Key Takeaways:
- Thorough screening ensures esketamine is safe and appropriate, with detailed assessments before starting treatment.
- Treatment sessions are calm and supervised, with self-administered nasal esketamine and a two-hour observation period.
- Post-session care focuses on safety, including monitoring, guidance on side effects, and requiring a ride home.
- Esketamine is part of a broader care plan, supported by therapy and medication, with esketamine FDA approval for treatment-resistant depression.
Starting any new treatment can feel like a big leap. When that treatment involves a medication like esketamine—known for its rapid antidepressant effects and occasional dissociative sensations—it’s understandable to feel unsure or even nervous.
At PMC Heal, we’re committed to making every step of your esketamine therapy safe, structured, and supportive. Whether you’re exploring this treatment for the first time or preparing for your initial session, this guide is here to walk you through what to expect before, during, and after your visit.
Before Your Appointment: Screening and Approval
Before your first esketamine session, you’ll go through a careful pre-treatment screening process. This includes a psychiatric assessment, a review of your treatment history, and a conversation about your current symptoms and goals. You’ll also complete a consent process where we explain potential risks, benefits, and alternatives.
During this process, we’ll evaluate for any esketamine contraindications. These may include uncontrolled high blood pressure, a history of substance use disorder, or certain medical conditions such as pregnancy. Safety comes first, and we only proceed with treatment when it’s the right fit for you.
This step is important not just for your physical well-being, but also for building trust and clarity about what esketamine therapy involves.
Arrival and Check-In
On treatment day, you’ll want to arrive feeling comfortable and prepared. Here’s how to get ready:
- Eat a light meal beforehand.
- Wear comfortable clothes.
- Arrange for someone to drive you home.
- Bring anything that helps you relax (e.g., music, an eye mask, a support person if allowed).
At check-in, you may complete a short mood or symptom survey to help your care team track how you’re feeling that day. This helps us monitor progress and tailor support throughout your treatment journey.
The Treatment Room Experience
After check-in, you’ll be shown to a quiet, low-stimulus treatment room. These spaces are designed for comfort and calm. You’ll be seated or reclining in a chair, and one of our clinicians will stay with you throughout the session.
Esketamine—often administered under the esketamine brand name Spravato—comes in a nasal spray form. You’ll self-administer the spray under supervision and then begin a two-hour observation period.
During this time, many patients experience:
- Mild dissociation (feeling “floaty” or disconnected from thoughts or surroundings).
- A calm or dreamlike state.
- Lightheadedness or a shift in perception.
These sensations are temporary and part of the medication’s effect on the brain’s glutamate system. Some people feel introspective or emotional, while others simply feel quiet or detached. Clinicians are present to monitor and support you throughout the experience.
Side effects like dizziness, nausea, or confusion are common but typically mild and short-lived. You’ll be encouraged to rest and relax during the session.
For more information on how esketamine works and what it feels like, read our post on
After the Session: Monitoring and Discharge
After the observation period, your care team will check your vital signs, assess your mental state, and confirm that you’re feeling stable and safe before discharge. Most patients stay on-site for at least two hours.
Because esketamine can temporarily affect coordination and perception, you’ll need a trusted ride home. You won’t be able to drive or operate machinery for the rest of the day.
What to Expect in the Hours and Days After
It’s common to feel tired or mildly “off” in the hours following your treatment. You may also notice side effects like:
- Headache
- Nausea
- Mild dissociation or fatigue.
These usually resolve within 24 hours. Some patients report feeling emotionally lighter or more hopeful the same day. For others, it may take a session or two before they notice meaningful shifts.
As with all therapies, individual responses vary. It’s also worth noting that esketamine long-term side effects are still being studied. However, supervised use in controlled clinical settings has shown strong safety so far, with no evidence of addiction or cognitive decline in treatment-compliant patients.
How Esketamine Fits Into a Larger Plan
Most patients begin with two sessions per week for the first four weeks. This intensive phase helps “kick-start” a response. After that, treatment may taper to once a week or less, depending on your progress.
Esketamine is rarely a stand-alone solution. At PMC Heal, we integrate it into a broader care plan that includes therapy, medication management, and lifestyle support when appropriate. You’re never navigating this alone—we’re here to tailor your treatment as your needs evolve.
FDA Approval and Confidence in the Process
Esketamine FDA approval became official in 2019 for adults with treatment-resistant depression. This designation means the therapy has passed rigorous safety and efficacy standards. But FDA approval also signals something deeper: growing recognition that people with depression need more effective options, especially when traditional medications fall short.
Spravato is only available at certified clinics like PMC Heal, where each session is delivered under medical supervision with full attention to compliance, comfort, and care.
A Supported Start Toward Healing
Beginning esketamine treatment may feel like stepping into the unknown—but you won’t be doing it alone. At PMC Heal, we provide clear guidance, a structured environment, and a compassionate team focused on your safety and success.
If you’re considering esketamine therapy or just want to learn more about whether it’s right for you, we’re here to answer your questions and help you take the next step.
Schedule your consultation today and take your first step toward clarity, calm, and renewed hope.
[AP1]This is the link to the shared Word document for this blog since it is not live yet. Once this blog goes live, we can fix this.
