What to Expect During a SPRAVATO® Treatment Session

SPRAVATO® is the first FDA-approved nasal spray of its kind for treatment-resistant depression, available only through certified healthcare providers (U.S. Food and Drug Administration). That certification requirement means the treatment happens in a monitored clinical setting, which is a detail that shapes every session from start to finish. At DreamWork Wellness Center, we want patients to know exactly what to expect before they arrive.

What SPRAVATO® Is

SPRAVATO® contains esketamine, a compound that acts on the glutamate system in the brain. Standard antidepressants primarily target the serotonin and norepinephrine systems; esketamine works through a different neurological pathway, which is part of why it produces results in patients whose depression has not responded to conventional medications. The FDA approved SPRAVATO® as the first medication of its class for treatment-resistant depression, and it is also the first and only FDA-approved monotherapy for adults with TRD, meaning it can be used as a standalone treatment rather than requiring combination with an oral antidepressant (Johnson & Johnson).

At DreamWork Wellness Center, we offer SPRAVATO® at our Frisco and Sherman, TX locations. Every candidate completes a thorough evaluation before treatment begins to confirm that SPRAVATO® is the right fit for their situation.

How the Process Starts

Before the first SPRAVATO® session, patients at DreamWork complete a telebehavioral health evaluation. This allows our team to review your psychiatric history, confirm your diagnosis, assess candidacy, and handle prior authorization and insurance verification before anything else takes place. We do not begin treatment until we understand your full clinical picture and your coverage situation is confirmed.

After prior authorization is approved, our front desk team walks you through what your insurance covers and what, if anything, you will owe out of pocket before your first appointment. Because SPRAVATO® carries FDA approval for treatment-resistant depression, coverage has improved considerably in recent years, though it varies by plan. We accept Medicare, Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna, United Medical Resources, Magellan, and TriWest Healthcare Alliance, and our team manages every step of the authorization process.

What Happens During a Session

On the day of your appointment, you will receive SPRAVATO® as a self-administered nasal spray, under direct supervision by a member of our clinical team. After administration, you remain at our office for a two-hour observation period. During that time, our staff monitors your vital signs throughout the session. Many patients choose to journal, listen to music, or simply rest during the observation window. You may bring a support person with you if that would be helpful.

You will need a driver to take you home after each SPRAVATO® session. You should not drive or operate heavy machinery on the day of treatment, which is why we ask every patient to arrange transportation in advance. Once the observation period is complete and our team confirms you are ready to leave, you are free to go.

Dissociative symptoms, meaning a sense of detachment or perceptual shifts, are a known and expected effect of SPRAVATO® and are one of the primary reasons the two-hour observation period and clinical supervision are required. Most patients find these effects manageable within the observation window. If you have questions about what to expect during the session itself, discuss them with your provider before your first appointment.

How Often You Come In

A standard SPRAVATO® course at DreamWork involves one to two appointments per week, with the full course lasting approximately eight weeks. The frequency may be adjusted based on how you are responding to treatment. Our team monitors your progress at each visit, and the plan is adapted throughout the course as needed.

Some patients continue beyond the initial eight weeks. Others transition into a less frequent maintenance schedule depending on their clinical response. Results vary by individual, and we do not apply a one-size-fits-all timeline to every patient.

The Team Behind Your Treatment

SPRAVATO® treatment at DreamWork is overseen by Dr. Jahi Anderson, our board-certified psychiatrist and medical director with more than fifteen years of clinical experience in mood disorders, PTSD, anxiety, and substance use disorders. Every patient completes an evaluation with our psychiatric staff before beginning, and our team remains in contact with you throughout the course. SPRAVATO® is not a walk-in treatment. The supervised setting and the evaluation process exist because this treatment is taken seriously by the providers who offer it.

Frequently Asked Questions

Do I have to stay at the clinic after taking SPRAVATO®?

Yes. A two-hour observation period is required after every SPRAVATO® session. Our clinical team monitors your vital signs throughout that time. You cannot drive yourself home after a session, so arranging a driver in advance is required before your first appointment.

Is SPRAVATO® the same as IV ketamine?

No. SPRAVATO® is a nasal spray formulation of esketamine, a close chemical relative of ketamine. IV ketamine is administered intravenously and is used off-label for depression; SPRAVATO® is an FDA-approved treatment specifically for treatment-resistant depression, available only through certified providers (U.S. Food and Drug Administration). The administration method, dose, clinical setting, and regulatory status are all different.

How long does a SPRAVATO® treatment course last?

A standard course involves one to two appointments per week over approximately eight weeks. Some patients continue in a maintenance schedule after that. The timeline is adjusted based on how you are responding, and results vary by individual.

Will I feel disoriented during treatment?

Dissociative symptoms are a known effect of SPRAVATO® and are one of the reasons the observation period and clinical supervision are in place. Most patients find these effects manageable during the observation window. Discuss any concerns with your provider before treatment begins so you know what to expect.

Who is a candidate for SPRAVATO®?

SPRAVATO® is FDA-approved for adults with treatment-resistant depression. Candidacy is determined through a thorough psychiatric evaluation at DreamWork. Patients with certain medical or psychiatric histories may not be appropriate candidates. Discussing your full history with our team is the right starting point.

Key Takeaways

• SPRAVATO® is the first FDA-approved nasal spray of its kind for treatment-resistant depression, available only through certified healthcare providers.
• Every SPRAVATO® session at DreamWork includes a required two-hour observation period during which our clinical team monitors vital signs. Patients cannot drive themselves home after treatment.
• A standard SPRAVATO® course involves one to two appointments per week for approximately eight weeks. Results vary by individual.
• Coverage for SPRAVATO® has expanded significantly and is accepted by many major insurance plans. DreamWork handles prior authorization and verification before treatment begins.
• Every patient completes a telebehavioral health evaluation before their first session to confirm candidacy and complete insurance verification.

What to Do Next

The supervised setting, the observation period, the required driver, and the telebehavioral health evaluation are not obstacles. They are how SPRAVATO® treatment is done correctly. At DreamWork Wellness Center, our team in Frisco and Sherman, TX is here to make that process as clear and straightforward as possible before you ever walk through the door. Call us at 901-484-5157 or reach out through our website to schedule an evaluation. Discuss your treatment history with our team, and explore whether SPRAVATO® is the right option for where you are.