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

Wholistic Perspective • March 23, 2026

Starting Spravato is often not someone’s first step in mental health care—it’s something people consider after trying multiple treatments that didn’t fully work.


If you’re here, you’re probably wondering:
 “What actually happens once I start?”


Here’s a realistic, step-by-step breakdown based on how the process actually works in practice.

Step 1: Determining If You’re a Candidate

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.

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:

  • 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?



  • 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.

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.

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.

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

  • How long does Spravato treatment last?

    Initial treatment is about 4 weeks, followed by a longer maintenance phase.

  • Do I take Spravato at home?

    No, it’s always administered and monitored in-office.

  • Can the schedule change over time?

    Yes, frequency can be adjusted based on your response.

  • What if I don’t feel better right away?

    That doesn’t mean it isn’t working—many patients need multiple sessions.

Ready to take the next step?

Our team is here when you're ready.

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