Spravato and your other medications.
Most medicines carry on as usual alongside Spravato, including your oral antidepressant. A few need care because they add to Spravato's temporary effects on treatment days: sedatives can add to the sleepiness, and stimulants or MAOIs can add to the blood pressure rise. Bring your full medication list to your evaluation and we'll plan around it.
What medications interact with Spravato?
The medications that interact with Spravato are the ones that add to its sedation or its blood pressure rise (Spravato Prescribing Information). None of them automatically rule Spravato out; they change how we plan and monitor.
| Medicine or substance | Why it matters | What we do |
|---|---|---|
| Benzodiazepines (e.g. Xanax, Klonopin), opioids, sleep medicines | Can add to sedation on treatment days. | Work with your psychiatrist to see whether they can be taken after your treatment instead of before; monitor sedation closely. |
| Stimulants (e.g. Adderall, Ritalin, Vyvanse, modafinil) | Can add to the blood pressure rise. | Work with your psychiatrist to see whether your stimulant can be taken after your treatment; check blood pressure closely. |
| MAO inhibitors | Can add to the blood pressure rise. | Monitor blood pressure closely. |
| Nasal steroid or decongestant sprays | Can change how the spray is absorbed. | Use them at least one hour before your Spravato dose on treatment days. |
| Alcohol | Adds to sedation. | Skip it on treatment days. |
From the SPRAVATO® (esketamine) Prescribing Information, Janssen Pharmaceuticals. Brand names are examples, not a complete list.
Can you take Spravato with antidepressants like Wellbutrin?
Yes, Spravato is commonly taken alongside an oral antidepressant, including bupropion (Wellbutrin), SSRIs, SNRIs and Auvelity, which we often pair with it. Since 2025 it can also be used on its own for treatment-resistant depression, so whether you continue your antidepressant is a decision we make with you and the clinician who prescribes it.
Can you take Spravato with lithium or lamotrigine?
Yes. People with bipolar depression take Spravato alongside a mood stabilizer, never instead of one. Spravato and bipolar depression.
Should you take your blood pressure medicine on treatment days?
Yes, and this is the one we stress most: take it as prescribed before your treatment, and don't let a busy treatment-day morning make you forget it. Spravato raises blood pressure for a few hours after each dose, so well-controlled blood pressure going in is exactly what we want. We check it before every dose and again during your rest.
Can you take Spravato if you take opioid pain medicine?
Often, yes, with care. Opioids can add to Spravato's sleepiness, so we look at your dose and timing and watch how alert you are during each session (Spravato Prescribing Information). Don't stop a pain medicine on your own to start Spravato; we'll plan any change with you and the doctor who prescribes it.
What about supplements, cannabis and other substances?
Tell us about supplements and anything else you take, even if it seems unrelated, so we can check it. Cannabis has its own page: Spravato and cannabis.
The fastest way to a safe plan.
A photo of your pill bottles or your pharmacy's printout is enough. We go through it at your evaluation, which usually happens within one business day.
How do we decide what to do with each of your medicines?
We decide together, medicine by medicine. At your evaluation we go through everything you take and give you specific guidance on each one, rather than leaving you to work it out. Where timing matters, we work with the psychiatrist or doctor who prescribes it, so the plan suits all of your care: stimulants and anxiety medicines are often best taken after your treatment, and blood pressure medicines before it. If anything changes, tell us and we'll update the plan.
Treatment dayHow should you handle your medicines on a treatment day?
- Take your regular medicines as usual, unless we've agreed a different plan with you.
- Use nasal steroid or decongestant sprays at least an hour before your Spravato dose.
- Take your blood pressure medicine before you come. Set a reminder if mornings are rushed.
- Hold sedatives, anxiety medicines and stimulants until after your treatment if that's the plan you and your psychiatrist agreed.
- Skip alcohol for the rest of the day.
- Tell us about anything new, including a short course of antibiotics, cold medicine or a new supplement.
Why the interactions are manageable.
Spravato's effects are temporary and happen in our office, with our team checking your blood pressure and how alert you are. That's what makes these interactions manageable: they matter for a few hours on treatment days, under supervision, not around the clock.
30 doses
Every day.
Side effectsEvery single day: sedation, dry mouth, sexual side effects, weight gain.
8 visits
Twice a week.
4 visits
Down to once a week.
2–4 visits a month
Down to once a week or every other week. Dashed: weeks you may or may not need.
Side effectsMostly gone by the end of each visit.
Check if you qualify, then bring your list.
Answer a few questions about your history. At your evaluation we'll go through every medicine you take.
Name, date of birth and insurer. We check your plan and call you back. No commitment.
Check my coverageRegister once, and our team starts your insurance check and reaches out to schedule your evaluation.
Request an evaluationWhat people ask about Spravato and their medicines.
Can you take Adderall with Spravato?
Often yes, with care, and having ADHD alongside depression doesn’t rule you out. Stimulants like Adderall can add to Spravato's temporary blood pressure rise, so we check your blood pressure closely and plan timing on treatment days.
Can you take Xanax or other benzodiazepines with Spravato?
Often yes, with care. They can add to sedation, so we review timing and dose with you.
Can you drink alcohol while on Spravato?
Skip alcohol on treatment days, since it adds to the sleepiness.
Can you take magnesium or other supplements with Spravato?
Tell us about every supplement you take. Most don't affect Spravato, but we check each one at your evaluation rather than guess.
Can you take sleeping pills with Spravato?
Often yes, with care. Sleep medicines add to sedation, so we agree the timing with you around treatment days.
Do I stop my antidepressant when I start Spravato?
Usually not. Many people take Spravato alongside an oral antidepressant. Any change is decided with you and your prescriber.