If you are considering Spravato® (esketamine) to treat your symptoms of depression, you may be wondering: what does Spravato feel like?
Spravato offers real hope to people suffering from depression who have not found relief from conventional therapies and medications. Many patients experience relief from their symptoms within hours or days of their initial treatment.
It’s common for patients to be curious — or even concerned — about the side effects of Spravato. Will Spravato make me high or hallucinate? Will I lose control? Can I have a bad reaction?
Know that you are safe. Patients are closely monitored during Spravato treatment by clinicians who are highly trained to make you feel comfortable and cared for.
What is Spravato?
Also known as esketamine, Spravato is a prescription nasal spray used to treat adults suffering from treatment-resistant depression or major depressive disorder.
Spravato is closely related to ketamine, a general anesthetic used in clinical settings for pain management. Interest in ketamine as a treatment for depression grew when patients treated with the anesthetic reported also feeling better emotionally.
Spravato (esketamine) was developed by Janssen Pharmaceuticals, a division of Johnson & Johnson, and approved as a treatment for depression by the Food and Drug Administration in 2019.
According to long-term studies, Spravato’s antidepressant effects can be maintained for up to 4.5 years with ongoing, intermittent treatment.
How does Spravato work?
Spravato works differently than antidepressants by making it easier for patients to process emotions and break through treatment plateaus.
Spravato works by targeting the glutamate system, the brain’s chemical messenger involved in learning, memory, and mood. It helps the brain recover more quickly from depression by forming new connections between cells and restoring the balance of brain chemicals.
This process of “synaptic plasticity” helps many people feel better within hours or days, even if other treatments haven’t helped before.
A full treatment plan typically lasts about eight weeks. It starts with a four-week “induction” phase, where patients receive treatment twice a week, and then gradually tapers off from there. Most patients continue with maintenance sessions as needed.
What to expect during Spravato treatment?
A single Spravato treatment session lasts about two hours. After getting your vitals checked, you will self-administer the nasal spray and sit back in a reclined chair. The room will be kept dark, and you’ll be offered blankets, an eye mask, and noise-cancelling headphones.
Some patients listen to music; Spotify offers an assortment of “ketamine” playlists to choose from. Others bring a journal to write their thoughts, while still others meditate or rest. A call button is nearby should you have any questions or concerns.
Over the next two hours, your care team will monitor your safety and provide comfort and reassurance as needed. While this is not a therapy session, they are here to support you should any thoughts or feelings come up.
After treatment, you will not be allowed to drive or operate machinery the rest of the day. It is important to rest after treatment and avoid alcohol, excessive screen time, and strenuous activities.
What does Spravato feel like?
Patients often describe their experience of Spravato as “dreamlike.” This dissociation is a temporary state where you feel disconnected from your body, thoughts, and surroundings. You know what’s going on, but it feels like you’re watching the experience from afar.
This dissociation occurs because of how esketamine alters how your brain processes sights, sounds, and feelings. Esketamine makes the brain more flexible and open to change, which helps reset old patterns and form new connections and pathways.
This feeling of dissociation usually begins within the first five to 10 minutes of treatment and can last 30 to 90 minutes.
Here’s what many people report feeling during a Spravato session:
- Feeling floaty or dreamlike: You might feel like time is moving differently or that you’re watching your thoughts from a distance.
- Mild visual distortions: Some people notice brighter colors or more pronounced sounds, but this is not the same as full hallucinations.
- Disconnection from reality: Known as dissociation, things can feel a bit surreal or like you’re in a trance. You’re aware, but not fully grounded in the moment.
- A sense of calm: Some patients feel a deep sense of calm or emotional release. Problems that previously seemed challenging are now not as important.
- Waves of emotions: Patients may experience temporary anxiety or worry that they are losing control. This is more likely to happen during the first treatment, especially if the dissociation feels intense or unfamiliar. Your care team will closely monitor for side effects and help you stay calm and comfortable.
- Fatigue or drowsiness: It’s common to feel tired or mentally foggy as the medication wears off.
While these sensations may feel unusual at first, most patients adjust to the experience over time.
What if I have a bad reaction to Spravato?
The chances of having a “bad” reaction to Spravato are low, especially in a controlled clinical setting. But for some, the first treatment in particular can feel intense and unfamiliar.
While rare, some patients can experience intense dissociation or confusion, panic or severe anxiety, or elevated blood pressure. During these situations, your care team is trained to help you stay calm and relaxed in the following ways:
- Calm reassurance: They will help you normalize the experience by speaking gently and reminding you that these feelings are a temporary effect of the medication.
- Grounding techniques: They may guide you through deep breathing techniques or encourage you to name the things you hear and see to keep you grounded in the present moment.
- Adjust the environment: They will make any adjustments necessary to help you feel comfortable by dimming the lights, minimizing noise, or adjusting your position.
- Monitor your vital signs: These are monitored throughout treatment to ensure your safety. While extremely rare, your care team may administer anti-anxiety medications as needed.
- Post-session debrief: After the treatment, patients are given time to rest and talk about their experience. Based on this, their care team may make adjustments to future sessions.
Most patients tolerate Spravato well, while others gradually adjust and get used to it over time.
Key takeaways
- Spravato can cause a dissociative, dreamlike experience. You may feel floaty, detached, or like you’re observing things from a distance, but you’re still aware of what’s going on around you.
- Most side effects are temporary and manageable. These can include dissociation, mild visual distortions, dizziness, and drowsiness. These usually fade within a couple of hours after treatment.
- Dissociation is an important part of how Spravato works. By disrupting rigid thought patterns, it helps “reset” the brain and support recovery from depression.
- You’re never alone during treatment. Trained professionals are with you every step of the way to ensure you feel safe, calm, and cared for.
Looking for Spravato or ketamine treatment near you?
Pacific Mind Health offers Spravato (esketamine) and ketamine therapy for treatment-resistant depression, major depressive disorder, and more. Our experienced clinicians provide compassionate, evidence-based care to help you feel better.
Ready to take the next step? Schedule a free consultation today to see if Spravato or ketamine is right for you.
