During a Spravato treatment session, you’ll spend at least two hours in a supervised clinic setting after taking the nasal spray. Most of that time involves resting in a comfortable position while the medication’s effects peak and fade. What you do with that window can shape how the experience feels, so it helps to go in with a plan.
What Happens During a Session
Each Spravato session has three phases: a brief preparation, the nasal spray administration itself, and a two-hour observation period. You’ll self-administer the spray under staff supervision, typically using two or three devices with a five-minute rest between each one. After that, you settle in for monitoring.
Staff will check your blood pressure before dosing, again around 40 minutes after (when the drug reaches its peak level in your body), and as needed until your readings come back down. They’re also watching for sedation and dissociation, two expected effects that typically peak around the 40-minute mark and resolve within about 90 minutes. Once you’ve been stable for at least two hours, your care team decides whether you’re ready to leave.
How to Prepare Before You Arrive
Avoid eating for at least two hours before your appointment and stop drinking liquids at least 30 minutes prior. This reduces the chance of nausea, which is one of the more common side effects. If you take a nasal decongestant or corticosteroid spray, use it at least an hour beforehand so your nasal passages can absorb the medication properly.
You’ll also need to arrange a ride home before you show up. You cannot drive, operate machinery, or do anything requiring full alertness until the next day after a restful sleep. This restriction applies every single session, not just the first one.
Bring a few comfort items: headphones, a playlist you find calming, a blanket or eye mask if the clinic doesn’t provide them. Some people bring a journal. Leave anything that requires sharp focus or quick responses at home, because you likely won’t be able to use it meaningfully once the medication kicks in.
What Dissociation Actually Feels Like
The most distinctive part of a Spravato session is dissociation, a temporary shift in how you perceive yourself and your surroundings. People describe it in various ways: a sense of detachment from your own body, feeling like you’re spinning or floating, confusion about time and place, blurred vision, or a sensation often compared to feeling “drunk.” Some find it mildly pleasant. Others find it disorienting or anxiety-provoking, especially the first time.
These sensations are not a sign that something is going wrong. They’re a known, expected effect of the drug. Knowing this ahead of time makes a real difference, because the confusion can feed on itself if you start worrying that something is wrong. Staff are trained to remind you that you’re safe, that the feelings are temporary, and that they’ll stay with you until things settle.
What to Do While the Drug Is Active
The single most effective thing you can do during a session is listen to music. Clinicians who manage dissociative side effects consistently recommend it as a grounding tool. Choose something familiar and calming rather than intense or emotionally charged. Having it ready on your phone with headphones means you can start it immediately after dosing, before the effects set in.
Beyond music, the general approach is to rest and let the experience unfold rather than trying to fight or control it. Lie down or recline if your clinic offers a couch. Close your eyes if the visual distortion bothers you. Some people find it helpful to adopt a curious, open attitude toward whatever sensations arise, rather than tensing against them. Trying to force yourself to “act normal” or stay mentally sharp tends to increase anxiety rather than reduce it.
A few practical comfort strategies that clinics use and that you can request:
- Dim lighting. Bright rooms can intensify visual discomfort during dissociation.
- Cool room temperature. Some people feel flushed or overheated as a side effect.
- Propping your feet up. Lying with your legs slightly elevated can help if you feel dizzy or lightheaded.
- Physical grounding. Holding someone’s hand or gripping a textured object can anchor you if the detachment feels overwhelming.
You don’t need to “do” anything productive during this time. Reading, scrolling your phone, or having complex conversations will likely be difficult once dissociation peaks, and attempting them can be frustrating. Think of the observation period as intentional rest, not downtime to fill.
What to Avoid
Don’t try to stand up or walk around without telling staff first. Dizziness and impaired coordination are common, and falls are a real risk during peak effects. If you need to use the restroom, let someone know so they can help you get there safely.
Avoid making important decisions or sending messages you might regret. The drug temporarily impairs judgment and can alter your emotional state in ways that don’t reflect your baseline. Treat it like any other situation where you know your thinking is temporarily altered.
Don’t eat or drink during the session unless your clinic gives you the go-ahead, typically closer to the end of the observation period. Some clinics offer light snacks and water once the acute effects have worn off.
What Happens at the Two-Hour Mark
At the end of the observation window, staff will check your blood pressure again and assess whether you seem clinically stable. If your blood pressure is still elevated or you’re still noticeably sedated, they’ll keep monitoring until things normalize. Most people are ready to leave right around the two-hour mark, but plan for some flexibility in case your session runs longer.
When you’re cleared to go, your pre-arranged driver takes you home. Many people feel tired or slightly “off” for the rest of the day. The best thing you can do afterward is go home, eat a light meal, and rest. The driving restriction lasts until the next day after a full night of sleep, so plan your schedule accordingly. Treat the rest of that day as a recovery day, not a half-day where you try to squeeze in errands or work.
How Sessions Change Over Time
The first session tends to be the most intense because you don’t yet know what to expect. Many people report that dissociation becomes more manageable and less anxiety-producing as they learn what the experience feels like for them. You’ll develop your own preferences for music, positioning, lighting, and how much interaction you want with staff.
Some clinics encourage keeping a journal between sessions to track how you felt, what helped, and what you’d change. This is worth doing. Knowing that cool temperatures helped last time, or that a particular playlist made things worse, lets you fine-tune your setup over the weeks of treatment. The observation period is the same every visit, so small adjustments to your routine add up.