What to Do During Spravato Treatment: Your Complete Guide
August 10, 2025
If you’ve tried multiple antidepressants without finding meaningful relief, you’re not alone. For adults with treatment-resistant depression, Spravato offers a different choice: an FDA-approved breakthrough treatment that works differently than traditional medications.
Understanding what to expect before, during, and after your Spravato treatment can help with depression by making you feel more prepared and confident as you take this important step toward healing from major depressive disorder.
Key Takeaways
- Spravato targets NMDA receptors: Unlike traditional antidepressants that work on serotonin, Spravato increases glutamate levels to help create new neural connections, potentially providing faster relief.
- Sessions require 2-3 hours with monitoring: Each treatment involves nasal spray administration followed by a mandatory two-hour observation period in our clinical environment with vital sign monitoring.
- Specific preparation required: No eating 2 hours before treatment, arrange transportation (no driving for 24 hours), wear comfortable clothes, and avoid alcohol 24 hours before and after.
- Temporary side effects are common: Expect dizziness, nausea, sedation, mild dissociation, increased blood pressure, and anxiety during or shortly after treatment. Effects typically resolve within hours under our professional monitoring.
What Is Spravato?
Spravato (Esketamine) represents a significant advancement in treating treatment-resistant depression. This FDA-approved nasal spray offers hope to individuals who haven’t found adequate relief from two or more traditional antidepressants at an adequate dose and duration.
Unlike traditional treatments that can take weeks or months to show effects, Spravato works through a unique mechanism that can provide faster results in a safe, monitored clinical environment.
How Spravato Works
Spravato is meant as an alternative to treatment-resistant depression, because it works differently from traditional antidepressants.
Esketamine targets the brain’s NMDA receptors rather than focusing solely on serotonin pathways. When it targets these N-methyl-D-aspartate (NMDA) receptors, Esketamine helps create new neural connections and can restore brain plasticity that depression often disrupts.
The treatment blocks certain receptors in your brain and increases levels of glutamate, a neurotransmitter that plays a crucial role in learning, memory, and mood regulation. As a result, Spravato triggers a cascade of biological events that can lead to rapid antidepressant effects.
Spravato vs. Traditional Treatments
Traditional depression medication typically work by adjusting levels of neurotransmitters like serotonin, norepinephrine, or dopamine. While effective for many people, these medications can take four to six weeks to show full benefits and don’t work for everyone. Spravato offers a fundamentally different approach that can complement your existing treatment plan.
Unlike oral medications that you take daily at home, Spravato is administered as a nasal spray in a clinical setting under medical supervision. This ensures your safety while allowing healthcare providers to monitor your response and adjust treatment as needed. The clinical environment also provides additional support during your healing journey.
Rapid Onset
One of Spravato’s most significant advantages is its potential for rapid onset of effects. While other depression treatments often require weeks to show benefits, some patients experience improvements within hours or days of their first Spravato treatment. This faster timeline can provide much-needed hope and motivation to continue with treatment.
Clinical studies have shown that patients may experience meaningful improvements in depression symptoms within the first few treatment sessions. However, it’s important to remember that everyone’s response is unique, and some individuals may need several treatments before noticing significant changes.
Side Effects
As with any medical treatment, Spravato can cause side effects, though they’re generally manageable and temporary. The most common side effects include dizziness, nausea, sedation, mild dissociation, increased blood pressure, and anxiety.
These effects typically occur during or shortly after treatment and usually resolve within a few hours.
Your healthcare provider will carefully monitor you throughout your treatment session and for at least two hours afterward to ensure your safety and comfort. They’ll check your blood pressure and assess your overall health before allowing you to leave the clinic. This comprehensive monitoring system ensures that any side effects are promptly addressed.
Wondering if Spravato can work for you? Read more on our blog:
- Does Spravato help with depression?
- Does Spravato help with anxiety?
- How long does Spravato last?
- Can Spravato be taken at home?
- How does Spravato make you feel?
What to Do During Your Spravato Appointment
Your Spravato treatment appointment is designed to be as comfortable and stress-free as possible. At Marpa Minds, we make sure you are surrounded by a serene, supportive environment throughout your entire treatment.
Here are some pieces of advice we usually share with patients when they come to us:
Follow the Instructions
Your healthcare provider will give you specific pre-treatment instructions tailored to your individual needs. These guidelines are designed to ensure your safety and maximize the treatment’s effectiveness against depressive disorder.
Following these instructions carefully helps prevent complications and ensures you get the most benefit from your treatment. If you have questions about any instructions, don’t hesitate to contact your healthcare provider before your appointment. Clear communication helps ensure the best possible outcome and the highest possible success rate of the treatment.
Make Sure You Arrange for Enough Time
Plan to spend approximately two to three hours at Marpa Minds for each Spravato treatment session. This includes time for pre-treatment preparation, the actual nasal spray administration, and the required two-hour monitoring period afterward. Having adequate time prevents you from feeling rushed and allows you to fully focus on your treatment experience.
Consider clearing your schedule for the remainder of the day after treatment. While many patients feel fine after the monitoring period, some prefer to rest at home and avoid demanding activities. This approach supports your healing process and reduces any potential stress.
Fill in the Paperwork
Complete all required paperwork honestly and thoroughly. This documentation helps your healthcare team understand your current depressive symptoms, medication history, and any concerns you might have. Accurate information ensures you receive the most appropriate care and helps providers identify any potential interactions or contraindications.
Your paperwork may include mood assessments, side effect questionnaires, and updates about your overall health. Taking time to provide detailed, accurate responses helps your healthcare team tailor your treatment and monitor your progress effectively.
It is crucial to understand that every detail matters when it comes to your Spravato treatment session, from your blood pressure history to what treatments you’ve followed before and how your body reacted to them.
Administer Spravato
The Spravato nasal spray is administered under direct supervision of trained healthcare professionals. You’ll be guided through the proper technique to ensure you receive the correct dose. The process involves using the nasal spray device according to specific instructions, with rest periods between doses as directed by your provider.
Your healthcare team will explain each step and ensure you’re comfortable throughout the administration process. The actual medication delivery typically takes only a few minutes, but the careful, supervised approach ensures your safety and the treatment’s effectiveness.
Rest for a Couple of Hours
After receiving Spravato, you’ll rest in a comfortable, calm environment in our clinic for at least two hours, all while being monitored by our experts.
This monitoring period is essential for your safety and allows providers to observe how you respond to the treatment. Many patients find this time peaceful and use it for relaxation or quiet reflection.
The monitoring environment is typically designed to be serene and spa-like, promoting relaxation rather than feeling clinical or sterile. You’ll have access to comfortable seating or reclining areas where you can rest while your healthcare team keeps a watchful eye on your well-being.
Report Any Side Effects
Communicate openly with your healthcare team about any sensations, emotions, or physical effects you experience during and after treatment. Even minor changes are worth mentioning, as they help providers understand how you’re responding to Spravato and whether any adjustments might be beneficial.
Your healthcare team is trained to manage Spravato side effects and can provide immediate support if needed. Remember that experiencing side effects doesn’t mean the treatment isn’t working—many patients who benefit from Spravato do experience some temporary effects during their sessions.
Discuss with Your Healthcare Provider
Use your treatment appointments as opportunities for meaningful dialogue with your healthcare provider. Discuss how you’ve been feeling between sessions, any changes in your mood or symptoms, and any concerns or questions you might have. This ongoing communication helps optimize your treatment plan.
Your provider may adjust your treatment schedule, discuss complementary therapies, or change other aspects of your care, based on your progress and feedback. This may or may not include changes in dosage, sessions, or any other elements of your risk evaluation and mitigation strategy. Open communication ensures that your treatment remains personalized and effective.
Schedule Follow-up Appointments
The Spravato treatment process typically follows a specific schedule, with more frequent sessions initially and then maintenance sessions, as needed.
Stay consistent with your scheduled appointments, as regular treatment is often key to achieving and maintaining benefits. Your healthcare team will work with you to coordinate scheduling and handle any insurance requirements.
Consistent attendance helps maximize your treatment’s effectiveness and allows your healthcare team to monitor your progress accurately. If scheduling conflicts arise, communicate with your provider as early as possible to arrange alternative appointment times.
Extra Advice for Your Spravato Appointment
Here are some additional recommendations that can help you get the most from your Spravato treatment experience, while ensuring your comfort and safety throughout the process.
Avoid Eating For Two Hours Before the Treatment
Refrain from eating for at least two hours before your Spravato appointment to reduce the risk of nausea and vomiting during treatment. We recommend drinking clear liquids like water up to 30 minutes before your session. This fasting period is a standard safety precaution that helps prevent adverse effects during and after the administration.
If you have diabetes or other conditions that require regular meals, discuss this with your healthcare provider beforehand. They can help you develop a plan that manages your health needs while following safety protocols for Spravato treatment.
Dress Comfortably
Wear loose, comfortable clothing that allows you to relax easily during your treatment and monitoring period. Avoid tight or restrictive clothing that might become uncomfortable while resting. Comfortable attire supports your ability to relax and focus on the healing process rather than physical discomfort.
Consider layers that you can adjust as needed, since some patients experience temperature changes during treatment. Soft fabrics and comfortable shoes that are easy to remove can enhance your overall comfort during the session.
Wear an Eye Mask
Many patients find that wearing an eye mask or keeping their eyes closed helps them relax and focus inward during treatment. The reduced visual stimulation can make the experience more peaceful and allows you to concentrate on your breathing and inner experience. Some clinics provide eye masks, but you’re welcome to bring your own if you prefer.
An eye mask can also help if you experience any visual distortions during treatment, which are temporary side effects that some patients report. The darkness can feel soothing and help you remain calm throughout the session.
Listen to Calming Music
Soft, instrumental music or nature sounds can enhance relaxation during your Spravato treatment. Many patients find that calming audio helps them stay centered and peaceful throughout their session. You may bring your playlist or headphones, or our clinic can provide relaxing background music.
Choose music that you find genuinely soothing rather than energizing or emotionally intense pieces. The goal is to create a peaceful atmosphere that supports your healing process and helps you remain comfortable during treatment.
Focus on Your Breathing
Gentle, mindful breathing can help you stay relaxed and grounded during your Spravato session. Deep, slow breaths can reduce anxiety and help you maintain a sense of calm throughout the treatment process. Your healthcare provider may guide you through breathing techniques if you find this helpful.
Focusing on your breath also gives you something positive to concentrate on if you experience any temporary side effects. This mindfulness practice can enhance your overall treatment experience and support your emotional well-being.
Do Not Drive
You cannot drive or operate machinery for at least 24 hours after your Spravato treatment due to potential effects on your coordination and judgment. Arrange for someone to drive you to and from your appointment, or use ride-sharing services or public transportation. This safety precaution is essential and non-negotiable.
Plan alternative transportation in advance to avoid last-minute stress. Many patients find it helpful to have a trusted friend or family member accompany them, providing both transportation and emotional support during their treatment journey.
Go on with Other Therapies
Continue your ongoing therapy sessions, support groups, or other mental health treatments alongside Spravato. This comprehensive approach often provides the best outcomes, as different therapies can complement each other in supporting your recovery. Spravato works well as part of a broader treatment plan rather than as a standalone solution.
Communicate with all members of your mental health team about your Spravato treatment so they can coordinate care effectively. This collaboration ensures that all aspects of your treatment work together to support your healing and recovery.
Take Care of Yourself
Prioritize self-care and mental wellness between Spravato sessions by maintaining healthy habits that support your mental health.
This includes getting adequate sleep, doing some light exercise, ensuring you get plenty of nutrition from your meals, staying hydrated, and engaging in gentle relaxation techniques or meditation. Good self-care enhances your body’s ability to respond positively to Spravato..
Self-care also means being patient and compassionate with yourself throughout the treatment process. Healing takes time, and everyone’s journey is unique. Celebrate small improvements and remember that seeking help through Spravato demonstrates strength and self-advocacy.
Communicate with Your Healthcare Specialist
Maintain open, honest communication with your healthcare provider between appointments. Report any significant changes in your mood, sleep patterns, or overall well-being. Don’t hesitate to contact your provider if you have questions or concerns between sessions.
Your healthcare team is there to support you throughout your entire healing journey, not just during appointments. Building strong communication helps ensure you receive the most effective care and feel supported every step of the way.
Avoid Alcohol
Refrain from consuming alcohol for at least 24 hours before and after your Spravato treatment. Alcohol can interfere with the medication’s effectiveness and increase the risk of adverse effects. This precaution helps ensure your safety and maximizes your treatment’s potential benefits.
If you have concerns about alcohol use or need support managing alcohol consumption, discuss this openly with your healthcare provider. They can provide resources and support to help you maintain the lifestyle changes that support your recovery.
Improve Your Sleeping Schedule
Prioritize good sleep hygiene to support your mental health and enhance your response to Spravato treatment. Aim for consistent sleep and wake times, create a restful bedroom environment, and practice relaxing bedtime routines. Quality sleep supports your brain’s healing processes and overall well-being.
If you’re experiencing sleep difficulties, discuss this with your healthcare provider. Sleep problems and depressive symptoms often interconnect, and addressing sleep issues can enhance your overall outcomes. Your provider may offer specific recommendations to help improve your sleep quality.
More info: If you want to know how long Ketamine nasal spray lasts, click on the link to read our article about this to understand the length of the treatment, as well as how long the effects of Esketamine last in the body.
Conclusion
Spravato represents hope for individuals who haven’t found adequate relief through traditional antidepressants, like SSRIs or SNRIs.
When you understand what to expect and follow these guidelines, you can approach your treatment with confidence and focus on your healing journey.
Remember that your healthcare team is there to support you every step of the way, and open communication ensures you receive the most effective, personalized care possible.
Your decision to try Spravato demonstrates courage and commitment to your mental health. With the preparation, professional support, and self-care we provide at Marpa Minds, this FDA-approved treatment can be an important step toward the relief and recovery you deserve.
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