How Long Does Spravato Treatment Last? What to Expect
Curious to learn how long does Spravato treatment last? In this article, you'll get answers on the typical treatment timeline, how many sessions are needed, and what long-term care looks like.
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What Is Spravato
What Is Spravato
Spravato® (esketamine) is a groundbreaking prescription medication approved by the FDA for adults with treatment-resistant depression (TRD) and major depressive disorder (MDD) with suicidal thoughts or actions. Unlike traditional antidepressants that primarily target serotonin or norepinephrine, Spravato works on a different system in the brain, i.e. the glutamate system, offering a rapid-acting option for individuals who haven’t found relief with other treatments.
Spravato is administered as a nasal spray in a certified clinical setting, under the direct supervision of a healthcare provider. It's not a take-home medication; patients remain onsite for observation after each dose, which typically includes a two-hour monitoring period to ensure safety and comfort.
HOW long does Spravato treatment last? Phases and Timeline
So, how long is Spravato treatment and what can you expect along the way? While every patient’s journey is unique, Spravato treatment typically follows a structured, evidence-based progression through three main phases: induction, optimization, and maintenance.
Here’s a breakdown of the typical Spravato timeline:
Phase 1: Induction (Weeks 1 - 4)
You’ll typically receive two treatments per week for the first four weeks, totaling 8 sessions during the induction phase. This initial stage is designed to jumpstart symptom relief and allow your provider to closely monitor how your body responds to the medication.
Session frequency: 2 times per week
Session duration: About 2 hours (includes a mandatory observation period)
Goal: Rapid symptom improvement and adjustment to dosing
Many patients begin to notice improvements within the first few sessions, which is one of the reasons Spravato is considered a fast-acting option for treatment-resistant depression.
Phase 2: Optimization (Weeks 5 - 8)
After the first month, your treatment shifts into a less frequent but still consistent schedule, with Spravato administered once per week. This phase allows your care team to stabilize your results and make dosing adjustments if needed.
Session frequency: 1 time per week
Goal: Sustain early improvements and prevent relapse
Dosing flexibility: Some patients may adjust between 56mg and 84mg depending on response
This is also a crucial point for evaluating whether long-term maintenance will be helpful, especially for those with a history of recurring depressive episodes.
Phase 3: Maintenance (Week 9 and Beyond)
The maintenance phase is highly individualized. Based on how you're doing, your provider may taper sessions to once every two weeks, or even every 3 - 4 weeks in some cases. At this point, the goal is long-term stability, helping you stay well.
How long do you stay on Spravato? That depends on your history, risk factors, and response.
According to clinical studies (including the SUSTAIN-3 study), some patients benefit from ongoing maintenance for 6 months or longer, with some staying on it for multiple years under careful supervision.
Each session lasts about two hours from check-in to discharge, taking approx. 10–15 minutes for self-administering the nasal spray and 2-hour observation period in a quiet, relaxing clinical setting. You won’t be able to drive yourself home, so arranging a ride is required for every appointment.
How Many Spravato Treatments Will You Need?
One of the most common questions we hear is “how many Spravato treatments do I need before I start to feel better?”
The short answer: Most people begin with 8 treatments in the first month and continue based on how they respond.
But the full picture is more nuanced. The number of Spravato sessions you’ll need depends on your symptoms, your response to the medication, and your long-term mental health goals.
Typical Number of Spravato Treatments by Phase
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Week 1 -4, 8 sessions in total (2 per week).
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Weeks 5 - 8, 4 sessions in total (1 per week).
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Ongoing, total number of sessions varies: approx. 2 - 4 per month
How Long Do You Stay on Spravato?
Most patients complete at least 12 - 16 sessions within the first two months. From there, treatments are tapered to maintain progress while minimizing overuse.
Of course, everyone’s treatment plan is different; and that’s a good thing. Here are key factors that determine how many Spravato treatments you’ll need:
Response rate: Some patients feel relief after just a few sessions; others may need more time to stabilize.
Depression severity: Individuals with chronic or recurring depression often require longer-term care.
Side effects: Some people may need to space sessions out further based on tolerability.
Life circumstances: External stressors, trauma history, or comorbid conditions (like anxiety or PTSD) can influence treatment length.
Therapy integration: Combining Spravato with psychotherapy may reduce the total number of sessions needed.
What Happens During a Spravato Session?
A typical Spravato session begins with a brief clinical check-in, where vital signs are taken and your current symptoms are reviewed. Once cleared for treatment, you'll self-administer the nasal spray under medical supervision, usually in two to three doses spaced a few minutes apart.
Spravato begins to take effect quickly, with many patients reporting feelings of dissociation, drowsiness, or lightheadedness within 15 to 40 minutes. These sensations are normal and typically fade within a few hours.
After administration, you’ll remain in the clinic for a mandatory two-hour observation period. During this time, healthcare providers monitor your physical and emotional response to ensure safety and comfort. Because of the sedative effects of Spravato, you won’t be able to drive or return to work for the rest of the day, so arranging transportation in advance is essential. Sessions typically last around two hours from start to finish.
Factors That Affect How Long You’ll Need Spravato
While the FDA-approved protocol provides a general timeline, the actual duration of treatment can vary significantly based on individual needs and how well the medication works for each person.
One of the biggest factors is how quickly you respond to the treatment. Some patients notice relief after just a few sessions, while others may take several weeks to experience meaningful change. Another major consideration is the severity and history of depression; individuals with chronic, recurring, or treatment-resistant depression often require longer-term maintenance care. Additionally, side effects and tolerability can influence how frequently sessions are scheduled or whether the dose needs to be adjusted.
Other important influences include whether you’re combining Spravato with therapy or other medications, as integrated care tends to enhance results and potentially shorten the need for ongoing sessions. Finally, life stressors or major changes in mental health status during treatment may extend or intensify the schedule to help maintain stability.
Can You Stop Taking Spravato?
Yes, you can stop taking Spravato, but it should always be done under the guidance of your healthcare provider. Many patients taper off treatment after reaching sustained symptom relief, especially during the maintenance phase.
Stopping too early or without supervision may increase the risk of relapse or returning symptoms. A gradual, personalized discontinuation plan helps ensure a safe and stable transition off the medication.
Spravato at Wele Clinic: Personalized Care
Our clinic provides Spravato treatment with a deep commitment to safety, precision, and personalized mental health care. Every patient begins with a comprehensive evaluation to determine whether Spravato is the right fit, followed by a treatment plan tailored to their unique history, symptoms, and goals.
We offer a calming environment for your sessions and attentive support in every step of your journey. If you’re ready to explore whether Spravato can help you move forward, learn more on our Spravato treatment service page.
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Where To Find Us
Wele Clinic | Ketamine & Spravato Treatment NYC
1123 Broadway # 1117, New York, NY 10010, United States
Weekly hours:
Thursday: 9 AM - 6 PM
Friday: 9 AM - 6 PM
Saturday: Closed
Sunday: Closed
Monday: 9 AM - 6 PM
Tuesday: 9 AM - 6 PM
Wednesday: 9 AM - 6 PM
Frequently Asked Questions
1. How long does Spravato treatment typically last?
Spravato treatment usually begins with twice-weekly sessions for the first four weeks (induction phase), followed by weekly or biweekly sessions during the maintenance phase. The total duration varies by individual, but many patients continue treatment for several months, depending on symptom response and clinical guidance.
2. How many Spravato treatments will I need?
Most patients receive about 8 treatments in the first month, with additional sessions scheduled weekly or biweekly after that. The total number of treatments depends on how well you respond and whether ongoing maintenance is recommended.
3. Can you stop taking Spravato after a few months?
Yes, some patients discontinue Spravato after achieving stable improvement. However, stopping treatment should always be done under the supervision of your provider to prevent relapse or withdrawal symptoms.
4. How long do the effects of Spravato last after a session?
Spravato’s immediate effects, such as dissociation or drowsiness, typically wear off within 1 - 4 hours. However, the antidepressant benefits may last for days or even weeks, especially with ongoing treatment.
5. Do I need therapy or other medications alongside Spravato?
Yes, Spravato is most effective when used in combination with an oral antidepressant and talk therapy. This integrated approach helps strengthen and sustain results, especially for those with treatment-resistant depression.
This article was written by Dr. Mehdi Omidvari, founder of Wele Clinic.