If you are living with depression that will not lift, you are not alone. Many adults do not get better after trying more than one antidepressant. Spravato for depression is an in-clinic nasal spray that works in a different way and can bring relief on a faster timeline. At Maryland Spravato & TMS Center in Laurel Maryland, Spravato is provided with careful medical supervision for adults with Treatment Resistant Depression or for adults with Major Depressive Disorder who have urgent suicidal thoughts or actions.
Table of Contents
Who may benefit
How Spravato works
Safety first through the REMS program
Because Spravato can cause sedation and dissociation and carries a risk of misuse, the Food and Drug Administration requires a safety system called a Risk Evaluation and Mitigation Strategy. Clinics must be certified. Patients self administer the spray only while staff supervise. Observation in clinic lasts at least two hours after every dose. You will also arrange a ride home and avoid driving until the next day after a full night of sleep. In late 2024 the FDA updated the program materials to add respiratory depression as a risk and to require pulse oximetry on site.
What to expect at Maryland Spravato & TMS Center
Your care team prepares you step by step so you know what will happen before, during, and after each session.
Before your first session
- A medical review covers your mental health history and current medicines and supplements.
- ollow simple fasting guidance. Avoid food for two hours and liquids for thirty minutes before dosing unless your clinician advises otherwise.
- Use any other nasal medicines at least one hour before you arrive if needed.
- Plan safe transport home since you will not drive until the next day.
During the session
You will self administer Spravato in a calm clinical setting while staff monitor vital signs and mental status. Side effects such as dizziness, nausea, sedation, and dissociation are possible. Staff remain with you to support comfort and safety.
After you leave
You will stay in clinic for at least two hours. Staff will check that you are medically stable before discharge. Plan for rest and light activity for the remainder of the day and avoid driving or operating machinery until the next day.
Dosing schedule and timeline
Spravato treatment follows an induction phase then a maintenance phase. The standard pattern is two visits each week during weeks one through four. During weeks five through eight visits are once weekly. Starting week nine visits are weekly or every two weeks based on your response. Your clinician will aim for the least frequent schedule that keeps you well.
Benefits you may notice
Many people feel mood or energy changes within hours to days of the first sessions. That faster effect can be meaningful when previous medicines have not helped enough. Early clinical research and later experience suggest improvements in depressive symptoms and in suicidal thoughts for some adults, while side effects often resolve the same day. Your clinician will review expected benefits and the limits of current evidence.
Side effects and monitoring
Common short term effects include sedation, dissociation, nausea, increases in blood pressure, and brief changes in perception. Blood pressure peaks around forty minutes after dosing and returns toward baseline within several hours. Because Spravato is a Schedule 3 controlled medicine there is a risk of misuse that your team will monitor. The clinic follows a structured protocol to watch for these effects and to treat symptoms if they arise.
Who should avoid Spravato or use extra caution
Spravato is not right for everyone. People with certain blood vessel problems or a history of bleeding in the brain should not take it. Those with uncontrolled high blood pressure or certain heart or brain issues need extra caution. Tell your clinician if you are pregnant or planning pregnancy. Share all medicines and supplements. Your team will weigh benefits and risks and will coordinate with your other providers.
How Spravato compares with other options
For people who do not respond to standard oral medicines, two paths at our center can help. Spravato offers a medication based approach with clinic monitoring and a different brain target. Transcranial Magnetic Stimulation is a non drug therapy that uses focused magnetic pulses. Some adults pursue one path first then the other based on response and preference. We will help you understand which approach may fit your history and goals. For an overview of the TMS service on this site please see the TMS Therapy pages.
Practical safeguards you can expect at each visit
- Pre dose checks for blood pressure and current symptoms
- Supervised self dosing with staff nearby at all times
- Observation for at least two hours with vital sign checks and symptom review
- Clear rules on rest after you leave and on no driving until the next day
- A plan for missed sessions and ongoing communication in between visits
Support and insurance
Why choose Maryland Spravato & TMS Center
We are a certified Spravato clinic serving adults across Maryland. Care is personal and evidence based. You receive clear education, close monitoring, and a plan that fits your life. Our team also offers NeuroStar TMS and other services when a non drug therapy is preferred or when you want to continue gains after your Spravato course.
Next step
If Spravato for depression sounds like a fit, request a consult with Maryland Spravato & TMS Center. We will review your history, discuss goals, and map a treatment plan. Bring a list of medicines and questions. We will walk you through preparation, your first day in clinic, and follow up care so you feel confident and supported.