Depression Treatment

​​​​​​​Subanesthetic Ketamine Infusion Therapy

Patients searching for a viable alternative to most conventional treatments for Complex Regional Pain Syndrome (CRPS) and other types of chronic pain may want to consider Subanesthetic Ketamine Infusion Therapy.

​​​​​​​SPRAVATO® for Depression

If you suffer from treatment-resistant depression(TRD) or major depression disorder(MDD) you might benefit from SPRAVATO® nasal esketamine spray.

​​​​​​​Transcranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain. TMS Therapy has been shown to be safe, well-tolerated, and effective for the treatment of adult patients with depression who have not benefited from antidepressant treatment.

Information and Referral Forms

SPRAVATO, TMS, And IV KETAMINE COMPARISONS

Categories Spravato TMS Ketamine
Mechanism of Action Esketamine, the S-enantiomer of ketamine, acts as an NMDA receptor antagonist, modulating glutamate neurotransmission. TMS uses electromagnetic pulses to stimulate specific brain regions, primarily the left dorsolateral prefrontal cortex (DLPFC). Ketamine, an NMDA receptor antagonist, affects glutamate transmission, potentially enhancing synaptic plasticity and alleviating depression and pain.
Administration Self-administered via nasal spray under medical supervision by REMS-certified prescriber. Monitored in-office for 120 minutes. Non-invasive treatment involves placing a magnetic coil on the scalp to deliver pulsed magnetic stimuli to the brain. Takes less than 30 minutes. Administered intravenously (IV) over 1 to 3.5 hours, depending on the condition being treated.
Treatment Schedule Twice weekly for the first 4 weeks, followed by once weekly for 4 weeks, followed by maintenance dosing. Five days a week for about 6 weeks. Variable, generally a series of 8 infusions for chronic pain and 4 infusions for depression.
Potential Candidates Patients with Major Depressive Disorder, single episode or recurrent, moderate to severe. Failure of 2+ oral antidepressants. Patients with Major Depressive Disorder, single episode or recurrent, moderate to severe. Failure of 2-3+ oral antidepressants. Participation in psychotherapy. Patients seeking viable alternatives to conventional treatments for depression, Complex Regional Pain Syndrome (CRPS), and other types of chronic pain.
Insurance Generally authorized by insurance; coverage and out-of-pocket expenses vary by plan. Generally authorized by insurance; coverage and out-of-pocket expenses vary by plan. Unlikely to be covered by insurance.
Side Effects Common side effects include dissociation, dizziness, nausea, sedation, anxiety, increased blood pressure, and feeling "drunk". Common side effects include headaches, scalp discomfort, lightheadedness, facial muscle twitches, tingling. Rarely (0.1%), TMS may trigger transient seizures. Common side effects include dissociation, dizziness, nausea, sedation, anxiety, increased blood pressure, and feeling "drunk".
Drive Self to/from Treatment No Yes No