Esketamine (Spravato) sessions last about 60 to 90 minutes in a Lumin Health location, with antidepressant effects often beginning within 24 hours and treatment continuing through months of maintenance.
Esketamine (Spravato) is FDA-approved for adults with treatment-resistant depression and major depression with suicidal thoughts.
Lumin Health provides esketamine (Spravato) therapy across Greater Boston, with most major insurance plans accepted.
"How long does Spravato last" is one of the most common questions we hear from patients weighing a treatment decision. But it turns out to be several questions packed into one. How long is an individual session? When do the antidepressant effects start? How long do those effects hold between sessions? How long might a full treatment program run?
Each has a different answer. This guide walks through them, grounded in the clinical framework we use at Lumin Health and in the research literature that informs it.
The in-session timeline from start to finish
A Spravato session at a Lumin Health location typically runs about two hours from check-in to discharge, and looks something like this:
- 0 – 15 minutes: Check-in, vitals, and a brief review of how you are feeling that day. You settle into a private treatment space.
- 15 – 20 minutes: Self-administration of esketamine nasal spray under direct clinical supervision.
- 20 – 40 minutes: Onset. Most patients begin to feel effects within 15 to 40 minutes after the first spray.
- 40 – 90 minutes: Peak effects. The dissociative window is most pronounced in this period.
- 90 – 120 minutes: Resolution. Dissociation fades, and most patients feel clear-headed well before discharge.
After the session, you cannot drive for the rest of the day. Reaction times are slowed, and transportation home must be arranged in advance. This is not optional – it is part of the FDA REMS safety requirements that apply to every esketamine (Spravato) administration nationwide.
"A person cannot drive home after treatment. Reaction times have been shown to be slowed after treatment. People need to arrange transportation home and be aware they cannot drive for the rest of the day."
– Dr. Ben Yudkoff, Chief Medical Officer, Lumin Health
When do the antidepressant effects begin?
This is the part patients really want an answer to. Not when the session ends – when the depression starts to lift. The honest answer is that response varies, but here is what the research and our clinical observation both support.
Within the first 24 hours, a meaningful subset of patients describe a shift. This is rarely full remission. It is more often described as the weight lifting slightly, or a sense of being able to imagine relief for the first time in a long time. A 2024 review of five years of post-approval esketamine data found rapid antidepressant effects within 24 hours to be consistent across real-world populations – a pattern that is clinically distinct from the 4 to 8 week onset of traditional oral antidepressants.
Across the first week, more patients begin to notice clearer effects. Sleep may improve. Appetite may return. The rumination that has been running on repeat may quiet.
By the end of the induction phase – four weeks of twice-weekly sessions – many patients have experienced a cumulative shift that is meaningful in daily life. That said, about three in ten patients do not respond meaningfully to Spravato. Our providers track response closely and have direct conversations with patients about whether treatment is working.
How long does relief last between maintenance sessions?
In the early induction phase, sessions are close enough together that there is not really a "between sessions" gap where relief would fade. After induction, during the maintenance phase, the question becomes whether relief holds across one or two week intervals.
For patients who respond well, relief often holds across the full interval. Some patients describe a gradual dimming of mood in the day or two before their next session. Our providers adjust session frequency based on how long your relief lasts. If mood reliably dims at day 10, we may move to weekly sessions. If you feel stable through a full two week interval, we may consider extending.
There is no single right answer to "how long does Spravato last" in the maintenance phase. The clinical goal is to find the interval that sustains your relief with the fewest sessions necessary.
Does tolerance to Spravato develop over time?
A fair question that comes up often. Current evidence does not show significant tolerance requiring dose escalation when esketamine (Spravato) is used as prescribed for depression. A systematic review of long-term ketamine and esketamine safety examined longer-duration data and did not identify tolerance as a dominant concern in the mental health indication.
There is also a clinical framing worth holding. Dissociation during esketamine or ketamine treatment may represent a ceiling dosage – meaning providing additional treatment beyond the dissociative window does not add therapeutic benefit. If a higher dose would not add therapeutic value, then tolerance is not the limiting factor. The clinical window is.
This is very different from recreational ketamine use, where tolerance can develop with frequent, high-dose exposure. Clinical esketamine at Lumin Health is carefully dosed and spaced in a way that does not create the conditions for that kind of tolerance.
How long is a full Spravato treatment program?
When patients ask "how long does Spravato last," some of them mean "how long am I going to be in treatment?" That is a fair question to ask at the outset. Here is the typical shape at Lumin Health:
- Weeks 1 – 4 (induction): Two sessions per week, totaling 8 sessions.
- Weeks 5 – 8 (stabilization): One session per week, totaling 4 sessions.
- Week 9 onward (maintenance): Sessions every 1 to 2 weeks, clinically guided based on how you respond.
Most patients continue maintenance for an extended period, often twelve months or longer. Treatment-resistant depression is typically a chronic condition, and ongoing maintenance is more common than a time-limited course.
This is an important expectation to set. Spravato is not a one-and-done treatment. It is closer to how patients think about other maintenance therapies for chronic conditions – you stay on it as long as it is helping, and you and your provider agree it is the right path forward.
What Spravato does not do
Being direct about what esketamine (Spravato) is not is part of setting honest expectations. It does not ensure a specific outcome, and no provider should promise one. It does not replace other mental health care – many patients benefit from working with an outside therapist during treatment, and we coordinate with outside providers (Lumin Health does not offer psychotherapy ourselves). Spravato also does not work for every patient, and if that is your experience, our providers will have a direct conversation with you about whether to continue or explore other paths, including IM ketamine therapy.
Frequently asked questions
How long does a Spravato session last from start to finish?
About two hours total at a Lumin Health location. That includes check-in, administration, and the mandatory two-hour observation period that follows.
How long before I feel something after taking Spravato?
Most patients describe onset within 15 to 40 minutes. Peak dissociative effects are strongest between 40 and 90 minutes after administration.
How long until Spravato works for depression?
Some patients describe shifts within 24 hours. More patients notice clearer effects across the first week. Full induction phase benefit is usually apparent by the end of week 4.
How long can I drive after a Spravato session?
You cannot drive for the rest of the day after a session. Arrange transportation home before your appointment.
How long do patients stay on Spravato?
Most patients continue maintenance for twelve months or longer. Treatment-resistant depression is typically chronic, and ongoing maintenance is more common than a time-limited course.
If you are weighing Spravato, we would welcome a conversation
Lumin Health is based out of the Boston Metro area and expanding to other states. We offer esketamine (Spravato), which is FDA-approved for adults with treatment-resistant depression and major depression with suicidal thoughts, led by psychiatrist providers. If you have been holding this decision and want to understand how the timeline would look for you specifically, a consultation is a grounded way to start. Check whether your insurance is accepted, or reach out directly.
If you or someone you love is navigating treatment-resistant depression and considering esketamine (Spravato), Lumin Health's team is ready to help. We invite you to explore whether this may be a fit through a brief, complimentary consultation.
Based out of the Boston Metro area and expanding to other states.
