What Is Spravato Treatment Actually Like?

If standard antidepressants haven't been enough, your provider may bring up Spravato — and the natural next question is what treatment actually looks like day to day. Here's the honest walkthrough.

Who is Spravato for?

Spravato is FDA-approved for adults ages 18 and up with treatment-resistant depression — meaning depression that hasn't responded adequately to standard antidepressants. Whether your depression "counts" as treatment-resistant is a conversation with your provider, not a checkbox: they'll review what you've tried, at what doses, and for how long. Because it's approved only for adults, patients must be 18 or older. The manufacturer's official patient information lives at spravato.com.

What happens at a Spravato visit?

Spravato is never taken at home. At each visit to one of our offices, you self-administer the nasal spray under the direct supervision of our clinical team, then stay for a required post-dose observation period while we monitor how you're doing. All told, plan on roughly two hours per treatment visit. Most patients settle into a comfortable chair, and many bring headphones or something low-key to pass the time.

During the observation window you may feel drowsy, dizzy, or briefly disconnected from your surroundings — that's expected, it's why the observation period exists, and it's monitored every time. Because of these day-of-dosing effects, you'll need someone to drive you home afterward. This entire structure is part of the federally required Spravato REMS safety program (spravatorems.com), which every certified treatment center follows.

How often will I come in?

A typical course of treatment looks like this:

• First month: treatment sessions twice a week.
• Second month: sessions step down to once a week.
• After that: you and your provider individualize the frequency based on how you're responding.

It's a real time commitment up front — two roughly two-hour visits a week for the first month — so it helps to plan work and rides around it before you start.

Do I keep taking my regular antidepressant?

Spravato can be used with or without an oral antidepressant, depending on your situation. Either way, Spravato doesn't replace the rest of your care: your provider continues managing your overall treatment — any oral medication, therapy, and follow-up visits — as one coordinated plan.

How should I prepare for treatment days?

• Arrange your ride home before you book the visit — it's required, not optional.
• Keep the rest of the day light. Plan to rest afterward rather than returning to driving, heavy machinery, or big decisions.
• Follow your care team's day-of instructions about eating and drinking beforehand; they'll go over the specifics with you before your first session.

How will I know whether it's helping?

The same way you know with any depression treatment: structured follow-up. Your provider tracks your symptoms across visits, compares them against where you started, and talks with you about what's changing — sleep, energy, mood, how much of the day depression is taking up. Response varies from person to person, which is exactly why the schedule after the second month is individualized rather than fixed. Be candid at every stage; the observation visits build regular check-ins into the treatment itself, so there's plenty of opportunity to speak up.

Does insurance cover Spravato?

Most plans cover Spravato for treatment-resistant depression, but nearly all of them require prior authorization — documentation of the antidepressants you've already tried. Our team handles that process with your insurer before treatment starts, and verifies your benefits so you know where you stand. You can read more about the treatment itself on our Spravato page, or start with a comprehensive evaluation to find out whether it's an appropriate option for you.

This article is for general education and isn't medical advice. For guidance about your own care, talk with your provider.