SPRAVATO® appointments are different from a typical medication visit because the treatment is designed to be given in a structured clinical setting, followed by a period of observation. That time is not an inconvenience added around the edges of care. It is part of the care itself.
For many people considering SPRAVATO® in Columbia or Annapolis, the practical questions arrive before the clinical ones. How long will I be there? Can I drive afterward? What happens if I feel tired, detached, or simply not ready to go back into the day? These are reasonable questions. We want you to understand the shape of an appointment before you decide whether it fits into your life.
SPRAVATO® is an FDA-approved ketamine nasal spray used under supervision as part of a broader treatment plan. At The Mood Center, we approach each visit with attention to both the medication and the person receiving it, including the hours surrounding treatment.
Monitoring is part of the treatment, not time in the waiting room
SPRAVATO® is self-administered in our clinic under medical supervision. After the nasal spray is given, you remain with us for at least two hours of monitoring. During that time, our clinical team checks how you are doing, including blood pressure and any changes in how you feel physically or mentally.
This observation period reflects the known short-term effects that can occur after dosing. Some people experience sleepiness, dizziness, nausea, or a sense of dissociation, meaning they may feel temporarily detached from their usual thoughts, body, or surroundings. These experiences are often time-limited, but they deserve a calm setting and clinical attention. A review of monitoring considerations for psychotropic treatment describes why structured assessment is an important part of safe medication use (DeBattista et al., 2024).
The room becomes a place to pause. There is no expectation that you should be productive, sociable, or ready to make decisions immediately afterward. You can rest, listen to music, or simply be quiet while the acute effects settle.
Research involving passive physiologic monitoring during SPRAVATO® treatment has also illustrated how much happens within the appointment window, including measurable changes in physiologic signals over time (physiological data collected during treatment (Solomon et al., 2023)). Monitoring gives us the opportunity to respond to your experience in real time rather than treating it as something you need to manage alone.
Why transportation planning matters
Because SPRAVATO® can affect alertness, coordination, and judgment on the day of treatment, you cannot drive yourself home after an appointment. You will need to arrange for a trusted adult to pick you up or use a rideshare or other transportation service that allows you to travel safely as a passenger.
This can take planning, especially for people balancing work, parenting, or a long commute through the Baltimore-Washington corridor. We encourage you to think about transportation before beginning treatment, not as an afterthought on the morning of an appointment.
A few practical details can make the day easier:
Plan for the appointment itself and the monitored observation period afterward.
Arrange a ride before you arrive.
Avoid scheduling obligations that require driving, focused work, or important decisions later that day.
Wear comfortable clothing and bring anything that helps you feel settled, such as headphones or a light layer.
Follow the eating, drinking, and medication instructions we provide before treatment.
The goal is not to make your day smaller. It is to give your body and mind enough room to move through the treatment day safely.
A structured visit allows us to pay attention
Medication treatment can become overly transactional when there is little time to notice what a person is actually experiencing. SPRAVATO® visits create a different rhythm. We can assess how you are feeling before treatment, remain available during the observation period, and talk through what you noticed as you prepare to leave.
That structure matters because responses are individual. Some patients feel little beyond fatigue. Others notice transient changes in perception or a quieter internal state. Neither experience needs to be dramatized, but both are useful clinical information.
The broader evidence base for esketamine emphasizes implementation, patient selection, monitoring, and follow-up alongside questions of symptom change. An international expert review of esketamine implementation underscores that treatment is more than the dose itself (McIntyre et al., 2021). We agree. Care includes the setting, the clinical relationship, and the decisions made over time.
For those looking specifically for Columbia treatment options, our Columbia office follows this same commitment to a deliberate, supervised experience. You may also wish to explore our broader mental health care in Columbia as you consider what ongoing support might look like.
What monitoring can and cannot tell us
Two hours of observation does not predict whether SPRAVATO® will be the right treatment for you long term. It does not guarantee a particular response. What it does provide is immediate clinical oversight during the period when short-term effects are most likely to be noticeable.
Evidence from a randomized relapse-prevention trial found that continued esketamine plus an oral antidepressant was associated with a lower risk of relapse than placebo plus an oral antidepressant in certain adults with treatment-resistant depression (relapse-prevention findings (Daly et al., 2019)). Those results are meaningful, but they do not replace an individualized conversation about diagnosis, history, current medications, medical factors, and goals.
Safety surveillance matters as well. A large real-world analysis of esketamine safety drew on nearly five years of post-approval data, reinforcing the value of continued attention to adverse effects and clinical oversight (real-world safety data (Sanacora et al., 2025)). We take that oversight seriously at every appointment, even when treatment begins to feel familiar.
How SPRAVATO® fits among our treatment options
SPRAVATO® is one part of the work we do. It is distinct from IV ketamine therapy, which is administered differently and, for psychiatric uses, is off-label. It is also distinct from TMS, a noninvasive treatment that is FDA-cleared for specific indications. If you are comparing treatment experiences, our TMS faqs can help clarify some of the practical differences.
The right next step is not always obvious from a diagnosis alone. We consider your treatment history, your day-to-day realities, your preferences, and whether the required structure of an in-clinic SPRAVATO® appointment is workable for you. Our role is to make that conversation clear and unhurried.
Frequently asked questions about SPRAVATO® monitoring
Can I work during the observation period?
We recommend treating the monitoring period as protected time rather than work time. You may read, rest, or listen to something familiar, but it is best not to plan on answering emails, attending meetings, or making consequential decisions.
Can someone stay with me?
Please ask us about current office policies when scheduling. What matters most is that you have reliable transportation arranged for your departure and that you feel supported going into the appointment.
What if I feel anxious about being monitored?
Tell us. Anticipatory anxiety is common, especially when a treatment involves a new setting or an unfamiliar sensation. We can explain each step, answer questions, and help you make a plan for comfort before you begin.
What happens if I have urgent suicidal thoughts?
SPRAVATO® appointments are not a substitute for emergency care. If you are in immediate danger, call 911 or go to the nearest emergency department. You can also call or text the 988 Suicide and Crisis Lifeline for immediate, confidential support (988 Suicide and Crisis Lifeline, n.d.).
Key takeaways
SPRAVATO® monitoring time is built into the appointment because safety and clinical attention belong together. You should plan to remain in the clinic for at least two hours after administration and arrange transportation home. The visit is intentionally structured, but it should not feel impersonal.
If you are considering SPRAVATO® and want to talk through the practical details, we invite you to reach out to The Mood Center. We can help you understand the appointment process, the preparation involved, and the questions worth asking before you begin.
Medical disclaimer
This article is for general educational purposes and is not medical advice. Eligibility for SPRAVATO® and all treatment decisions require an individualized evaluation with a qualified clinician.
Works Cited
1. DeBattista C, et al. The Black Book of Psychotropic Dosing and Monitoring. https://pubmed.ncbi.nlm.nih.gov/38993656/
2. Solomon TM, et al. Evaluating passive physiological data collection during SPRAVATO® treatment. https://pubmed.ncbi.nlm.nih.gov/38094111/
3. McIntyre RS, et al. Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation. https://pubmed.ncbi.nlm.nih.gov/33726522/
4. Daly EJ, et al. Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression: A Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/31166571/
5. Sanacora G, et al. Real-World Safety of Esketamine Nasal Spray: A Comprehensive Analysis Almost 5 Years After First Approval. https://pubmed.ncbi.nlm.nih.gov/40926574/
6. 988 Suicide and Crisis Lifeline. https://988lifeline.org/
Disclaimer
This article is for educational purposes only and is not a substitute for individualized evaluation, diagnosis, or treatment from a qualified healthcare professional.
