TMS, Spravato®, and Psychiatry: Your Top Questions Answered
Intro: Taking the First Step
If you’ve been struggling with depression that hasn’t improved with medication, you probably have a lot of questions about your next options. At Redbud Behavioral Health in Fredericksburg, VA, we specialize in treatment-resistant depression (TRD) and offer advanced treatments like TMS therapy, Spravato®, and metabolic psychiatry.
Below, we’ve answered some of the most common questions we hear from patients who are exploring care.
What is a psychiatric nurse practitioner?
A psychiatric nurse practitioner (PMHNP) is a registered nurse with advanced training in diagnosing and treating mental health conditions. Nurse practitioners can prescribe medications, provide therapy, and order testing.
👉 At Redbud, you’ll work directly with Jonathan Yoder, PMHNP-BC, FNP-C. While we do not provide physician services (such as disability form signatures), we focus exclusively on advanced psychiatric care for adults with difficult-to-treat depression.
What happens at my first appointment?
Your initial consultation lasts 60 minutes. Beforehand, you’ll complete a detailed intake form that covers your symptoms, medical history, and past treatments. This ensures our time together is focused on:
Your goals
Your current status
Evidence-based treatment options
At the end of your visit, you can choose to continue with your current care team or start a new plan with us. Either way, you’ll leave with a clear understanding of your next steps.
What is TMS therapy and how does it work?
Transcranial Magnetic Stimulation (TMS) is a non-invasive, FDA-approved treatment for depression that hasn’t improved with medications. It uses gentle magnetic pulses to stimulate brain areas involved in mood regulation.
✅ FDA-approved since 2008
✅ No anesthesia, no downtime
✅ Covered by Anthem/BCBS and Cigna
Many patients begin noticing improvements in mood and energy within 2–4 weeks of starting treatment.
Does insurance cover TMS and Spravato?
Yes. Both TMS therapy and Spravato® (esketamine) are FDA-approved for treatment-resistant depression and are covered by most major insurance plans, including Anthem/BCBS and Cigna.
This makes them more accessible and affordable for patients in Fredericksburg compared to treatments like IV ketamine, which are not covered.
How soon will I feel better with TMS or Spravato?
TMS: Many patients notice gradual improvement after 10–15 sessions (2–4 weeks).
Spravato: Some patients experience relief within hours to days of their first treatment, many need four to eight weeks to see a difference.
Everyone responds differently, but both treatments are backed by strong clinical research and FDA approval.
Is Spravato the same as ketamine?
Not exactly. Spravato® is a nasal spray form of esketamine — a medication related to ketamine.
Spravato is FDA-approved for treatment-resistant depression.
It is covered by insurance.
It is administered in-office with medical supervision for safety.
IV/IM ketamine infusions, while sometimes helpful, are not FDA-approved for depression and are typically not covered by insurance.
What if medications haven’t worked for me in the past?
You are not alone. Up to one-third of patients with depression don’t respond to standard antidepressants. At Redbud, we specialize in advanced treatments beyond typical options:
TMS Therapy (non-drug, brain stimulation)
Spravato® (FDA-approved, rapid-acting nasal spray)
Advanced Medications (lithium, MAOIs, dopamine agonists, thyroid strategies)
Metabolic Psychiatry (addressing inflammation, sleep, and insulin resistance)
Do I need a referral to get started?
No referral is required. You can schedule a consultation directly with Redbud Behavioral Health.
If you’ve been struggling with depression that hasn’t improved with medications, you still have options. From TMS therapy to Spravato® to advanced medication strategies, our team in Fredericksburg is here to help you find the right path forward.
📍 Located in Fredericksburg, VA — In-network with Anthem/BCBS & Cigna
