September is Suicide Awareness Month, a time to offer support to those struggling with suicidal thoughts and highlight the need for effective mental health care. If you or someone you know is experiencing a mental health crisis, dial 988. If you or they are experiencing a medical emergency, dial 911.
Anyone struggling with dark thoughts knows how suicidal ideation and behavior can quickly escalate without proper intervention and care.
One mental health treatment saving lives is Spravato® (esketamine.) It is the only treatment approved by the US Food and Drug Administration (FDA) for acute suicidal thoughts and behavior associated with major depressive disorder (MDD) when used with antidepressant medication.
Unlike standard antidepressants that can take weeks to work, Spravato can reduce symptoms within hours. This rapid action delivers safety and hope when every moment counts.
What causes suicidal thoughts?
Suicidal thinking does not come from weakness or lack of willpower; it is the result of complex changes in the brain.
Research suggests that suicidal thoughts often arise from imbalances in key brain regions:
- Underactive control centers, like the prefrontal cortex, which normally help regulate decisions and emotions.
- Overactive emotional regions, such as the amygdala, which can heighten fear, stress, and hopelessness.
- Disrupted reward and stress circuits, which make it harder for a person to experience pleasure or see a path forward.
When these systems are out of balance, it becomes difficult for someone to manage overwhelming emotions or to hold on to hope. This is why suicidal ideation is so serious and why rapid, effective treatment is needed.
What is Spravato and how does it work?
Spravato (esketamine) is a nasal spray approved for adults and administered only under medical supervision in a certified treatment center.
Unlike selective serotonin reuptake inhibitors (SSRIs) and other traditional medications that target serotonin, Spravato works on the glutamate system, which is a major chemical messenger in the brain involved in learning, memory, and mood.
By acting on glutamate, Spravato helps the brain form new connections between cells and restore communication across circuits that regulate emotions and stress. This process, called synaptic plasticity, is believed to underlie the fast improvements many patients experience.
Spravato is closely related to ketamine, an anesthetic used in surgery that has been found to rapidly relieve symptoms of depression.
How is Spravato different from traditional antidepressants?
Traditional antidepressants are lifesaving for many people, but they often take four to six weeks to reach their full effect. For someone struggling with active suicidal thoughts, waiting weeks is not always possible.
Spravato works on a faster timeline. In clinical studies, many patients reported meaningful relief within 24 hours of their first dose and, in some cases, as quickly as four hours. This rapid action can provide a critical window of safety and stability, giving both patients and their care providers more time to address long-term treatment needs.
Importantly, Spravato is not a replacement for other therapies. It is always combined with an oral antidepressant when treating MDD with suicidal thoughts and behaviors. Spravato is approved as a monotherapy only in cases of treatment-resistant depression.
What to expect from treatment
Treatment usually begins with a four-week induction phase where patients come in twice a week for supervised sessions.
After that is the continuation phase, where the schedule slowly tapers (often weekly or every other week) based on how each patient responds.
From there, some people move into a maintenance phase, returning for periodic sessions that help them stay on track and reduce the risk of relapse.
Each session takes place in a certified clinic, where the patients self-administer the Spravato under medical supervision.
Because Spravato can cause temporary side effects such as dizziness or dissociation, patients remain in the clinic for at least two hours after each treatment and must arrange for a ride home.
Is Spravato safe?
Spravato is considered safe when prescribed and monitored in a medical setting. The most common side effects include dizziness, nausea, and a feeling of detachment, known as dissociation. These usually fade within a couple of hours. Patients are encouraged to rest for the remainder of the day.
Patients may be referred by their physicians to receive Spravato treatment as it can provide:
- Rapid stabilization during a psychiatric crisis.
- Evidence-based care with measurable outcomes.
- A collaborative treatment plan, since patients continue with their existing psychiatrist or primary provider while receiving Spravato.
Spravato is a breakthrough option that offers relief and hope to adults suffering from suicidal thoughts and depression. For many, it can provide a vital first step, calming the crisis and allowing space for healing to begin.
Key takeaways
- Spravato is the only FDA-approved treatment for adults with major depression and acute suicidal ideation or behavior (when combined with an oral antidepressant).
- Unlike SSRIs that can take weeks, Spravato often reduces symptoms within hours, providing a critical window of safety.
- Spravato acts on the brain’s glutamate system, helping restore connections in circuits that regulate mood and stress (a process called synaptic plasticity).
- Patients receive Spravato as a nasal spray in a certified clinic, starting with twice-weekly sessions that taper over time. Each visit includes at least two hours of monitoring.
- Side effects like dizziness, nausea, or dissociation are usually short-lived. Patients cannot drive until the next day and must arrange a ride home.
Looking for Spravato or ketamine treatment near you?
Pacific Mind Health offers Spravato (esketamine) and ketamine therapy for treatment-resistant depression, major depressive disorder, and more. Our experienced clinicians provide compassionate, evidence-based care to help you feel better.
Ready to take the next step? Schedule a free consultation today to see if Spravato or ketamine is right for you.
