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Major Depressive Disorder

Depression is a disabling condition and the third most common reason for consulting a GP in the UK. Depression is the second cause of disability worldwide in 2020. Treatment-resistant depression defined as people with major depressive disorder (MDD) who do not respond adequately to two courses of appropriate antidepressant medication within a certain time. A multicentre study found that around 50% of depressed patients were considered treatment-resistant after two consecutive courses of treatment with antidepressants.


Many people worldwide are suffering from major depression and every day is a battle in confronting the symptoms that comes with this mental condition. An additional burden that people suffering from major depression are facing is that the medications that they are on are not having the desired effect or no effect at all making patients treatment-resistant. 


This is a frustrating scenario for many people who are suffering from major depression. Another major disadvantage is that most antidepressants that are available take weeks or months to start working and for some patients do not work at all. This is failing patients who are at risk of harming themselves through self-harm and suicide.





Spravato® is the new nasal spray that has been approved by the Food and Drug Administration in the United States and also approved by the EC in Europe.

This spray was developed by Janssen Pharmaceuticals to serve those who are currently suffering from major depression and patients who have thoughts of suicide and patients who are treatment-resistant to other treatments for major depression. This new nasal spray is for those who are treatment-resistant to standard drugs such as antidepressants.


Spravato® works on the glutamate the brain neurotransmitter that uplifts the mood state you will be in. Other antidepressants work on serotonin and norepinephrine, these two neurotransmitters then work on the glutamate neurotransmitter.


Spravato® works smarter and faster and targets the glutamate straight away. Spravato is a brand new medication nasal spray and major step forward in three decades since Prozac wooed the depression market and prescribed by psychiatrists all over the globe.

Spravato® is a new antidepressant spray that is indicated for adults with treatment-resistant Major Depressive Disorder, who have not responded to at least two different treatments with antidepressants in the current moderate to a severe depressive episode.

Spravato® is uniquely provided at Ciconia Recovery London. It is advised to be taken by a nasal (nose) spray device.

At CRL, we will show you how to use Spravato® properly.

You will spray the medicine into your nose yourself. At CRL, the doctor will decide if you need one, two or three nasal spray devices and how often you should come to the clinic for the medicine.


Who will I speak to when I call?

Experienced recovery workers who are compassionate, experienced and knowledgeable about substance misuse and mental health issues, they will be happy to take your call and discuss all your queries in a discreet and confidential manner. And if needed they will offer you a free video consultation with a psychiatrist.

How much does treatment cost?

At CRL we endeavour to keep our costs as low as possible whilst at the same time continuing to  provide high quality care. The cost of treatment varies depending on the level of care needed and the length of the treatment plan required. The best way to ascertain this cost would be to speak to one of our experienced recovery workers to determine what treatment plan will be the most effective for you in achieving your desired goals.

Does insurance cover mental health or addictive treatment?

Some private health insurance companies cover the treatment, you will have to check your policy to see if you qualify.

Does insurance cover adult ADHD assessment or treatment?

Yes, most private health insurance companies cover the treatment, you will have to check your policy to see if you qualify.

Do you only treat substance misuse?

No, in addition to our drug and alcohol treatment packages, we also treat a wide range of mental health disorders, some of which may be associated with the individual’s substance misuse and dependency, these include treatment for personality disorders, anxiety, depression, adult ADHD and PTSD amongst other disorders.

What if I need a detox?

We offer a wide range of options for smooth and painless detox thanks to our new provided medications (i.e. long-acting buprenorphine monthly injections). If this is something you are interested in, please call us to discuss which is more suitable for you.

The main emphasis in our detox programs is to provide as much comfort and support while doing our best to minimise any withdrawal symptoms the individual may experience throughout their recovery. Many users recognise they need help and support to get clean but fear the consequences of withdrawals, we have created detox plans to greatly reduce the unpleasant effects of withdrawals.

Do your programs offer aftercare?

Yes, we will continue to support clients after they have completed treatment either by us or elsewhere by offering a wide range of aftercare programs, studies have shown that people have a much better chance of avoiding relapse if they are engaged in aftercare programs. Please get in touch to discuss the best aftercare options for yourself.

Is smoking permitted?

No, this is a medical facility and smoking is not permitted at all.

Do you treat trauma?

Yes, our staff are specially trained in trauma, grief/loss and attachment, we know very well the negative impact these can have on someone’s mental health which can then trigger alcohol/drug misuse and other negative behavioural health challenges. Among our treatment approaches to trauma is EMDR therapy which is very effective in easing and treating PTSD.

What is outpatient care?

utpatient care is less intensive than inpatient care. The patient will usually attend regular meetings with a consultant psychiatrist, counsellor, therapist or key-worker where they will be given similar treatments to those in an inpatient clinic. However, as the patient does not stay overnight, the cost of this care is less expensive.

Outpatient programmes consist of daily, weekly or monthly sessions. Because outpatient treatment requires less time in-attendance, the entire recovery programme generally lasts longer than inpatient care. While inpatient treatment typically lasts for a period of six to eight weeks, an outpatient programme can last many months.

Who is outpatient treatment suitable for?

Outpatient treatment is suitable for individuals who have been struggling with addiction but may benefit from a less intensive approach to recovery than inpatient care.

CRL staff are available to offer helpful advice and information on all types of addiction and the most suitable treatment options. If you would like a referral to a counsellor, therapist or consultant psychiatrist for outpatient treatment, call us today. We can also provide support and advice to the loved ones of those struggling with addiction, as well as information on the treatments we provide and how these can be accessed.

Our staff are compassionate and caring and will treat anything you discuss in the strictest of confidence. If you need advice on addiction, or simply need someone to talk to, please do not hesitate to call us.

Are your staff qualified?

All CRL staff are qualified for their specific roles with many years of experience in working in the addiction and mental health fields. In addition all our staff are always up to date with all their relevant training and registrations.


Our clinical team is happy to answer any questions or concerns that you may have.
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