Which New Depression Treatment Is Right for You? Compare Ketamine, Spravato, TMS & Psilocybin

A Comprehensive Guide to Understanding Modern Mental Health Treatments

Choosing the right treatment for depression can be overwhelming. From chat forums filled with conflicting opinions to confusing insurance rules, it’s hard to know where to start. At Axis Integrated Mental Health, we believe in empowering patients with clear, trustworthy information. This guide compares four modern treatment options we offer or discuss frequently in our Colorado clinics: Ketamine, Spravato, TMS, and Psilocybin. Learn about their effectiveness, time commitment, cost, insurance coverage, and pros and cons.

What Are the Most Promising New Treatments for Depression?

• Ketamine: A fast-acting, off-label treatment typically administered via IV or IM. Offers relief in hours for some patients.
• Spravato (Esketamine): An FDA-approved nasal spray used alongside an oral antidepressant. Covered by most insurances.
• TMS (Transcranial Magnetic Stimulation): A non-invasive, FDA-approved therapy that uses magnetic pulses to stimulate areas of the brain involved in mood regulation.
• Psilocybin: A psychedelic compound being studied in clinical trials. Shows promise, but is not yet FDA-approved or legally available outside research settings.

How Do These Treatments Work?

• Ketamine and Spravato both act on NMDA glutamate receptors and increase BDNF and mTOR activity, promoting brain plasticity.
• TMS uses magnetic fields to regulate neural activity in mood-related brain circuits.
• Psilocybin binds to serotonin receptors, inducing altered states that may lead to therapeutic breakthroughs.

How Fast Do These Treatments Work?

Ketamine: Total treatment usually lasts 4 weeks or less. Each session takes 2–3 hours. Frequency depends on the diagnosis. Note: No driving after treatment, and patients may feel tired.

Spravato: Can continue long-term. Each session is 2 hours. Administered twice weekly in the first month, then weekly. No driving after sessions.

TMS: The Plan lasts 6 weeks. Each session takes about 30 minutes. Administered five times a week. No downtime required.

Psilocybin: Currently used in clinical trials. Sessions last 6–8 hours and are administered one or two times. Availability is highly limited.

What Does Each Treatment Cost?

Ketamine: $300–$800 per session. Not covered by insurance. Read more about Ketamine infusion cost here.

Spravato: $10 per session with commercial insurance and a rebate card. Free for many Medicaid patients. Read more about Spravato cost here.

TMS: $12,000–$15,000 for a full course. Covered by insurance after two failed antidepressant trials.

Psilocybin: Costs vary and are not covered by insurance. Only available in clinical or underground settings.

For a personalized insurance benefit check, call (720) 400-7025.

How Effective Are These Treatments?

Ketamine: About 55% of patients report improvement.

Spravato: Around 65% report benefits, with 36% reaching remission.

TMS: Success rates range from 50% to 60%, with about one-third reaching remission.

Psilocybin: Early trials suggest sustained symptom relief in some patients for up to a year, but research is ongoing.

Pros and Cons of Each Treatment

KETAMINE

Pros: Fast-acting, flexible dosing, strong PTSD results, no withdrawal, short treatment duration.
Cons: No insurance coverage, post-treatment downtime, maintenance required.

SPRAVATO

Pros: Covered by insurance, non-invasive, supervised, no needles, no withdrawal.
Cons: Requires concurrent antidepressant use, delayed relief, requires maintenance and downtime.

TMS

Pros: Non-pharmacological, minimal side effects, insurance-covered, no downtime.
Cons: 6-week time commitment, mild headache possible, clinical setting required.

PSILOCYBIN

Pros: Single-dose potential, long-lasting effects, generally non-addictive.
Cons: Not FDA-approved, variable dosing and sources, potential for psychosis, no medical oversight.

Matching Treatment to Your Needs

Not all treatments are equally suited for everyone. Consider:

• Time Off Work: TMS or psilocybin may require less recovery than ketamine or Spravato.
• Medication Sensitivity: TMS is ideal if you want to avoid pharmaceuticals.
• Insurance: Spravato and TMS are typically covered; ketamine and psilocybin are not.
• Symptom Severity: Ketamine may be preferred for acute cases or PTSD.

Talking to Your Psychiatrist

If you're considering these options, here are a few questions to ask your provider:

• Do I meet the criteria for Spravato or TMS insurance coverage?
• What are the side effects or lifestyle considerations for each treatment?
• How quickly should I expect results?
• What happens if one treatment doesn’t work?

Ready to Take the Next Step?

Axis Integrated Mental Health offers personalized consultations to help you choose the best path forward. Call us at (720) 400-7025 or book an appointment online to start your journey toward better mental health.

People Also Ask

1. What are the main differences between ketamine and Spravato?
2. Will my insurance cover TMS if I’ve tried antidepressants?
3. Is psilocybin legal or available in Colorado for depression?
4. How soon will I start feeling better with these treatments?
5. What should I expect during my first Spravato or TMS session?

Disclaimer: This blog does not constitute medical advice. Always consult a licensed mental health provider to determine the best treatment for you.