A decision aid, not a treatment selector
TMS and SPRAVATO are different care experiences.
The table below clarifies practical differences without ranking one option above the other. Your history, safety needs, diagnosis, preferences, and access determine which conversations are relevant.
| Question | TMS | SPRAVATO |
|---|---|---|
| Treatment form | Repeated magnetic pulses delivered with a coil near the scalp | Prescription esketamine nasal spray self-administered under provider supervision |
| Care setting | In-office treatment course | Certified health care setting with direct supervision |
| After the visit | The care team explains individual activity and transportation guidance | Observation for at least two hours; arrange transportation and follow current driving restrictions |
| Schedule | Repeated visits over a clinician-planned course | Induction and maintenance schedule determined from current labeling and the care plan |
| Safety review | Medical history, seizure and device considerations, medications, diagnosis, and protocol fit | Medical history, blood pressure, respiratory status, sedation/dissociation risk, medications, and labeled-use fit |
| The decision | Based on clinical evaluation—not preference alone | Based on clinical evaluation—not preference alone |
What the table cannot tell you
“Which is better?” is the wrong shortcut.
Neither option can be selected responsibly from a checklist. The clinician first reviews what has been tried, whether the diagnosis and prior care are clear, safety considerations, practical access, and what matters to you.