For years, antidepressants have been the traditional treatment, but the emergence of newer depression treatments such as ketamine infusion therapy and Spravato has changed how we approach depression. If time to relief is the primary criteria, then ketamine infusion therapy or Spravato – both of which are available at NeuPath Mind Wellness in Delray Beach – should be seriously considered.
At our psychiatry practice in Delray Beach, Florida, we frequently hear an important question from patients: “When will I start feeling better?” It’s a common and understandable concern, especially when struggling with the debilitating symptoms of depression. Naturally, patients want relief as soon as possible.
If you’re weighing your options and wondering which treatment — ketamine, Spravato, or traditional antidepressants — offers the quickest path to feeling like yourself again, this article shares what the science and clinical experience of doctors and patients has taught us about antidepressants vs. ketamine infusions or Spravato for effective depression treatment.
Traditional Antidepressants: A Slower, Steady Ascent
When a patient starts on a traditional oral antidepressant, such as an SSRI (selective serotonin reuptake inhibitor) or SNRI (serotonin-norepinephrine reuptake inhibitor), it can take several weeks before patients notice an improvement. This often catches patients off guard, and causes many patients to stop taking their medication, believing it isn’t helping.
How antidepressants work: Traditional antidepressants primarily target neurotransmitters like serotonin, norepinephrine, and dopamine, aiming to rebalance chemical messengers in the brain.
Time to effect: Most patients need to take traditional antidepressants consistently for 4 to 8 weeks before they will notice a significant symptom improvement. Some might notice subtle changes earlier, but the full therapeutic effect often takes much longer. During this ramp-up period, patients may continue to experience the full force of their depression, which can be incredibly disheartening. It can be very difficult for patients to continue taking their medication when they aren’t seeing any result.
Also, finding the right antidepressant and dosage can involve a trial-and-error process. Only about 40 percent of patients find adequate relief from the first antidepressant tried. This means patients may need to endure this waiting period several times as different medications are attempted.
Efficacy: While antidepressants are effective for many patients, approximately one-third of individuals with major depressive disorder don’t achieve adequate relief from traditional antidepressants, even after trying multiple medications. This is known as treatment-resistant depression (TRD). Fortunately, if medication isn’t working for you, there are other options, including ketamine therapy available in Delray Beach at NeuPath Mind Wellness.
Ketamine Infusion Therapy: Rapid Relief in Hours to Days
Ketamine infusion therapy has revolutionized the landscape for patients seeking faster relief from depression. It is also a good choice for those who have been labeled with treatment resistant depression, because “treatment resistant” only refers to antidepressants, not to other treatment methods.
How ketamine works: Unlike antidepressants, which focus on serotonin, ketamine works on the glutamate system, the brain’s most abundant excitatory neurotransmitter. It’s believed to rapidly repair neural connections damaged by chronic stress and depression, promoting neuroplasticity. Neuroplasticity is a state where the brain is more amenable to change and repair. This effect is thought to be responsible for ketamine’s swift antidepressant action.
Time to effect: Ketamine’s short time to efficacy is truly remarkable. Many patients report significant improvement in their mood, outlook, and energy levels within hours to days after their first infusion. For some, relief can be almost immediate. A typical treatment course involves a series of infusions delivered over a few weeks, with the rapid initial response often building with subsequent treatments.
Efficacy: Studies show that ketamine infusion therapy can lead to significant reductions in depressive symptoms for a substantial percentage of patients with depression, including patients who have failed multiple other treatments.
Spravato (Esketamine Nasal Spray): A Fast-Acting Alternative
Spravato is a nasal spray derived from ketamine and is a newer treatment option approved specifically for treating depression in adults. It’s chemically related to ketamine but delivered differently.
How it works: Like ketamine, esketamine targets the glutamate system in the brain, rapidly enhancing neural connections and promoting neuroplasticity. It is administered as a nasal spray in our ketamine clinic in Delray Beach under supervision from our medical staff.
Time to effect: Similar to ketamine infusions, Spravato offers a much faster onset of action compared to antidepressants. Patients may experience improvement in depressive symptoms within days to a few weeks of starting treatment.
Efficacy: Clinical trials have demonstrated that Spravato can lead to significant and rapid reductions in depressive symptoms. It is FDA-approved for treating depression in part because of its ability to demonstrate its efficacy in clinical trials. Our own real-world clinical experience also has demonstrated the positive effects of Spravato treatment in treating depression.
A Quick Comparison: Ketamine, Spravato, Antidepressants, and TMS
This table compares the treatment efficacy and time to relief of several different psychiatric treatments, including TMS, ketamine, Spravato, and antidepressants. (Note: TMS therapy will be available at NeuPath Mind Wellness later this year).
| Treatment Modality | Response Rate | Remission Rate | Time to Response |
|---|---|---|---|
| TMS Only | 75% | 50% | 3-4 weeks |
| TMS + Ketamine Infusions | 88% | 62% | 1-3 Days |
| TMS + Spravato | 85% | 60% | 1-3 Days |
| Ketamine Infusions Only | 70% | 40% | 1-3 Days |
| Spravato Only | 65% | 35% | 1-3 Days |
| Antidepressants Only | 65% | 48% | 4-6 Weeks |
Which Depression Treatment Option Is Right for You?
The choice between ketamine infusion therapy, Spravato, or traditional antidepressants depends on several factors, including the severity of your depression, your treatment history, and your individual response. Your psychiatric team at NeuPath Mind Wellness will help you make the right choice for you, based on your individual circumstances.
At NeuPath Mind Wellness, we offer and provide all three treatment options. Although we are recognized as one of the premier ketamine clinics in the Delray Beach area, we provide multiple psychiatric treatment options – including antidepressants and soon to include TMS – in order to meet our patients’ full scope of needs.
If you or someone you love is struggling with depression, we are here to help. Reach out today to schedule an appointment. You can reach us at 561-847-3662 or use our online appointment request form to schedule a consultation.
