Common Questions
Short, honest answers to the questions people around O'Fallon ask most - about treatment-resistant depression, Spravato, TMS, insurance, and how to actually get started.
Treatment-resistant depression is depression that has not improved enough after a fair trial of at least two different antidepressants, each taken at a proper dose for long enough, usually four to eight weeks. It does not mean nothing will work. It means the first medications were not the right fit, and it is a signal to try different approaches such as Spravato (esketamine), TMS, or a change in medication and therapy.
Spravato is the brand name for esketamine, an FDA-approved nasal spray for treatment-resistant depression. It works on the brain's glutamate system rather than serotonin, which is why it can help people who did not respond to standard antidepressants. It is given in a certified medical setting under supervision, and it is used alongside an oral antidepressant.
TMS, or transcranial magnetic stimulation, is an FDA-approved, drug-free treatment for depression. A device placed against the head delivers gentle magnetic pulses to a mood-regulating part of the brain. Sessions are done while you are awake, involve no anesthesia, and most people drive themselves home afterward. A typical course runs about five days a week for several weeks.
No. Spravato is a specific, measured, FDA-approved medication (esketamine) given under medical supervision in a certified clinic. It is related to ketamine, which has been used safely in hospitals for decades, but it is not the same as unregulated street ketamine and should never be sourced on your own. The supervised setting is part of what makes it safe.
Signs include giving two or more antidepressants a full, fair trial without real relief, feeling that medications help only a little before the heaviness returns, or having side effects that make it hard to stay on a medication long enough. If you are starting to believe the problem is your effort or character, that is worth raising with a doctor, because it is often a sign the treatment plan needs to change.
Both Spravato and TMS are FDA-approved for depression and are covered by many insurance plans, often after other treatments have been tried. In Missouri this can include MO HealthNet. Clinics that offer these treatments usually verify your benefits before you start, so it is reasonable to call and ask exactly what your plan covers.
A simple, effective sentence is: "I have tried a couple of antidepressants and they have not helped enough. What else is out there?" You can also ask directly whether Spravato or TMS makes sense for you and whether your doctor can refer you to a clinic that offers them. A recommendation from your own doctor is, for most people, the thing that finally turns reading into action.
Yes. It is very common to have anxiety and depression together, and unresolved trauma or PTSD can drive both. Because having more than one condition can change which treatment makes sense, it is worth mentioning all of your symptoms to a provider rather than only the most obvious one.
O'Fallon sits in St. Charles County, part of the greater St. Louis region, which has good access to modern mental health care. Brain Recovery Centers is a doctor-supervised clinic in St. Charles County that offers FDA-approved options like Spravato (esketamine) and TMS for treatment-resistant depression and PTSD, and accepts most insurance including MO HealthNet. Your own doctor can also refer you to local options.
If you are in crisis or thinking about suicide, call or text 988, the Suicide and Crisis Lifeline, at any time. It is free, confidential, and available 24 hours a day, 7 days a week. Veterans can dial 988 and then press 1. If you are in immediate danger, call 911.
Recommended partner · sponsored placement
Brain Recovery Centers is a doctor-supervised clinic in St. Charles County serving the greater St. Louis area. They offer FDA-approved options like Spravato (esketamine) and TMS for treatment-resistant depression and PTSD. Most insurance is accepted, including MO HealthNet, and they can help check your benefits.
Visit Brain Recovery CentersDisclosure: Brain Recovery Centers is a recommended partner of this site and this is a sponsored placement. We suggest them because they are a real, licensed, local clinic. Always talk with your own doctor about whether a treatment is right for you.
What treatment-resistant depression means and what comes next.
TreatmentsHow it works and what a supervised session actually involves.
Getting StartedThe exact words that open the door to newer treatments.