What to Expect With Spravato Treatment

If you’re considering Spravato treatment, it’s normal to have questions about how it works, what the experience is like, and whether it might help. Spravato (esketamine) is an FDA-approved treatment for adults with treatment-resistant depression and for depressive symptoms associated with major depressive disorder with suicidal thoughts. It is different from traditional antidepressants and is offered in a structured, closely monitored clinical setting.

This guide walks you through what to expect before, during, and after Spravato treatment so you can feel informed and prepared.

What Is Spravato?

Spravato is a nasal spray form of esketamine, derived from ketamine, and used alongside an oral antidepressant. Unlike medications that can take weeks to work, Spravato acts on NMDA receptors in the brain and may lead to faster symptom relief for some people.

Because of how it works, Spravato must be administered in a certified medical clinic under supervision. It is not taken at home.

Who May Benefit From Spravato?

Spravato may be an option if you:
• Have tried two or more antidepressants without adequate relief
• Continue to experience severe depressive symptoms
• Have depression with suicidal ideation and need rapid intervention
• Are looking for a different approach after traditional treatments haven’t worked

A comprehensive psychiatric evaluation is required to determine whether Spravato is appropriate for you.

Before Your First Spravato Appointment

Before starting treatment, you can expect:
• A full psychiatric assessment and review of prior medications
• Insurance verification or discussion of self-pay options
• Education about benefits, risks, and alternatives
• Enrollment in the required safety monitoring program

On treatment days, you will be asked not to eat for at least 2 hours and not to drink liquids for 30 minutes before your appointment to reduce nausea.

What Happens During a Spravato Session?

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A typical Spravato visit lasts about two hours and follows a structured process:

1. Check-in and baseline assessment
   Your blood pressure and vitals are checked, and you’ll review how you’re feeling that day.

2. Self-administration of Spravato
   Under staff supervision, you administer the nasal spray yourself. This usually takes only a few minutes.

3. Observation and monitoring
   You’ll relax in a comfortable, quiet treatment room for at least two hours. During this time, staff monitor your blood pressure, safety, and overall response.

Common sensations during treatment may include:
• Feeling disconnected or “dream-like”
• Mild dizziness or lightheadedness
• Changes in perception or time awareness
• Sleepiness or deep relaxation

These effects are expected and usually fade before you leave.

1. Discharge
   Because Spravato can temporarily affect alertness, you will need a ride home. Driving is not allowed until the next day.

How Often Is Spravato Taken?

Most treatment plans follow this general schedule:
• Weeks 1–4: Two treatments per week
• Weeks 5–8: One treatment per week
• Ongoing maintenance: Every 1–2 weeks, depending on response

Your provider will tailor the schedule based on how you respond and how your symptoms change.

After Treatment: What to Expect

Many patients report improvement in mood, motivation, or clarity within the first few weeks, sometimes sooner. Others notice gradual changes over time. Spravato is not a cure, but for some people it can significantly reduce symptoms and improve daily functioning.

You may feel tired the rest of the day after treatment. Planning a light schedule, resting, and avoiding major decisions on treatment days is recommended.

Is Spravato Safe?

Spravato has been extensively studied and is FDA-approved, but it is carefully regulated. Possible side effects include:
• Temporary increases in blood pressure
• Nausea
• Dissociation
• Fatigue

This is why treatment only occurs in a certified medical clinic with trained staff and monitoring protocols in place.

Spravato at Nebraska Peace of Mind Behavioral Health

At Nebraska Peace of Mind Behavioral Health, Spravato treatment is provided in a calm, supportive, and trauma-informed environment. Our team focuses on safety, comfort, and individualized care. We work closely with you to determine if Spravato fits into your overall mental health treatment plan and continue to support you throughout the process.

If you’re struggling with depression that hasn’t responded to traditional treatments, you’re not out of options. Spravato may be a next step worth exploring.

Schedule a Consultation

If you’re interested in learning whether Spravato is right for you, contact our team to schedule a consultation. We’re here to answer your questions, review your history, and help you take the next step toward relief and stability.