Supporting a Loved One Through Spravato Treatment

When someone you love has struggled with depression that has not improved after trying other antidepressants, hearing about a new option can bring a mix of hope and questions. If their care team is considering SPRAVATO® (esketamine), you may find yourself in a supporting role: the person who drives them home, helps keep track of appointments or simply sits with them through a hard season.

This article is for that support person. It covers the basics of what treatment involves, the practical ways you can help and how to take care of yourself along the way. It does not replace guidance from your loved one's treatment team, who will explain their specific plan.

A quick overview of Spravato

SPRAVATO® is an FDA-approved nasal spray for adults with treatment-resistant depression, which generally means depression that has not responded well enough to at least two different antidepressants. It is used alongside an oral antidepressant. It works through a different brain pathway than most traditional antidepressants.

Because of how it can affect people in the short term, SPRAVATO® is only given at certified treatment centers. Your loved one uses the nasal spray themselves under supervision, then stays at the clinic for monitoring. They do not take it home.

Whether it is right for someone is decided by their psychiatrist or psychiatric nurse practitioner after an evaluation of their history, symptoms and overall health.

What a treatment day looks like

Understanding the routine helps you plan. At SOS Wellness, a typical session includes:

• A blood pressure check before treatment begins
• Self-administration of the nasal spray while staff supervise
• A monitored rest period of about two hours, during which the care team watches how your loved one is doing
• A second blood pressure check before they leave

Each session takes about two hours in total. In the early weeks, sessions are more frequent, and the schedule is adjusted over time based on how your loved one responds. Their treatment team will share the exact schedule.

The most important job: the ride home

After a SPRAVATO® session, a person cannot drive, operate machinery or do potentially dangerous activities until the next day after a full night of restful sleep. That means every treatment day requires someone else to get them home.

If you are the driver:

• Confirm the timing of each appointment so you know roughly when to arrive for pickup.
• Plan for the full session. Build in some flexibility, since the care team decides when your loved one is ready to leave.
• Have a backup. Life happens. It helps to have a second person or another transportation plan if you cannot make it.
• Keep the rest of the day simple. Your loved one may want to rest when they get home.

If transportation is a barrier for your loved one, they can ask the clinic's care coordination team about options.

How they may feel during and after treatment

During the monitored rest period, people commonly notice temporary effects such as feeling disconnected from themselves or their surroundings, dizziness, numbness or a sense of relaxation. Blood pressure can rise, which is why it is checked before and after. These effects typically fade during the monitoring period, before the person goes home.

On the ride home and later that day, your loved one might be tired, quiet or simply want to rest. Others feel fine. Let them lead. A calm car ride, a snack once they are home and a low-key evening are often all that is needed.

If you notice anything that concerns you after they are home, contact the treatment center. For any emergency, call 911.

Helping with preparation

The treatment team will give specific instructions, and you can help your loved one keep track of them. At SOS Wellness, these include:

• Avoiding food for at least two hours before treatment
• Avoiding liquids for at least 30 minutes before treatment
• Letting the care team know about any changes in medications or health

A shared calendar or a reminder on your phone can make busy weeks easier.

Supporting progress without pressure

People respond to treatment differently and on different timelines. Some notice changes early. For others it takes longer, and some find it is not the right fit. It is natural to watch closely for signs of improvement, but try not to ask "Do you feel better yet?" after every session.

Instead, you might:

• Ask open questions, such as "How has this week been for you?"
• Notice small things out loud, like "It was good to see you get outside today"
• Encourage them to share what they are noticing with their treatment team, who adjust the plan based on how they are responding
• Keep inviting them to everyday activities without making it a test

Your loved one will continue their oral antidepressant and regular appointments. Gently supporting that routine can matter just as much as treatment days.

Know the warning signs and what to do

Depression can be serious, and support people should know where to turn. If your loved one talks about wanting to die, says they feel like a burden, starts giving things away or seems to be saying goodbye, take it seriously.

Call or text 988 to reach the Suicide and Crisis Lifeline. You can call on their behalf, or stay with them while they call. If someone is in immediate danger, call 911 or go to the nearest emergency room.

Take care of yourself too

Supporting someone through depression can be tiring and emotional. You may feel worry, frustration, hope and guilt, sometimes all in one day. Those feelings are normal.

• Share the load. If possible, rotate driving and support with other people.
• Keep some routines that help you feel steady, like exercise, time with friends or hobbies.
• Consider support for yourself, whether that is a support group, therapy or a trusted friend.

You do not need to be perfect to be helpful. Showing up consistently is often what makes the difference.

Learning more

SOS Wellness is a certified SPRAVATO® treatment center, and our psychiatrists and psychiatric nurse practitioners evaluate whether it may be appropriate for each person. If your loved one would like to learn more, or you have questions about how the process works, they can request an appointment or you can contact us for general information.