Spravato is an esketamine nasal spray used as part of treatment for certain adults with depression that has not improved enough with traditional antidepressants. Because it can cause temporary changes in alertness, perception, and blood pressure, Spravato is administered in a healthcare setting rather than taken independently at home. Understanding the possible side effects can help you feel more prepared for treatment.
Spravato affects the brain differently from conventional antidepressants, so some patients notice temporary sensations during or shortly after treatment. The most common side effects can include dizziness, sleepiness, nausea, increased blood pressure, a feeling of disconnection from surroundings, and changes in perception.
Not everyone experiences the same effects, and their intensity can vary from one treatment session to another. Some patients may notice only mild sensations, while others may feel more pronounced effects during the observation period.
These effects are generally temporary, which is one reason patients remain under professional supervision after receiving Spravato.
Dissociation is one of the effects patients may notice with esketamine. It can feel like being detached from your body, surroundings, thoughts, or emotions. Some people describe the experience as feeling dreamlike or as though their surroundings seem temporarily unfamiliar.
Although this sensation can be unusual, it is an expected potential effect of Spravato rather than necessarily a sign that something has gone wrong. The healthcare team monitors patients throughout the visit and can respond if symptoms become uncomfortable or concerning.
Knowing what dissociation may feel like before your first appointment can make the experience less surprising.
Yes. Dizziness and drowsiness can occur after Spravato administration. You may feel less alert than usual or have temporary difficulty standing and moving around comfortably.
For this reason, patients should not plan to drive themselves home after treatment. The treatment process includes a monitored recovery period so the clinical team can observe how you are responding before you leave.
At Scottsdale TMS & Spravato, Spravato treatment includes professional monitoring during the recovery period. This allows the team to watch for changes in alertness, blood pressure, or other temporary effects while you recover.
Spravato is not simply administered and followed by an immediate return home. The treatment process is designed around safety and observation.
After an appropriate evaluation, the medication is administered as a nasal spray under clinical supervision. Your response is then monitored during the observation period. Blood pressure and your overall condition may be checked as needed throughout the appointment.
You may experience some temporary effects during this period, including:
Because these effects can develop after administration, remaining at the clinic for observation is an important part of the spravato treatment process.
Most side effects associated with Spravato are temporary, but some reactions require medical attention. Increased blood pressure can occur, and significant changes in alertness or breathing need to be taken seriously.
Spravato also carries important safety considerations related to sedation and dissociation. Patients should provide their healthcare team with a complete medical history and information about medications or substances they use. Proper screening helps determine whether Spravato is appropriate and allows the team to plan treatment safely.
The goal of monitoring is not only to watch for common side effects but also to identify unusual or more serious reactions promptly.
The effects of Spravato generally occur around the treatment period and gradually wear off as the medication leaves your system. The exact experience can differ between patients.
Your first few sessions may also feel different from later treatments as you become more familiar with the process. Keeping your provider informed about what you experience can help the treatment team understand your response and make appropriate decisions about ongoing care.
Because Spravato can temporarily affect alertness and coordination, you should arrange transportation home and follow the specific instructions provided by your healthcare team after each appointment.
Knowing what to expect is one of the simplest ways to make Spravato treatment more comfortable. Follow your provider’s instructions before each appointment, disclose relevant medications and health conditions, and arrange transportation in advance.
Avoid treating the appointment like a routine medication visit where you can immediately return to your normal activities. Give yourself time to recover and follow the post-treatment guidance provided by your clinical team.
Dr. Michael Vines and the Our Team at Scottsdale TMS & Spravato can explain potential side effects, what monitoring involves, and what you can expect during your treatment sessions.
Spravato side effects may include dizziness, sleepiness, nausea, increased blood pressure, dissociation, and temporary changes in perception or alertness. These effects are why treatment is provided under professional supervision with a monitored recovery period. Understanding the process ahead of time can help you approach each appointment with greater confidence. Scottsdale TMS & Spravato can help determine whether Spravato is appropriate for your treatment plan and provide supervised care throughout the process.
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.
August 20, 2026
