Spravato Treatment: What to Expect at Your First Session
Starting a new treatment can come with plenty of questions, especially when you are not sure what the experience will be like. If your healthcare provider has recommended Spravato (esketamine) nasal spray for treatment-resistant depression, knowing what to expect when you start the session can make your journey easier.
A qualified medical professional administers Spravato in a supervised healthcare setting. Unlike many antidepressant medications that can be taken at home, Spravato must be received at an authorized treatment center, where you will remain for a period of monitoring after treatment.
Here is a step-by-step look at what you can expect during your first Spravato treatment.
Before Your First Spravato Treatment
Before you begin treatment at a Spravato treatment center, your healthcare provider will review your medical history, current medications, mental health history, and previous depression treatments. Your provider may also discuss your blood pressure and other medical considerations to determine whether Spravato is appropriate for you.
Spravato has specific safety requirements, and treatment must be provided through the SPRAVATO REMS (Risk Evaluation and Mitigation Strategy) program. Your provider should also explain what you should and should not do before your appointment.
What Should You Do Before Your Appointment?
Your treatment center will give you specific instructions, but patients are generally advised to follow certain preparation guidelines.
Avoid Eating for a Period Before Treatment
The prescribing information recommends avoiding food for at least two hours before Spravato administration and avoiding liquids for at least 30 minutes before administration. Your provider can guide you further based on your circumstances.
Plan for Transportation
One of the most important things to plan for is how you will get home.
Spravato can cause sedation and can temporarily affect your thinking and judgment, attention span, reaction speed, etc. You should not drive or operate machinery until the next day after a restful sleep, according to the prescribing information.
Arrange for transportation rather than planning to drive yourself home after treatment.
Wear Comfortable Clothing
You may spend a couple of hours at the treatment center, so comfortable clothing can make the experience more relaxing.
You may also want to bring headphones, a book, or another quiet activity for your observation period, if your treatment center permits them.
Step 1: Checking In
When you arrive, your healthcare team will check you in and review any relevant changes in your health or medications.
Your blood pressure will typically be checked before treatment because Spravato can temporarily increase blood pressure.
Your provider may also discuss how you are feeling and answer any pending questions you have about the session. This is a good time to mention anything that could affect your treatment, including new medications, recent health changes, or unusual symptoms.
Step 2: Receiving Your Spravato Dose
Your Treatment Resistant Depression treatment, Spravato is administered as a nasal spray.
Your healthcare professional will explain how to use the device and supervise the administration. The prescribed dose depends on the treatment plan established by your provider. Once you have received your medication, the observation period begins.
Step 3: The Monitoring Period
After receiving Spravato, you remain at the treatment center while the healthcare team monitors you.
Patients must be monitored for at least two hours after administration.
During this time, your healthcare provider or treatment team may monitor your blood pressure and assess how you are feeling.
The reason for the observation period is that Spravato can cause temporary effects such as:
- Sleepiness or sedation
- Dissociation
- Dizziness
- Nausea
- Vertigo
- Increased blood pressure
- Anxiety
- Feeling intoxicated
Not everyone experiences these effects, and the intensity can vary from person to person.
What Does Dissociation Feel Like?
One term you may hear when discussing Spravato is dissociation.
Dissociation can involve a temporary feeling of being disconnected from your surroundings, your body, or your normal sense of time and perception.
The experience varies considerably between people. Some patients may notice changes in their awareness or ability to perceive things, while others may experience little or no dissociation.
If you experience anything unusual or uncomfortable during treatment, let your healthcare team know. They are there to monitor you and help you remain safe and comfortable.
How Long Will My First Spravato Appointment Take?
Although the medication itself is administered relatively quickly, your appointment includes preparation, administration, and a monitoring period.
Plan to spend at least two hours at the treatment center after receiving Spravato, with additional time potentially needed for check-in and preparation.
Your provider will determine when you are ready to leave based on your clinical condition.
Because you should not drive until the day after you get a full night’s sleep, plan your arrangements accordingly.
Will I Feel Better After My First Treatment?
It is natural to wonder whether you will notice a difference immediately.
Responses to Spravato treatment for depression vary from person to person. Some people may notice changes relatively early in treatment, while others may require additional sessions before evaluating their response.
Your healthcare provider will monitor your symptoms over time to determine whether the treatment is helping and whether continuing treatment makes sense for you.
Don’t judge the entire treatment based solely on how you feel after your first session.
How Often Will I Need Spravato Treatments?
For adults receiving Spravato for treatment-resistant depression, the FDA-approved treatment schedule generally begins with treatments twice a week during Weeks 1–4.
If treatment continues, the frequency typically decreases to once weekly during Weeks 5–8. Beginning in Week 9, treatment may be administered once weekly or once every two weeks, depending on the patient’s response and tolerability.
Is Spravato Treatment Safe?
Spravato has important safety considerations and is subject to a restricted distribution and monitoring program.
The FDA prescribing information includes a boxed warning concerning risks such as sedation, dissociation, respiratory depression, and abuse and misuse. Spravato can also temporarily increase blood pressure.
This is why Spravato must be administered in an appropriate healthcare setting with monitoring rather than being used independently at home.
Your healthcare provider will discuss the possible benefits and risks with you before treatment.
Tips for Making Your First Session More Comfortable
A little preparation can make your first appointment feel less stressful.
Consider:
- Arranging transportation ahead of time.
- Following your provider’s instructions about food and liquids before treatment.
- Wearing comfortable clothing.
- Bringing something quiet to do during the observation period, if permitted.
- Writing down questions you want to ask your provider.
- Letting your treatment team know how you are feeling throughout the appointment.
- Keeping the rest of your schedule relatively flexible after your first treatment.
Your First Spravato Session: The Bottom Line
Your first Spravato treatment may look unfamiliar, but knowing the process ahead of time can make the experience easier to navigate.
You will check in, have your health and blood pressure assessed, receive Spravato under professional supervision, and remain at the treatment center for monitoring for at least two hours. Because Spravato can affect alertness, judgment, and coordination, you will need transportation and should not drive until the next day after a restful sleep.
Most importantly, Spravato treatment is not a one-size-fits-all approach. Your healthcare provider will monitor your reaction and determine the treatment plan that is appropriate for you.
If you are considering Spravato for treatment-resistant depression, speak with our expert medical professional at Torii to determine whether it may be an appropriate option for you.
