The Time Commitment for Spravato

Spravato (esketamine) is an FDA-approved, fast-acting nasal spray used alongside an oral
antidepressant to treat adults with treatment-resistant depression (TRD) or major depressive
disorder with acute suicidal ideation. Spravato is used alongside at least one oral
antidepressant medication. Administered in certified centers, it works by targeting the
glutamate system to improve mood, often within hours or days. The following is a description
of the treatment process and the time commitment needed.

It is recommended not to eat for 2 hours before and not to drink liquids for 30 minutes before
treatment. A healthcare provider checks the patient’s vitals (blood pressure and pulse) before
the session. The patient self-administers the nasal spray in both nostrils, usually spaced 5
minutes apart, while under supervision. The patient needs to stay at the clinic for 2 hours after
administration to monitor any problematic side effects, such as sedation or dissociation.

People often report a feeling of being detached from their bodies, or experiencing a dream-like
state. Common, temporary side effects of Spravato include:
− Dizziness
− Nausea
− Vertigo
− Increased blood pressure

Regarding the frequency of appointments, Spravato treatment involves a significant, multi-
month commitment, typically starting with twice-weekly sessions for 4 weeks, followed by once-weekly sessions for another 4 weeks, and then ongoing maintenance. Each session lasts approximately 2 hours for observation to ensure the patient’s safety. While the immediate side effects usually wear off within 2–4 hours, the patient must arrange for someone to drive them home, and they should not operate heavy machinery or work for the rest of the day. The medication is generally eliminated from the system within 24–48 hours.

Here are some key time commitment details:
− The induction phase (Weeks 1–4) has two sessions per week for 8 sessions total.
− The continuation phase (Weeks 5–8) has one session per week for 4 sessions total.
− The maintenance phase (Week 9+) has sessions typically occurring every 1–2 weeks
based on response, which can continue for months or years.

While some patients may feel relief within the first few weeks, the initial 8-week regimen is
designed to maximize long-term benefits. The total duration is highly individualized and
depends on the patient’s response to the treatment.

For more information on Spravato, check out our blog. For other questions or to make an
appointment, write to us on our website or call us at (585) 442-6960.