You’ve decided to try Spravato treatment after years of battling treatment-resistant depression. It’s a big step, one that brings hope but also some understandable concerns. What will the side effects feel like? How can you prepare yourself? And most importantly, how can you manage them so they don’t hold you back from getting the relief you need?
At Resilience Integrative Wellness, we’ve helped hundreds of San Diego patients navigate Spravato treatment successfully. Our experienced team has learned what works best for managing side effects, and we’re here to share that knowledge with you. The good news? While Spravato side effects are real, they’re typically temporary and manageable with the right approach.
Here’s what you need to know about managing Spravato side effects based on real clinical experience from our San Diego team.
Understanding Common Spravato Side Effects
Before we dive into management strategies, it helps to understand what you’re actually dealing with. Spravato works differently than traditional antidepressants. While conventional medications target serotonin or dopamine pathways and can take weeks to show effects, Spravato acts on the brain’s glutamate system through NMDA receptor modulation.
This unique mechanism is why Spravato works so quickly, but it’s also why the side effects feel different from what you might’ve experienced with other antidepressants. The side effects typically peak within the first 90 minutes after administration and usually resolve within two hours.
According to Spravato’s safety information, the most common side effects experienced during clinical trials included dissociation, dizziness, nausea, sedation, headache, and increased blood pressure. In studies, about 46% of patients experienced some degree of dissociation, while 28% experienced dizziness and 27% had nausea.
What’s important to remember is that these effects are temporary. They’re not signs that something’s wrong, they’re simply how your brain responds to the medication as it begins its work.
Preparing for Your Treatment Session
The best way to manage Spravato side effects starts before you even arrive at our clinic. Here’s what our San Diego clinicians recommend:
The Night Before
Get a solid night’s sleep. Being well-rested makes a significant difference in how you experience the treatment. If you struggle with sleep, talk with your provider about safe sleep aids you can use the night before your session.
Eat a light, healthy dinner and stay hydrated. You’ll need to avoid eating for at least two hours before your treatment, but proper nutrition the evening before sets you up for success.
Morning of Treatment
Stick to light, easily digestible foods if you’re eating breakfast. Think toast, oatmeal, or fruit rather than heavy, greasy options. Remember to stop eating two hours before your scheduled appointment.
Avoid caffeine if you’re sensitive to it. While some patients tolerate their usual morning coffee just fine, others find that skipping caffeine helps reduce any jitteriness or anxiety during treatment.
Wear comfortable clothing. You’ll be reclining during your monitoring period, so choose loose, comfortable clothes that won’t restrict your movement or breathing.
Arrange your ride home in advance. You cannot drive after Spravato treatment, so having this sorted beforehand removes one potential stressor.
Managing Dissociation During Treatment
Dissociation is the most commonly reported Spravato side effect, and it’s often the one that concerns patients most before their first treatment. But here’s what we’ve learned from years of administering this therapy: dissociation doesn’t have to be frightening or uncomfortable when you know what to expect and how to work with it.
Dissociation can feel like you’re slightly disconnected from your surroundings or your body. Some patients describe it as feeling dreamlike or as if they’re observing themselves from a slight distance. These sensations usually begin within 15 to 30 minutes after administration and peak around 30 to 45 minutes.
Our Team’s Top Tips for Managing Dissociation
Don’t fight the feeling. The most uncomfortable dissociation experiences happen when patients resist or become frightened by the sensation. Instead, remind yourself that this is temporary and expected. Let the experience flow rather than fighting against it.
Use grounding techniques if needed. Some patients find it helpful to focus on physical sensations like the weight of their body in the chair or the texture of the blanket we provide. Others prefer to simply close their eyes and breathe steadily.
Trust your environment. You’re in one of our six private treatment rooms at Resilience Integrative Wellness, equipped with comfortable reclining chairs, Bose headphones, soft blankets, and complimentary refreshments. Our experienced medical team is monitoring you throughout. You’re safe.
Communicate with your care team. If dissociation feels overwhelming, let us know. We can talk you through it, adjust your positioning, or simply provide reassurance. There’s no need to suffer in silence.
Reducing Nausea and Dizziness
Nausea affects about one in four Spravato patients, while dizziness is similarly common. These symptoms are related to how esketamine affects the vestibular system and certain receptors in the brain. Fortunately, there are several effective strategies our San Diego clinicians use to minimize these effects.
Before Treatment
Take anti-nausea medication if prescribed. Many providers, including our team at Resilience, will prescribe ondansetron or another anti-nausea medication to take 30 minutes before your Spravato dose. This proactive approach significantly reduces nausea for most patients.
Use nasal spray correctly. Proper administration technique matters. We’ll show you exactly how to use the Spravato nasal spray device to ensure you’re getting the right dose without excessive drainage into your throat, which can trigger nausea.
During Treatment
Recline at the right angle. Our treatment chairs are adjustable, and we’ll help you find the optimal position. A 45-degree recline often works best for minimizing dizziness while keeping you comfortable.
Keep your head still. Once you’ve administered your dose and settled into your chair, try to minimize head movements for the first 30 minutes. Quick head turns can intensify dizziness.
Breathe through your nose slowly and deeply. This helps settle your stomach and can reduce both nausea and anxiety about the experience.
After Treatment
Sit up slowly when you’re ready to leave. Even if you feel fine, sudden movements after treatment can trigger brief dizziness. Take your time standing up and let us know if you feel unsteady.
Handling Blood Pressure Changes
Spravato can cause temporary increases in blood pressure and heart rate. This is why we monitor your vital signs before treatment, during the session, and for at least two hours afterward. For most patients, these changes are mild and return to baseline without intervention.
If you have a history of high blood pressure or cardiovascular concerns, our team takes extra precautions. We may check your blood pressure more frequently or adjust your existing blood pressure medications in coordination with your primary care provider.
What you can do: Stay calm and relaxed. Anxiety naturally raises blood pressure, so the relaxation techniques that help with dissociation also help with blood pressure management. Focus on slow, steady breathing and trust that our team is monitoring everything closely.
If your blood pressure rises significantly during treatment, we have medications on hand to bring it down safely if needed. This is rare, but it’s one reason why Spravato must be administered in a certified medical setting rather than at home.
Managing Post-Treatment Effects
For most patients, Spravato side effects resolve within two hours of treatment. However, some people experience lingering tiredness, mild headaches, or slight cognitive fogginess for the rest of the day. Here’s how to handle these effects:
Plan for Rest
Don’t schedule important activities for your treatment day. You won’t be able to drive until the next morning, and even if you feel fine, your reaction times and decision-making abilities may be slightly affected for several hours.
Consider taking the rest of the day off work, especially for your first few treatments while you’re learning how your body responds. Many of our San Diego patients schedule afternoon treatments and take the remainder of the day to relax.
Stay Hydrated
Drink plenty of water after your treatment session. Hydration helps your body process the medication and can reduce headaches and fatigue.
Eat When You’re Ready
You were required to fast before treatment, so you’ll likely be hungry afterward. Start with something light and see how your stomach responds before moving to a full meal.
Monitor Your Mood
Some patients notice improvements in their mood within hours of their first dose. Others don’t see changes until they’ve had several treatments. Both experiences are normal. Pay attention to how you’re feeling, but don’t worry if you don’t see immediate results.
Long-Term Side Effect Management
While most Spravato side effects are acute and resolve within hours, there are some considerations for long-term treatment. Here’s what our experienced team in San Diego has learned:
Developing Tolerance to Side Effects
Good news: most patients find that side effects decrease with repeated treatments. Your first session might feel intense, but by your fifth or sixth treatment, you’ll likely find the effects much more manageable. Your brain adapts to the medication, and you also become more comfortable with the experience.
Bladder Health
Ketamine and esketamine can potentially affect bladder function with very long-term use at high doses. This is something we monitor carefully. If you notice any changes in urination frequency, urgency, or discomfort, let us know immediately. This side effect is rare at therapeutic Spravato doses but shouldn’t be ignored.
Cognitive Function
Clinical trials haven’t shown significant long-term cognitive impairment from Spravato treatment at prescribed doses. If you notice memory problems or thinking difficulties that persist beyond your treatment days, discuss this with your provider.
When to Contact Your Provider
While Spravato side effects are typically manageable, there are times when you should reach out to your healthcare team between sessions:
Contact us if you experience severe or persistent headaches that don’t respond to over-the-counter pain relievers. Let us know about any unusual mood changes, particularly if you notice increased suicidal thoughts, though it’s worth noting that Spravato is actually FDA-approved for treating depression with suicidal ideation.
Reach out if you have vision changes, especially double vision or persistent blurriness beyond your treatment day. Call immediately if you develop chest pain, severe shortness of breath, or signs of an allergic reaction.
Also contact us if side effects aren’t improving with repeated treatments or if they’re significantly affecting your quality of life. We may be able to adjust your dose, change your dosing schedule, or add medications to help manage specific symptoms.
The Role of Your Care Team
Managing Spravato side effects isn’t something you do alone. At Resilience Integrative Wellness, our veteran-owned practice brings over 60 years of combined medical experience to your care. Every member of our team is REMS-certified to administer Spravato, meaning we’ve completed specialized training in managing this unique treatment.
During your monitoring period, we’re not just watching the clock. We’re assessing your response, checking your vital signs, and making sure you’re comfortable. If something doesn’t feel right, we can intervene immediately.
Between sessions, we’re available to answer questions and address concerns. Many new patients worry about side effects before their first treatment, and we’re happy to talk through your specific concerns. Understanding what to expect significantly reduces anxiety about the experience.
Balancing Side Effects with Benefits
Here’s the reality: yes, Spravato has side effects. But for the vast majority of our San Diego patients, those temporary effects are far outweighed by the benefits of treatment. We’re talking about a therapy with a 70% remission rate in clinical trials for treatment-resistant depression, effects that can begin within hours rather than weeks, and the potential to finally find relief after years of struggling.
One of our patients described it this way: “The dissociation was strange at first, but it was nothing compared to the fog of depression I’d been living in for years. Now that I know what to expect, treatment days are just a small inconvenience for the relief I get.”
That’s the perspective we hope you can develop too. Spravato side effects are real and deserve respect, but they don’t have to prevent you from accessing breakthrough treatment that could change your life.
Your Comfort is Our Priority
At Resilience Integrative Wellness, we’ve designed every aspect of our Spravato program with your comfort in mind. Our six private treatment rooms provide a peaceful environment where you can relax during your monitoring period. We offer Bose headphones if you’d like to listen to music, warm blankets for comfort, and complimentary refreshments when you’re ready.
More importantly, our team understands that this treatment can feel intimidating. We’ve guided hundreds of patients through their first sessions and beyond. We know the questions you’re likely to have, the concerns you might not voice, and the techniques that help patients feel most comfortable during treatment.
As a veteran-owned practice, we’re particularly attuned to the needs of veterans, first responders, and others dealing with treatment-resistant depression and PTSD. We understand that asking for help can feel vulnerable, and we’re committed to providing care that honors that trust.
Insurance and Accessibility
One advantage of Spravato over some other innovative treatments is that it’s often covered by insurance for FDA-approved indications like treatment-resistant depression. Our team has extensive experience navigating prior authorization processes and maximizing insurance benefits.
We’ll work with your insurance company to verify your coverage, handle the paperwork for approval, and help minimize your out-of-pocket costs. The goal is to make breakthrough treatment accessible, not to add financial stress to your healing journey.
Take the Next Step
Managing Spravato side effects is largely about preparation, communication, and working with an experienced care team that knows what they’re doing. At Resilience Integrative Wellness, we’ve refined our approach based on years of clinical experience and hundreds of successful patient treatments.
If you’re considering Spravato treatment but have concerns about side effects, we encourage you to schedule a consultation. We can discuss your specific health history, answer your questions, and help you understand what to expect from treatment. You’ll have the chance to see our treatment rooms, meet our team, and get a clear picture of what the experience will be like.
Depression doesn’t have to be permanent, and treatment-resistant doesn’t mean hopeless. With the right support and preparation, Spravato side effects can be managed effectively while you access the rapid relief this breakthrough treatment offers.
Ready to learn more about whether Spravato is right for you? Contact Resilience Integrative Wellness today.
Contact Resilience Integrative Wellness
Resilience Integrative Wellness
6719 Alvarado Road, Suite 201
San Diego, CA 92120
Phone: (619) 768-8723
Website: resilienceintegrative.com
Our experienced team is here to answer your questions about Spravato treatment, side effect management, and whether this innovative therapy might be right for your treatment-resistant depression. Schedule your consultation today and take the first step toward the relief you deserve.
The information on this page is for educational purposes only and does not constitute medical advice. Individual results may vary. Always consult with a qualified healthcare provider before beginning any new treatment. Spravato side effects should be discussed with your medical provider, and treatment must be administered in a certified healthcare setting by trained professionals.
