What to Expect When Starting Spravato Treatment (Step-by-Step Guide)

Starting Spravato treatment can bring up a lot of questions—especially if you’re not sure what the process actually looks like. This step-by-step guide walks you through what to expect, from your first evaluation to ongoing treatment, so you can feel more prepared and confident moving forward.

While every treatment plan is personalized, most patients follow a similar overall structure. Knowing what to expect ahead of time can help reduce uncertainty and make the process feel more manageable.

Before You Begin: What to Know

Before starting Spravato, there are a few important things to keep in mind:

• Treatment is done in a monitored clinical setting
• You’ll need someone to drive you home after sessions
• Sessions are longer than typical appointments (about 2 hours)
• It’s part of a broader treatment plan—not a standalone solution

Step 1: Determining If You’re a Candidate

This step helps ensure that Spravato is appropriate for your specific situation. Your provider will review your history, current symptoms, and previous treatments to determine if it’s a good fit.

Spravato is typically used for people experiencing:

• Treatment-resistant depression
• Ongoing or persistent suicidal thoughts

In most cases, patients have already:

• Tried multiple antidepressants
• Possibly tried therapy or other medications
• Continued to struggle with motivation, relationships, or daily functioning

This isn’t a first-line treatment—it’s considered when other approaches haven’t provided enough relief.

Step 2: Insurance Approval

Before treatment begins, there’s an important administrative step. This step can feel like the most uncertain part, but your care team typically helps guide the process and handle much of the coordination.

Most insurance companies require proof that:

• Other treatments were attempted
• Those treatments were not effective

This is called prior authorization, and it’s a critical step in making treatment accessible.

During this time, your provider is essentially advocating on your behalf to show that this level of care is medically necessary.

Step 3: The Induction Phase

Once approved, treatment begins with what’s called the induction phase. The induction phase is the most structured part of treatment and is designed to help your body respond to the medication.

In the induction phase:

• You’ll come in twice per week for 4 weeks
• Each session lasts about 2 hours
• The medication is administered as a nasal spray in-office

This isn’t something you take at home—everything is done in a controlled, monitored setting.

What happens during each session?

During your visit, you’ll be monitored in a comfortable setting. Most people spend the session resting, and a provider is available to ensure your safety throughout.

• You receive the medication
• You stay in the office for observation
• Providers monitor how you respond

Some patients notice changes early. Others don’t feel much right away—and both experiences are normal.

Step 4: The Maintenance Phase

After the first month, treatment doesn’t just stop—it shifts. As treatment progresses, sessions become less frequent based on how you’re responding. This phase focuses on maintaining progress over time.

The schedule typically becomes:

• Once per week for several weeks
• Then once every other week



From there, treatment becomes more individualized.

Step 5: Adjustments Over Time

One of the most important things to understand is that this treatment is flexible. Your treatment plan may be adjusted based on your response, goals, and overall progress. This flexibility helps ensure your care stays aligned with your needs.

Patients may:

• Take breaks
• Increase frequency during harder periods (like winter months)
• Combine it with therapy or other medications

It’s not a rigid, one-size-fits-all plan—it evolves based on how you’re doing.

Common Misunderstanding: “If it doesn’t work right away, it won’t work.”

This is one of the biggest reasons patients stop too early. It’s common to expect quick results, but Spravato is designed as a series of treatments. Evaluating progress over time is more meaningful than focusing on a single session.

Some people:

• Try 1–2 sessions
• Don’t feel immediate relief
• Assume it’s not working

But this treatment is designed as a process, not a one-time experience.

Frequently Asked Questions

Ready to take the next step?

If you’re considering Spravato and want to understand what the process would look like for you, our team can guide you through each step and answer your questions along the way.