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During treatment and the monitoring period, I pay attention to how patients are doing and to changes they describe. Some information comes from the observations and vital signs directed by the clinical team. Other information comes from a conversation: a patient may say that today's experience feels different, that nausea is increasing, or that something has changed since the last visit. Both kinds of information matter.
Monitoring is more than waiting for an appointment to end. The team follows the requirements of the treatment being provided and communicates concerns to the clinician overseeing care. For SPRAVATO®, required observation includes monitoring for sedation, dissociation, and breathing changes for at least two hours, followed by a clinical assessment of readiness to leave. IV ketamine has its own clinician-directed monitoring process; its schedule should be confirmed separately.
Things worth telling the team include:
- A physical sensation that is new, uncomfortable, or getting stronger, including dizziness, nausea, unusual warmth, or difficulty breathing. Speak up when it happens rather than waiting until departure.
- An emotional or perceptual experience that feels distressing or different from previous visits. Plain descriptions are useful; you do not need to know a medical term.
- Changes between visits in mood, sleep, daily functioning, or how well you are tolerating treatment. Mention medication changes and information another treating provider has asked you to share.
I document relevant observations and patient reports and bring notable changes to the provider's attention. Standardized rating scales can also help the clinical team follow symptoms over time. A score or a single observation is one part of the picture; interpreting it and deciding what it means for care remains the treating clinician's responsibility.
When coordination is needed, the treating provider may communicate with a patient's psychiatrist, therapist, primary care provider, or other care-team member through the appropriate clinical process. Before leaving, ask how to report concerns that arise at home and which symptoms need urgent attention. Clear communication helps the next visit build on what the team learned today.