Key takeaways:
Spravato (esketamine) is a nasal spray that treats severe or treatment-resistant depression. You’ll administer Spravato treatments in a healthcare setting and be observed for at least 2 hours after your dose. It’s not safe to use Spravato on your own without medical supervision.
Avoid eating for at least 2 hours before and drinking liquids for at least 30 minutes before Spravato treatments to reduce the chance of nausea and vomiting. Wear comfortable clothing and bring music or activities that help you feel at ease to treatments.
Arrange to have someone drive you home after your Spravato treatments. After you receive Spravato, you may feel dizzy, drowsy, or disconnected from your thoughts for the rest of the day. Avoid alcohol and allow yourself to rest and relax until after you’ve had a full night’s sleep.
There are ways to save on Spravato. A manufacturer savings card can help you get Spravato for as little as $10 per treatment if you’re eligible. There’s also a patient assistance program available.
Spravato (esketamine) is a prescription nasal spray that treats severe or treatment-resistant depression. But it’s not a medication you take on your own at home. Instead, you'll receive Spravato treatments in a healthcare setting.
Even though you’ll be using this medication at your prescriber’s office, there are a few things you should know before you start treatment. This includes what to do before and after receiving Spravato. Below, we review eight tips to help you get the most out of your Spravato treatments.
1. Avoid eating and drinking before your Spravato treatments
Nausea and vomiting are common Spravato side effects. To help reduce the risk of these side effects and help you feel more comfortable, it’s recommended to limit food and liquids leading up to your Spravato appointments. You should avoid eating for at least 2 hours before each Spravato treatment session. You should also avoid drinking liquids at least 30 minutes before each session.
2. Blow your nose before administering Spravato nasal spray
During each treatment session, blow your nose just before your first dose of Spravato. This helps make sure your nasal passages are clear so the medication can get into your system properly.
If you need to use more than one Spravato device to get your full dosage, you’ll need to wait 5 minutes in between doses. But you shouldn’t blow your nose before any doses other than your first one.
You also shouldn’t blow your nose after using Spravato to avoid losing any medication. If you feel any liquid dripping out of your nose, just dab it away gently with a tissue.
Good to know: If you use a steroid nasal spray such as Flonase (fluticasone) or a decongestant nasal spray such as Afrin (oxymetazoline), use it at least 1 hour before your Spravato treatment.
3. Only administer Spravato in the presence of a medical professional
It’s not safe to use Spravato on your own without medical supervision. In fact, Spravato has a Risk Evaluation and Mitigation Strategy (REMS) program that ensures it’s used as directed. Both you and your prescriber are required to enroll in the Spravato REMS program in order for you to receive Spravato treatments.
Spravato is only approved for use in a healthcare setting. This means that you’ll go to a medical facility to receive and administer your doses. The medical staff at the facility will monitor you during and at least 2 hours after treatments. And they’ll let you know when it’s OK to leave the facility.
This may sound excessive, but it’s for your safety. Spravato can affect your cognition and alertness. In rare cases, it can cause you to see things that aren’t there or feel intense emotions. Spravato can also raise your blood pressure and slow down your breathing. Having a healthcare professional nearby ensures that, if any serious side effects occur, you’ll receive prompt medical attention.
4. Bring comfort items to your Spravato treatments to help pass the time
It may be helpful to bring some comfort items with you to your Spravato treatment sessions. Keep in mind that you’ll be at the appointments for at least 2 hours after receiving the medication. And a calm state of mind may help lessen negative side effects from Spravato. So think about things that help you relax and feel comfortable and safe. This might include:
Headphones and a device to listen to music
A book or magazine to read
A tablet to play games on
Crossword puzzles, sudoku, or word searches
A knitting or crocheting project
A comfortable neck pillow, blanket, and cozy pair of socks or slippers
It’s also a good idea to wear loose, comfortable clothing to your Spravato treatment sessions. The medication may make you more sensitive to rough or tight fabrics, so this can help you feel more relaxed.
Spravato dosages: Review how to use Spravato nasal spray and what the recommended dosage schedule looks like.
Spravato versus ketamine: Learn about how these medications compare when it comes to treating certain types of depression.
Treatment-resistant doesn’t mean untreatable. Explore the different options to help improve depression symptoms when other treatments haven’t worked.
5. Make sure someone can bring you home after your Spravato treatments
Spravato may leave you feeling dizzy, drowsy, or mentally disconnected for a while after you use the medication. For this reason, it isn’t safe for you to operate a vehicle or machinery on treatment days. So make sure to arrange for a friend or family member to drive you home from your appointments.
You should be able to drive again the day after you receive Spravato, once you’ve had a full night’s sleep.
6. Spravato side effects can linger for hours after treatment
Most Spravato side effects will resolve in the 2 hours you’re under observation by a healthcare professional. But sometimes, they may linger after your treatment session. And in rare cases, they may last for a day or two.
On your Spravato treatment days, you may want to plan ahead for this. It may help to block off the rest of your day so you can rest and relax. Set the stage for a good night’s sleep by limiting caffeine and avoiding electronics before bedtime. You should be able to get back to your usual routine the next day. But let your prescriber know if you have side effects that don’t improve or you’re not feeling like yourself after 24 hours have passed.
7. Other post-treatment tips
There are some steps you can take to minimize side effects and help you get the most from your Spravato treatments. In general, the following steps can be helpful to practice after receiving Spravato:
Prioritize rest and relaxation. Since Spravato can leave you feeling drowsy, it’s a good idea to take it easy for the rest of the day after your treatment. This can help you avoid falls or other accidents. It can also give your mind and body time to recover from the treatment session.
Stay hydrated. Since you should avoid food and drink before your Spravato treatment, having a nutritious snack and staying hydrated once you’re at home can help ensure you’re getting the nutrients you need. It can also help manage nausea caused by Spravato.
Monitor your mood. In rare cases, Spravato may lead to thoughts of suicide or self-harm. In this case, seek emergency care right away. You should also let your prescriber know if you notice new or worsening symptoms of depression after using Spravato.
Follow up with your healthcare team. Be sure to keep your follow-up appointments with your healthcare team while you’re receiving Spravato. This helps ensure your safety during treatment. It also helps your prescriber make adjustments to your treatment as needed.
If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the 988 Suicide & Crisis Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
8. Avoid combining Spravato and alcohol
As mentioned, Spravato can temporarily affect your mental state. It can make you feel dizzy and disoriented. Alcohol can worsen these effects, so it’s best to avoid alcohol while you’re receiving Spravato — especially within a day or two before and after treatment.
Keep in mind that alcohol can also worsen depression symptoms. So it’s a good idea to limit alcohol overall while you’re being treated for depression. Your prescriber can help you decide how much, if any, alcohol is OK for you to consume. They can also provide support if you’re having trouble cutting back on alcohol on your own.
If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.
Tips for saving on Spravato
There are ways to save on Spravato, which is only available as a brand-name medication. GoodRx can help you navigate patient assistance programs and copay savings cards to save money on your prescription:
Save with a copay savings card. You may be eligible to pay as little as $10 for each Spravato treatment if you have commercial insurance by using a savings card from the manufacturer.
Save with a patient assistance program. If you’re uninsured or underinsured, you may be eligible for Spravato’s patient assistance program, which offers the medication free of charge.
Good to know: As mentioned, Spravato is administered in a healthcare setting. In most cases, your prescriber will have the medication in the office when you get there. (It isn’t a medication you pick up at your local pharmacy.) So it may be covered by your medical insurance instead of your prescription benefits. Your prescriber’s office will help you determine the best way to access Spravato and apply any available savings.
Frequently asked questions
It’s probably best to avoid working on the days you receive Spravato. The appointment itself will typically take at least 2 hours. And in some cases, side effects can linger after your treatment. So it’s best to avoid driving and performing tasks that require coordination or mental clarity. Instead, spend the rest of the day at home in a relaxing setting. You should be able to return to your normal routine the next day, after a full night’s rest.
Immediately after receiving Spravato, it’s common to feel dizzy and drowsy. You may also feel disconnected from your mind and body. These side effects typically peak about 40 minutes after your dose. From there, these effects slowly fade over the course of about 2 hours. The antidepressant effect of Spravato is typically noticed within hours of your first dose. And Spravato doesn’t seem to cause sexual issues or other side effects that are common with other antidepressants. But keep in mind that everyone responds to Spravato treatment differently. So be sure to let your prescriber know how you’re feeling during treatment.
No, Spravato should only be used in a healthcare setting under medical supervision. In rare cases, it can cause serious side effects that require immediate medical care. So it isn’t safe to use Spravato on your own at home.
It’s probably best to avoid working on the days you receive Spravato. The appointment itself will typically take at least 2 hours. And in some cases, side effects can linger after your treatment. So it’s best to avoid driving and performing tasks that require coordination or mental clarity. Instead, spend the rest of the day at home in a relaxing setting. You should be able to return to your normal routine the next day, after a full night’s rest.
Immediately after receiving Spravato, it’s common to feel dizzy and drowsy. You may also feel disconnected from your mind and body. These side effects typically peak about 40 minutes after your dose. From there, these effects slowly fade over the course of about 2 hours. The antidepressant effect of Spravato is typically noticed within hours of your first dose. And Spravato doesn’t seem to cause sexual issues or other side effects that are common with other antidepressants. But keep in mind that everyone responds to Spravato treatment differently. So be sure to let your prescriber know how you’re feeling during treatment.
No, Spravato should only be used in a healthcare setting under medical supervision. In rare cases, it can cause serious side effects that require immediate medical care. So it isn’t safe to use Spravato on your own at home.
The bottom line
Spravato (esketamine) is a prescription nasal spray that treats severe and treatment-resistant depression. You’ll receive Spravato in a healthcare setting and be monitored for at least 2 hours by medical staff after each treatment. It’s not safe to administer Spravato at home on your own.
Don’t eat for at least 2 hours before or drink liquids for at least 30 minutes before treatments. This helps decrease the chance of nausea and vomiting related to Spravato. Since the treatment sessions last at least 2 hours, be sure to wear comfortable clothing and bring calming music or activities with you to help pass the time.
You may feel dizzy or drowsy after receiving Spravato. So be sure to arrange for a ride home from sessions with a friend or family member. Side effects may linger for the rest of the day after you receive Spravato, so it’s a good idea to stay at home, take it easy, and avoid alcohol. For most people, side effects resolve by the next day, following a good night’s sleep.
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References
Bahr, R., et al. (2019). Intranasal esketamine (Spravato) for use in treatment-resistant depression in conjunction with an oral antidepressant. Pharmacy and Therapeutics.
Buchmayer, F., et al. (2023). Overcoming the myths of esketamine administration: Different and not difficult. Frontiers in Psychiatry.
Guo, H., et al. (2022). Neurological adverse events associated with esketamine: A disproportionality analysis for signal detection leveraging the FDA adverse event reporting system. Frontiers in Pharmacology.
Janssen Pharmaceuticals. (n.d.). What is the Spravato REMS (risk evaluation and mitigation strategy)?
Janssen Pharmaceuticals. (2025). Spravato instructions for use.
Janssen Pharmaceuticals. (2025). Spravato - esketamine hydrochloride solution [package insert].
Raza, A. A., et al. (2025). Spravato for treatment-resistant depression: Efficacy and sexual side effect profile. Neuropsychiatric Disease and Treatment.
Zaki, N., et al. (2023). Long-term safety and maintenance of response with esketamine nasal spray in participants with treatment-resistant depression: Interim results of the SUSTAIN-3 study. Neuropsychopharmacology.
