Spravato is a ground-breaking treatment for depression that works differently from standard medications. While it isn’t recognized as a psychedelic drug, it can change how you think and feel.
In this article, we’ll discuss the psychological and physical effects of Spravato and what to expect during treatment.
Key Takeaways
- Spravato is a nasal spray used in clinics for certain types of hard-to-treat depression
- Clinics supervise dosing and require a post-dose observation period to manage safety
- The drug often causes dissociation. People describe feeling detached, dreamlike, or slowed. Effects peak in the first hour and usually fade within a few hours
- Spravato shares a mechanism with ketamine but differs in form and how clinicians use it
- Clinics monitor blood pressure and watch for sedation, nausea, and other side effects. Staff are available to help if you feel panicky or uncomfortable.
- Deep breathing and feeling into your body can help reduce any anxiety that may occur during Spravato experiences
What is Spravato?
Spravato is a nasal spray that contains esketamine, one of the two mirror-image molecules that make up ketamine. Ketamine was originally developed as an anesthetic, but has since become recognized as a groundbreaking treatment for mental health disorders. Spravato was developed from ketamine specifically as a nasal spray for people with severe depression.
Like ketamine, Spravato can bring about rapid relief from mental health conditions, even when first-line treatments haven’t worked. However, unlike ketamine, clinics only provide Spravato for two indications: treatment-resistant depression (TRD) and major depressive disorder with suicidal thoughts (MDSI).
The U.S. Food and Drug Administration (FDA) has approved Spravato specifically for these conditions, and clinics must follow a strict approved protocol to deliver the medication.
This approval means that, while the treatment is more limited, it’s typically covered by insurance. As such, Spravato is a financially accessible treatment option for those who meet the clinical criteria.
How Clinics Give Spravato
Clinics give Spravato only in certified treatment centers. You go to the clinic and take the nasal spray under staff supervision. Staff watch you throughout the session and during a post-dose observation period. The program requires that staff check your blood pressure before and after dosing.
Typical dosing starts with an induction phase. Clinics often give Spravato twice each week for the first four weeks. After that, clinics reduce dosing to once a week and later to every two weeks, as needed.
What Spravato Feels Like: Common Reports
Spravato is mildly psychoactive and can change how your mind and body feel for a short period. Most people notice the effects within minutes. The strongest sensations usually appear in the first 40 to 60 minutes, then fade within about two hours.
The experience is different for everyone. Some people feel changes only mildly, while they can be stronger for others. People often describe Spravato as subtly psychedelic, meaning it changes perception and normal thinking.
Here are some real-life examples of how patients feel on Spravato:
“For me personally, it feels like time and space are slightly distorted not to the point where I start tweaking out, but more like where I go woah this is kinda neat. My body feels numb (in the good way) for instance my fingers would go numb and I’d scratch my beard and I couldn’t feel my hairs on my chin as much.”
“What it feels to me is kind of like being drunk or high. It mainly feels the way it feels when you have surgery and they’ve just turned on the IV with the anesthetic to put you under. Like warm, heavy, a bit numb, and physically relaxed. I can think but my thoughts are floaty and it’s harder to grab onto them during the intense part.”
“ Spravato is a dissociative and it will have you in a state of just pure calm, and it will seem like you’re just spacing off ever so slowly and it makes time feel pretty slow and calming.”
Physical side effects are also common during Spravato and may include:
- Nausea
- Dizziness
- Headache
- Raised blood pressure
- Vomiting
- Sedation
Most of these pass after a few hours, and you’ll be monitored to make sure they’ve worn off before you leave the clinic. If you have certain medical conditions, you might not be able to have Spravato because of its effect on blood pressure.
How Spravato and Ketamine Compare
Both Spravato and ketamine act on NMDA receptors in the brain. These proteins normally interact with the chemical messenger glutamate, which is responsible for normal signaling across the brain.
By changing how NMDA receptors respond to glutamate, both drugs shift brain activity in circuits linked to mood. This helps explain why they can relieve depression. The same changes in brain signaling can also cause psychoactive effects that people typically feel during treatment.
Spravato binds more selectively to NMDA receptors than ketamine. Because of this, doctors typically use lower doses, which often makes the experience of Spravato milder. Ketamine is also normally delivered intravenously, meaning more of the drug enters the bloodstream and brain, giving rise to more pronounced effects.
What to Do if You Have a Bad Reaction to Spravato
Spravato can feel calming and even pleasant for some people, but that’s not always the case. At times, the experience may feel intense, confusing, or uncomfortable. Knowing what to expect can help you feel more prepared.
How the Clinic Supports You
When you take Spravato, you’re never alone. A trained medical team monitors you during the entire session. They:
- Check your vital signs – Your blood pressure, heart rate, and oxygen levels are measured before and after dosing
- Stay nearby – Staff can step in quickly if you feel panicky, lightheaded, or unwell.
- Offer medical support – If side effects like nausea or high blood pressure occur, they can provide care or medication to ease symptoms
- Guide you through it – Staff often remind you to focus on breathing or reassure you while the effects pass
Tips You Can Use During Treatment
There are also simple steps you can take yourself if you start to feel uneasy:
Most unpleasant effects fade within a couple of hours, and you’ll remain in the clinic until you’re stable enough to leave. If you feel any lingering negative effects once you’re back, get in touch with your clinic.
FAQs
How Long Does a Spravato Session Last?
You spend time before the dose for checks. After you take the spray, clinics observe you for at least two hours. The strongest effects usually last up to one hour. Mild aftereffects can last longer, so you avoid driving the rest of the day
How Does Spravato Work?
Spravato acts on NMDA receptors and the glutamate system in the brain. This action can increase brain activity in areas involved in mood regulation. It also increases neuroplasticity, the brain’s ability to change and form new neural connections.
Sources
- https://www.reddit.com/r/Spravato/comments/13zoum3/what_does_spravato_feel_like_is_it_psychedelic
- https://www.spravatorems.com/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9922941/
