I have MDD, PTSD, and chronic suicidal ideation (my therapist suspects OCD-like tendencies).

My psychiatrist has brought up Spravato several times and thinks it’s worth trying. Everything I’m reading said it’s helpful for MDD with acute suicidal ideation but I don’t see any evidence that it’s helpful for those with chronic SI.

If this treatment works it would be life changing. But I fear going through it and it not helping at all. I think I would feel more broken if I go through yet another treatment that doesn’t help.

I had my first session today, and it was kind of rough. A little after the second set, I started freaking out. I was alarmingly high and all of the scariest and most painful thoughts I've been dealing with came at me. I thought I was going to jump out of my chair. I asked the nurse practitioner if I could take half a klonpin, and she said it was probably okay so I did, and eventually calmed down. I decided not to take the third set, though.

They told me since I got through it and didn't puke, I did well and that it would get easier as my body gets used to it. I'm not convinced that this treatment is going to be good for my anxiety, though, and I'm thinking about asking for an anxiety medication before my next session (other than klonopin, which I'm not currently on but have a few left for emergencies). I'd like to avoid it if possible, though. I want to believe this is going to work.

i bring headphones for treatment ofc and was wondering what’s up

Hi guys, I'm hoping some folks with greater knowledge than me can weigh in on my understanding of how this medication exerts its benefits, as I see it:

• Spravato/Esketamine produces NMDA-receptor blockade. This disrupts neural signaling akin to a sinkhole in a road.
• In response to this, neurons attempt to restore normal signaling/traffic by activating multiple plasticity pathways, trying to bridge and detour around the sinkhole.
• The disruption is commonly subjectively experienced as dissociation, with the brain perceiving familiar stimuli in unfamiliar ways. For some, this can be a frightful experience, for others, perceiving the world in novel ways inspires awe.
• The different plasticity pathways (bridges, detours) are constructed for varying durations. They can remain active long after the acute need for them has passed.
• Future drugs may be able to trigger the same plasticity responses to NMDA disruption without needing to cause the disruption itself. The necessity of dissociation is unclear, but it seems to both initiate and direct the plasticity responses.
• Awe is an indicator of a person's inclination toward positive learning (curiosity, exploration) and disruption of depression's negative bias. When you feel the world is vast and full of wondrous things to uncover, your model of what's possible in the future changes, including what's possible for yourself.
• Pour one out for all those who lived before modern medicine.

Inspired by these studies: Ketamine and rapid antidepressant action: new treatments and novel synaptic signaling mechanisms, Experiences of Awe Mediate Ketamine’s Antidepressant Effects: Findings From a Randomized Controlled Trial in Treatment-Resistant Depression

After 12 induction session I had a review with the docs and finished it as I am even worst.

Works like this in spain

I am in total despair because I had hope but another medication to the failing list.

I asked for tms but the pshyc in charge is on leave for two weeks and in theory will call me back ( I am doubting it ).

I am tired and desperate and I already lost enough time.Also I cant afford tms or ect privately so welcome to my world....

My doctor believes I’m a good candidate for Esketamine. I’m open to it, as every other medication has proven either ineffective or harmful. My main concern is- how debilitating are the treatments themselves? I want to get better, but don’t want to sacrifice the other things going on in my life such as work, preparation for moving/going back to school, and my social life. If you’ve been treated with Esketamine before, how much of an impact did it put into the logistics of your day to day life?

Hi everyone! 🩷 I’m a BHT and I’ve been the primary Spravato Tech in my office for the last almost 4 years!

I’m starting a little project for my new patients & patients who are going through a rough patch — I’m having my current patients write some small encouraging messages if they’d like for me to keep on hand to give to new patients since everyone is always SO nervous on your first appointment.

I love both Spravato and TMS, but since I started my program from the ground up in my center Spravato has a special place in my heart & I would love to share this project with you all!

SOOO if you all want to share positive words or encouraging messages about your experiences, feel free to comment below and I will print them out to include! I will block out usernames as well. 💜

I’ve done a handful of spravato treatments now, almost done with the induction phase. I would say all the the appointments except for one, my blood pressure appears to drop instead of increase.

However, I’m wondering if it’s actually accurate or not to monitor BP with the finger?? Also, no one really checked on me despite some pretty low numbers throughout the appointment so I am just a little confused. I’ll probably say something to them next appointment

I’ve taken Kpin for 6 years for Social and generalized anxiety. Of course the rebound anxiety alongside a ton of other side effects(can’t eat certain foods without getting hives, tremors, immune system decreased where I have hives, anxiety, benzo belly and a ton of other things. The rehab took me off 2mg per day by switching me to Ativan and taking me off in 10 days… It’s been two weeks and I scheduled an appointment for IV ketamine and then transitioning to spravato spray after a month. Could healing neuroplasticity assist my GABA A receptors to recover and help anxiety? I currently take Nardil(antidepressant), I’d take Lamictal a day prior to appointment and gabapentin for my herniated discs. Any advice is appreciated!

The clinic I consulted with today is checking my UMR coverage. They said I may need to try another class of depression medication for 8 weeks before insurance will cover Spravato.

I was on Pristiq for about 10 months. Around two months after starting it, I began having hyperthyroid symptoms—heart palpitations, lightheadedness, low energy, and feeling awful almost every day. They got worse over time, but stopped after I discontinued Pristiq. I don’t know if they were connected, but I’m not really interested in going back on it.

Has anyone gotten an exception or appeal approved? Any Chicago-area clinics that are good with insurance? Any advice or experiences are appreciated :)

Thanks for all the supportive responses yesterday. I’ll just tell you the highlights of my first time with Spravato.

I have high anxiety so I mentally prepared with a bag of comfort items and comfy clothes for the chair. I did took half my Ativan upon waking and the other half an hour before leaving. The car picked me up and the driver was friendly and put me at ease, which really helped.

I got to the clinic and sat in a comfy recliner in a little cubicle that had a small bedside table with a low level light, candies, a cute little cup of dum-dum lollipops, tissues and crackers. The nurse I spoke to was helping me and she was really nice. Kept offering me water and when I said I was afraid of nausea she showed me where the throw-up bags were in the drawer of the table. So that helped with that part of my anxiety. At first I thought I wasn’t in a recliner and asked to go to a room with one, and the nurse showed me how to use the chair. I filled out the paperwork, and could hear a lot of other patients being asked how they were and I was trying to stay in a positive mindset so I put my headphones on and finished the papers. I did two nasal sprays 5 minutes apart and I expected the taste to be horrible but It wasn’t as bad as I’ve heard and a wintergreen candy helped it pass quickly.

I covered my eyes with a mask, put on a Spravato video off YouTube, covered myself with my blanket and felt excited about the idea of dissociating on legal meds. (I’m 63 and back in my HS days I tried acid and shrooms but wasn’t a fan of the exhaustion the next day). I started to feel lighter and just relaxed and said, “show me what you got.” I had dissociative images that were sometimes calming and other times negative memories. I was able to refocus by lifting up my eye mask and watching the video of a cool green moving blob that was part of my youtube music.

Once or twice I had to mess with my phone because my cell signal was glitching. I remember calling for help to get on the free WiFi but I think I was too quiet. I hit the call button but I might have done it wrong because no one came. Then my video started working and I put my head back, smiled and thought it was funny, “they aren’t going to come help a patient with signal issues and they’re probably watching me on the camera and saying nope.” LOL

I was so groggy when it was time to wake up. I was worried when I saw my ride would be there in 15 minutes. The nurse was reassuring that I had plenty of time and told me to just start sitting up. I packed my things and left.

I got home, ate something and crawled in bed with my cat for a couple hours. I have a lot to process and even though nothing terrible happened it was mentally and emotionally exhausting. I feel like I don’t want to go back. But the nurse told me don’t drive and don’t make any big decisions like buy a car or a house. LOL I think she also meant process what happened before I decide not to go back.

Spravato has been a lifesaver for me. I have a pretty lengthy hangover following treatment into the next day. Total fatigue. I schedule my treatment bi-weekly on Friday afternoons so I can work my job and crash on Saturday. By Sunday I feel amazing.

Does anybody else experience this? Is there anything I can do ?

I’ve been in treatment for almost 2 years. After the first 6 months the sessions stopped feeling like much and I was back to baseline shortly after. Due to life I started experiencing bad insomnia months ago. Now my sessions are super intense again and the rest of my evening is done. Has anyone else experienced this? Don’t know why I didn’t think of the correlation between the two until now.

I'm restarting Spravato today after a year and a half and I was considering how I journal during treatment.

Has anyone found any specific journal prompts or journaling themes that were particularly helpful during sessions?

My clinic didn't do the "Do's and Dont's" call before treatment, so I'm trying to remember all the little things I need to know before I go in.

Someone posted this a year ago and I couldn’t bypass just how accurate it is. Three horribly dissociative and trippy sessions later and I’ve balled up in the fetal position for every single one 😂

After 3 years of Spravato, sharing my routine. Maybe others would want to do the same

Wake up, don't eat, don't drink. One hour before treatment, do a sinus rinse

Bring bag. Blanket, eye mask, noise cancelling earbuds, saline spray, nasal strip, vaseline, tissues

When I get there, I do saline spray. Put vaseline around bottom outside of nose. Put nasal strip on nose to keep it open. Do my 3 doses aiming outward with a gentle sniff. Gently rub the outer nose after each spray to keep it in. If any runs down, use tissue on outside. Try not to inhale too hard or too soft. I takes practice.

During treatment, listen to unfamiliar music without lyrics. I love nature sounds. Try not to use your "earth brain". In other words, don' try to steer it Just look into the darkness and let whatever happens, happen

When I get home , I do another sinus rinse and put nasal gel inside nostril.

I hope this helps someone..

This may sound like a dumb question. I had a vars plana vitrectomy to repair a detached retina on oct 7th. I had a gas bubble put in and my eye is blurry and will be for atleast several more weeks up to 2 months. I have severe depression and anxiety, hence the spravato treatment. Not being able to see out of my eye gives me additional anxiety. Im concerned about a bad trip due to not being able to see and panicking. While I can see out of my left eye, my eye gets tired and will get a little blurry now and then also. Close your right eye for as long as you can and imagine if you'd had to do treatment like that. I have some minor pain and itching with the healing and am not allowed to touch my eye. Obviously my first instinct is to rub it. If I have that urge to rub my eye, will I know not to while under the spravato treatment?

I am going into my ninth week on Spravato. The first six I did 56mg twice weekly. After that I have been doing 84 once a week. I see a lot of posts on here about how this is a magical treatment that changed that person's life after the first session. That was not my experience. But holy shit, for the first time ever my mental health has been going in a good direction. I hope everyone that gets discouraged that their depression is not turning around as quickly as they expected can gain something from this post.

The first weeks were really hard on me emotionally. September is not short on bad reminders and difficult memories so it's generally a bad month. During my sessions, everything I keep hidden underneath to function started to bubble to surface. I was forced to process it. I was lucky enough to have a flexible therapist that put some of our appointments on the same day. My therapist said the first change she noticed in me is that I was a lot more open. Just bringing up certain topics can be enough to make me freeze up and not want to talk. There had even been a few occasions where a simple question was enough to send me into a full-on PTSD flashback (thank god for Klonopin in those times). All the walls I built in my mind to protect myself are slowly coming down. God, it hurts. But after the pain, I feel a lot lighter.

Another change that came early in my treatment was my energy. I don't mean in terms of physical energy... I still feel very lethargic as my depression is quite severe. But I had the mental energy to do more things. It became routine that after my treatment, I would take a 45min walk around sunset and journal when I got home. That has also helped me process my trauma. Now I am doing these things almost every day, not just on the days I do Spravato. Before I started, I would leave the house once a week or even every other week, mostly for appointments and no other reason.

The most recent change (as in the past few weeks) has been my ability to feel pleasure. I am extremely anhedonic. When mental health professionals ask me the last time I had a good day was, I cannot give them an answer. It's been this way for a long time. I don't really know if I am "happy." Actually, I know that I'm not. Joy and excitement aren't really things I feel. But I get little glimpses of what it's like to enjoy things. I will pass by something on a walk, notice its beauty, and take a picture. Photography is a hobby I abandoned a long time ago and would like to get back into. Every now and then, I feel like watching a movie. I hadn't been indulging in my love for film because not being able to feel the emotion or depth from the art form like I used to was really depressing. I started going back and watching my old favorites and even some new movies and I feel enjoyment. I wish I could get immersed in the worlds put on screen again. I trust that will come in time.

Lastly, another change in myself that I am just starting to notice is that I am starting to put myself out there and talk to people more. It's so easy to want to hide away from the world when you are depressed. Why would you want anyone to see you like that? But now I feel emboldened to make a quick comment to a stranger or strike up a casual conversation with someone.

Also, I stopped biting my nails? Like, completely. No urge to anymore. It has been a habit I have been struggling to break all my life and now it's easy as pie and I have beautiful, healthy nails. This happened when I started treatment so I assume I can attribute it to its effects.

I don't feel great most days. I am not "fixed." But I can see my mental health going in a positive direction. I have tried over fifteen medications (many of the standard treatments and some off-label) and nada. I am thankful I never gave up and did research until I heard about Spravato. My PTSD and depression are what it is helping me the most with. I haven't seen much of a change with my anxiety. My depression score keeps going down but my anxiety score is as high as it has always been. But my panic hasn't gotten worse, for anyone concerned about that. I also have autism if that puts more context to my experience for anyone else on the spectrum.

My insurance pays for a car to pick me up in the morning and off I’ll go. I’m expecting to have an anxiety attack so I was going to take an Ativan (per the psych nurse’s advice) but I keep reading benzo’s lessen the effects. So maybe I’ll take half a pill a couple hours before.

Thanks to all the suggestions everyone gives so freely to posters—I have my “clinic bag” packed w/ wintergreen mints, jolly ranchers, head phones, a reiki video on YouTube (i don’t pay for a music library so I’m just hoping I don’t get ads!), a comfy blanket and a face mask. I’ll throw a cool compress in there in the am. I don’t have any fidgets that I know of so I think I’ll bring a crystal or heart rock that I can hold and help with grounding, if that’s what I need.

Intellectually in the safety of my home, I got this, but once I get to the car and to the clinic I don’t know what I’ll do. I’m 63, which feels old for the treatment. I beat myself up that I haven’t got this depression thing figured out yet. But, the truth is, the SI is pervasive lately and it’s probably my way of coping with the fear I have about Spravato. Afterward, at home, my prescribing NP who also does therapy with me, wants me to call her so that’s good because I’m socially isolated.

I went to this same clinic 2 years ago for TMS which didn’t work out due to side effects. I know this post is flat on emotions because I’m already dissociating and numb. My greatest fear is tripping my brains out and feeling out of control. I will try to go with an open mind, though, and will try to let the drug and my mind show me whatever they want to.

Anxious thoughts right now: Do I need to bring a ziplock bag just incase I’m nauseous and throw up? I want to pack some Clorox wipes to wipe down the chair so it doesn’t have germs from the person before me, but if I do that I have to bring a dry paper towel to dry it off, too. Am I supposed to tip the person picking me up and dropping me off? Will my wallet be safe while I’m dissociating? Will I hear others making noise or will I be alone? On my intake the psych nurse said she’d give me a room to myself but I’m not believing it because all the people I talk to seem to have completely separate responsibilities and I doubt that’s hers. Can I have a cup of coffee in the morning? I have to remember not to take my adderal in the morning….and the worries go on and on…

Thanks for reading my post!

Hey all! I'm a college student, going between a few different locations underneath the same umbrella clinic, depending on if I'm home or not. my regular therapist from home is unable to practice in the state that I go to school in, so if I want to start therapy up again during the school year, I'd have to find a new place, person and swap between two providers throughout each year. it's probably worth finding one, especially since my original psychologist isn't versed in drug-assisted hallucinogenic psychotherapy, but that's a separate issue. my main question is just about how to get more out of each session, as I usually find myself centering on some issue at some point, and coming out of the high with a little bit more clarity. I'm about 20 sessions deep, still figuring out a playlist which works best for me, and working through a lot of other things simultaneously. I'm not entirely sure what I'm asking for, aside from general advice? it feels like there's so many current variables to my life, and I can't really tell what's helpful. please feel free to share tips/tricks/stories/advice and I'll do my best to respond to everything! thank you :)

I'm finding myself getting angry and annoyed more often since starting Spravato (I've had 6 treatments so far). I'm telling myself that it's a good thing, as it means I'm less numb

I'm not sure I believe it.

Does this sound familiar to anyone?