If you’re considering Spravato for depression, you probably have questions about its side effects. Will you feel dizzy? Could the treatment make you sleepy? What happens if you experience an uncomfortable reaction?
These are important questions to discuss with your healthcare provider before starting treatment.
Spravato (esketamine) is an FDA-approved prescription nasal spray for certain adults with depression. It works differently from many traditional antidepressants. However, it also carries specific risks that require medical supervision.
Understanding possible Spravato side effects can help you prepare for treatment, recognize warning signs, and have a more informed conversation with your provider.
What Are the Most Common Spravato Side Effects?
Spravato can cause several temporary physical and psychological effects. Some begin shortly after administration, while others may become noticeable during the observation period.
Commonly reported side effects include:
- Dizziness or a spinning sensation
- Sleepiness or sedation
- Nausea or vomiting
- Headache
- Anxiety
- Feeling disconnected from your surroundings
- Changes in sensation
- Temporary increases in blood pressure
- Feeling unusually tired
- Feeling intoxicated or different from normal
Not everyone experiences these reactions. Their intensity and duration can also vary.
Your healthcare team will monitor you during treatment and assess your condition before you leave.
Why Does Spravato Cause Dizziness or Sleepiness?
Spravato affects brain signaling through a mechanism involving NMDA receptors.
As a result, some patients experience temporary changes in alertness, perception, or coordination.
You may feel sleepy, lightheaded, or less aware of your surroundings.
These effects are among the reasons Spravato requires supervised administration.
Can Spravato Cause Nausea?
Yes. Nausea and vomiting are recognized side effects.
To help reduce the chance of vomiting during treatment, prescribing guidance recommends avoiding food for at least two hours and liquids for at least 30 minutes before administration.
Your healthcare provider may give additional preparation instructions.
What Is Dissociation During Spravato Treatment?
Dissociation is one of Spravato’s important side effects.
It can create a temporary feeling of separation from your body, thoughts, emotions, or surroundings.
Some patients describe changes in how they perceive time, space, or physical sensations.
What Does Dissociation Feel Like?
Experiences vary, but a person might notice:
- Feeling detached from their surroundings
- Changes in their sense of time
- Unusual visual or physical sensations
- Feeling disconnected from their body
- Difficulty describing what they are experiencing
These sensations can feel unfamiliar or uncomfortable.
Tell your healthcare team immediately if you feel frightened, confused, or overwhelmed.
How Long Does Dissociation Last?
Dissociative effects often begin relatively soon after administration and may lessen during the monitoring period.
However, the timing varies.
Your provider will assess your condition rather than assume that symptoms have resolved after a fixed amount of time.
Can Spravato Increase Blood Pressure?
Yes. Spravato can temporarily increase blood pressure.
This effect is particularly important for patients with cardiovascular or cerebrovascular conditions.
Your healthcare provider should evaluate relevant medical history before recommending treatment.
How Is Blood Pressure Monitored?
Healthcare professionals check blood pressure before administration and monitor it afterward.
The prescribing information directs clinicians to reassess blood pressure approximately 40 minutes after dosing and continue monitoring as clinically appropriate.
If your blood pressure remains concerning, your provider may recommend additional observation or medical evaluation.
Who Should Discuss Blood Pressure Risks?
Tell your provider if you have:
- High blood pressure
- Heart or blood vessel disease
- A history of stroke or other cerebrovascular conditions
- Other medical conditions that may increase the risks of elevated blood pressure
Certain vascular conditions and a history of intracerebral hemorrhage are contraindications to Spravato.
A healthcare professional must assess whether treatment is appropriate.
What Serious Side Effects Should Patients Know About?
Although many Spravato side effects are temporary, some risks can be serious.
The medication carries an FDA boxed warning addressing sedation, dissociation, respiratory depression, abuse and misuse, and suicidal thoughts and behaviors associated with antidepressant treatment in younger patients.
Severe Sedation
Spravato may cause significant sleepiness or reduced consciousness.
Some patients may become difficult to awaken.
Your healthcare team monitors alertness and other safety indicators during treatment.
Tell your provider immediately if you feel unable to remain awake or think you may faint.
Breathing Problems
Respiratory depression is another serious risk.
It can involve dangerously slow, shallow, or inadequate breathing.
Healthcare professionals monitor patients for breathing problems after administration.
Severe breathing difficulty requires immediate medical attention.
Abuse and Misuse
Esketamine is a Schedule III controlled substance.
Spravato has the potential for abuse and misuse. Therefore, providers assess relevant risk factors before and during treatment.
Patients cannot take Spravato home for self-administration.
Changes in Mood or Suicidal Thoughts
Antidepressant treatment requires careful monitoring for worsening depression or new suicidal thoughts, particularly in younger patients.
Spravato is not approved for pediatric patients.
If you experience new or worsening suicidal thoughts, contact a healthcare professional immediately.
If you are in immediate danger, call 911. In the United States, you can also call or text 988 for suicide and crisis support.
Why Does Spravato Require Medical Supervision?
Unlike many prescription medications, Spravato cannot be administered independently at home.
The FDA requires treatment through the Spravato Risk Evaluation and Mitigation Strategy (REMS) program.
This program helps manage serious risks associated with the medication.
At Least Two Hours of Observation
After each treatment, patients must remain under medical supervision for at least two hours.
During this time, healthcare professionals assess:
- Alertness and sedation
- Breathing
- Blood pressure
- Changes in perception
- Other concerning symptoms
Your provider determines when you are clinically stable and ready to leave.
Some patients may require longer monitoring.
Why You Cannot Drive After Treatment
Spravato can temporarily impair judgment, coordination, reaction time, and attention.
You must not drive or operate machinery until the next day after a restful sleep.
Arrange transportation before your appointment.
For additional guidance, read What Happens After Your First Spravato Treatment?.
Can Other Medications Increase Spravato Side Effects?
Yes. Certain medications may increase sedation or other risks when used with Spravato.
For example, central nervous system depressants, including benzodiazepines and opioids, may increase sedation.
Some stimulant medications and monoamine oxidase inhibitors may increase blood pressure concerns.
Tell your healthcare provider about all medications and substances you use.
This includes prescriptions, over-the-counter products, supplements, and alcohol.
Do not stop or change prescribed medications without medical guidance.
Is Spravato Safe for Everyone?
No medication is appropriate for every patient.
Spravato has specific indications, contraindications, and safety requirements.
Your provider should review your medical and psychiatric history before recommending treatment.
Medical Conditions That Require Careful Evaluation
Important considerations may include:
- Cardiovascular or cerebrovascular conditions
- A history of substance misuse
- Certain psychiatric conditions
- Breathing-related concerns
- Pregnancy or plans to become pregnant
- Current medications
Spravato is contraindicated in patients with certain aneurysmal vascular conditions, arteriovenous malformations, a history of intracerebral hemorrhage, or hypersensitivity to esketamine, ketamine, or its ingredients.
Pregnancy also requires special attention because Spravato may cause fetal harm.
How Do You Know Whether You’re Eligible?
Eligibility depends on a clinical evaluation, diagnosis, medical history, and treatment considerations.
Your provider can explain whether Spravato may be appropriate and what alternatives are available.
Read Who Is a Candidate for Spravato Treatment? for more information.
How Can You Prepare for Spravato Side Effects?
Preparation cannot eliminate every side effect. However, following treatment instructions can help you plan for a safer appointment.
Before Your Appointment
- Review your medical history with your provider.
- Share a complete medication and supplement list.
- Follow instructions about food and liquids.
- Arrange transportation home.
- Avoid scheduling demanding activities afterward.
- Ask questions about possible side effects.
During Treatment
Tell your healthcare team how you feel.
Report dizziness, nausea, anxiety, breathing difficulty, or unusual sensations.
You do not need to wait until a symptom becomes severe before mentioning it.
After Treatment
Follow your provider’s discharge instructions.
Plan for rest and avoid driving or other activities that require full alertness until the next day after a restful sleep.
Contact your healthcare provider about persistent or concerning symptoms.
Seek emergency medical care for severe reactions.
Frequently Asked Questions About Spravato Side Effects
Are Spravato side effects permanent?
Many common effects are temporary and lessen after treatment. However, individual reactions vary, and serious or persistent symptoms require medical evaluation. Do not assume every reaction will resolve on its own.
Does everyone experience dissociation with Spravato?
No. Dissociation is a recognized side effect, but not every patient experiences it. The intensity and nature of symptoms vary.
Can Spravato make you feel anxious?
Yes. Anxiety can occur during treatment. Tell your healthcare team if you feel distressed or uncomfortable.
Can you drive home after Spravato?
No. You must arrange transportation and avoid driving until the next day after a restful sleep.
Is Spravato the same as IV ketamine?
No. Spravato contains esketamine and is administered as a nasal spray. IV ketamine involves intravenous administration of ketamine. They have different regulatory statuses and clinical considerations.
Learn more in IV Ketamine vs. Spravato: Which Treatment Is Right for You?.
Should I stop treatment if I experience side effects?
Do not make treatment changes independently. Tell your healthcare provider about side effects so they can assess their severity and determine appropriate next steps.
Understanding Spravato Treatment Options in Lee’s Summit and Rogers
Learning about potential side effects is an important part of making informed healthcare decisions.
Before starting Spravato, discuss your medical history, current medications, treatment goals, and safety concerns with a qualified provider.
Ascend Wellness Centers serves patients in Lee’s Summit, Missouri, and Rogers, Arkansas.
Have Questions About Spravato Treatment?
If you’re exploring Spravato or want to understand the evaluation process, contact Ascend Wellness Centers.
Contact Ascend Wellness Centers
Our Locations
- Lee’s Summit, Missouri: Clinic information | Google Maps
- Rogers, Arkansas: Clinic information | Google Maps
Please contact your preferred location to confirm Spravato availability and discuss appropriate evaluation options.
Medical disclaimer: This article provides general educational information and does not replace professional medical advice, diagnosis, or treatment. Spravato has serious risks and requires supervised administration. Consult a qualified healthcare professional about your individual circumstances.