FREQUENTLY ASKED QUESTIONS ABOUT Spravato (esketamine)
FREQUENTLY ASKED QUESTIONS ABOUT TMS
Spravato (esketamine) is a groundbreaking FDA-approved treatment for individuals struggling with treatment-resistant depression (TRD) or major depressive disorder (MDD) with suicidal thoughts or behaviors. It is a nasal spray formulation of esketamine, a derivative of ketamine, and is designed to work differently from traditional antidepressants. Unlike conventional antidepressants that primarily target serotonin, dopamine, and norepinephrine, Spravato acts on the glutamate system, the brain's most abundant neurotransmitter. This unique mechanism promotes rapid neural repair and synaptic growth, effectively rewiring brain circuits involved in depression. This is why many patients report feeling significant improvements within hours or days, rather than waiting weeks or months for relief. This treatment is not just about managing depression—it’s about providing a pathway to recovery for individuals who have felt stuck, hopeless, or exhausted by the limitations of traditional therapies. The process to get started is simple, with most insurance plans covering treatment for eligible patients. If you or a loved one has been struggling with depression despite trying multiple medications, Spravato may be the life-changing solution you’ve been waiting for.
1. What is Spravato?
2. Who is a good candidate for Spravato?
If you have been battling depression and have tried at least two antidepressants without success, Spravato may be the game-changer you’ve been looking for. It is designed for individuals who feel stuck in their current treatment and need a new approach to reclaim their lives. Spravato is also an option for those experiencing suicidal thoughts, providing rapid relief when it is needed most. A consultation with a provider can help determine if this treatment is the right fit for you.
3. Is Spravato safe?
Spravato is FDA-approved and has undergone rigorous clinical trials to ensure its safety and effectiveness. It is administered under medical supervision in a calm, supportive environment to ensure the best possible experience. Because it can cause mild dizziness or temporary disconnection from reality, patients are monitored for a short period after each session before returning home.
4. How soon will I see results?
One of the most exciting aspects of Spravato is how quickly it can work. Many patients report noticeable improvements in their mood and mental clarity within hours of their first session. While results vary, clinical studies have shown that many individuals experience a significant reduction in depressive symptoms within the first two weeks. This means you don’t have to wait months to feel better;relief may be just around the corner.
5. How long do the effects of Spravato last?
The effects of Spravato can last for weeks or even months, depending on the individual. During the initial phase, treatments are scheduled twice per week for the first month, followed by once-weekly or biweekly sessions. This structured approach helps ensure long-term benefits while giving your brain time to adjust and heal. Who is a good candidate for TMS? TMS is FDA-cleared for Major Depressive Disorder (MDD), Obsessive-Compulsive Disorder (OCD), and smoking cessation. It is most effective for individuals who: Have not responded to medication or therapy Experience side effects from antidepressants Are looking for a non-invasive, drug-free alternative
6. Can I return to work or drive after treatment?
Because Spravato can cause temporary dizziness or drowsiness, it is required that patients arrange for a ride home after treatment. Most patients feel back to normal within a few hours, but to ensure safety, driving and operating machinery should be avoided for the rest of the day.
7. Does Spravato hurt or is it painful?
Spravato is completely painless. It is a nasal spray, so there are no needles, IVs, or invasive procedures involved. Some patients report a mild tingling sensation in the nose, but this is temporary and fades quickly.
8. What happens if Spravato does not work for me?
Spravato has been life-changing for many, but if it doesn’t provide the relief you need, there are always other options. Your provider will work closely with you to explore alternative treatments, such as transcranial magnetic stimulation (TMS), or medication adjustments. Mental health treatment is highly personalized, and there is always hope.
9. What do patients usually feel during treatment sessions?
Most patients describe feeling relaxed, calm, and sometimes even euphoric. Some experience a dream-like sensation or mild dissociation, where they feel detached from their surroundings. This effect is temporary and typically subsides within an hour or two. Many find this part of the treatment to be a unique and even enjoyable experience.
10. What is the difference between Spravato(esketamine) and IV/IM Ketamine)?
Both Spravato and IV ketamine are powerful treatments for depression, but they have some KEY differences. Spravato is a nasal spray that is FDA-approved for treatment-resistant depression and must be administered in a certified treatment center.
11. What do patients usually feel after treatment sessions?
Some patients experience a subtle mood boost after several sessions, though full therapeutic effects may take a few weeks. Overall, Spravato is well-tolerated, and any discomfort typically decreases over time as patients adjust to the treatment. Many patients describe feeling tired for a few hours after treatment and thus we recommend taking the rest of the day to rest and recoup.
12. How much does Spravato cost? Is it covered by insurance?
Spravato is very commonly covered by most insurance plans through the medical or pharmacy benefits. Each plan covers the medication and monitoring differently but it most commonly comes down to your usual copays for medication and/or visits. You will get a breakdown of the cost prior to starting. For individuals without insurance or with very high copays- there are programs that you may qualify for that make this medication accessible.
13. How long does Spravato treatment take?
Spravato is self-administered under supervision in a certified treatment center- like TMS of Austin. You will remain under observation for a minimum of 2 hours to ensure you are fully alert, steady on your feet and that your vital signs are stable.
14. Are there side effects associated with Spravato therapy?
During treatment you may experience: dizziness, nausea, headaches, dissociation, elevated blood pressure. We make every possible effort to keep these side effects to the minimum. This may involve treatment with anti-nausea medication or blood-pressure medication. Your comfort and safety are our #1 priority and will aim to create the most relaxing, therapeutic experience for you.
15. What do patients usually feel during treatment sessions?
Patients receiving Spravato® (esketamine nasal spray) often report a mix of physical, emotional, and perceptual effects during and shortly after treatment. Here's a short summary of what they commonly experience: Dissociation or detachment: A feeling of being disconnected from thoughts, body, or surroundings. Sedation or drowsiness: A sense of calm or sleepiness, sometimes leading to a nap post-treatment. Dizziness or floating sensation: A lightheaded, spinning, or floating feeling. Mild euphoria or emotional release: Some feel a temporary lift in mood or experience emotional catharsis. Unusual thoughts or perceptions: Visual distortions or dream-like states are common but usually mild. Nausea or headache: Less frequent but possible side effects. Most effects peak within 40 minutes and resolve within 1.5–2 hours. Patients remain under observation during this time for safety. Many report increased hope or a “mental reset” after several sessions.
16. What do patients usually feel after treatment sessions?
Everyone’s experience is a little different, but many patients report a mix of sensations in the hours and days after their Spravato® treatment. Here's what you might notice: Right After the Session (First Few Hours): You may feel tired, a bit foggy, or emotionally quiet. Some people experience a mild headache, nausea, or dizziness, but these usually fade with rest. You might feel more introspective or reflective—like your mind is processing things in a new way. Later That Day or the Next Day: Many people describe a lift in mood, even a small one, or a sense of relief. Some feel like their brain had a “reset”—a subtle shift in how they view things or how heavy things feel. You may feel more motivated, hopeful, or able to take on things that felt too hard before. It's also common to feel a bit fatigued, especially early in the treatment process. Over Time (With Ongoing Treatment): Improvements tend to build gradually over the weeks. You may notice a growing sense of resilience, less emotional weight, and more connection with life again. 🌿 Tip: Give yourself time to rest and recover after each session. Journaling, light walks, and calming activities can help support the healing process.
17. Do I need to stop medication or therapy for Spravato?
No, you do not need to stop taking medication or participating in psychotherapy while receiving esketamine treatment. Medication: Most patients continue their prescribed antidepressants or other medications during treatment. In some cases, a provider may adjust medications based on treatment response. Psychotherapy: Spravato can be complementary to therapy or other treatments like TMS, and many patients continue talk therapy alongside treatment for the best results.
18. I don't want to take medication anymore, can I get off them with Spravato?
Spravato® is not a replacement for antidepressants but is designed to work alongside your current medication. It’s FDA-approved to be used in combination with an oral antidepressant for treatment-resistant depression or major depressive disorder with suicidal thoughts or behavior. That said, some patients do experience enough improvement over time that their psychiatrist may consider adjusting or tapering other medications carefully. This is a highly individualized process that depends on your overall progress, mental health history, and response to treatment. 🔍 Important: If your goal is to reduce or stop medications in the long run, talk to your provider openly. Together, you can create a treatment plan that supports your mental health while exploring nontraditional options like Spravato®, therapy, TMS, or lifestyle changes.