Sessions 2-12 and Beyond: What to Expect With Spravato:
The first Spravato session is often the most unfamiliar. After that, many people settle into a steadier rhythm. Sessions become more predictable, your nervous system learns what the environment feels like, and the real work becomes easier to see: noticing shifts, protecting the landing, and integrating changes into daily life.
Spravato can be a catalyst. It may create a shift in perspective, energy, or emotional burden that makes new choices possible. But the medicine is not the whole treatment. The real question is: what becomes more possible between sessions, and what will you do with that opening?
What sessions 2–4 often feel like
Many people report that the early phase is when:
The experience becomes less anxiety-provoking because it is familiar
Side effects feel more predictable
The “shift” can begin to show up as subtle relief rather than a dramatic moment
Some people notice changes quickly. Others notice that it is easier to do the things that help depression (getting outside, responding to messages, taking care of basics), even if mood is not fully improved yet.
What sessions 5–8 often look like
This is the phase where patterns start to matter:
Are mornings/nights any easier?
Is rumination quieter or shorter?
Are you getting small returns of motivation or interest?
Are you less emotionally flooded by stressors?
Are you turning to unhealthy habits less often?
This is also where integration makes the biggest difference. If your intention is “more self-compassion,” this is the moment to practice it in small, repeatable ways. Spravato can help shake the snow globe. Your daily actions help it settle into a new pattern.
Typical schedule shifts and what they mean
Spravato starts with two sessions per week for four weeks, then one session per week for four weeks. After that, many patients transition to a personalized maintenance schedule—weekly, every other week, or monthly—based on response and goals.
A taper is not a sign that you are “done.” It is a test of stability: can the gains hold as frequency decreases? If symptoms return, the schedule can be adjusted.
Consider tracking:
Sleep quality and consistency
Energy level
Rumination (how long you stay stuck, not just whether it happens)
Ability to complete basics (shower, food, errands, reply to family and friends)
Social connection (avoiding friends/family vs willing to see them)
Hopelessness (intensity and frequency)
Even small shifts matter. Depression often shifts in quiet ways first.
What if sessions feel different each time?
It is common for Spravato sessions to feel different each time. Some sessions feel lighter, some feel deeper, and some may feel like “nothing happened.” That does not automatically mean it is not working. Response can be gradual and not always a straight path, and it can be influenced by things like sleep, stress, nutrition, substance use, or a cold. It is also shaped by what you do after sessions—how you rest, what support you lean on, and how you integrate any shifts into daily life.
Integration: turning relief into new pathways
Integration is how you turn relief into new pathways. When depression lifts even slightly, you often regain access to choices that used to feel impossible—getting outside, returning a message, cooking real food, showing up to therapy with more capacity, setting a boundary, or starting one small task you have been avoiding. Those are the pathway changes. Spravatox can help you see the left turn; integration is choosing it, practicing it, and repeating it until it becomes part of your life.
Maintenance phase: what “beyond 12” often looks like
Beyond session 12, many patients continue on a maintenance schedule that matches their needs. Some stay weekly for a while. Some shift to every other week. Some stabilize with monthly sessions. The goal is not a perfect mood. The goal is steadiness, flexibility, and forward movement—and a plan that is sustainable.
Call Inner Journey Healthcare: 406-541-2012 for more information
Medical note: This blog is for education and is not medical advice. Ketamine and Spravato are not right for everyone, and treatment should always be guided by a qualified medical and behavioral health team.
