Official Monitoring Time After Spravato
Patients must stay at the certified clinic for at least 2 hours after each Spravato (esketamine) nasal spray administration. This allows healthcare providers to monitor for side effects like sedation, dissociation, blood pressure changes, and respiratory issues under the FDA's Risk Evaluation and Mitigation Strategy (REMS) program.[1][2]
Why 2 Hours Specifically?
Spravato peaks in the bloodstream within 40 minutes, but effects like dissociation and sedation can last up to 2 hours or longer in some cases. Providers assess patients before discharge using tools like the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale, ensuring they're stable enough to leave safely.[1][3]
What Happens During Monitoring?
- Vital signs checked every 15-30 minutes initially.
- No eating or drinking (except water) right after dosing.
- Patients can't drive or operate machinery for the rest of the day—arrange a ride home.[2][4]
Can You Leave Early or Stay Longer?
No early discharge; the 2-hour minimum is mandatory. Some clinics keep patients longer if side effects persist, like elevated blood pressure or confusion. Total visit time, including prep and dosing, often runs 2.5-3 hours.[1][5]
Common Patient Experiences and Tips
Dissociation feels like a "floaty" or altered state for many, fading within 1-2 hours. Nausea or vertigo affects about 20-30% of users. Tips: Wear comfortable clothes, bring a support person (not required but helpful), and avoid stimulants beforehand.[3][6]
Sources
[1]: Spravato REMS Program
[2]: FDA Spravato Label
[3]: Janssen Spravato HCP Site
[4]: Spravato Patient Guide
[5]: American Psychiatric Association Guidelines
[6]: Patient forums and clinical reviews (e.g., Drugs.com user reports)