Spravato
SPRAVATO™ (Esketamine) is an innovative, FDA-approved treatment that has helped thousands of individuals struggling with treatment-resistant depression. Administered as a nasal spray under the supervision of a certified healthcare provider, SPRAVATO™ stands out because it can begin relieving symptoms of depression within hours—much faster than the weeks or months often required by traditional antidepressants.
What is SPRAVATO™?
SPRAVATO™ is an esketamine nasal spray used in combination with an oral antidepressant to treat treatment-resistant depression and Major Depressive Disorder (MDD). Unlike standard antidepressants, which work by increasing levels of naturally occurring brain chemicals such as dopamine, norepinephrine, glutamate, and serotonin, SPRAVATO™ acts through a different mechanism that may help restore balance and communication between brain cells. These neurotransmitters are vital for regulating mood and emotional stability, and when their function is disrupted, mood disorders can arise.
For more information, visit www.spravato.com.
Standard SPRAVATO™ Treatment Plan:
Month 1: Receive two treatments each week
Month 2: Reduce to one treatment per week
Month 3 and onward: Continue weekly sessions or move to every other week, based on your provider’s recommendation
What to expect from a Spravato session
A Spravato session combines medical monitoring with a relaxing environment.
After checking in, you’ll settle in while your provider reviews your symptoms, checks your blood pressure, and confirms any recent medications. You’ll then self-administer Spravato as a nasal spray under supervision. A mild metallic taste or lightheaded feeling is normal.
As the medication takes effect, you may feel relaxed, detached, or “floaty.” We provide dim lighting, aromatherapy, and music to help you stay comfortable while staff monitors you throughout.
As the effects wear off and you’ll begin to feel grounded again. Since you can’t drive until the next day, please arrange a ride home. Mild side effects like dizziness or fatigue usually fade within a few hours. Each session can feel different, and benefits often build over time.
Before Your Session
Pre-screening: Your provider will check your blood pressure, review your symptoms, and confirm you haven’t eaten or drunk too much recently (to reduce nausea risk).
Medication review: We will confirm any other medication you’ve taken that day to avoid interactions.
Preparation: You’ll sit or recline in our massage chair in our quiet room. We provide dim lighting, aromatherapy, blankets, and music as requested.
During the Session (about 2 hours total)
Administration (first few minutes): You’ll self-administer Spravato as a nasal spray under supervision. The medication absorbs over a few minutes, and you might taste a metallic or bitter flavor—this is normal.
Onset (within 5–15 minutes): You may begin to feel lightheaded, detached, or “floaty.” Some people describe mild visual distortions or a dreamlike state. Blood pressure and heart rate may temporarily rise, so staff will monitor these.
Peak (about 40 minutes): The dissociative effects are strongest. You might feel detached from your body or surroundings, notice changes in perception (sounds, colors, time), or experience euphoria, calm, or brief anxiety/confusion. You’ll remain in the clinic under observation the entire time.
Come-down (after ~1 hour): The intensity gradually fades, and you’ll start feeling more grounded. Some people nap or sit quietly; others journal or reflect on emotions or thoughts that surface.
After the Session
Transportation: You cannot drive until the next day. Arrange a ride home, have someone take you to the office, or we can schedule an Uber.
Side effects: Common temporary ones include dizziness, nausea, mild dissociation, or fatigue. These usually resolve within a few hours.
Integration: Some providers encourage you to discuss or process what came up during your session with a therapist later—it can help solidify benefits.
General Tips
Go in with an open mind and minimal expectations—each session can feel different.
Stay hydrated before and after (but avoid large meals right before).
Have a calm, low-stimulation evening planned afterward. Benefits often accumulate after several sessions, not just one.
Frequently Asked Questions
What is Treatment-Resistant Depression (TRD)?
In SPRAVATO™ clinical trials, treatment-resistant depression was identified in adults diagnosed with major depressive disorder (MDD) who did not respond adequately to at least two different antidepressants of appropriate dose and duration during their current depressive episode.
How is SPRAVATO™ Nasal Spray Different from Ketamine Infusion?
SPRAVATO™ (esketamine) CIII nasal spray is a derivative of ketamine and is FDA-approved for the treatment of treatment-resistant depression, as well as depressive symptoms in adults with major depressive disorder who have suicidal thoughts or actions. Ketamine, on the other hand, is not FDA-approved for treating depression. Both SPRAVATO™ and ketamine are classified as Schedule III controlled substances under the U.S. Controlled Substances Act.
What Personal Items Can I Bring to My Treatment Session?
You may bring personal items that help you feel relaxed and comfortable during your session. Many patients choose to bring headphones or a music player, a tablet or book to pass the time, and a blanket or small pillow for added comfort.
What Happens During the Observation Period After Taking SPRAVATO™?
After SPRAVATO™ is administered, you will enter an observation period where you can rest comfortably while being monitored by a healthcare provider. During this time, your provider will check your blood pressure periodically, observe for any side effects, and ensure you feel safe and supported before you are cleared to leave.
What Side Effects Could I Experience While on SPRAVATO™?
Some patients experience increased blood pressure, difficulty thinking clearly, or bladder problems. The most common side effects include feeling detached from yourself or your surroundings (dissociation), dizziness, nausea, sleepiness, spinning sensations, numbness, anxiety, low energy, vomiting, or feeling euphoric or “drunk.” Because nausea or vomiting can occur, it’s best to avoid eating for at least two hours and drinking liquids for 30 minutes before your treatment.
SPRAVATO™ can cause sedation, dissociation, and increased blood pressure. There is also a risk of misuse or abuse. If you experience sudden changes in mood, behavior, or thoughts — including suicidal thoughts — contact your healthcare provider immediately.
How Quickly Might I See Improvement in My Depression Symptoms?
In clinical studies, patients treated with SPRAVATO™ plus an oral antidepressant showed improvement in depressive symptoms as early as four weeks, compared with those taking a placebo nasal spray plus an oral antidepressant. Individual results may vary, and not all patients will respond to SPRAVATO™.
What Should I Tell My Healthcare Provider Before Starting SPRAVATO™?
Before starting treatment, tell your healthcare provider about your medical history and any medications, vitamins, or supplements you are currently taking. You should not take SPRAVATO™ if you have a blood vessel condition such as an aneurysm, an abnormal connection between blood vessels (arteriovenous malformation), a history of bleeding in the brain, or if you are allergic to esketamine, ketamine, or any of the ingredients in SPRAVATO™.
Be sure to inform your provider if you have heart, brain, or liver problems, a history of psychosis, or if you are pregnant, planning to become pregnant, or breastfeeding. SPRAVATO™ should not be taken during pregnancy or while breastfeeding.
