The thought of starting SPRAVATO® (esketamine) might raise questions and concerns, particularly if treatment with antidepressants or other therapies for depression has not helped you find relief. Before starting, take time to ask yourself clear and thoughtful questions so you feel prepared, know what to expect, and establish a good working relationship with your care team.
This guide reviews some of the most helpful questions to ask your provider. This includes whether the treatment is suitable, what it will entail, and how it will be followed up. Here, the aim is to provide you with a clear picture, so you can proceed with confidence.
Is SPRAVATO Right for My Situation?
The first and most critical discussion is, “Am I eligible?” SPRAVATO has been approved for treating adults with depression that does not respond to adequate trials with a treatment plan consisting of 2 or more antidepressants, also called treatment-resistant depression. It is also used, together with an oral antidepressant, for adults who have major depressive disorder with acute suicidal thoughts or behaviors.
Ask your provider:
- Given my history of treatments, do I meet the criteria for this option?
- Have we carefully reviewed the doses and duration of the medications I have already tried?
- Do I have any medical condition in my past that would make this treatment less appropriate or pose additional risks?
Provide information about heart or blood pressure conditions, known history of vascular problems or bleeding in the brain, liver concerns, previous experiences with psychosis, substance use, and pregnancy, planning pregnancy, and breastfeeding. Certain conditions rule out the treatment for safety reasons. An open history of your entire medical history enables your provider to consider the risks and advantages just for you.
What Will the Treatment Experience Be Like?
Having some specifics regarding the visit takes out a lot of uncertainty. SPRAVATO is not something you take at home. It is administered in a certified clinical facility under direct supervision and subsequently observed for a mandatory designated amount of time.
Helpful questions include:
- Can you walk me through a typical session from arrival to the time I leave?
- How is the Nasal Spray given, and for how long is the dosage administered?
- How long will I stay for monitoring afterward?
- What does the overall schedule usually look like in the first weeks, and how might it change later?
- Will I continue my current oral antidepressant, and how do the two work together?
You will self-administer the spray while staff observe, then remain for monitoring until you are considered stable enough to leave. A reliable means of transport home must be available for each transfer, as driving or operating machinery is not permitted until the next day after a night’s rest. Understanding the time commitment and logistics helps you plan support and arrange your schedule.
How Is Safety Handled During and After Each Session?
In the field of care at SPRAVATO, safety is an integral part of the process. It can cause temporary side effects like drowsiness, feeling withdrawn, or affecting blood pressure, so it is only available through a special restricted program, with strict standards to ensure the safety of screening and treatment for clinics and patients.
Ask about:
- Is this clinic registered by the required safety program for SPRAVATO?
- Who will be with me during the observation period, and what will they be monitoring?
- If side effects occur, how are they managed?
- Any checks performed before providing a dose, like blood pressure?
- Are there any activities, foods, or substances I should avoid before or after treatment?
Blood pressure is taken before medication administration. You are observed for a minimum period until any temporary effects have settled and staff determines it is safe for you to leave. The value of talking through these points is that you will gain confidence in the environment and the team’s readiness.
What Side Effects Are Common, and How Are They Addressed?
Most feel some short-term effects when they are in the session or shortly afterwards. These may be a sensation of being out of touch with the environment, dizziness, sleepiness, nausea, or a temporary increase in blood pressure. Their symptoms tend to fade during the monitoring period.
Questions worth asking:
- Which effects are most common, and how long do they typically last?
- What can I do beforehand to lower the chance of nausea?
- How will the team support me if I feel uncomfortable?
- Are there any longer-term considerations I should know about?
- How does the potential for misuse factor into ongoing monitoring?
Your provider can also tell you how your medical history might affect your experience and what measures the clinic implements to ensure that you are comfortable and safe.
How Will We Know If the Treatment Is Helping?
SPRAVATO is one part of a larger plan. Clear communication about tracking progress keeps everyone aligned.
Consider asking:
- Will improvement be measured through frequent check-ins, symptom checklists, or other methods?
- What will the criteria be for reviewing results and seeing if we should continue, change, or terminate?
- How will this clinic keep in touch with my usual psychiatrist or therapist?
- What other supports, such as therapy or lifestyle strategies, will be part of my overall care?
Discussing the bigger picture ensures SPRAVATO is integrated thoughtfully rather than used in isolation.
What About Cost, Insurance, and Everyday Logistics?
Practical details often shape how sustainable treatment feels.
Useful questions include:
- Will I be entitled to this treatment under my insurance, and what documents are required, or do I need to be approved for it?
- What out-of-pocket costs should I expect?
- How far ahead do appointments need to be scheduled, and what is the policy for changes?
- What transportation arrangements are recommended?
- Who can I contact if questions come up between visits?
Having clear answers early in the process will help you plan rides, time away from work/responsibilities, and any financial implications.
How Should I Prepare for Sessions and Stay Supported?
Preparation can make the experience smoother.
Ask:
- What should I do or avoid in the hours before a session?
- What things may be useful, for example, a list of medications or an item for comfort?
- How will communication work if I see more than one provider?
- What resources are available if I need extra support between appointments?
Providers often recommend avoiding food for a period before treatment and limiting liquids closer to the appointment to reduce the chance of nausea. A treatment plan that is known and has a dependable transportation strategy favors a calmer treatment day.
Moving Forward with Clarity
These are questions to get you started in a discussion that is personalized to you. Write them down, add any personal concerns, and bring notes about your history and goals. It can be useful to have a trusted individual involved in the discussion as a support person.
Trained Mind Psychiatry provides a room for these conversations. Your history is reviewed carefully, the safety requirements and monitoring are explained, realistic expectations are discussed, and your care is coordinated so that SPRAVATO is an integral part of your good care, which consists of a broader plan. We focus on ensuring that you are fully informed and supported throughout.
If you are considering use, there is nothing more important than taking the next step and contacting us to schedule a consultation to see if SPRAVATO is right for you. The right set of questions is the starting point for clarity and care that is equal to your needs.
This information is educational only and is not a substitute for professional medical advice. Treatment decisions should be made with a qualified healthcare provider who understands your individual situation.
