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If you have completed both SPRAVATO and TMS without the response you needed, you are not at the end of psychiatry. A patient guide to the evidence-based options that come next.
Read MoreYou've tried two antidepressants. Now your psychiatrist is talking about Spravato — or TMS. A specialist breaks down both, with the numbers and the realities.
Read MoreBoth Spravato (esketamine) and IV ketamine work fast for treatment-resistant depression. Here's how they differ in FDA approval, safety oversight, insurance coverage, and clinical evidence — and why our practice offers Spravato. By Nefretiri Abat,
Read MoreFor most patients with TRD, SPRAVATO and TMS can be combined or sequenced. Here's what the evidence says — and how we sequence at Exxceed Wellness.
Read MoreWhy Spravato (esketamine) acts in 24 hours when SSRIs take six to eight weeks — and why the dissociation patients fear is not the antidepressant. A patient-first walkthrough of the NMDA → AMPA → BDNF
Read MoreA patient-facing clinical guide to the FDA/EMA two-failed-trials standard for diagnosing treatment-resistant depression — what counts as an adequate trial, why pseudoresistance must be ruled out first, and what comes next. By Nefretiri Abat, PMHNP-BC,
Read MoreA 2026 clinical guide to treatment-resistant depression: definitions, pseudoresistance workup, evidence-based treatments including SPRAVATO monotherapy, SAINT, and a 10-step management algorithm. By Nefretiri Abat, PMHNP-BC, JD.
Read MoreIf depression, anxiety, PTSD, or persistent burnout has been weighing you down—making even the basics feel overwhelming—we see you. You’re not alone, and these challenges are real. At Exxceed Wellness, we’re opening in Castro Valley
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