What Happens During Ketamine and Spravato Treatment

A plain description of what a session involves. This is general information about how these treatments are usually given — your own clinic will have its own routine, and your prescriber will tell you what applies to you.

Before you go

• Most clinics ask you not to eat for a few hours beforehand, and to avoid drinking much fluid shortly before.
• Arrange a lift home before the day. This is not optional and it is not negotiable at the door.
• Bring a list of every medicine you take, including anything bought over the counter.
• Bring headphones and music if that helps you settle. Many people find the room easier with something familiar in their ears.
• Expect to be there considerably longer than the treatment itself takes.

An IV ketamine session

The infusion itself usually runs about forty minutes to an hour, given through a drip in your arm, with your blood pressure and pulse checked throughout. Most people stay somewhere quiet afterwards until the effects settle, so plan for two to three hours at the clinic in total.

During the infusion many people feel detached from their body or surroundings — this is called dissociation. It can be strange and it can be unsettling, particularly the first time. It is expected, it is temporary, and the staff have seen it before. Tell them if you are frightened; the rate can usually be slowed.

A Spravato session

Spravato is available only through a restricted safety programme called a Risk Evaluation and Mitigation Strategy (REMS), and may only be given in a certified healthcare setting under a provider's direct observation. Patients never take it home. as of 30 Apr 2025 · U.S. Food and Drug Administration (source 1, opens in a new tab)

You spray the medicine yourself, under supervision, in a certified clinic. Then you wait.

A healthcare provider must monitor the patient for at least two hours after every Spravato dose before deciding they are ready to leave. as of 30 Apr 2025 · U.S. Food and Drug Administration (source 1, opens in a new tab)

Your blood pressure is checked before the dose and again during the wait, because it commonly rises for a while afterwards. The two hours are not a formality — they are the reason this treatment is only given in certified settings.

You must not drive until the next day, after a full night's sleep. Not that evening, however well you feel.

After a Spravato dose you must not drive or operate machinery until the next day, following a restful night's sleep, so you need to arrange a ride home from every session. as of 30 Apr 2025 · U.S. Food and Drug Administration (source 1, opens in a new tab)

Side effects

In treatment-resistant depression studies the most common side effects of Spravato were dissociation, dizziness, nausea, sedation, vertigo, reduced sense of touch, anxiety, lethargy, increased blood pressure, vomiting, feeling drunk, and headache. as of 30 Apr 2025 · U.S. Food and Drug Administration (source 4, opens in a new tab)The label lists a different set for the major-depressive-disorder-with-acute-suicidality indication. The two lists should not be conflated.

Most of these fade within the observation period. Tell the clinic about anything that does not, or anything that frightens you — including changes in mood. If your mood worsens after a session, that is a reason to contact your prescriber promptly rather than wait for the next appointment.

What a course usually looks like

IV ketamine is commonly given as six sessions over two to three weeks, sometimes followed by occasional boosters. Spravato is usually twice a week for four weeks, then weekly, then every one to two weeks — your prescriber decides based on how you respond.

Nobody can tell you in advance whether it will work for you, how quickly, or for how long. Any source that offers you a number for that is guessing.

Integration, and what the research actually shows

Best available information: Laboratory and animal research suggests ketamine and esketamine may work partly by increasing BDNF and mTOR signalling, which strengthens connections between brain cells — but human evidence is limited and mixed, so this is a promising theory rather than a proven explanation. as of 5 Dec 2024 · International Journal of Molecular Sciences (source 1, opens in a new tab)This is a narrative review, not a systematic review, and it reports mixed clinical findings. It does not support any personal recovery timeline.

You will find a great deal written about a "window of neuroplasticity" after treatment, often with specific timings attached. Treat those timings with caution. The underlying research is mostly laboratory and animal work, the human evidence is limited and mixed, and no study supports a personal timeline calculated from your treatment date.

What is uncontroversial is more ordinary: many clinicians pair these treatments with talking therapy, and people who have some structured support around the course tend to find it easier to make use of. That is worth asking your clinic about.

Getting there, in Nevada

Nevada's two care hubs are about 448 miles and seven and a half hours apart by road, and Elko sits roughly four and a half hours from Reno. Outside Clark and Washoe counties, multi-hour one-way drives to reach a ketamine or Spravato provider are normal — and a course of infusions, or twice-weekly Spravato induction visits, means making that trip again and again, with someone else driving you home each time.

Nevada borders CA, OR, ID, UT, AZ. If a clinic across the state line is closer, that may be worth considering — but check it is in your insurance network first.

For the drug-level detail on Spravato specifically — how it works, what the trials showed — our sister site spravato.clinic goes deeper than we do here.