Spravato (esketamine nasal spray) is a prescription medication approved for adults with treatment-resistant depression (TRD), defined as not responding adequately to at least two oral antidepressant treatments. It is administered in a certified healthcare setting under medical supervision. Spravato is typically used in conjunction with an oral antidepressant, though it is also approved for monotherapy.
During the Session: Sensory and Perceptual Changes
During a Spravato treatment session, patients commonly report distinct sensory and perceptual alterations. These are primarily dissociative, meaning individuals may feel a sense of detachment from their body, thoughts, or surroundings, often described as “dream-like” or “floating.” Perceptions of time, space, and sound can also distort; for example, minutes might feel like hours, or sounds may seem distant or amplified.
These experiences are an expected part of the treatment and are closely monitored by healthcare professionals. The dissociative effects typically begin shortly after administration, peaking within 30 to 40 minutes. These acute effects are temporary and generally subside within the observation period. The healthcare team supports patients through these experiences, ensuring a safe environment as the effects manifest and diminish.
Physical Sensations and Side Effects
Beyond perceptual changes, patients may experience physical sensations and side effects during and immediately following Spravato administration. Dizziness is common, often accompanied by lightheadedness. Nausea is frequently reported, and some individuals may experience headache or fatigue.
Spravato can also cause a transient increase in blood pressure, which is carefully monitored before and after administration for patient safety. These physical effects are generally mild to moderate and managed by the healthcare team.
After the Session: Recovery and Lingering Effects
Following the acute phase of Spravato’s effects, patients enter a recovery period where they are observed for at least two hours. During this time, dissociative sensations gradually wear off, but individuals may still feel groggy, tired, or “out of it.” This lingering sedation is common as the medication is processed by the body.
Healthcare providers monitor patients to confirm sufficient recovery before discharge. A responsible adult must transport the patient home after the session. Patients are advised to refrain from driving, operating machinery, or engaging in other potentially hazardous activities until the day after treatment, following a restful night’s sleep.
Preparation and Environment’s Impact on Experience
The overall experience of a Spravato session is influenced by patient preparation and the treatment environment. Patients are advised to avoid food for at least two hours and liquids for 30 minutes before administration to mitigate nausea. Discussing current medications or health concerns with the healthcare provider beforehand contributes to a more informed and comfortable session.
A calm and quiet environment can significantly enhance comfort and help manage sensory input during the dissociative period. Many treatment centers offer options like listening to music or using eye masks, which can create a personal and soothing atmosphere. Feeling prepared and secure in the setting can help reduce anxiety and promote a more positive therapeutic experience.