For someone considering this treatment, uncertainty about the appointment itself can feel almost as heavy as the depression that led them to seek help. Understanding what happens during Spravato sessions can replace some of that uncertainty with a clear, manageable plan. Each visit is structured around comfort, clinical monitoring, and giving your mind and body time to respond safely.
Spravato is the brand name for esketamine, a prescription nasal spray used alongside an oral antidepressant for certain adults with treatment-resistant depression. It may also be prescribed in specific circumstances for adults with major depressive disorder and acute suicidal thoughts or actions. It is not a take-home medication. Sessions occur in a certified healthcare setting because the medication can temporarily affect alertness, perception, blood pressure, and coordination.
Before Your First Spravato Appointment
Spravato treatment begins with a thorough psychiatric evaluation rather than a quick prescription. Your clinician reviews your depression symptoms, treatment history, current medications, medical conditions, and goals for care. This step helps determine whether Spravato is an appropriate option and how it may fit with therapy, medication management, and other supports.
The conversation also includes practical planning. Because you cannot drive, operate machinery, or ride a bike until the next day after a restful night’s sleep, you will need a reliable ride home after every session. This is a nonnegotiable part of safe treatment, even if you feel alert before leaving.
Your care team will give you individualized instructions before the appointment. Many patients are asked to avoid food for about two hours and liquids for about 30 minutes beforehand to reduce the chance of nausea or vomiting. Follow the instructions you receive, especially if you take medications or have health conditions that may affect your preparation.
What Happens During Spravato Sessions
A Spravato visit usually lasts at least two hours, often a little longer when check-in or follow-up needs more time. The pace is intentionally unhurried. You are not expected to push through the experience alone or immediately return to a busy day.
Check-in and safety screening
At the start of the session, a member of the clinical team checks in on how you have been feeling since your last visit. They may ask about changes in mood, sleep, anxiety, side effects, medications, alcohol or substance use, and any new medical concerns.
Your blood pressure is checked before dosing. Because Spravato can temporarily raise blood pressure, the clinician needs to confirm that it is safe to proceed that day. If your reading is elevated or you are not feeling well, the team may repeat the measurement, adjust the plan, or postpone treatment. That decision is not a setback. It is careful medical oversight.
Taking the nasal spray
Spravato is self-administered under a clinician’s supervision. The care team explains how to use the nasal spray device and guides you through the process. Depending on your prescribed dose, you will use more than one device, with a short rest period between devices.
The spray itself is brief. Some people notice an unpleasant taste in the throat, nasal discomfort, or mild irritation. Sitting upright, taking slow breaths, and using water only when your clinician says it is appropriate can help. Let the team know if you have congestion, nausea, or trouble using the device. Small adjustments in comfort and timing can make future sessions easier.
The observation period
After dosing, you remain at the clinic for monitoring for at least two hours. This is the central part of the appointment. You can rest in a quiet, supervised space while the medication’s short-term effects wear off.
Many people feel sleepy, relaxed, detached from their usual surroundings, or slightly unsteady. Some experience dissociation, which may feel like being less connected to their body, thoughts, time, or environment. Others describe visual changes, a floating sensation, or thoughts that feel unusually distant. These effects can be unsettling if they are unexpected, but they are generally temporary and are one reason in-clinic monitoring matters.
Your clinician or staff member checks on you throughout the session and measures your blood pressure again about 40 minutes after dosing, as well as at other times when clinically appropriate. You are encouraged to speak up about anything you notice, including anxiety, nausea, headache, dizziness, or emotional discomfort. There is no need to minimize a symptom or worry about saying the “right” thing. Honest feedback helps your team tailor care to you.
People spend this time differently. Some prefer quiet, an eye mask, or calming music. Others simply sit, rest, or journal a few words afterward. Deep emotional processing is not required during the appointment. If an experience brings up difficult thoughts or feelings, your clinician can help you feel grounded and discuss whether therapy support would be useful alongside treatment.
What the Rest of the Day May Feel Like
By the time you are cleared to leave, you should be stable enough to go home with your arranged ride. Still, it is common to feel tired, mentally slowed, or more sensitive to stimulation for the remainder of the day. Plan for a low-demand evening whenever possible.
Avoid driving, making major decisions, drinking alcohol, or doing tasks that require sharp coordination or judgment. Rest, eat as tolerated, hydrate, and allow yourself time to settle. Many patients find it helpful to let a trusted family member know that they have had treatment, especially for early appointments when they are learning how their body responds.
The next day, after a full night of sleep, most people can return to their usual activities if they feel well. If side effects continue, worsen, or concern you, contact your prescribing team for guidance rather than trying to manage the issue alone.
How Often Are Sessions Scheduled?
The schedule depends on why Spravato is being prescribed, how you respond, and your clinician’s treatment plan. For treatment-resistant depression, the early phase commonly includes twice-weekly sessions for several weeks, followed by weekly sessions and then less frequent maintenance visits when appropriate.
This schedule can sound demanding, particularly for people balancing work, parenting, school, or transportation needs. That is a real trade-off to consider. At the same time, the repeated contact creates opportunities for close monitoring, medication adjustments, and conversations about whether symptoms are improving in daily life, not just on a rating scale.
Response is individual. Some people notice a shift in mood, motivation, or hopelessness relatively early. Others need more time, and some may determine with their clinician that Spravato is not the right fit. It is best viewed as one component of a personalized depression treatment plan, not a replacement for therapy, supportive relationships, healthy routines, or ongoing psychiatric care.
Common Questions About Spravato Appointments
Will I be asleep during treatment?
No. Spravato is not anesthesia, and most people remain awake. You may feel drowsy or less connected to your surroundings for a period of time, which is why you stay in the clinic under observation.
Can someone stay with me?
Clinic policies and your individual needs may guide this decision. Some patients feel reassured by having a support person available, while others prefer a quiet, private setting. Ask your care team what is possible and what would best support your comfort.
Is Spravato appropriate for teens or children?
Spravato is approved for adults, not children or adolescents. For younger patients with depression, anxiety, ADHD, emotional regulation concerns, or other behavioral health needs, a comprehensive evaluation can clarify developmentally appropriate therapy, psychiatric, school-based, and family supports.
What if I feel anxious during the observation period?
Tell the clinician or staff member right away. Anxiety can be addressed with reassurance, grounding strategies, a quieter environment, and clinical assessment. You do not need to wait until the session ends or assume that discomfort is something you must handle by yourself.
Starting Spravato can feel like a significant step, especially after depression has not improved with previous treatments. A well-run session gives you more than a medication dose: it provides a monitored setting, a team that listens, and time to notice what helps you move together toward a healthier you.
