How Often Do You Take Spravato?

The answer to the question "how often do you take Spravato" differs on personal factors and in what phase of treatment you're in. That said, the Spravato treatment frequency is typically twice weekly when starting out. 

Over time, many patients shift to a once weekly schedule. Some patients even take it less frequently, such as once every other week. The esketamine treatment schedule is clinician-directed and planned, but as a patient, it’s still useful to understand what to expect ahead of time.

Quick answers

• During the induction phase, which lasts about four weeks, a patient has two Spravato sessions per week at a certified clinic. During each session, patients self-administer the esketamine nasal spray, and trained staff monitor them during treatment.
• At the end of four weeks, many patients continue with one Spravato session per week for the next four weeks. Later on, treatment sessions may be even more infrequent. A clinician may adjust treatment frequency as needed, and Spravato maintenance sessions may occur once a month or every other week as well. 
• While session frequency often looks the same for most patients in the beginning, Spravato treatment is clinician-determined, meaning individual patients may require a different schedule after the induction phase.

The Spravato dosing schedule

The dosing schedule for Spravato, an esketamine nasal spray, can be divided into three parts:

• Induction: “The first time that you come in and you're new to Spravato, you would usually get the 56 milligrams of Spravato, which is two devices,” says Carlene MacMillan MD, FCTMSS, DFAACAP, co-founder at Radial and board-certified psychiatrist. She adds that the induction phase frequency is two sessions a week, and the dose typically goes up to 84 milligrams (three devices) during this phase. Induction lasts a month, and Spravato is administered eight times during it.
• Maintenance: During the second month, you usually maintain the 84 milligram dose, but sessions become weekly as opposed to twice a week. Then, “after two months have passed, some people will stop and others will continue,” says Dr. MacMillan, “It's kind of up to the clinician's discretion.” Dr. MacMillan has worked with patients who continue to take Spravato once a week, and others who take it once every other week or even monthly.

What determines how often you take Spravato

The Spravato dosing schedule starts off pretty standard, though someone’s personal experience influences dosing after the induction phase. “It’s kind of up to the clinician's discretion and what the patient prefers,” explains Dr. MacMillan. 

The most common reason providers adjust frequency is the patient’s clinical response. Tolerability may also play a role, and Dr. MacMillan mentions this affects both how often Spravato is administered as well as the dose. Real-life scheduling can also influence treatment frequency; someone may need to skip a session due to a vacation or work trip, for example.

To learn more about if Spravato might be the right choice for you and, if so, what your dosing schedule may look like, contact a REMS-certified provider, such as the team at Radial.

Disclaimer: One medical reviewer listed on this article, Steve Harvey, MD, is a paid speaker for Johnson & Johnson, the manufacturer of Spravato.

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