Many families have a member who is suffering from Treatment Resistant Depression. If you are affected, or know someone who is, my practice may be a resource for you. Treatment-resistant depression (TRD) is a clinically significant condition defined by an inadequate response to at least two antidepressant treatments of sufficient dose and duration within a single depressive episode. Affecting an estimated 30% of patients diagnosed with major depressive disorder, TRD is associated with prolonged functional impairment, reduced quality of life, increased risk of hospitalization, and elevated rates of suicidality. The persistence of depressive symptoms despite multiple pharmacological interventions can leave patients and their families feeling exhausted and discouraged — yet advances in psychiatric research have made it increasingly clear that treatment-resistant depression is not untreatable depression. With the right specialized care and access to novel therapeutic options, meaningful and lasting improvement is an achievable clinical goal.
What Is Involved
I am Board Certified by the American Board of Psychiatry and Neurology in adult, adolescent, and child psychiatry, and am very skilled when it comes to using medication in treatment.
I am licensed by the FDA to dispense SPRAVATO® for Treatment Resistant Depression. Spravato® (esketamine) represents a landmark advancement in the treatment of depression, offering a mechanistically distinct alternative for patients who have not responded to conventional antidepressants. While traditional medications primarily target monoamine neurotransmitters such as serotonin, norepinephrine, and dopamine, esketamine acts as an N-methyl-D-aspartate (NMDA) receptor antagonist, modulating glutamatergic signaling — a pathway now recognized as central to the neurobiology of depression. This novel mechanism produces rapid antidepressant effects, with many patients experiencing meaningful symptom relief within hours to days of their initial treatment, a clinical outcome that has historically been unattainable with standard oral antidepressants that may take weeks to demonstrate efficacy.
Spravato® is FDA-approved specifically for treatment-resistant depression and for major depressive disorder with acute suicidal ideation or behavior, and is administered as a 56mg or 84mg intranasal spray in a certified healthcare setting under direct medical supervision. Following each session, patients remain on-site for a mandatory two-hour observation period to monitor for potential side effects, including transient dissociation, dizziness, and elevated blood pressure, all of which are carefully managed by our clinical team. Treatment is typically initiated twice weekly for four weeks, followed by a gradual taper based on clinical response. For patients who have spent years navigating an exhausting cycle of ineffective medications, Spravato® offers not only a new pharmacological pathway, but a renewed and well-founded sense of hope for recovery.
If you would like to learn more about SPRAVATO®, please email Vicki at office@schopickpsychiatry.com and she will work with you on the scheduling from there.
We serve New Hampshire, southern Maine and northern Massachusetts. 
