What to expect at your first Spravato session

Before you arrive

See the Spravato hub, the coverage hub, the coverage checker, treatment comparisons and condition and treatment pages.

• No food for two hours and no liquids for 30 minutes before dosing, to reduce nausea.
• Take your usual oral antidepressant.
• Skip nasal decongestants that day; if you have a cold, tell the clinic.
• Arrange a ride. You cannot drive until the next day after a full night's sleep.

Arrival (0 to 15 minutes)

You sign the REMS enrollment form, review the consent, and the nurse checks your blood pressure. Readings above about 140/90 delay dosing until they settle.

Dosing (15 to 20 minutes)

You sit in a recliner. The nurse hands you the first device; you spray once in each nostril, then wait five minutes for the second device (and a third for the 84 mg dose). You do not sniff hard and should not blow your nose for the rest of the session.

Monitoring (20 minutes to 2 hours)

Within 15 to 20 minutes most people feel dissociation: detachment, a floating sensation, altered sense of time, sometimes vivid thoughts. It peaks at about 40 minutes and fades by 90. Sedation and nausea are common; dizziness on standing is why you stay seated. Blood pressure is rechecked at 40 minutes and before discharge. Bring headphones and an eye mask; many clinics dim the lights.

Discharge

After two hours, once the nurse confirms you are alert and blood pressure is back to baseline, you leave with your ride. Expect to feel tired that evening. Antidepressant effect, when it comes, is often noticed within the first week or two.

The schedule ahead

Two sessions a week for four weeks, then weekly, then every one to two weeks. Each visit is billed separately. See Spravato cost and the complete guide.