New Research on Spravato

Spravato treatment is a prescription nasal spray containing esketamine, a form of ketamine. It was approved by the U.S. Food and Drug Administration (FDA) for adults with treatment-resistant depression (TRD) and for some individuals with major depressive disorder (MDD) who have suicidal thoughts. Unlike traditional antidepressants, Spravato treatment works on the glutamate system, specifically targeting NMDA receptors in the brain.

The different mechanism helps in these ways:

− Restores communication between brain cells
− Promotes new neural connections
− Improves mood more rapidly than standard medications

New 2026 data indicates that Spravato nasal spray provides durable, long-term effectiveness
for treatment-resistant depression (TRD), with significant symptom reduction maintained for up
to 6 months after stopping treatment. Studies show over 70% of patients experience significant
symptom reduction, with high response rates in real-world settings.

A real-world study has revealed the long-term impact of Spravato in TRD, which analysts say
could pave the way for the uptake of classical psychedelic medicines. The Phase IV ECHO trial
spanned sites across Europe and Israel, enrolling 570 patients with severe and chronic TRD
characterized by a mean Montgomery-Åsberg Depression Rating Scale (MADRS) score of 33.3
and episodes of three years or longer. 301 of the patients enrolled in this study were evaluated
in the six-month post-treatment follow-up period.

In the study, patients treated with the nasal spray experienced a statistically significant 14-point
improvement in MADRS scores from baseline after 12 weeks of treatment, with this impact
deepening to a 17.6-point reduction after 48 weeks. Spravato’s antidepressant effects were
also maintained after patients discontinued treatment, as those who stopped taking the
therapy saw a mean -1.4-point change from the post-treatment follow-up baseline to week 24.
According to J&J, most patients evaluated in this portion of the study remained stable, with no
indication of relapse.

Here is some summarized data from the 2025-2026 research:

− Data presented at the 2026 European Psychiatric Association Congress showed that
patients continued to experience improved depression scores (measured by MADRS)
during a 6-month post-treatment follow-up, indicating durable benefits.
− Tracking patients for an average of 2.5 years found that 85% of patients improved, with
25% achieving remission.
− Phase 4 studies show Spravato is effective as a standalone treatment (monotherapy) for
TRD, offering a faster reduction in symptoms within 24 hours to 4 weeks, compared to
placebo.
− The REAL-ESK study found that response and remission rates increased from 28.4% and
11.2% at month 1 to 64.2% and 40.6% by month 3.
− While highly effective, common side effects include dissociation, dizziness, nausea, and
headache. Long-term studies have noted that urinary symptoms, such as cystitis, can
occur in some patients, suggesting the need for long-term monitoring.

Johnson & Johnson has sought FDA approval for Spravato as a standalone therapy
(monotherapy), which would expand its use beyond the current requirement to use it in
combination with a new oral antidepressant. Research continues to support the use of
esketamine to rapidly reduce suicidal thoughts in patients with MDD.

We are happy to offer Spravato at our clinic as a possible solution for our patients suffering
from TRD. Find out more at this page, contact us on this page, or call us at (585) 442-6960.