Starting Spravato can bring up two very different feelings at once – relief that there is another option, and anxiety about what the treatment day will actually be like. If you are wondering how to prepare for Spravato, the goal is not to do everything perfectly. It is to make each visit feel more predictable, comfortable, and manageable.
Spravato, the brand name for intranasal esketamine, is an FDA-approved treatment for adults with treatment-resistant depression and certain cases of major depressive disorder with acute suicidal thoughts or behavior when used as part of a broader treatment plan. Because it can cause temporary side effects such as dissociation, dizziness, sleepiness, nausea, or increases in blood pressure, it is given in a medically supervised setting with monitoring afterward. That structure is there to protect you, but it also means preparation matters.
How to prepare for Spravato before your first appointment
The most helpful preparation starts before treatment day. Your clinician will review your psychiatric history, current symptoms, medications, medical conditions, and whether Spravato is a good fit for your needs. This is the time to ask practical questions, not just clinical ones. Many patients want to know how long the appointment will take, whether they can work afterward, and how they may feel later that day. Those are good questions, and asking them early often lowers anxiety.
It also helps to think of Spravato as part of a larger plan rather than a one-time fix. Some people notice improvement quickly. Others need time, repeated sessions, and adjustments to the overall treatment plan before they feel meaningful change. Setting realistic expectations can make the experience less stressful and help you stay engaged with care.
You will also need to plan transportation. You should not drive yourself home after Spravato treatment. Arrange a trusted adult to take you home, or use a preapproved transportation option if your clinic allows it. Do not leave this detail for the last minute. Knowing your ride is handled can make the whole visit feel much easier.
What to do the night before and morning of treatment
Preparation for Spravato is usually simple, but a few details can improve comfort. Try to get a reasonable night of sleep before your appointment. You do not need a perfect sleep routine, but arriving already exhausted can make the day feel harder.
Your treatment team may give you specific instructions about eating and drinking before your appointment. In many cases, patients are advised not to eat for at least two hours before treatment and not to drink liquids for at least 30 minutes beforehand. This is meant to reduce the chance of nausea. Follow the instructions given by your prescribing clinician, since recommendations may vary based on your medical history.
Wear comfortable clothing and avoid scheduling anything demanding afterward. Even if you end up feeling fine, it is better to protect the rest of the day. Most patients do best when they treat Spravato days as lower-pressure days.
If you take routine medications, ask in advance whether you should take them as usual. Do not stop psychiatric or medical medications on your own. Some medicines may need review, especially if they affect sedation, blood pressure, or alertness, but those decisions should come from your clinician.
What to bring to a Spravato appointment
You do not need to pack much, but bringing a few familiar items can help. Most patients appreciate having their ID, insurance information if needed, and anything the clinic requested for check-in. Beyond that, comfort matters.
A light jacket or sweatshirt can be helpful if you tend to get cold while sitting for observation. Some people bring headphones and listen to calming music. Others prefer an eye mask, a small blanket, or simply their phone on silent mode. If your clinic permits it, these small comforts can make the monitoring period feel less clinical and more relaxed.
If nausea has been an issue in the past, mention it before treatment rather than trying to push through it. The same is true if you have a history of panic symptoms, migraines, or sensitivity to medications. Your care team can often make the experience easier when they know what tends to affect you.
What Spravato feels like during treatment
One reason patients look up how to prepare for Spravato is that they are unsure what the experience will feel like. The honest answer is that it varies. Some people feel mildly detached, floaty, sleepy, or emotionally quieter for a period of time. Others notice very little beyond tiredness or a strange taste from the nasal spray.
These effects are usually temporary and monitored closely. You will remain at the clinic for observation after the medication is administered, and your blood pressure and overall status will be checked. The purpose is safety, but it also gives you time to let the effects pass before going home.
For many people, the most useful mindset is to avoid fighting the experience. If you feel different for a while, that does not mean something is wrong. Trying to stay grounded, breathe slowly, and let your treatment team guide you often helps more than analyzing every sensation in real time.
How to make the observation period easier
The monitoring period after Spravato is part of treatment, not an inconvenience added to it. That time allows your body to settle and gives your team the chance to watch for side effects. It can feel long if you arrive unprepared, but it often goes better when you assume the day will move slowly.
Some patients like quiet. Others do better with a familiar playlist, a simple meditation, or a supportive person dropping them off with encouraging words beforehand. There is no single right routine. What matters is choosing something that helps you feel safe without overstimulating you.
Try not to plan work meetings, errands, or emotionally heavy conversations during the observation window or immediately after you get home. Even if you are technically awake and talking, your processing may feel slower than usual. Giving yourself space is part of good preparation, not a sign of weakness.
Practical and emotional ways to prepare for Spravato
There is the logistical side of treatment, and then there is the emotional side. Both count. Patients pursuing Spravato are often doing so after multiple antidepressants, months or years of symptoms, and a lot of disappointment. It is normal to arrive with hope mixed with skepticism.
Try to give yourself permission to be where you are. You do not have to feel optimistic every minute for treatment to help. You also do not need to decide after one session whether it is working. Depression often distorts expectations in both directions – either nothing will help, or this must fix everything quickly. A steadier view is more useful.
It can help to keep a simple journal of symptoms, sleep, energy, and mood across the first few weeks. Changes are not always dramatic at first. Sometimes the earliest improvements are subtle, such as getting out of bed a little easier, feeling less emotionally stuck, or noticing fewer hopeless thoughts. Tracking those shifts can help you and your clinician evaluate progress more clearly.
Safety, scheduling, and follow-through
Spravato works best when patients can follow the recommended treatment schedule and stay connected with ongoing psychiatric care. The induction phase usually involves more frequent visits at the beginning, followed by a maintenance schedule that depends on your response. If transportation, work, childcare, or cost may interfere, bring that up early. These barriers are common, and discussing them honestly is often the first step toward solving them.
It is also important to avoid alcohol or other substances that could increase sedation or complicate your response around treatment days unless your clinician has specifically discussed them with you. If anything changes in your health between appointments, such as new medications, pregnancy, severe headaches, chest pain, or major blood pressure concerns, tell your treatment team before your next session.
At Brainiac Behavioral Health, Spravato is offered in a structured, medically supervised setting designed to support both safety and comfort. For many patients, that level of support makes it easier to stay consistent with care and focus on recovery rather than logistics alone.
When preparation needs to be personalized
The best advice on how to prepare for Spravato is not always the most general advice. For example, someone with severe anxiety may need more reassurance and sensory comfort during appointments. Someone with a demanding job may need help building a realistic schedule around treatment days. Someone with high blood pressure or multiple medications may need closer medical review before starting.
That is why individualized care matters. A preparation plan should fit your symptoms, medical history, and day-to-day life. Good treatment is not just about administering medication. It is about making the process workable enough that you can continue it and benefit from it.
If you are considering Spravato, think of preparation as one small but meaningful part of care. Arrange your ride, follow pre-visit instructions, protect your schedule, and let your treatment team know what you need. When the day feels more predictable, it becomes easier to focus on what you came for in the first place – the possibility of relief, restored clarity, and a path forward that feels more hopeful than the one behind you.