What Is a Spravato Session Like? Common Questions

A Spravato (esketamine) session at Staats Psychiatric Services is a structured, two-hour in-office appointment at our Cedar Park location, designed for safety and comfort. You self-administer the nasal spray under the direct supervision of a trained clinician, rest in a private space during a two-hour observation period, and leave with a pre-arranged ride once you are cleared. Understanding the process can reduce anxiety and help you get the most out of treatment.

Understanding Spravato Treatment

Before diving into session details, it helps to know the basics of this therapy. At Staats Psychiatric Services, we provide clear information so patients can feel confident and prepared.

What Is Spravato?

Spravato is the brand name for esketamine, a prescription nasal spray and a different form of the anesthetic medicine ketamine. It is FDA-approved for adults with treatment-resistant depression, and is only available through a restricted program at certified treatment centers like ours.

• Treatment takes place in our office, not at home, and not through telehealth

• Our team stays with you for structured observation and support throughout the visit

• Spravato is one part of care; we also provide medication management and therapy

• Many patients work with more than one of our providers so treatment stays coordinated

Who Is Spravato For?

Spravato is prescribed for adults diagnosed with major depressive disorder who have not responded adequately to at least two different oral antidepressant treatments. This condition is known as treatment-resistant depression.

• It is not a first step for every person who feels low

• A thorough psychiatric evaluation is required to determine if you are a candidate

• We see patients ages 10 and older for psychiatric care overall; Spravato itself is reserved for appropriate adults after a full review of history, current medicines, and treatment goals

• Our collaborative team of psychiatrists, nurse practitioners, and therapists assesses your treatment history and current needs

• Patients from nearby communities often come to Cedar Park to receive Spravato treatment in our office

How Does Spravato Work?

While traditional antidepressants primarily work on serotonin, norepinephrine, and dopamine, Spravato targets the N-methyl-D-aspartate (NMDA) receptor. By modulating glutamate, it is thought to help restore synaptic connections between brain cells that can be damaged by long-term depression, which can lead to a rapid reduction in depressive symptoms for some people.

• The medicine is delivered as a nasal spray during a scheduled visit, not as a daily pill you take on your own

• You remain in our office afterward so our team can watch how you respond

• It is often paired with ongoing medication management, therapy, or both

What to Expect During a Spravato Session

Each Spravato treatment at our clinic follows a structured protocol to ensure safety and consistency. The entire appointment lasts about two hours.

Arrival and Check-In

When you arrive at our Cedar Park office, you will be greeted and checked in. Staff confirm your appointment, your ride home, and any updates since your last visit, then guide you to a private, comfortable room.

• If this is your first Spravato day, we review the flow of the session again so nothing feels like a surprise

• The setting is meant for rest, not a crowded waiting room

• Our goal is boutique-style service with personalized local care

• Let us know if you need the lights lower, a blanket, or help contacting your driver later

Step One: Before the Dose

Before you administer the medication, a member of our clinical team will talk with you and check your blood pressure. This is a routine safety measure to ensure you are ready for treatment that day.

• We review how you have been feeling and confirm you have a driver

• Mention nausea, anxiety, poor sleep, or anything that feels off before dosing

• We will answer last-minute questions, even if you asked them at a prior visit

• We would rather hear concerns before dosing than after

Step Two: Administering the Medication (Nasal Spray)

The Spravato nasal spray device is designed for self-administration. Our provider will show you how to use the device correctly, and you will administer the prescribed number of sprays into your nostrils.

• Our team member will guide and supervise this process but will not administer the medication for you

• You do not take this medicine home, and you do not use it on your own between visits

• After the spray, you stay seated; effects can begin while you are still in the treatment space

• Our team remains nearby

Step Three: Relaxation and Monitoring

After you have used the nasal spray, the two-hour observation period begins. This is your time to relax; you can recline in your chair, listen to music, close your eyes, or rest quietly.

• Our clinical staff will monitor you and check your blood pressure periodically

• You are not asked to work, drive, or make important decisions during this period

• If you feel detached, dizzy, nauseated, anxious, or uneasy, say so immediately

• Monitoring is not a test you pass; it is how we keep the session safe

• Remain until the observation period is complete; do not plan to walk out early for another errand

Step Four: Clearing for Departure

At the end of the two-hour observation period, your provider will assess you to determine if you are ready to leave. They will check that initial side effects, such as sedation or dissociation, have resolved to a safe level.

• Once cleared, you can be picked up by your pre-arranged ride

• Do not drive, operate machinery, or return to work that requires alertness on a treatment day

• Follow after-visit instructions even if you feel “fine” in the parking lot

• Go home and rest

Sensations and Experiences During Treatment

The experience during a Spravato session is unique to each person and can vary from session to session. Most effects are temporary and occur within the first two hours of treatment.

• Some visits feel quiet; others feel more intense

• Effects are watched in real time, which is why this medicine is not sent home with you

Dissociation and Altered Perception

One of the most common experiences is dissociation – a sense of detachment from your body, your thoughts, or your surroundings. You might feel like you are observing yourself from a distance, that things around you seem unreal, or that sounds, your hands, feet, or breathing feel different from usual.

• This is a known effect of the medication and typically eases during the observation period

• It is one reason we keep you in a supervised space

• Tell our team what you notice rather than trying to push through in silence

Euphoria and Relief

Some patients report feeling calm, at peace, at ease, or even euphoric during the session. For those who have lived with the weight of severe depression, this can be a welcome feeling of relief.

• That feeling is not guaranteed, and it is not the only sign that treatment is working

• Relief may be subtle and may show up later as slightly better sleep, a bit more energy, or less stuck thinking

• We track change over a course of visits, not by a single dramatic moment

Hallucinations and Changes in Time Perception

It is possible to experience changes in your perceptions of shapes, colors, and sounds, and time may seem to speed up or slow down. These experiences are generally mild and are a temporary effect of the medication working in the brain.

• A few minutes may seem longer than they are

• These changes are part of why you stay for monitoring

• You are not asked to interpret or “figure out” these sensations

• If an image or sensation bothers you, say so; our team can help you stay oriented to the room, your breath, and the fact that you are safe in our office

Anxiety or Nausea

While many experiences are neutral or pleasant, some patients may feel a temporary increase in anxiety or experience nausea. Anxiety can rise at check-in, during the spray, or as sensations begin.

• Neither means you have failed the visit

• Let our monitoring staff know immediately; we are trained to help you manage these feelings

• We can adjust the environment, pause conversation, or support you through the feeling

• Do not wait until you are overwhelmed; speaking up is part of treatment, not a disruption of it

After Your Spravato Session

Care at Staats Psychiatric Services extends beyond the two-hour appointment. Post-treatment care and follow-up are integral parts of your overall plan.

Immediate Post-Treatment Care

For the remainder of the day after your session, you should not drive, operate heavy machinery, or engage in activities that require full mental alertness. Plan for a restful, quiet evening at home; the acute effects will wear off, but you may feel tired, groggy, foggy, or off balance.

• Go home with your driver and keep the rest of the day light

• Drink water if you were told you may; eat if you are hungry and your stomach feels settled

• Someone should be available if you feel sleepy or off balance; many patients nap or rest in a quiet room

Monitoring and Follow-Up Appointments

Spravato is a course of care, not a single visit. Your plan is personalized, typically with an induction phase of twice-weekly sessions for the first four weeks (the first month), followed by a maintenance phase of weekly or bi-weekly sessions.

• We continue to watch your mood, sleep, appetite, energy, and any side effects across appointments

• Follow-up may include medicine management, therapy, or both

• Because we offer these services together, you do not have to repeat your story in several unrelated places

• Your Spravato provider, medication manager, and therapist can all work together to monitor progress and adjust your comprehensive care plan

Safety and the Spravato REMS Program

Patient safety is the foundation of our Spravato treatment program.

REMS sets rules for who can receive treatment, where it can be given, and how patients are watched. It is the framework that keeps dosing in a controlled setting.

Why Is REMS Required?

The REMS program is required due to the potential for sedation, dissociation, misuse, and other short-term effects that need observation. It creates a closed system where the medication is tracked from the distributor to our certified facility and administered under professional supervision.

How the REMS Program Protects Patients

Treatment in a Certified Facility

Staats Psychiatric Services is a certified Spravato treatment center. Our facility and protocols meet the strict requirements for administering the medication safely.

• All treatments must occur in our office at our Cedar Park location

• You cannot take Spravato home or pick it up to use on your own

• Sessions include structure around check-in, dosing, and observation

Care from Trained Clinicians

Our team, including our psychiatrists and psychiatric mental health nurse practitioners, has been specifically trained in the administration and monitoring of Spravato. They know the session sequence, what to watch for, and when you are clear to leave.

• We understand the potential side effects and are prepared to provide support

• You are not left alone with the medicine or asked to manage the observation period yourself

Patient Enrollment and Monitoring

Every patient receiving Spravato must be enrolled in the REMS registry.

• Enrollment confirms that treatment is being given the right way

• Monitoring is how we see how you respond in real time, visit after visit

No Driving on Treatment Days

A core component of the REMS program is the requirement that patients have a safe plan to get home. No driving on treatment days is a safety rule, not a suggestion.

• Arrange a driver every time

• If your ride falls through, tell us before dosing

• We will not treat transportation as optional

Is Spravato Right for You?

Deciding on a new treatment for depression is a significant step. Spravato may be worth discussing if you are an adult with depression that has not responded enough to oral antidepressants.

• It may not be the next step if you have not had a full evaluation, cannot arrange a driver, or are looking for a home-based option

• Telehealth is available for other services we offer; Spravato is not one of them

• Fit also depends on your wider picture; depression often overlaps with anxiety, PTSD, or other mood symptoms

How to Get Started?

The first step is to schedule a comprehensive psychiatric evaluation with our team. During this appointment, one of our providers will review your medical history, past treatments, and current symptoms to determine if you are an appropriate candidate. Our collaborative model – medication management, therapy, and advanced treatments like Spravato – ensures you receive comprehensive support on your journey to wellness.

Conclusion

A Spravato session is a structured, closely monitored experience designed to help you feel supported from check-in through your ride home. While sensations such as dissociation, dizziness, or nausea can occur, your care team remains available throughout the observation period to monitor your response and answer questions. If you are considering Spravato for treatment-resistant depression, a comprehensive evaluation can help determine whether it may be appropriate for you.

At Staats Psychiatric Services in Cedar Park, our team provides coordinated medication management, therapy, and Spravato care to support you throughout your treatment journey.