New Spravato Indication Offers Greater Flexibility and Personalization for Patients with Treatment-Resistant Depression

PE: How does Spravato’s availability as a monotherapy enhance your ability to personalize treatment plans for patients with treatment-resistant depression?

Mattingly: I think this indication gives patients the freedom to choose whether or not they want to use Spravato with or without an antidepressant. Up until now, patients haven't had that freedom. They've had to use it with an antidepressant, and maybe that antidepressant either didn't work or it had side effects, weight gain, or sexual side effects. Now it gives patients the freedom to either use it with the medicine they're already taking, or to use it by itself. I think the ability to personalize treatment, to have freedom of treatment, and to give patients choice is a really important thing. The other part about this indication is it gives people the option to treat depression as needed for the first time ever. Up until now, you had to take something every day, or take it as instructed. This lets people take it as needed. Some people are going to need it once a week, while some are going to take it every two weeks.

Full Interview Summary: Spravato’s availability as a monotherapy provides a pivotal shift in treating patients with treatment-resistant depression (TRD), offering unprecedented personalization in care. Historically, patients using Spravato had to pair it with an antidepressant, which could result in side effects like weight gain or sexual dysfunction. The new indication allows patients the freedom to choose Spravato as a standalone therapy or alongside existing medications, enabling tailored treatment based on individual needs and tolerability. Additionally, Spravato introduces a groundbreaking option to treat depression on an as-needed basis, rather than daily, accommodating diverse patient schedules and symptom patterns.

Clinicians highlight Spravato’s rapid efficacy, often delivering noticeable relief within hours to days compared to the weeks or months required by traditional antidepressants. This quick onset provides hope to patients who may have struggled with depression for years. Moreover, Spravato’s mechanism, targeting glutamate pathways to promote brain connectivity and healing, offers unique benefits beyond what standard antidepressants achieve, as reflected in numerous patient experiences. For instance, one patient described emerging from a “decade-long fog” after starting Spravato, finding renewed clarity and vitality.

Clinical data underscores its impact, with a 22.5% remission rate by week four among TRD patients—remarkable given the diminished response rates typical after failing two or more antidepressants. While the REMS program imposes strict protocols for administration, it ensures consistent, safe treatment delivery, building patient confidence in care quality across locations.

Looking ahead, the monotherapy indication and as-needed flexibility position Spravato to expand its global reach and redefine depression management. By reducing dependency on daily medication and offering customizable care, it represents a transformative step toward more accessible and patient-centric treatments for TRD.