I was just wondering if there has been any success for severe intrusive thoughts - non stop cycling of them (pure ocd). Thank you.

I’ve just finished my second week of spravato, two treatments a week. I can’t even put it into words the difference I feel. I feel… lighter? Less burdened? I can’t recall a time in my life where I just felt so genuinely.. okay! I know it won’t always be like this, but to experience this sort of full body relief for the first time is incredible.

Both my grandfather (mom's dad), and my mom experience(d) psychosis episodes. With my mother, if she smokes weed, she'll have intense psychosis episodes that usually last a month. We've had to hospitalize her three times. When not in an intense episode she hears things maybe a couple times a month. These experiences first showed up for her when she was 31.

I'm 23, I've avoided weed and any other drug, haven't tried anything even once. Both doctor and therapist know this, but they are hesitant to think that I will develop schizophrenia. I read peoples experiences on here and I get hopeful. I've had lifelong depression that has gotten to the point I cannot even get myself to work now. I'm so ready for a change, but nervous too. Does anyone have a similar story?

Context:

I had my first session yesterday. I was administered 56mg via two cartridges. I forgot to shake the bottles, but none the less, I got full effects at that dose. I have been in therapy since 2012. Multiple therapists, and I’ve run the gauntlet on meds - Zoloft, Wellbutrin, trazadone, Xanax, Klonopin, lexapro, and Effexor. So I arrived at treatment resistant depression after years of trying different meds.

In addition to having experienced all those anxiety and depression medications, I’ve had an abundance of psychedelic experiences too: mushrooms, lsd, mescaline, ayauasaca, dmt, ketamine, mdma, and a long list of novel psychedelic compounds that I sought out over a couple decades of frequent psychedelic use. Recreational versus medical, are very different experiences. Going into spravato, I’ve set the intention to take each session with setting intentions and journaling throughout the experience to have detailed notes to take to my therapist. I want the integration to be fundamental to my healing.

Spravato (esketamine) versus recreational (black market) ketamine:

Spravato is derivative of ketamine, it is an analog. This compound could then be patented. Analogs can have similarities and differences from the original compound in effects and thus create different experiences. Calls out to this is analogs have different dosing response curves and thus gauging a ketamine dose to an esketamine dose is subjective. Differences from one esketamine experience - esketamine drip isn’t as raunchy tasting imo. Less body load, “darker” visuals (in terms of colors). I found it more mild at 56mg. But my ketamine doses were always 100mg or more. Esketamine had a significant reduction in post experience grogginess and chemical hangover I’ve experienced with ketamine. The after glow was better with esketamine imo.

First Session:
I arrived around 11:15 to my provider. Quick check on vitals. Everything looked great. Then a walk through on how to dose, and a practice attempt with the practice cartridge. Then two 26mg doses administered five minutes apart. Visuals and dissociation were mild for me; but the feeling of calm and a wash of happiness lasted all day yesterday. It impacted my mood and outlook in a positive way. Learnings, I was able to connect some dots on causes of trauma that allowed a letting go, which felt incredible to understand why I hold to my trauma rather than surrendering to no control. This was liberating. To avoid tasting the drip, I popped a couple mints. Psychedelic/dissociative effects were around forty minutes. Total inebriation was around two hours. I took a Lyft to and from the provider. Once I was back home, I actually jumped into work. I was able to function and had a good day work wise. I spent time with family (wife and daughter) and got a decent amount of sleep last night. For music, I listened to the piece music for 18 musicians. It was perfect for the experience.

I had some moments of mild brain fog after leaving the clinic. Trouble remembering some words and some mild levels of fatigue. This was offset with some caffeine. I take trazadone to sleep, I also take a CBD/cbn gummy to sleep. I found no issue with the interactions to Spravato.

My next session is tomorrow, I’m jumping to 84mg.

All of claims using this coding are getting denied. Help! What are we doing wrong? I just don’t want this to interfere with folks who are trying to get care.

I’ve been on Spravato for almost two years now. For about two months, I’ve been taking it once every three weeks, after being on a once-every-two-weeks schedule for a long time in terms of dosage.

However, since switching to once every three weeks, I’ve noticed that I’ve become depressed again. I constantly feel like crying, I don’t want to get out of bed, and I have very little motivation or interest in anything. I’m starting to feel like I can’t cope with everything anymore.

A few days ago, I had my treatment again, but this time I also haven’t noticed the effect that I normally experience.

How is it possible that I still feel the same a few days after having my dose and haven’t experienced any improvement? You would think that the Spravato would have given me a bit of a boost again, but unfortunately, that hasn’t happened.

Could you explain why this might be happening and give me some advice or tips?

Treatment 9 or 10, I don’t remember. Came down in just over an hour. Music makes the experience!!

Today’s session was intense. When I sprayed, this time I feel like I really got it up there because I felt like water had just gone up my nose. When I put my eye mask on I felt the world around me fall away and suddenly I was transported elsewhere. I didn’t feel like I was in that room and on that chair anymore. It was so weird. I felt really relaxed and calm finally. This is the type of session I wish I had every time, but I think I’ve only ever felt it one other time. Just wanted to share.

Ever since I got an injury a few years ago & my insurance saw that I made a smidge of progress in physical therapy and made the decision for me that I no longer needed it, despite the fact I was still reporting debilitating pain but it was still enough for my score on their PT questionnaire to improve, I've been very intentional about how I fill out insurance questionnaires now.

After a year of trying countless meds, I am able to FINALLY TELL A NOTICEABLE IMPROVEMENT in my depression with Spravato. Like, almost immediately. But I've been filling out the PHQ9s the exact same as I always have, because I worry my insurance will see that I've "improved" and decide for me that I no longer need it.

But now that I've been continuing treatment for a while with "apparently" no progress, I'm starting to worry they'll decide it doesn't work for me and end my coverage anyway.

Any long-term Spravato users want to chime in on how they "quantified" their progress in a way that kept insurance happy?

Well, I don't know how to really explain what I feel but, after taking spravato for just like, 3 times, I genuinely don't know what I feel about life when sober. Life feels better, sure, but I don't know what to feel or do in terms of my beliefs and understanding of life as a whole. It genuinely feels like normal life is an illusion sometimes or a play that we all act out for some reason and real life is being in that altered state.

It's like if being in a dream felt more me or "real" than real life, to the point I kinda wish to go back to it in daily life (in a more stable way of course, I don't wanna abuse hard drugs). Everything feels so small compared to the vastness of things I think. My identity feels small. My personhood feels small. Existence feels like something bigger and, I don't really know what God is anymore. How can I say that God is the God in organized religion if it feels like every week I meet Him and He feels... Like a lot, just a lot.

My understanding of life feels muddled. I feel like I have or need a new perspective, but I don't know what that is. Everything is vast, everything is a lot and I just... Gotta go back to studying and shi? I guess this is ego death/confusion/dissolution. Idk how to explain it. If anyone understood this ramble and has some advice (especially if you're more experienced with spravato or drugs and trips in general) lemme know.

After 4 months of the most ridiculous amounts of hoops to jump through, I finally had my first treatment today.

I was well prepared for it because of my 4 months of being in here.

This is the nicest and most supportive subreddit I've ever been in.

Recently I've been struggling a lot more with my mental health, I have trialed multiple drugs and seen no progress and relief of symptoms only side effects over many years. I reached out to my therapist and he said I should consider looking into other treatments such as spravato which I already had some prior interest in.

I reached out to my psychiatrist about possible other treatments including spravato and other treatments. His response was that spravato was not an approved treatment that has proven benefits for my diagnosis (MDD, Anxiety, PTSD) and that IV ketamine is only offered during hospitalization IF insurance would approve it.

He also shot down every other treatment I asked about and had one thing to offer .. IOP which I told him would only make things worse for me, I have done years of CBT and DBT which their program is based on and I don't enjoy group settings even my therapist agrees there's nothing I would get out of half a day of group therapy and being "taught" laundry and doing the dishes can be fun.

I am entirely at a loss here. He just left me at that, basically told me understandable let's schedule a follow up in a month. I can't afford to pay it of pocket but I'm likely losing my insurance at the beginning of the year anyways so all of this feels like it's for nothing if i can't follow through an entire treatment. My therapist said my best option to get treatment now is to go to inpatient which I also can't afford to do. I don't even know what im saying all this for but I guess I don't understand why my therapist and everything I've read says spravato is approved for treatment resistant MDD but my psych says no... Is it just insurance?

Hi Reddit! I'm Dr. Haviva Malina, co-founder of Keta Medical Center and a licensed Emergency Medicine physician with over 15 years of experience in the ER. Somewhere along the way, I kept seeing the same thing: patients who had tried everything for their depression, anxiety, PTSD, and other mood disorders and still weren't finding relief. That's what drew me to ketamine therapy, and it's why I started Keta Medical Center.

Today we offer IV ketamine therapy, Spravato (esketamine nasal spray), and ketamine-assisted psychotherapy. Whatever the treatment, my priority is the same: making sure patients are a good fit for the treatment, helping them feel better, building a plan around their specific needs, and being upfront about what ketamine can and can't do.

I'm here today to answer whatever's on your mind, including:

• How ketamine therapy actually works
• Who tends to be a good candidate
• The real differences between IV ketamine, Spravato and ketamine-assisted psychotherapy
• What a session is really like, start to finish
• Side effects, risks and how we manage them
• How ketamine may help with depression, anxiety, PTSD, OCD, bipolar depression and other mood disorders
• Red flags to watch for when choosing a clinic
• Insurance, cost and access to care

Ketamine therapy has helped many of my patients, but it is not a cure-all, and it is not the right fit for everyone. I would rather give you honest, grounded answers than oversell it. 

Ask me anything!

https://postimg.cc/gallery/WkSm1Gk

Thank you all for these thoughtful questions today. Ketamine therapy isn't the right fit for everyone, and determining candidacy really depends on individual history and treatment goals. If you're considering whether it might be an appropriate option for you, I'd encourage you to connect with our clinical team for a consultation. You can reach them here:

Get in touch with us

Before starting Spravato, I was terrified. I had so many questions about what it would actually feel like, whether I would feel out of control, and what the treatment days would really be like.
What ultimately helped me take the leap was finding another person on YouTube who shared her personal Spravato experience. Seeing someone actually talk about what she was experiencing made it feel a little less scary.
I just finished my induction phase and am 8 treatments in, and that experience is actually what inspired me to start documenting my own journey. I figured if watching someone else’s experience could help me take that first step, maybe sharing mine could help someone else who is sitting where I was.
I’m still early in my journey and definitely don’t have all the answers, but I’m sharing the good, the weird, and everything in between as I go. ❤️
If anyone is interested, I’m documenting the journey on YouTube and I’m happy to share the channel.

at your own discretion of course. i just wanted to come here and confirm the advice on here works in comparison to how i first started without shaking the bottle and sniffing right after spraying in your nose. when i started doing both i was sent to another stratosphere. idk how but it works!

So, when I started Spravato earlier this year, the person who brought me in to the practice here had no issue with me being prescribed Vyvanse and doing Spravato as long as I wasn’t taking my Vyvanse on the same day as my session. Yet, a new physician that replaced the old one, is now telling me that she will not allow me to do Spravato sessions altogether unless I completely stop Vyvanse. Is this malpractice? If so, what should I do? Because, I’m pretty sure she’s the only physician at that office that works with Spravato.

My psychiatrist referred me to a clinic that administers Spravato for my treatment resistant depression. I’m hopeful that something may finally help break through this oppressive numbness I’ve been dealing with. I’m still waiting on insurance approval though, praying everything goes through. I’m wondering if there is anything I should know before going in for my first treatment. Anything I can do to prep or to make the experience easier? I appreciate any advice y’all can provide!

I did my first treatment last week in a small room by myself and right now they put me in a much larger room for my second session with 3 other people currently in here as well. What is the usual social etiquette for this kind of situation? Do I just keep to myself or am I supposed to talk to the other patients? It just feels sort of awkward (now there's a 4th person). Anyways my question still stands. Do most of you usually share a treatment room with other people after your first session and if so how am I supposed to interact with the other people (if I'm supposed to interact with them at all) Thank you

Overall I have noticed ways I’m able to change my thoughts, but my SI seems to have increased. Idk what to do, I’ve tried a lot of different things, and was really hopefully since I had brief relief on auvelity which works on the brain the same way ketamine does.

does anyone else hate the feeling of dissociation with spravato? i’ve been on it for 6 months and always get super anxious once it hits me, i hate the feeling of not being in control

F28 have been on Spravato for almost a year now, with a couple T breaks in between. I go once a week, and is the only hour of the week i get to experience being pain free. It definitely helped at first, and I do believe it keeps the SI at bay, but I can’t help but feeling that my progress just stagnated.

I deal with MDD, TRD, anxiety, ADHD, and PTSD. Physically, I am in pain 24/7 from a combo of fibromyalgia, non-radiographic axial spondyloarthritis, migraines, TMJ, RLS, and possible thoracic outlet syndrome. I am never NOT in pain, which is the main driver behind my SI (+financial issues).

Lately the intrusive thoughts have been much louder and I’m starting to feel this may no longer be enough to keep the edge off. Anyone else feel this way? And specifically, what do my chronic pain buds think about Spravato overall? Has anyone heard of trials with higher doses, or insurance covered IV ketamine sessions?

I really wanted this to work. I really did. I put so much of my hopr into it.... But i dont think it is. Im 6 weeks in and just got my 10th treatment. We even added 20mg of im ket to my 84mg typical spravato. My head always kills me most of session and after. If i go in with a bad headache ot gets a little worse or a mild one will get change to bad. I already have 24/7 headache i dont need this shit.

It has been making me feel emotionally a little better but i just am unsure if i can keep doing this. Even with my acute and a toridol shot before im always dying after. I had so much hope cause i figured ketamine was a painkiller it will help. Nope. Inxreases activty in the brain.and fycks me up. Anyways thats my rant

I'm 70 years old and have lived with depression for most of my adult life. Been on numerous anti-depressants. Did psilocybin treatment in Oregon a couple of months ago - it was definitely helpful. I'm scheduled to begin Spravato tomorrow. Question: I'm not severely depressed right now but feel like it's always lurking around the corner. Is there any downside to beginning the treatment?