The Spravato Treatment Schedule: What the First Month Looks Like at New Horizon in West Hartford

Most questions about Spravato (esketamine) come down to logistics: how often, how long, and how do I get home. The dosing intervals come straight from the FDA label, and New Horizon Behavioral Health in West Hartford, CT follows them at every session. This is the shape of a course of treatment, from the candidacy visit through maintenance.

Before any dose: the evaluation

The first appointment decides candidacy, not dosing. It is a 60-minute psychiatric evaluation: your diagnosis, every antidepressant you have tried with dose and duration, your medical history, and your blood pressure history. No medication is given that day. If Spravato is appropriate, the office files the prior authorization and schedules your sessions. If it is not, you are told then and pointed toward what fits.

Weeks 1 through 4: induction, twice weekly

Eight sessions over four weeks, at 56 mg or 84 mg as your prescriber directs. Each visit runs about two and a half hours door to door:

• No food for two hours and no liquids for 30 minutes before your dose.
• Blood pressure is taken before dosing.
• You self-administer the nasal spray in a private room with a clinician present.
• Blood pressure is rechecked about 40 minutes after the dose.
• You stay for at least two hours of monitoring, which the REMS program requires before you can be discharged.

You need a ride home from every session. The label says no driving or operating machinery until the next day after a restful sleep. Committing to the twice-weekly schedule for the full four weeks is one of the eligibility questions, so plan work and rides before you start.

Weeks 5 through 8: once weekly

Sessions space out while your prescriber tracks response and side effects. Symptom scores from the evaluation give both of you a starting line, so the question of whether treatment is working is answered with numbers, not guesswork.

Week 9 onward: weekly or every two weeks

Maintenance at the least frequent interval that holds your response. Treatment continues only as long as it is helping. Your prescriber sets the actual schedule; the label sets the range.

What happens alongside it

Spravato is rarely the only thing happening. It is approved both as monotherapy and together with an oral antidepressant, so most patients keep a prescriber, and many keep a therapist. At New Horizon both are in the same building and the same chart, which means your dosing schedule, your oral medication and your therapy sessions are planned together rather than relayed by you between offices. Do not stop any other medication on your own; any change is made with your prescriber.

Side effects you may notice on session days

Dissociation, a sense of detachment during the session, is common and is one reason you stay for monitoring. Dizziness, nausea, sedation, a temporary rise in blood pressure, numbness, anxiety and headache are also listed. Spravato carries a boxed warning for sedation, dissociation, respiratory depression, abuse and misuse, and suicidal thoughts and behaviors. Tell the clinical team about anything that worries you, during or between sessions.

What to bring to session one

Your photo ID, insurance card, your current medication list, and your ride. Bring something to listen to. Most people rest or doze during monitoring.

The full description, including who qualifies and what insurance requires, is on the Spravato page. To start with an evaluation, request an appointment or call.

New Horizon Behavioral Health
10 Princeton St, Ste N, West Hartford, CT 06110
Phone: (860) 838-8799
By appointment, Monday through Friday. In person only. Adults 18 and over.
In a crisis, call or text 988, or call 911.