Spravato® (esketamine) is an FDA-approved treatment for adults with treatment-resistant depression or major depressive disorder with suicidal thoughts or actions, used together with an oral antidepressant. For many people who have not found relief from traditional medications, Spravato offers a new, evidence-based option for improving depressive symptoms.

Like any medication, Spravato can cause side effects — most of which are mild, temporary, and resolve the same day. Understanding what to expect can help you feel more comfortable and prepared before beginning treatment.

At Aurora Wellness, we guide patients through every step of Spravato treatment in our REMS-certified clinics in White Plains and Brooklyn, ensuring safety, clarity, and support throughout the process.

How Spravato® Works (Simple, Accurate Explanation)

Spravato targets the glutamate system, a brain pathway different from the serotonin and norepinephrine systems used by most traditional antidepressants. By working through this alternative pathway, Spravato can help improve mood in individuals whose depression has not responded well to standard medications.

Spravato is administered as a nasal spray in the clinic, and patients remain under monitoring for at least two hours after each dose, as required by the FDA. This allows us to observe side effects in real time and ensure each session is safe and comfortable.

Common Side Effects of Spravato®

Most patients experience some short-term effects during or shortly after a treatment session. These typically begin within minutes, peak early in the session, and gradually resolve.

The most common side effects include:

• Dissociation (a temporary disconnected or “floaty” feeling)

• Dizziness or lightheadedness

• Nausea

• Mild sedation or sleepiness

• Feeling relaxed or loopy

• Increased blood pressure (temporary)

• Altered perception or unusual sensations

• Changes in taste or nasal/throat discomfort from the spray

• Low energy or fatigue later in the day

  
  

✔ These effects are expected and usually short-lived

They typically improve within 1–2 hours and are usually gone by the next day.

How Long Do Spravato Side Effects Last?

Most side effects:

• Begin within the first 15–40 minutes

• Peak early in the session

• Improve steadily over the next 1–2 hours

• Resolve completely by the same evening or next morning

Because mild increases in blood pressure are common, we monitor your vitals throughout your visit. The vast majority of patients experience blood-pressure changes that remain within a safe, temporary range.

Understanding the Two Most Common Effects

1. Dissociation

This is one of the most common experiences with Spravato. Patients may describe:

• A sense of floating

• Feeling introspective or detached

• Changes in perception of time or space

Most people tolerate this sensation well, and many find it calming. It usually fades within 45–90 minutes.

2. Sedation

Feeling tired, relaxed, or drowsy is normal. You will not drive after treatment, so plan ahead for a safe ride home.

When Side Effects Are Less Common

Rarely, patients may experience:

• Noticeably elevated blood pressure

• More intense nausea

• Brief anxiety during dissociation

• Headache afterward

If this happens, we manage it immediately in the clinic. Most patients adjust over their first few sessions and find the experience becomes smoother over time.

When You Should Talk to Your Provider

Although serious reactions are rare due to REMS monitoring and careful screening, you should notify your provider right away if you experience:

• Chest discomfort

• Severe or persistent headache

• Unusual confusion

• Shortness of breath

• Any symptom that feels concerning or unusually intense

Again, these situations are rare, and the REMS requirements are designed to protect patients by ensuring observation in a clinical setting.

Preparing for Your Spravato Session: Tips to Reduce Side Effects

1. Avoid heavy meals beforehand

A light stomach reduces nausea.

2. Stay hydrated throughout the day

But avoid drinking immediately before the dose.

3. Come rested

Fatigue can make dissociation feel more intense.

4. Share your previous experiences

If nausea or dizziness occurred in earlier sessions, we can adjust your plan.

5. Bring calming items

Breathing exercises, or grounding techniques can help you remain comfortable.

The Safety of the REMS Program

Spravato can only be provided in REMS-certified clinics — including Aurora Wellness — to ensure:

• Proper monitoring

• Safe administration

• Clear follow-up

• Prevention of misuse

This structure is one of the reasons Spravato is considered a safe and well-controlled treatment when given in the appropriate setting.

Final Thoughts

Most Spravato side effects are mild, temporary, and manageable, and many patients find that the benefits outweigh the discomfort of early sessions. With close monitoring, preparation, and individualized support, the treatment experience becomes smoother over time.

If you're considering Spravato or want to understand whether it’s right for you, our team at Aurora Wellness offers:

• Comprehensive psychiatric evaluation

• Medication management

• Spravato® treatment in White Plains and Brooklyn

We’re here to answer questions, guide you through the process, and help you take the next step toward meaningful improvement.

If you’d like to learn more about Spravato or schedule a consultation, Aurora Wellness is here to help.