Your First Visit: What to Expect With Spravato
If you are exploring Spravato (esketamine) for treatment resistant depression, the biggest barrier is often not motivation—it is uncertainty. What will it feel like? How long does it take? What do I need to do beforehand?
What Spravato is (in plain language)
Spravato is a nasal-spray form of esketamine used for treatment-resistant depression (when you have tried standard options and have not gotten enough relief). It is given in-office under a special safety program (REMS), with at least 2 hours of monitoring after dosing.
Who it can be a fit for
Spravato may be considered when:
Depression has not improved enough with previous treatments
You need a structured, medically monitored option
You want a plan that is consistent and protocol-based
(Your eligibility and safety fit are determined through an intake evaluation and medical screening.)
What a typical Spravato visit looks like
Most visits follow the same rhythm:
Arrival and quick check-in
We review how you are doing, and check basics like blood pressure.Self-administered nasal spray (supervised)
Spravato is self-administered in the office under direct observation. It is not taken at home.Rest and monitoring (plan for 2+ hours total)
Because Spravato can cause sedation/dissociation and other temporary side effects, you are monitored by a healthcare provider durning the session.
How it might feel
People commonly describe:
Feeling “floaty,” dreamlike, or disconnected (dissociation)
Sleepiness, dizziness, or nausea
A quieter mind, emotional distance, or a sense of perspective
These effects are why the monitoring period exists.You cannot drive the same day. Plan for someone to drive you home, and do not drive or operate machinery until the next day after a restful sleep. Some people feel tired or “tender” after. You may go to school or work. Just no driving.
How to prepare
Have no food for 2 hours prior to your appointment.
No caffeine for 4 hours prior to appointment
No nasal sprays 2-4 hours before your sessions or you may be over sedated from the Spravato.
You will need a driver, you cannot drive the remainder of the day. You may walk but no bikes.
Arrive 5 mins early. You can expect to be at the appointment for 2 full hours.
Download music and bring headphones or EarPods. We will have you put the phone in airplane mode so it’s important to download music before appointment.
Bring a journal or coloring book, if desired.
Watch the following video to learn how to take the medication.
Wear comfortable clothing
Think of 1–2 gentle intentions (not goals): “I want a little relief” is enough.
How often is treatment?
Spravato begins with two sessions per week for the first four weeks, then shifts to one session per week for the next four weeks. After this initial eight-week phase, many people move into a personalized maintenance schedule—often weekly, every other week, or monthly—based on symptoms, goals, and response to treatment.
A note on support and integration
Even though Spravato is a medication protocol, outcomes tend to improve when your life has support around it—therapy, coping skills, and a plan for what you do with the relief once it shows up. We focus on helping patients leave each visit grounded and oriented, not just “done with an appointment.”
Next step: How to know if it is right for you
If you are curious, the next step is a consultation and screening to confirm fit, safety, and insurance logistics. You do not need to be “sure” to reach out—you just need enough curiosity to ask questions.
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.
