If someone you love has started Spravato (esketamine nasal spray), helping someone with depression through treatment mostly comes down to three jobs: handle the rides, keep visit days calm and be there afterward. They can’t drive until the next day after restful sleep, and our care team handles the monitoring.
What Spravato is
Spravato is a prescription esketamine nasal spray, given only at a certified center under medical supervision. It’s approved for adults with treatment-resistant depression, meaning depression that hasn’t improved enough after trying two or more antidepressants. It can be used on its own or with an antidepressant pill. Along with an antidepressant pill, it’s also approved for adults with major depression who are having suicidal thoughts or behaviors.
Every clinic that offers Spravato must be certified under REMS (Risk Evaluation and Mitigation Strategy), a safety program set by the Food and Drug Administration (FDA). Every Nushama clinic that offers Spravato, including Aventura, is certified. Our guide to starting Spravato in Aventura covers the schedule, and our plain-English eligibility guide covers who qualifies.
Your before, during and after checklist
Before each visit
- Confirm the ride both ways. Line up a backup driver too, in case your day changes.
- Help with food and drink timing. The FDA label asks for no food for 2 hours and no liquids for 30 minutes before a dose, which can help with nausea. Ask the care team how to plan meals around the visit.
- Pack a small bag. Bring water and a snack for later, a phone charger and comfortable layers.
- Leave extra time. Our Aventura center sits at Biscayne Boulevard and NE 191st Street, near the William Lehman Causeway. Traffic from Miami, Sunny Isles or Hallandale can be slow at busy hours.
- Ask about the drive. Find out whether they’d like to talk or ride in quiet.
During the visit
- Plan for about two and a half hours. That covers a brief check-in, the nasal spray under clinical supervision, and at least two hours of monitoring before they leave.
- Let the care team carry the medical side. The label calls for blood pressure checks before and after the dose, and our team stays with members through the monitoring period.
- Stay reachable. Keep your phone on and stay close by.
After the visit
- Get them home. Then follow their lead on how they want to spend the evening.
- Plan the rest of their day without driving. The label says no driving until the next day, after a restful night’s sleep.
- Jot down anything you noticed. They can share it with the care team next time if they want to.
The ride home
Someone else has to drive because Spravato can cause drowsiness, dizziness, nausea and dissociation. Dissociation means feeling separate from your body, your surroundings or your sense of time.
The care team decides when your person is ready to leave. Some tiredness or a slightly far-away feeling may linger into the evening.
A few things can make the trip easier:
- Keep the car cool and quiet, with soft music or none.
- Keep a bag within reach in case of nausea.
- Ask whether they’d like a hand getting settled at home.
- Let them decide whether to talk about the session, now or later.
What to say, and what not to say
Keep it simple and let them set the pace. Skip questions about whether it’s working. Lines that often help:
- “Take your time. I’m right here.”
- “Do you want quiet or music?”
- “Want me to grab dinner tonight?”
Questions that can feel like a test, even when they come from love:
- “So, did it work?”
- “You seem better already.”
- “Is this worth it?”
If you’re supporting a spouse with depression, let them choose how much to share with you. The rest can stay with their care team. Our guide for supporters of people having transcranial magnetic stimulation (TMS), a different depression treatment, has more ideas on talking about progress. Many of them work here too.
Fitting visits around work and holidays
Put each visit on your work calendar as a standing appointment that blocks a morning or afternoon, plus a quiet evening. You don’t owe anyone details.
Before you book a holiday trip or skip a visit, talk with the care team. The label notes that a missed treatment may change the dose and schedule. Schedules can also shift later in treatment, which our page on long-term Spravato maintenance explains.
What to watch for, and who to call
Call the care team for new or worse symptoms, call or text 988 in an emotional crisis, and call 911 in an emergency. The National Institute of Mental Health describes depression as symptoms that last most of the day, nearly every day, for at least two weeks. Compare what you see with how your person usually is.
Call the care team if you notice any of the warning signs the label lists, such as:
- New or worse depression
- Trouble sleeping
- New or worse irritability
- Other unusual changes in mood or behavior
Also call if drowsiness or a far-away feeling lasts into the next day, or if anything else worries you.
Call or text 988 to reach the 988 Suicide and Crisis Lifeline if they talk about suicide or seem to be in emotional crisis. You can call for them, too.
Call 911 if they’re in immediate danger or have trouble breathing.
Our guide to crisis support in Aventura explains how our team responds when things feel urgent.
Looking after yourself while helping someone with depression
Share the rides and protect your own sleep. Pacing yourself is a big part of how to help someone with depression, since treatment can run for months. Trade some rides with a friend or relative, and use the wait for a walk or a coffee that’s just yours.
If you’d like support from people who’ve been there, the National Alliance on Mental Illness (NAMI) runs free family education programs, including its Family-to-Family class. A therapist of your own can help as well.
FAQ
Can I stay in the room?
Ask our Aventura care team before the first visit. They can tell you where you can wait and whether you can sit in, and your person can say what they’d prefer.
How long will I wait?
Plan for about two and a half hours. That includes check-in, the dose and at least two hours of monitoring.
What if they seem different afterward?
Drowsiness or a disconnected feeling right after a dose is a known effect, and the care team checks that they’re ready before they go home. If changes last into the next day, or anything worries you, call the care team. In an emergency, call 988 or 911.
How Nushama helps
We handle the medical side of every Spravato visit in Aventura, so your job stays simple. Members set an intention before the session, rest in a private room during at least two hours of monitoring, and have integration therapy afterward. Our physicians, nurses and therapists can work with your person’s own doctor and therapist. Read more about our holistic approach to Spravato in Aventura, just north of Miami.
We offer Spravato and IV (intravenous) ketamine under one roof, so the care team can help your person choose the right fit. IV ketamine is a medicine given slowly through a vein, and for some members it can help supplement the healing journey alongside therapy.
We see the family as part of care. You bring them in and take them home, and we handle the rest. If you have questions about your role, or your person is still deciding, book a consultation and talk it through with our care team together.