Your First SPRAVATO® Session in Tyler, TX — Step by Step

You arrive at East Texas Psychiatry at your scheduled session time. Plan to arrive a few minutes early to allow for check-in.

At check-in, a staff member confirms your identity and reviews a brief pre-session questionnaire. This covers how you are feeling today, whether anything has changed in your health since your last appointment, your blood pressure, and whether you have adhered to pre-session preparation (light meal, no alcohol, transportation arranged).

Blood pressure is measured before your session. SPRAVATO® can raise blood pressure, and we establish your pre-dose baseline at each session. If your blood pressure is significantly elevated before the session, we assess whether it is safe to proceed.

We also confirm that your transportation is in place. If you are planning to leave by rideshare, we ensure this is arranged before the session begins — not something to figure out after.

After pre-session assessment, you are taken to the monitoring room where your session will occur. You receive a brief orientation to what will happen during the session and have the opportunity to ask any last questions before the dose is administered.

SPRAVATO® is a nasal spray. The nasal device delivers a specific dose across one or two spray cycles per nostril, depending on the prescribed dose. You administer the spray yourself, following staff instructions and with staff present in the room throughout.

The administration itself takes only a few minutes. After each spray cycle, there is a brief rest period before the next cycle. Once all cycles are complete, the monitoring period begins.

The onset of effects typically begins within five to fifteen minutes of the last spray. The most commonly described onset experience is a mild shift in perception — things may seem slightly different, sounds may feel more pronounced, or you may begin to feel slightly dissociated from your surroundings. This is expected and not a sign that something is going wrong.

The intensity of acute effects typically peaks within 40 minutes and then gradually resolves over the next hour to hour and a half. Most patients are within normal limits at the two-hour mark and can be discharged.

The first session is often the most disorienting because the experience is unfamiliar. Many patients describe subsequent sessions as more manageable — partly because they know what to expect and partly because the acute dissociative effects may moderate slightly over the course of the induction phase.

After administration, you move to a comfortable rest position — a recliner or bed — in the private monitoring space. The two-hour period begins now.

You may feel dissociated, drowsy, dizzy, or mildly nauseous. You may feel a sense of unreality or perceptual change. These are expected. Rest. If you have earphones, listen to something quiet and comfortable. If you prefer silence, that is fine.

Staff check on you at regular intervals — at minimum every 15 minutes. Blood pressure is measured at specific points during the monitoring period. If you experience anything that feels overwhelming or distressing, alert staff immediately. They will not leave you unattended.

Most patients find the monitoring period passes more quickly than expected. The first session can feel strange or longer than it is; subsequent sessions typically feel more manageable.

Do not use your phone for active tasks — email, social media, work — during the monitoring period. Passive listening is fine. Some patients find a specific playlist or guided meditation they use consistently across sessions, which helps create a familiar, calming experience for each session.

At the end of the two hours, a staff member assesses your status — blood pressure, orientation, how you feel. When you are confirmed stable, you are discharged.

When you are discharged, you will feel substantially better than at the peak of the monitoring period, but you will likely not feel completely at baseline. Some mild residual drowsiness, lightheadedness, or a sense of detachment is common for several hours after discharge.

Your transportation should be ready. Do not attempt to drive under any circumstances on a session day. If you arranged a rideshare, confirm the pickup before leaving the clinic.

For the rest of the session day: rest, low-stimulation activities, and low-stakes decisions. Most patients find it helpful to have the evening after a session be quiet — no significant social obligations, no important work, no complex decisions. Light activity like a short walk is fine; strenuous exercise is not recommended.

The therapeutic work of SPRAVATO® — the neuroplastic changes triggered by esketamine — continues after you leave the clinic. Some patients notice the first signs of antidepressant effect in the 24–48 hours after a session, not during the session itself. Others notice changes more gradually across the induction phase. Paying attention to your mood, energy, and daily function in the days between sessions helps you and your provider track your response accurately.

Your second session is typically scheduled two to four days after your first. As induction continues — twice weekly for four weeks — most patients find the experience progressively more manageable.

The clinical picture usually becomes clearer by the third or fourth session. Some patients notice meaningful improvement in mood, energy, or motivation during weeks two or three. Others see the clearest response at the end of the four-week induction phase. A small proportion do not respond adequately to the standard induction and require a clinical conversation about dose adjustment or alternative approaches.

At the end of induction, we conduct a comprehensive symptom assessment and make a plan for maintenance. Most patients who respond to induction continue with maintenance sessions — weekly or biweekly — to sustain their improvement.

Call (430) 288-5800 or use the Schedule button with any questions between sessions or to report any concerns that arise. We are accessible throughout your treatment course.

This page is educational and is not a substitute for personalized medical advice.