Does Spravato Require a Driver After Treatment?
Yes, Spravato (esketamine nasal spray) requires a driver or responsible adult to take you home after each treatment session. The FDA-approved Risk Evaluation and Mitigation Strategy (REMS) program mandates this due to risks of sedation, dissociation, dizziness, and impaired thinking or judgment that can last hours.[1][2]
Why the Driver Rule Exists
Spravato is administered under medical supervision in a certified healthcare setting, typically twice a week for the first month, then once weekly or biweekly. Effects peak within 40 minutes and can persist for up to 2 hours or longer, making driving or operating machinery unsafe. Patients must stay at the facility for at least 2 hours post-dose for monitoring, then leave with an adult who can stay with them until fully recovered—usually overnight for the first dose.[1][3]
What Happens If You Don't Have a Driver?
No driver means no treatment that day. Clinics won't administer Spravato without confirmed transportation, as it's a core REMS requirement to prevent accidents. Some facilities offer ride services, but patients must arrange this ahead.[2][4]
How Long Before You Can Drive Again?
Driving is prohibited for the rest of the day and until cleared by your doctor. Full recovery varies: most feel effects resolve within 4 hours, but subtle impairments can linger. Avoid alcohol or sedatives, which worsen risks.[1][3]
Patient Experiences and Tips
Users report feeling "spacey" or unsteady for hours, reinforcing the need for help. Schedule afternoon appointments if mornings cause next-day grogginess. Telehealth follow-ups don't change the in-clinic driver rule.[4]
[1]: FDA Spravato Label
[2]: Spravato REMS Program
[3]: Janssen Spravato HCP Site
[4]: FDA REMS@FDA