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SPRAVATO® Side Effects: What Happens During and After a Session
Quick Answer
SPRAVATO® (esketamine) has a predictable side-effect profile centered on the two hours after a dose: dissociation (feeling detached from surroundings or oneself), sedation, dizziness, nausea, and a temporary rise in blood pressure are the most common, and they are the reason every dose is given in a certified clinic with monitoring. SPRAVATO® carries a boxed warning covering sedation, dissociation, respiratory depression, abuse and misuse, and suicidal thoughts and behaviors, and is available only through a restricted program. Most effects resolve during the monitoring period; you cannot drive until the next day. The full labeled information is on our SPRAVATO® Important Safety Information page.
During the session
Dissociation is the most distinctive effect — a sense of detachment or altered perception that typically begins shortly after the dose and fades within the monitoring period. Sedation and dizziness are common, which is why patients remain seated and supervised. Nausea occurs in some patients; eating is restricted before the dose to reduce it. Blood pressure is measured before dosing and during monitoring because it commonly rises temporarily.
The boxed warning
The labeling carries a boxed warning for sedation, dissociation, respiratory depression, abuse and misuse, and suicidal thoughts and behaviors. The clinic setting, screening, and monitoring exist because of it. Read the Important Safety Information before your first session.
After the session
You are monitored for at least two hours after each dose and released when your clinician judges you ready. You may not drive or operate machinery until the next day after a restful sleep, so a ride home is required every time. Some patients feel tired for the rest of the day.
Who should not take it
Patients with aneurysmal vascular disease, arteriovenous malformation, or a history of intracerebral hemorrhage, and patients with hypersensitivity to esketamine or ketamine, should not take SPRAVATO®. Uncontrolled hypertension, a history of psychosis, and substance use disorders are reasons for caution or exclusion. The evaluation screens for all of these.
Reporting side effects
Tell your psychiatrist about anything that persists beyond the session or feels different from what was described, and about any new or worsening mood or suicidal thoughts.
Frequently asked questions
How long do SPRAVATO® side effects last?
The main effects — dissociation, sedation, dizziness — typically peak within the first hour and resolve during the two-hour monitoring period; tiredness can persist the rest of the day.
Can I drive after SPRAVATO®?
No. You cannot drive or operate machinery until the next day after a restful sleep. A ride home is required for every session.
Does SPRAVATO® raise blood pressure?
A temporary rise is common and is monitored at every session. Uncontrolled hypertension is a reason not to proceed until it is managed.
Is SPRAVATO® addictive?
It carries a boxed warning for abuse and misuse and is dispensed only in a certified clinic; it is never taken home. Patients with substance use disorders are screened for suitability.
Questions about whether SPRAVATO® is appropriate for you are answered at the evaluation. Request a consultation.
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