What to Expect at Your First Spravato Session

You've heard about Spravato. Maybe your provider brought it up. Maybe you read about it online at 2am when you couldn't sleep, looking for something anything that might actually work.

Either way, you're here. And you're wondering: what does this actually look like?

That's a completely reasonable question, and we want to answer it as clearly and honestly as we can because walking into something unknown is hard enough without the added anxiety of not knowing what to expect.

At Telepsych 4 You in New Mexico, we want you to feel informed before you ever walk through the door.

First: What Is Spravato?

Spravato is the brand name for esketamine a medication derived from ketamine that comes in nasal spray form. It was approved by the FDA specifically for adults with treatment-resistant depression (TRD) meaning depression that hasn't responded to adequate trials of at least two different antidepressants.

It's also approved for adults with major depressive disorder (MDD) who have active suicidal ideation or behavior.

Here's what makes it different from the antidepressants you may have already tried:

Traditional antidepressants SSRIs, SNRIs, and others work primarily on serotonin, norepinephrine, or dopamine. They take weeks to start working. For many people, they work well. But for a significant portion of people with depression, they don't.

Spravato works on a completely different pathway. It targets glutamate receptors in the brain specifically NMDA receptors and can produce changes in brain function that begin working much faster. Some patients notice effects within hours. For others it takes multiple sessions. But the mechanism is fundamentally different from what most people have tried before.

It is not a standalone treatment. Spravato is used alongside an oral antidepressant, not instead of one. And it is not something you take home and administer yourself it is given in a certified healthcare setting, under supervision, every single time.

The Week Before Your Session

Leading up to your first Spravato appointment, there are a few things to know and prepare for:

You should not eat for at least two hours before your session and should avoid drinking liquids for at least thirty minutes before. A full stomach can increase the risk of nausea during the session.

You will need a driver. You cannot drive yourself home after a Spravato session this is a firm requirement, not a suggestion. Plan for this in advance. A family member, a friend, a rideshare that someone else books whatever works for you, but plan it ahead of time.

Let your provider know about any other medications you're taking. Some medications can interact with esketamine, and your care team needs the full picture.

The Day of Your First Session

You'll arrive at our office and check in. The environment is calm and private. This is not a clinical, sterile, intimidating space it's designed for exactly what it is: a therapeutic experience that requires you to feel safe.

Your care team will go over what to expect one more time, answer any last-minute questions, and get you settled in a comfortable space.

You will self-administer the nasal spray your provider will walk you through exactly how to do this. It's simple, and you're not doing it alone.

After the spray, the monitoring period begins. You will stay in our office for two hours. This is standard protocol, required by the FDA, and it's there for your safety. You're not just sitting there waiting for time to pass your provider is present and available throughout the entire session.

What You Might Feel

This is the part that people are most curious and sometimes most anxious about.

The most common experience during a Spravato session is dissociation. This sounds scary, but in this context it typically means a sense of detachment from your surroundings things might feel a little dreamlike, distances might seem different, time might feel altered. It is temporary, it is expected, and it is part of how the medication works.

You might also experience:

• Dizziness or lightheadedness usually mild and brief
• Nausea also typically mild; your provider will have tools to help if needed
• Changes in perception colors might seem more vivid, sounds might seem different
• Emotional responses some people feel tearful, some feel peaceful, some feel a strange kind of clarity

No two people experience Spravato sessions identically. Some people feel dramatically different after their first session. Others notice changes more gradually over multiple sessions. Your care team will check in with you throughout and debrief with you before you leave.

The Monitoring Period and Going Home

During the two hours after administration, you'll be in a comfortable, private space. You can rest. Some people journal. Some people simply sit with what they're experiencing.

Your provider will check in with you, monitor your blood pressure (which can increase during the session), and make sure you're stable before you're discharged.

When you're ready to leave with your driver your provider will give you guidance on the rest of the day. Plan for a low-key evening. Not because something is wrong, but because your brain has been through something and it deserves the space to integrate.

Is It Worth It?

For the right patient, Spravato can be genuinely life-changing. We've seen people who had given up on getting better have real, meaningful, lasting responses to this treatment.

It is not a guaranteed fix. It is not right for everyone. And your provider will be honest with you about whether you're a good candidate.

But if you've been trying and not getting better if you've been wondering if there's anything left to try this is worth the conversation.

We'll walk through everything together. You don't have to figure this out alone.