Spravato Side Effects: A Complete Guide for Patients and Caregivers

Spravato is an FDA approved medication used for treatment resistant depression and for major depressive disorder with suicidal thoughts or actions. It contains esketamine, which is a chemical form related to ketamine. Since Spravato works differently from traditional antidepressants, it offers hope to people who have not responded to other treatments. At the same time, understanding its side effects is essential for safe and informed use.

This guide breaks down the side effects of Spravato in clear language. It explains how long they last, why they happen, who is most at risk, and how to manage them. The goal is to help patients, caregivers, and healthcare professionals make confident decisions about treatment.

Understanding How Spravato Works

Spravato is taken as a nasal spray in a certified healthcare clinic under direct supervision. Unlike typical antidepressants that target serotonin or norepinephrine, Spravato interacts with glutamate receptors in the brain. This action supports fast mood improvement, which is one of the reasons many patients respond quickly.

Because of its unique mechanism, the side effects of Spravato can feel very different from what people experience with regular antidepressants. This is why the medication is only given in a controlled medical setting where professionals can monitor the patient.

Common Spravato Side Effects

Most side effects start within minutes of taking the nasal spray and usually fade within two hours. Some may last longer, especially during the first few sessions. Here are the most commonly reported effects.

1. Dissociation

Dissociation is the most well known side effect of Spravato. Patients often describe it as feeling disconnected from themselves, their surroundings, or their thoughts. Some compare it to a dreamlike sensation.

What Dissociation Feels Like

• Feeling outside your body
• Distorted perception of time
• Change in sound or visual clarity
• Difficulty focusing
• Floating or drifting sensations

Dissociation usually appears soon after administration and peaks in the first hour. Most people return to normal by the time the observation period ends. Healthcare staff monitor the patient throughout this time to ensure safety and comfort.

2. Dizziness

Dizziness is another common experience. It may feel like lightheadedness or a temporary loss of balance.

How to Manage Dizziness

• Avoid standing up too quickly
• Keep your eyes open and breathe steadily
• Rest until the sensation passes

The clinic environment is designed to reduce fall risk. After the session, patients are not allowed to drive and must arrange transportation home.

3. Sedation and Drowsiness

Sedation occurs because Spravato affects the central nervous system. Some patients fall asleep, while others feel deeply relaxed.

Tips for Handling Sedation

• Plan to rest for the remainder of the day
• Do not operate machinery or handle complex tasks
• Stay hydrated and eat lightly before your session

Sedation usually resolves the same day, but lingering tiredness may occur after the first few treatments.

4. Increase in Blood Pressure

Spravato can cause a temporary rise in blood pressure. This is why blood pressure is checked before and after every session.

Who Is More at Risk

• Patients with hypertension
• Individuals with heart disease
• People taking stimulants or other medications that affect blood pressure

The increase typically peaks around 40 minutes after the spray and returns to baseline within a few hours.

5. Nausea and Vomiting

Some people experience nausea or stomach discomfort. Vomiting is less common but can happen.

Reducing Nausea

• Eat a light meal before treatment
• Avoid heavy or greasy foods
• Ask your provider about anti nausea medications

Nausea often decreases after the first few treatments as the body becomes accustomed to the medication.

6. Feeling Drunk or Intoxicated

Spravato can make patients feel as though they are mildly intoxicated. This sensation may include slowed reactions, altered movement, or reduced coordination.

Helpful Tips

• Remain seated during the observation period

• Drink water slowly

• Focus on breathing if you feel uncomfortable

This effect usually improves once the dissociative symptoms fade.

7. Anxiety

While Spravato helps many people reduce their depressive symptoms, some experience anxiety during or shortly after treatment. This can be caused by unfamiliar sensations or by the dissociative effects.

Managing Anxiety During Treatment

• Practice slow breathing
• Talk to the medical team if you feel overwhelmed
• Ask about calming strategies for future sessions

Anxiety often becomes less frequent with continued treatments as the patient gets used to the process.

8. Headache

Headaches may occur during or after the treatment session. They can range from mild to moderate.

Ways to Prevent Headaches

• Stay hydrated
• Rest after your session
• Ask your provider about approved pain relief options

Headaches usually fade within a few hours.

Less Common Spravato Side Effects

Some side effects appear less often but are still important to understand. Healthcare providers monitor for these during every session.

1. Changes in Taste

Some patients report an unusual taste in their mouth shortly after using the nasal spray. This is generally mild and brief.

2. Tingling or Numbness

A small number of patients experience tingling in the face, hands, or legs. This effect normally fades as the medication wears off.

3. Blurred Vision

Temporary changes in vision can occur. You might notice difficulty focusing or slight blurriness.

Patients should avoid reading or using screens until the effect improves.

4. Feeling Hot or Flushed

Spravato may cause warmth in the face or body. This flushing is usually mild and short lived.

5. Irritability

Although Spravato is used to improve mood, some patients experience brief periods of irritability or restlessness.

This typically occurs with first time users.

6. Urinary Symptoms

Symptoms such as frequent urination or bladder discomfort are rare. If they occur repeatedly, providers may adjust the treatment plan.

Serious Side Effects of Spravato

Serious side effects are uncommon, but healthcare professionals closely monitor patients to ensure safety.

1. Respiratory Issues

Breathing problems are rare. However, the supervision period allows staff to detect any issues immediately.

2. Severe Blood Pressure Changes

A significant change in blood pressure may require immediate medical attention. This is why regular monitoring is mandatory.

3. Severe Dissociation

In very rare cases, dissociation can become intense and distressing. Patients may feel confused or extremely detached. Clinical staff are trained to manage these situations and keep the patient safe.

4. Allergic Reactions

Allergic reactions to Spravato are uncommon but can include swelling, hives, or trouble breathing. Severe reactions require emergency care.

How Long Do Spravato Side Effects Last?

Most side effects begin within minutes and fade within one to two hours. By the end of the required observation period, many patients feel stable enough to go home with their designated driver.

Factors That Affect Duration

• Overall health
• Dosage level
• Type of symptoms
• Previous experience with Spravato
• Underlying medical conditions

Some effects like fatigue or mild headaches may last the rest of the day. People generally experience fewer side effects as treatments continue.

Who Is at Higher Risk of Side Effects

Certain individuals may experience stronger or more frequent side effects.

Higher Risk Groups

• People with high blood pressure
• Patients with cardiovascular issues
• Individuals with substance use history
• Those taking sedatives or stimulant medications
• Older adults
• People with certain neurological conditions

A complete medical evaluation helps determine whether Spravato is a safe option.

How Clinics Manage Spravato Side Effects

Healthcare providers follow strict protocols to ensure patient safety.

Common Safety Measures

• Pre treatment health checks
• Blood pressure monitoring
• A calm and quiet environment
• Patient observation for two hours
• Access to trained medical staff
• Post treatment instructions for care at home

This structured process minimizes risks and makes the experience more comfortable.

Tips for Reducing Spravato Side Effects

Patients can take several steps to improve their comfort during and after treatment.

Before Treatment

• Eat a light meal
• Stay hydrated
• Avoid caffeine
• Follow medication instructions
• Arrange transportation home

During Treatment

• Practice deep breathing
• Stay relaxed
• Communicate with the healthcare team

After Treatment

• Rest for the remainder of the day
• Avoid driving or important tasks
• Drink fluids
• Keep the environment calm

Following these tips can make sessions easier and reduce the intensity of side effects.

Long Term Side Effects of Spravato

Spravato is still being studied for long term use, but current research shows that many side effects decrease over time as the body becomes familiar with the medication.

Possible Long Term Concerns

• Repeated episodes of increased blood pressure
• Cognitive effects for sensitive individuals
• Urinary tract symptoms in rare cases

Patients on ongoing treatment schedules receive regular checkups to ensure continued safety.

Spravato and Substance Use Concerns

Since Spravato is related to ketamine, some people worry about addiction potential. Research shows that Spravato has a lower risk of misuse because it is given in a clinic under supervision and on a scheduled basis.

Safeguards in Place

• Controlled access
• No at home use
• Monitoring for tolerance
• Regular mental health evaluations

Patients with a history of substance misuse should discuss their concerns with their provider.

When to Call Your Healthcare Provider

Contact a healthcare professional if any of the following occur:

• Symptoms that do not improve within a few hours
• Severe headache with vision changes
• Intense anxiety or panic
• Chest pain
• Persistent nausea or vomiting
• Urinary problems
• Allergic reaction symptoms

Early communication ensures proper care and adjustments.

Spravato Side Effects Compared to Traditional Antidepressants

Spravato works differently from selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors. This means the side effect profile is also different.

How Spravato Differs

• Faster onset of action
• Dissociation is unique to this class of medication
• Sedation tends to be more common
• Blood pressure changes can occur more frequently
• Clinical supervision is required for every dose

People who have not responded to traditional antidepressants often find Spravato beneficial despite its distinct side effects.

Final Thoughts

Spravato has changed the landscape of depression treatment by offering a rapid acting option for people who have struggled with traditional medications. While Spravato side effects can be strong at first, most are temporary and carefully monitored in a clinical setting. By learning what to expect, patients and caregivers can make informed decisions about whether Spravato is the right option.