeted depression treatment exists, especially if you have already tried more than one medication or you are managing symptoms that keep returning.
At our adult and adolescent psychiatry practice, we evaluate what you have tried, what helped, and what got in the way. Then we explain your options, such as transcranial magnetic stimulation and esketamine therapy, in clear, straightforward language. We can also outline the differences between TMS therapy and SPRAVATO® so you can understand how each approach may fit into your life.
While TMS therapy and SPRAVATO® both treat depression, they work differently. TMS uses magnetic pulses to stimulate specific brain networks involved in mood regulation. During a magnetic stimulation session, you stay awake and alert while the device delivers brief pulses to a targeted area. The experience is structured and repeatable, which many people find reassuring when they are rebuilding routines.
SPRAVATO® is an esketamine nasal spray administered in a medical office under a required safety program. It is thought to work through the brain’s glutamate system, which is different from most traditional antidepressants. Although the underlying mechanisms of depression are not fully understood, SPRAVATO is described as a noncompetitive NMDA receptor antagonist. Because some people can feel temporarily sleepy or detached during and after dosing, treatment includes on-site monitoring, including vital sign checks and a post-dose observation period.
TMS therapy and SPRAVATO® also have different timelines. A typical course of TMS treatment is built around frequent, shorter visits over several weeks. Many people return to normal activities afterward, depending on how they feel that day.
SPRAVATO® visits are usually less frequent, but they are longer. The FDA label requires monitoring for at least two hours after each dose, and you need a plan for transportation home. Dosing commonly starts with twice-weekly appointments and may shift to weekly or every-other-week maintenance based on your progress and your psychiatrist’s guidance.
We also help you build support around treatment. Since our practice is psychiatrist-led, we focus on diagnosis, medication management, and procedure-based care. If counseling is part of your plan, we coordinate with your current therapist or connect you with community therapy partners so your care feels aligned.
Choosing between TMS therapy and SPRAVATO® for depression is not about which option is “stronger.” It is about matching the approach to your history, symptoms, and practical needs. We consider factors such as:
After we review your situation, we will explain the pros and cons of each approach and recommend clear next steps. Some people start with one approach and reassess, while others benefit from an integrated plan that includes medication adjustments and collaboration with a community therapist.
If you are weighing two effective in-office treatments, you deserve guidance that feels organized and personal. We will help you understand what each option involves, what changes to expect over time, and how to stay supported throughout treatment.
Contact us to talk through your goals and learn the differences between TMS therapy and SPRAVATO®.