The In-Clinic Experience: Immediate Effects
During a Spravato session, which is administered under close medical supervision, the immediate sensations are distinct and temporary. Most patients begin feeling the effects within 5 to 10 minutes, with the peak occurring around 40 minutes post-dose. This acute phase typically lasts for 30 to 90 minutes.
Dissociation and Altered Perception
Dissociation is one of the most notable and expected effects of Spravato. Patients describe it as a temporary feeling of detachment from their surroundings, body, thoughts, and emotions. This can manifest in several ways:
- A dreamlike or 'floaty' sensation, where time seems to slow down or move differently.
- A feeling of observing thoughts rather than actively thinking them, as if they are simply passing by.
- Mild visual and auditory shifts, such as brighter colors or sharper sounds, though not typically full hallucinations.
- Feeling a sense of unreality or depersonalization.
Emotional and Cognitive Shifts
Alongside perceptual changes, emotional responses vary. Some patients report a deep sense of calm, emotional lightness, or mild euphoria, which offers a break from the heaviness of depression. However, it is not always a pleasant experience, especially during the first few sessions.
- Relaxation and Calm: A gentle wave of relaxation can wash over patients, quieting the constant mental noise associated with depression.
- Moments of Clarity: The dissociative state can sometimes create a mental space for introspection, allowing for clearer insights into underlying thought patterns and emotional issues.
- Anxiety or Stress: Some individuals, particularly during their first session, may feel temporary anxiety or worry that they are losing control due to the unfamiliar sensations. Medical staff are trained to provide reassurance and grounding techniques during these moments.
Physical Sensations and Side Effects
Spravato can also cause several common physical side effects, which typically resolve within the observation period. The most frequently reported include:
- Dizziness: A feeling of lightheadedness or unsteadiness.
- Nausea: This is a very common side effect, which can sometimes lead to vomiting. Patients are advised to fast beforehand.
- Sedation: A feeling of sleepiness or drowsiness.
- Vertigo: A spinning sensation that can be disorienting.
- Temporary Blood Pressure Increase: Your blood pressure will be monitored, as it often increases temporarily after administration.
The Aftermath and Long-Term Outlook
After the initial peak, the more intense effects of Spravato begin to fade over the next hour or two, during which you remain under observation in the clinic. It's common to feel tired or 'mentally foggy' for the rest of the day, which is why a restful night's sleep is advised and driving is prohibited.
Beyond the transient effects, the long-term goal of Spravato is lasting relief from depression. Some patients report feeling better within hours or days of their first treatment, while others see a more gradual improvement over several weeks. Continued treatment can lead to:
- Reduced Depressive Symptoms: Many patients experience a significant lifting of the heavy, dark feelings associated with depression.
- Renewed Motivation and Energy: Tasks that once seemed monumental can become manageable again.
- Improved Cognitive Function: Long-term studies show cognitive function remaining stable or even improving over time, with patients reporting better attention, memory, and executive function.
Spravato vs. Traditional Antidepressants
For individuals with treatment-resistant depression, Spravato offers a distinct approach compared to conventional oral antidepressants. The table below highlights some key differences in their mechanism, administration, and effects.
| Feature | Spravato (Esketamine) | Traditional Antidepressants (SSRIs, SNRIs) |
|---|---|---|
| Mechanism of Action | Targets the glutamate system, specifically the NMDA receptors, promoting new neural connections (synaptogenesis). | Primarily increases levels of serotonin and/or norepinephrine to alter existing brain communication pathways. |
| Speed of Onset | Rapid, with some patients feeling relief within hours or days of treatment. | Delayed, typically taking 4 to 6 weeks to show a noticeable effect. |
| Administration | Nasal spray, administered under direct medical supervision in a certified clinic. | Oral medication (pill or capsule), taken daily at home. |
| Typical Effects | Causes transient dissociation, sedation, and physical sensations during a 2-hour observation period. | Side effects like drowsiness, weight changes, or sexual dysfunction can persist throughout treatment. |
| Intended Use | For treatment-resistant depression or MDD with acute suicidal ideation, typically when other antidepressants have failed. | First-line treatment for mild to moderate depression. |
Conclusion: Beyond the Session
Understanding what Spravato makes you feel like is about more than just the temporary, in-session sensations. While the dissociative and perceptual changes are a hallmark of the experience, the ultimate goal is to facilitate a long-term improvement in mood and function. For many, this innovative treatment serves as a powerful tool to break free from the persistent symptoms of depression when other methods have proven ineffective. The unique and rapid-acting nature of Spravato, coupled with a supportive clinical environment, offers a pathway toward renewed hope and a return to a more fulfilling life. For further information on mental health and different medications, consult the National Alliance on Mental Illness (NAMI).
