Starting a new depression treatment can bring questions, especially when you are unfamiliar with what happens during a Spravato session. Knowing how to prepare, what to expect, and what happens afterward can make the experience feel more manageable. Spravato, or esketamine nasal spray, is administered under medical supervision for adults with certain forms of depression.
Before beginning treatment, your provider will review your medical history, current medications, mental health concerns, and overall health to determine whether Spravato is appropriate. Blood pressure is assessed before administration because Spravato can temporarily increase blood pressure.
It is important to tell your provider about all prescription medications, over-the-counter medicines, vitamins, and supplements you take. Your provider can also explain the treatment schedule and answer questions about possible side effects.
Food and fluid intake should be planned around your appointment. Because nausea and vomiting can occur after administration, FDA prescribing information recommends avoiding food for at least two hours before treatment and avoiding liquids for at least 30 minutes beforehand.
If you use a nasal corticosteroid or nasal decongestant on a treatment day, the medication should generally be used at least one hour before Spravato. Follow your provider’s specific instructions regarding medications and preparation.
You should also arrange transportation in advance. Spravato may cause sedation, dizziness, or dissociation, so patients should not drive themselves home after spravato treatment.
Spravato session is administered as a nasal spray while you are in a certified healthcare setting under direct supervision. Your provider will explain how to use the device and oversee administration.
After receiving the medication, you remain in the treatment setting for observation. Blood pressure is reassessed at approximately 40 minutes and monitored as clinically appropriate. Respiratory status is also monitored for at least two hours, including pulse oximetry.
Some patients experience temporary sedation, dissociation, dizziness, or changes in attention and thinking. These effects are why supervised monitoring is an important part of treatment.
The observation period provides time for the medication’s immediate effects to decrease while your clinical team monitors your condition. You may want to bring something comfortable to read or listen to if your treatment setting allows it.
Try not to judge your treatment based on how you feel during the first session alone. Responses vary, and your provider will evaluate your progress over time.
Our Team can monitor your response during treatment and discuss any symptoms or concerns you experience. Communicating openly about how you feel can help your provider make informed decisions about your ongoing care.
You should plan for the remainder of your treatment day around rest and recovery rather than activities requiring full alertness. Because Spravato can impair attention, judgment, thinking, and coordination temporarily, patients should not drive or operate machinery until the following day after a restful sleep.
Your provider will determine when you are clinically stable enough to leave the treatment setting. If you do not meet the appropriate discharge criteria after two hours, monitoring may continue longer.
Dr. Michael Vines and the clinical team can help you understand what to expect throughout the treatment process and address questions about your individual response.
Preparing for your first Spravato session involves more than arriving for the medication. Following food and fluid restrictions, reviewing medications with your provider, arranging transportation, and allowing sufficient time for supervised monitoring can help you approach treatment safely.
Scottsdale TMS & Spravato provides supervised Spravato care as part of an individualized treatment approach. Understanding the process beforehand can help you arrive prepared, communicate your concerns, and have realistic expectations about your first session.
Dr. Vines has practiced psychiatry in Arizona for for over 25 years and has experience working with diverse populations that include children, adolescents, adults, geriatrics, SMI patients, and the chemically dependent.
September 10, 2026
