When depression has not improved enough, it does not mean you or your family has failed. Depression is not a normal part of aging, and medical conditions, chronic pain, mobility changes, grief, and changes in independence can make recovery more complex.
Depression can complicate the management of other health conditions and may be overlooked in older adults. BioMental evaluates psychiatric and medical safety, previous treatment response, daily needs, available support, and personal preferences. Some patients may be candidates for both deep transcranial magnetic stimulation (dTMS) and SPRAVATO.
Age alone is not a barrier to evaluation. Bring information that helps the team assess safety and practical fit:
dTMS and SPRAVATO may be covered when medical criteria are met. Requirements and prior authorization vary. Our team verifies benefits and explains expected costs before treatment.
Individual results and coverage vary. A clinical evaluation is required.
Our team can review treatment fit, medical considerations, scheduling, insurance, and next steps.
dTMS and SPRAVATO work differently. An inadequate response to one does not automatically mean the other will be ineffective. The treatment plan should be reassessed rather than considered a failure.
Compassionate care. Science-backed results.
For Depression in Older Adults
Non-invasive magnetic stimulation delivered through a cushioned helmet while you remain awake and seated.
Prescription esketamine nasal spray self-administered under supervision in a certified clinic.
No test can reliably predict the better option. BioMental compares safety, treatment history, daily needs, and preferences. Some patients may be candidates for both.
An open-label dTMS analysis of 247 adults ages 60-91 reported 79.4% response and 60.3% remission among those completing at least 30 sessions. There was no sham group.
In a four-week randomized study of adults age 65 and older, SPRAVATO plus a new oral antidepressant did not significantly outperform a new oral antidepressant plus placebo nasal spray on the primary endpoint.
These were not head-to-head studies and do not show that one treatment is superior. Designs differed, and individual results vary.
Response means symptoms decreased by at least 50%. Remission means symptoms became minimal on a standardized depression scale.
When depression has not improved enough, it does not mean you or your family has failed. Depression is not a normal part of aging, and medical conditions, chronic pain, mobility changes, grief, and changes in independence can make recovery more complex.
Depression can complicate the management of other health conditions and may be overlooked in older adults. BioMental evaluates psychiatric and medical safety, previous treatment response, daily needs, available support, and personal preferences. Some patients may be candidates for both deep transcranial magnetic stimulation (dTMS) and SPRAVATO.
Depression can affect sleep, appetite, energy, memory, motivation, relationships, and daily functioning. Symptoms may also resemble grief, cognitive decline, medical illness, poor sleep, or medication side effects. No test can reliably predict which treatment will work best for one person, so evaluation focuses on which options are safe, feasible, and aligned with what matters most to you.
Both are office-based treatments for depression that has not improved enough with standard care, but the treatment experience and safety considerations differ.
| Measure | dTMS | SPRAVATO |
|---|---|---|
| Treatment | Non-drug magnetic stimulation | Prescription esketamine nasal spray |
| Time in clinic | Usually 10-20 minutes; the first mapping visit takes longer | At least 2 hours after dosing, plus check-in and preparation |
| Typical schedule | Weekday visits for 4-6 weeks, followed by taper or continuation when recommended | Twice weekly in weeks 1-4, weekly in weeks 5-8, then weekly or every 2 weeks when continued |
| Before the visit | No fasting or sedation preparation is generally required | Avoid food for at least 2 hours and liquids for at least 30 minutes |
| After the visit | Most patients can drive and resume usual activities when clinically appropriate | A ride home is required; no driving until the next day after restful sleep |
| Medication plan | May continue alongside medication and psychotherapy when appropriate | For treatment-resistant depression, may be used alone or with an oral antidepressant |
| Common effects | Temporary headache or scalp, facial, or jaw discomfort | Dissociation, sedation, dizziness, nausea, and increased blood pressure |
| Safety review | Seizure risk, neurologic history, and metal or electronic implants | Blood pressure, cardiovascular or cerebrovascular conditions, cognition, fall risk, and substance use |
Response means symptoms decreased by at least 50%. Remission means symptoms became minimal on a standardized depression scale.
No test can reliably predict the better option. BioMental compares safety, treatment history, daily needs, and preferences. Some patients may be candidates for both.
An open-label dTMS analysis of 247 adults ages 60-91 reported 79.4% response and 60.3% remission among those completing at least 30 sessions. There was no sham group.
In a four-week randomized study of adults age 65 and older, SPRAVATO plus a new oral antidepressant did not significantly outperform a new oral antidepressant plus placebo nasal spray on the primary endpoint.