What Is Spravato® Treatment? A Complete Guide for Patients
What Is Spravato Treatment?
What Is Spravato® Treatment? A Complete Guide for Patients
Depression can feel heavy and lonely. Many people try more than one antidepressant and still do not feel better. This is called treatment resistant depression. Spravato treatment offers a new path for people in this situation. It works differently from most antidepressants. It is given in a clinic with close monitoring. This guide explains Spravato in simple words so you know what it is, how it helps, and what to expect.
What Is Spravato Treatment
Spravato is the brand name for esketamine. It is a nasal spray used for adults with treatment resistant depression. It is also used with an oral antidepressant when a person has major depressive disorder with suicidal thoughts or actions. Spravato is not a daily pill. A clinician gives it in a medical setting. You spray it into your nose under supervision. Then you rest in the clinic while a trained team monitors you for a few hours.
Spravato vs ketamine
Ketamine is an older medicine used in hospitals for anesthesia and pain. Esketamine is a part of ketamine that has targeted effects. Spravato uses esketamine as a nasal spray. This gives controlled dosing and a set treatment plan. It is not the same as IV ketamine. It is also not a take home treatment.
How Spravato Treatment Works on the Brain
Most antidepressants act on serotonin, norepinephrine, or dopamine. They often take weeks to help. Spravato works on the glutamate system. It blocks NMDA receptors and opens pathways that help brain cells talk to each other in new ways. In simple terms, it helps your brain form healthier connections. Many patients feel relief in hours or days rather than weeks.
Think of your mood like a dimmer switch. Traditional medicines slowly raise the light. Spravato can flip the switch faster. You still need a full plan that includes therapy, healthy habits, and follow ups. Spravato is one part of that plan.
Who Spravato for Depression May Help
Spravato may be right for you if:
You tried at least two different antidepressants at proper doses and time.
You still have significant depression.
Your clinician believes a different approach could help.
You have major depression with suicidal thoughts and need faster symptom relief.
Spravato is always used with an oral antidepressant. It is not a stand alone cure. It supports a broader care plan. Your clinician will review your medical history, current medicines, and goals before starting.
Conditions Treated with Spravato
Treatment resistant depression in adults. You have had limited response to two or more antidepressants.
Depressive symptoms with suicidal thoughts or actions. Spravato can reduce symptoms quickly when time matters.
Spravato is not approved for every mood disorder. It is not for children. It is not for people who want a quick fix without monitoring. It is a serious medical treatment with a clear process.
Spravato Treatment Process Step by Step
1. Evaluation and planning
Your first visit includes a full assessment. We review your mental health history, medication trials, and medical conditions. We discuss benefits and risks. We also plan logistics such as transportation. You cannot drive after treatment on the same day.
2. Preparation before each session
Eat a light meal a few hours before.
Avoid heavy caffeine right before.
Take your regular medicines unless told otherwise.
Arrange a safe ride home.
Wear comfortable clothing.
Bring calming items like music and a sweater.
3. On the day of treatment
You arrive at the clinic. A clinician checks your vitals and answers questions. You use the Spravato nasal spray as guided. You then rest in a quiet, comfortable room. Staff monitor your blood pressure, pulse, and comfort. You remain in the clinic for at least two hours.
4. After the session
You may feel tired or spacey. Someone must take you home. Do not drive or operate machinery until the next day. Plan a calm evening. Many people prefer soft food, water, and low stimulation. Keep your schedule light.
Dosing Schedule for Spravato Treatment
Spravato follows a structured schedule. Your clinician personalizes the dose based on your needs and response.
Weeks 1 to 4. Usually two sessions per week.
Weeks 5 to 8. Often one session per week.
Week 9 and beyond. Maintenance sessions every one to two weeks as needed.
This plan can change. Some people need longer maintenance. Others can taper. Your mood, side effects, and goals guide the plan.
What You May Feel During a Spravato Session
Common experiences include:
Lightheadedness or dizziness.
Feeling detached or dreamy.
Changes in how you see or hear.
Nausea in some cases.
A sense of calm or relief.
These effects usually start soon after the spray. They typically fade the same day. Staff are present to support you. You can rest with dim lights and soft music. Many people bring headphones and a playlist.
Spravato Side Effects and Safety Monitoring
All medical treatments can have side effects. The most common with Spravato include:
Dizziness.
Nausea.
Increased blood pressure for a short time.
Feeling sleepy.
Feeling disconnected or dissociated.
Because of these effects, Spravato is given only in certified clinics with trained staff. Your blood pressure is checked before and after the spray. You stay in the clinic for observation. You leave only when it is safe.
Tell your clinician about any heart, liver, or blood pressure conditions. Share all medicines and supplements you take. Be honest about alcohol or substance use. Safety starts with a full picture of your health.
How Spravato Treatment Compares with Traditional Antidepressants
Both aim to reduce depression and improve daily life. They work in different ways.
Speed. Antidepressants often need weeks. Spravato can help in hours or days.
Mechanism. Antidepressants target serotonin or related systems. Spravato targets glutamate and NMDA receptors.
Setting. Antidepressants are taken at home. Spravato is given in a clinic with monitoring.
Plan. Spravato is used with an oral antidepressant. It is part of a combined plan, not a replacement for all other care.
Spravato is not better for every person. It is different. The right choice depends on your history, symptoms, and preferences.
Preparing for Your First Spravato Session
Set yourself up for a calm day.
Plan a ride home. Do not drive.
Eat light two to three hours before.
Bring water and a snack for later.
Wear comfortable clothes.
Create a relaxing playlist.
Clear your evening schedule.
Tell your clinician if you are anxious about the session. We can talk through it. Many patients feel more at ease after the first visit.
Life After Spravato Sessions
After each session, listen to your body. Rest if you feel tired. Hydrate well. Keep follow up appointments. Use the window of relief to support healthy habits.
Keep taking your oral antidepressant as prescribed.
Stay active with gentle movement like walking.
Maintain a regular sleep schedule.
Eat balanced meals.
Continue therapy to build coping skills.
Relief creates space to practice skills. Skills help the relief last.
Costs, Insurance, and Practical Planning
Costs vary by plan and coverage. Many insurers cover Spravato when criteria are met. Our team helps you check benefits and submit paperwork. Ask about prior authorization, copays, and out of pocket costs. Keep receipts and explanations of benefits. Financial planning lowers stress and helps you stay on track with care.
Myths and Facts About Spravato Treatment
Myth: Spravato is the same as at home ketamine.
Fact: Spravato is esketamine in a nasal spray. It is given in a clinic with monitoring and a specific protocol.
Myth: Spravato is a quick fix that replaces all other care.
Fact: It works with an oral antidepressant and a full care plan. Therapy and healthy habits remain important.
Myth: You will feel out of control.
Fact: You are in a safe, calm room with trained staff. Effects are watched closely and wear off the same day.
When Spravato May Not Be the Right Choice
Spravato may not fit every case. It may not be recommended if you have certain medical conditions, uncontrolled blood pressure, or specific risk factors. It is not for people who cannot attend clinic visits. It is not for people who plan to drive on treatment days. Your clinician will guide you based on your health and safety.
Practical Tips to Get the Most from Spravato Treatment
Keep all visits on schedule, especially in the first month.
Share how you feel after each session. Details help us tailor your plan.
Use a simple mood diary to track progress.
Plan gentle activities on treatment days. Avoid heavy tasks.
Ask a trusted person to check on you in the evening.
Small steps add up. Consistency matters. Your team is here to support you.
Frequently Asked Questions About Spravato Treatment
How quickly will I feel better
Some people feel changes within hours or days. Others need several sessions. Your oral antidepressant and therapy also support progress.
Can I work the day after a session
Many people return to normal activities the next day. Plan to rest on the evening after treatment.
Will I need Spravato forever
Not always. Some patients move to maintenance sessions every one to two weeks, then taper. Your plan is personalized.
Do I still need therapy
Yes. Therapy builds skills that support long term recovery. Medicines and skills work best together.
Is Spravato addictive
In a clinical setting with supervision and the right plan, safety is the priority. Your team monitors each step to reduce risks.
How to Decide if Spravato Treatment Is Right for You
Start with an honest review of your journey. Have you tried two or more antidepressants without enough relief. Are you open to a clinic based option with monitoring. Do you have support on treatment days. Talk to a clinician who knows Spravato well. Ask questions. Share your concerns. A clear plan brings confidence.
Helpful questions to bring to your appointment
What goals can Spravato help me reach in the next one to three months.
How will we measure progress.
What side effects should I watch for.
How will Spravato fit with my current medicines and therapy.
What is my schedule for sessions and follow ups.
Write your questions down. Bring a friend or family member if helpful. Your voice matters in every step.
Why Choose Evolve Psychiatry for Spravato Treatment
You deserve care that is clear, safe, and respectful. At Evolve Psychiatry, a clinician stays with you through evaluation, treatment, and follow up. We create a calm environment with private rooms, gentle lighting, and supportive staff. We coordinate with your therapist and primary care when needed. We also help with insurance steps so you can focus on healing.
We provide in person Spravato treatment at our clinics in New York and North Carolina. Visit us in Massapequa, Syosset, Albany, Garden City, and Hauppauge in New York. Visit us in Wilmington in North Carolina. We do not offer virtual sessions for Spravato because the treatment requires in clinic monitoring for your safety.
The Bottom Line on Spravato Treatment
Spravato treatment is a clinic based, FDA approved option for adults with treatment resistant depression. It works on a different brain system than most antidepressants. It can provide relief faster. It is given with careful monitoring and as part of a complete plan. The process is structured, supportive, and focused on safety. If you have tried standard options and still struggle, Spravato may open a new door.
Ready to talk
Reach out to Evolve Psychiatry to learn if Spravato fits your needs. Our team will listen, explain the steps, and help you plan your first visit. Your path forward can start today with one conversation.
Evolve Psychiatry offers in person care at six clinics across New York and North Carolina:
