Last updated: October 2026. Reviewed by Dr. Steven Radowitz.
Starting Spravato in NYC means about eight clinic visits in your first month, each with at least two hours of rest and observation in the clinic. The first questions most people have are practical: how often to go, how to handle work, and how to get home.
About 11% of adults in New York City have been diagnosed with major depression, and about a third say they have mental health needs that aren’t being met, according to the city’s first State of Mental Health report. Spravato is a prescription nasal spray for depression that hasn’t lifted after at least two antidepressants, sometimes called treatment-resistant depression. It’s made from esketamine, a close relative of ketamine, and the FDA has approved it for this use. The FDA has also approved it for adults with depression who are having thoughts of suicide. It’s given only in health care settings certified under an FDA safety program called REMS, so you can’t take it home. If you’re still deciding whether it’s right for you, read what the research shows.
What does the Spravato schedule look like in NYC?
Spravato’s prescribing information, the FDA-approved instructions often called the label, sets out three phases for depression that hasn’t lifted:
- Weeks 1 to 4: two visits a week
- Weeks 5 to 8: one visit a week
- Week 9 onward: once a week, every two weeks or monthly, set by your care team
The first month is the busiest, at about eight visits. After week 8 comes the ongoing phase, often called maintenance, as Nushama’s Spravato maintenance roadmap explains.
Each visit includes at least two hours of observation in the clinic, and you can’t drive until the next day after a restful sleep. Observation means you stay in the clinic while staff check on you until it’s safe to leave. Add your travel time and check-in when you plan the day.
What happens in week 1?
In week 1 you have two visits, and each starts with a blood pressure check before you use the spray yourself while a clinician watches. Before each visit:
- Eat earlier. The label advises no food for at least 2 hours before your dose, and no drinks for 30 minutes before.
- Time any nasal sprays. If you use a decongestant or steroid nasal spray, take it at least an hour before your dose.
- Arrange your ride home before you arrive.
Many people feel floaty, dreamy or a little detached for a while after the dose, which clinicians call dissociation. Nushama’s guide to Spravato side effects covers what’s common and what the team watches for. In Manhattan, a guide can stay with you through the observation time.
What about weeks 2 to 4?
Weeks 2 to 4 keep the same twice-weekly rhythm, and this is when your care team checks how you’re responding. Some people notice small shifts in the first week or two, and others notice less until later.
Keep a few notes between visits about your sleep, energy and mood, and bring them to check-ins. Toward the end of week 4, the team reviews how things are going with you, and together you decide on weekly visits and what comes after.
How do you fit Spravato around a New York workweek?
Spravato fits around work most easily when you set your visit days early and know your leave rights:
- Set your visit days with the care team. Ask which days and times are open at your center before week 1 starts.
- Use your sick-leave rights. Under New York City’s protected time off law, most workers can use their leave to get medical care, and you don’t have to tell your employer why you used it.
- Keep the rest of the day clear. Ask the care team what is and isn’t fine to do after a visit.
After a full night’s sleep, the effects have usually cleared. Ask the care team what’s realistic for your job the next day.
Should you get Spravato in Manhattan or Rockland?
Choose the center that’s easier for you to reach about eight times in a month; Nushama offers Spravato at both its Manhattan and Rockland centers.
Manhattan (Midtown): 515 Madison Avenue, 21st floor, with the entrance on East 53rd Street. It’s steps from the 5 Av/53 St subway station (E train, plus the F on weekdays), a short walk from the 6 at 51 St, and on the M1, M2, M3 and M4 bus routes at Madison Ave and 53rd St.
Rockland County (New City): 200 E. Eckerson Road, Suite 280, just off NY-59 near the Palisades Interstate Parkway.
Nushama accepts Fidelis Care, a New York health plan, for Spravato at both its Manhattan and Rockland centers; benefits vary by plan.
FAQ
Can I go back to work after a Spravato visit? Plan to rest instead. The effects usually clear after a full night’s sleep, and the care team can tell you what makes sense for your job.
Can I take the subway home after a visit? Ask the care team what they recommend for you. Some people feel detached or dizzy for a while after a dose, so arrange your way home before the visit.
What if I miss a visit in the first month? Call the care team as soon as you can so they can reschedule.
Do I need a ride every time, even later on? Yes, if you’d normally drive: the no-driving rule applies after every dose, not just the first few.
How do you start Spravato with Nushama?
You start with a free consultation, where Nushama’s care team reviews your history, checks whether Spravato is safe for you, and helps you choose the center, days and times that fit your week. Ask the team how your insurance applies to your plan. When you’re ready, book a free consultation with Nushama’s care team.
If you feel unsafe or are thinking about ending your life, please reach out now rather than waiting for an appointment. Call or text 988, the Suicide & Crisis Lifeline, or go to the nearest emergency room. In New York City, NYC 988 also offers call, text and chat support in more than 200 languages.
