During a Spravato® treatment session, you use an esketamine nasal spray in our office under supervision, then rest while our team monitors you for at least two hours before you go home with a ride. That is our short answer when patients ask, “What happens during a Spravato® treatment session?” This article covers each step, from preparation to the ride home.
Spravato® is an FDA-approved nasal spray that contains a medication called esketamine. We offer Spravato™ at our Vancouver and Lakewood offices. You do not take it home. Every dose is given at one of our offices.
Spravato® is used for depression that has not improved with antidepressants, often called treatment-resistant depression. It is also used for depression with suicidal thoughts. You can read more in our article on Spravato® & suicide. It is one option within our broader Depression Treatment services.
Esketamine works differently from standard antidepressants, which often take weeks to show an effect. Spravato® typically improves symptoms within 24 hours, and some patients notice relief even sooner. Our article on how Spravato® Spravato® vs antidepressants explains this in more detail.
Before your first dose, a provider reviews your history, past treatments, current medications, and overall health. Your provider decides with you whether Spravato® fits your needs. You can learn more about our providers and their backgrounds.
Arrange a ride home before your session, because you should not drive afterward. Your care team will give you instructions about eating and drinking beforehand, since some patients feel nausea during treatment. Wear comfortable clothes. Plan a quiet rest of the day rather than returning to work or busy errands.
Every patient’s experience differs slightly, but the steps below show the general flow of what happens during a session.
When you arrive, a member of our team asks how you have been feeling and checks your blood pressure. This gives your care team a starting point to compare against later in the session.
You use the nasal spray yourself while a member of our team watches and guides you. Depending on your dose, you may use more than one device, with a short rest in between. The spray itself takes only a few minutes.
After your dose, you relax in a comfortable chair. Our team checks on you and rechecks your blood pressure during this time. Many patients close their eyes, listen to calm music, or simply rest.
Plan for at least two hours in our office. Monitoring continues until your provider confirms you are ready to leave, so some visits run a little longer.
Common effects include dizziness, nausea, sleepiness, and a temporary rise in blood pressure. Some patients feel detached or “floaty,” as if they are watching themselves from a distance. These effects usually begin soon after the dose and fade during the monitoring period.
Some patients find the session calming. Others notice changes in how they sense time, sound, or their own body. Emotions may surface, and that is a normal part of treatment. Our team is there to help you feel settled.
You are never left to manage a session alone. Our clinical team stays close by during your dose and the full monitoring period. Staff watch for changes in alertness, comfort, and blood pressure.
Let staff know right away if you feel nauseated, anxious, or uncomfortable. Simple steps such as dimming the lights, resting quietly, or closing your eyes often help. If your blood pressure is elevated, your care team keeps checking it before you leave.
Before you leave, a member of our team checks how you feel and confirms that side effects have eased. You go home only once your provider decides it is safe.
Do not drive or operate machinery until the next day, after a full night of restful sleep. Avoid tasks that require full alertness for the rest of the day. Your provider may also review how Spravato® fits with your other medications through Medication Management.
A friend, family member, or arranged ride should take you home. Having someone with you for the rest of the day can also help you rest and feel supported.
The answer to “What happens during a Spravato® treatment session?” is a supervised dose in our office, a rest period of at least two hours, and a ride home. Our team monitors your comfort and blood pressure at every stage.
Contact your care team if side effects last into the next day or your mood worsens between sessions. If you have thoughts of suicide, call or text 988 right away. Veterans can dial 988 and then press 1 for the Veterans Crisis Line.
About the Author
Dr. Elia R. Gonzalez-Rodriguez
Take the First Step Toward Feeling Better
Dr. Elia R. Gonzalez-Rodriguez
October 20, 2026
