Depression is one of the most common mental health conditions in the world. While many people find relief through standard treatments such as oral antidepressants and psychotherapy, a significant number of patients continue to struggle despite multiple treatment attempts, leading them to wonder how a Spravato experience might help.
The article we’ll explore today—based on findings from the STRIVE study—examines patient-reported outcomes from adults with treatment-resistant Depression (TRD) who are treated with esketamine (Spravato). By placing a new emphasis on patients’ voices, the STRIVE study goes beyond symptom checklists to capture how people actually feel about their Spravato patient experience in their daily lives.
The Spravato Experience: Forging A New Path for Treatment-Resistant Depression
For people living with TRD, the road can feel exhausting—cycling through medications, coping with side effects, and still experiencing symptoms that make daily life difficult. Because of this, researchers and clinicians have been searching for new options that work differently from traditional antidepressants. One of the most promising breakthroughs has been esketamine, an intranasal medication derived from ketamine, approved by the FDA in 2019.
What is Esketamine?
Esketamine is a form of ketamine, a medication originally developed as an anesthetic in the 1960s. While racemic ketamine contains two mirror-image molecules (R- and S-ketamine), esketamine contains only the S-enantiomer, which is thought to provide more potent antidepressant effects at lower doses.
Delivered as a nasal spray under medical supervision, esketamine (brand name Spravato®) was the first truly new antidepressant mechanism approved in decades. Unlike standard antidepressants that act on serotonin and norepinephrine, esketamine works on the brain’s glutamate system.
This means it may restore connections in the brain in ways other medications cannot—and can often bring relief much faster, within hours to days. Clinical trials have demonstrated that esketamine can help reduce depressive symptoms in individuals who have not responded to multiple prior treatments, and in some studies, it has also been associated with a reduction in suicidal thoughts. But this empirical research should also be augmented with personal accounts of the Spravato experience—and that’s where the STRIVE Study matters most.
The STRIVE Study: Understanding Spravato Patient Experience
Most antidepressant studies focus on standardized symptom scales such as the MADRS (Montgomery-Åsberg Depression Rating Scale) or the HAM-D (Hamilton Depression Rating Scale). While these tools are valuable for measuring symptom reduction, they don’t always capture how patients feel about their daily lives, social roles, and overall functioning.
The STRIVE study (Self-Reported Value of Esketamine) took a different approach. Instead of focusing only on clinician-reported scores, it emphasized patient-reported outcomes with detailed personal Spravato experiences—what individuals themselves said about how treatment affected their emotions, functioning, and sense of well-being.
STRIVE Study Overview:
- Population: Adults with treatment-resistant Depression.
- Intervention: Intranasal esketamine, given in conjunction with an oral antidepressant.
- Focus: Patient-reported improvements in daily life, emotional health, and social functioning.
By re-centering the narrative around the patients’ voices and their individual Spravato experiences, STRIVE provided new insights into the real-world impact of esketamine—insights that numbers alone cannot fully describe.
At Mid City TMS, we believe treatment should focus not just on reducing Depression scores, but on restoring meaningful life—energy, hope, relationships, and function. The STRIVE study helps us understand how esketamine may play a real role in that recovery journey.
What Patients Reported About Their Spravato Experiences: Key Findings
The most compelling aspect of STRIVE was hearing about the Spravato experience and its outcomes directly from patients. Their feedback revealed several thematic patterns:
1. Improvements in Emotional Well-Being
Patients often reported feeling lighter, more hopeful, and more motivated within days or weeks of treatment. Instead of only tracking reductions in sadness, the study captured positive changes—such as regaining interest in activities and experiencing more balanced emotions. Many patients emphasized that they felt a “shift” or “lift” after treatment, sometimes describing it as a clarity they had not experienced in years.
2. Better Daily Functioning
Depression often disrupts basic daily activities—getting out of bed, preparing meals, managing work responsibilities. In STRIVE, patients described a return of energy that made it easier to complete everyday tasks. This mattered deeply to participants, because functioning in daily life often reflects recovery more meaningfully than just symptom scores.
3. Social Reconnection
Depression frequently leads to withdrawal from family and friends. After esketamine treatment, some patients in STRIVE described reconnecting socially—reaching out to loved ones, feeling more engaged in conversations, and rebuilding strained relationships.
4. Perceived Value of Treatment
Perhaps most importantly, the Spravato patient experience involved reporting that the benefits of esketamine outweighed the challenges (such as traveling to a clinic multiple times per week to receive their dose). Many valued the treatment for restoring a sense of control and possibility to their lives.
Why Patient-Reported Outcomes and Spravato Experiences Matter
Traditional antidepressant trials often show only modest average improvements. But averages can hide the very real, life-changing benefits that many patients experience. Patient-reported outcomes like those in STRIVE highlight that recovery is not just about symptom reduction—it’s about living again. Improvements in energy, function, and relationships may not be fully captured by Depression rating scales or standard metrics, but they represent the goals that matter most to patients day-to-day.
The STRIVE study offers a hopeful message: for people living with treatment-resistant Depression, esketamine may restore not just relief from symptoms, but improvements in daily life and well-being. Patients in the study sharing their Spravato experience described regaining hope, functioning, and social connection—reminders that Depression recovery is about more than just numbers alone.
This approach to understanding the holistic Spravato patient experience aligns with modern, patient-centered psychiatry. At Mid City TMS, we believe every treatment decision should focus on what matters most to the individual—not just lab scores or survey results.
Your Spravato Patient Experience: Safety and Monitoring Protocols with Esketamine
Importantly, esketamine must be administered in a certified clinic. Patients self-administer the nasal spray in the presence of a clinician, then remain under observation for at least two hours. Like all medical treatments, esketamine is safe but not without risks. The most commonly reported side effects of patients’ Spravato experiences include:
- Temporary increases in blood pressure.
- Dissociation or feeling “detached.”
- Dizziness or nausea.
- Sedation and impaired coordination for several hours after dosing.
Because of these risks, esketamine can only be given under a Risk Evaluation and Mitigation Strategy (REMS) program. Patients must come to the clinic for each session, be monitored during and after administration, and arrange transportation home. For some, the logistics can be challenging at first. But for many participants in STRIVE, the benefits outweighed these hurdles.
Esketamine Compared to Other Treatments
Esketamine is not the only option for treatment-resistant Depression. The Spravato patient experience may be further improved by another highly effective, non-drug therapy: Transcranial Magnetic Stimulation (TMS). Esketamine works through the glutamate system, often producing rapid effects and TMS uses magnetic fields to stimulate brain circuits involved in mood regulation, typically requiring daily sessions over several weeks.
Both treatments are FDA-approved and considered safe when administered correctly. For some patients, esketamine may be a better fit; for others, TMS may be preferable. At Mid City TMS, we evaluate each patient individually and discuss all available options, sometimes combining therapies for best outcomes.
Creating a Supported Spravato Experience with Mid City TMS
Treatment-resistant Depression can feel overwhelming, but advances like esketamine offer real reasons for hope. By listening to each patient share their Spravato experience in the STRIVE study, we learn that esketamine’s impact goes beyond symptom reduction—it helps people reconnect with life.
At Mid City TMS, we see esketamine as an important addition to the toolkit for TRD. For patients who have tried multiple antidepressants without success, it represents a new mechanism and a new opportunity. It’s safe, FDA-approved, and covered by most insurance plans.
If you or a loved one is struggling with Depression that hasn’t responded to standard treatments, you are not alone. Get in touch today to learn more about our cutting-edge therapies like TMS and esketamine administered in a safe, supportive, and patient-centered environment. Recovery is possible, and the right treatment can help you reclaim your life.
Sources
- Bahr, R., Lopez, A., & Rey, J. A. Intranasal esketamine (Spravato™) for use in treatment-resistant depression in conjunction with an oral antidepressant. P & T. 2019 Jun;44(6):340–375. https://pmc.ncbi.nlm.nih.gov/articles/PMC6534172/ PMC+2PubMed+2
- Starr, H. L., Abell, J., Larish, A., Lewis, S., DeMuro, C., Gogate, J., Jamieson, C., Daly, E., Zaki, N., & Kramer, M. Self-reported review of the value of esketamine in patients with treatment-resistant depression: Understanding the patient experience in the STRIVE Study. Psychiatry Research. https://www.sciencedirect.com/science/article/pii/S016517812030158X
- Johns Hopkins Medicine. Esketamine for Treatment-Resistant Depression. Johns Hopkins Medicine website. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/esketamine-for-treatment-resistant-depression
