Spravato dosage: 56 mg or 84 mg, and how it's chosen.
A Spravato dose is either 56 mg or 84 mg. Each nasal spray device holds 28 mg, so a 56 mg dose is two devices and an 84 mg dose is three, taken a few minutes apart in our office. Your clinician chooses the dose with you and adjusts it based on how well it works and how you feel.
What is the dose of Spravato?
The dose of Spravato for treatment-resistant depression is 56 mg or 84 mg at each visit, through both the first month and maintenance (Spravato Prescribing Information). The maximum dose is 84 mg.
| Dose | Devices | When it's used |
|---|---|---|
| 56 mg | 2 devices (28 mg each) | A starting dose, and a maintenance dose for many people. |
| 84 mg | 3 devices (28 mg each) | The highest dose, when 56 mg isn't working well enough and you tolerate it. |
From the SPRAVATO® (esketamine) Prescribing Information. For depression with acute suicidal thoughts, the label dose is 84 mg twice a week, which can be lowered to 56 mg.
How is the Spravato dose chosen?
The Spravato dose is chosen by your clinician based on two things: how well it's working and how you're tolerating it. If your mood isn't improving enough at 56 mg and the session effects are comfortable, we may move to 84 mg. If a session felt like a lot, we may stay at 56 mg. Either way, you're part of the decision at every visit.
Is 112 mg a Spravato dose?
No. The label's highest dose is 84 mg, three devices. If you've seen higher figures online, they aren't approved doses, and we don't give them.
Is the Spravato dose based on your weight?
No. Spravato comes in fixed doses, 56 mg or 84 mg, whatever your size. In the label's analysis, body weight and sex made no meaningful difference to how esketamine moves through the body (Spravato Prescribing Information). That's different from ketamine infusions, which are usually dosed by weight.
Does the dose differ for older adults?
The approved doses are the same for adults of every age. Blood levels run somewhat higher in older adults, so we pay close attention to how you feel during the session and choose the dose with that in mind. Who needs a closer look.
How is Spravato administered?
- BeforeWe check your blood pressure. Skip food for two hours and drinks for 30 minutes beforehand.
- Each deviceOne spray in each nostril, leaning back slightly. One device is 28 mg.
- Between devicesA five-minute rest before the next device, for a 56 mg or 84 mg dose.
- AfterYou rest for at least two hours while our team monitors you.
With a Sherpa guiding you.
You use the spray yourself, sitting comfortably, with one of our Sherpas, the specially trained team members who look after you on treatment days, guiding you through each step.
What helps each dose work as intended?
- Blow your nose before the first device, then don't blow it again until the session is over. If a little liquid drips, dab it with a tissue.
- Use any nasal steroid or decongestant spray at least an hour before your Spravato dose on treatment days.
- Skip food for two hours and drinks for 30 minutes beforehand. It makes nausea much less likely.
- Rest for five minutes after each device, leaning back, before the next one.
From the SPRAVATO® Prescribing Information and Instructions for Use.
How often is each dose given?
Twice a week in month one, once a week in month two, then weekly or every other week. How often and how long.
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, and we'll plan your dose together.
Answer a few questions. At your evaluation your clinician will explain your starting dose and how it may change.
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 doses.
What is the maximum dose of Spravato?
84 mg, given as three 28 mg devices a few minutes apart.
How many sprays is 84 mg of Spravato?
Six sprays: three devices, each with one spray in each nostril.
Is 84 mg of Spravato better than 56 mg?
Not for everyone. Some people do well at 56 mg; others need 84 mg. Your clinician adjusts based on how you respond and how you feel.
What if I miss a Spravato dose?
If you're feeling as well as before, you simply carry on with your schedule. If your mood has slipped after missed visits, your clinician may move you back to more frequent visits for a while.
Can Spravato be taken without an oral antidepressant?
Yes. Since 2025, Spravato is approved for treatment-resistant depression on its own or alongside an oral antidepressant, at the same doses.
Does the Spravato dose change over time?
It can. The dose and how often you come both get adjusted as you improve.