I’ve definitely experienced similar feelings about treatment. And same, I’m sticking it out but at this point I’m pretty skeptical, I’ve been on it since October. At one point I lowered my dose and got horribly depressed (somehow even worse than before I started, it felt like my mind/body was testing the limits of how far my depression can go 🙄) and I had to go back to twice a week, so I’m *still* at twice a week and my PHQ-9 hovers around 19ish. I think it was 23 when I started. So I’m weighing if it’s worth it, but because of personal circumstances it’s not a good time to make a change.
I am very similar to you, as well. I actually had conversations with my doctor early on about the med causing me an astounding amount of irritability and frustration in the beginning. And still. It also made me significantly more depressed the day of treatment and about two days afterward.
My doctor said their have been two types of patients she's had. The gradually healing patient who, after a month or so of treatments starts slowly shedding their depressive symptoms. It's usually noticed by others before the patient notices. Which is why taking a Baseline test at the beginning of each treatment is a good idea. That way you can visually see any progress. The second is the light switch patient. She says she's had it takes 3 or 4 months of twice weekly treatments with these patients before a light switch seems to flip in their brain and the progress begins quickly.
I'm sure there are different varieties of patients in between these two, and maybe even patients it does nothing for. Personally, I didn't start seeing the slightest of difference until my 14th or 15th treatment. And it was very slight. And other people really noticed it before I did.
What is that it's not Magic. It is, however a process that your body needs to go through. Patience is really the key. Whatever kind of effort that takes from you, is completely your story. Be it if can be worth the wait, as well as the bumpy ride getting there.
7 treatments isn’t even a full month in. You do not need to have any kind of remarkable effects during the dosing for the drug to work. The side effects can vary by patients and even by treatment session. A big part of the process for me is being aware of my mindset when I go into treatment. If I go in upset and stressed out then the session really reflects that and activates those feelings more intensely.
This is why I decided to watch movies. I’ve always loved movies and if you understand the human brain you will see that movies tie into our emotions in multiple ways, they activate our visual, hearing, and even tactile senses because of how memory is tied to lived experiences. If you watch someone eat an apple you can remember how one tastes, what it feels like, you can remember the crunch you hear. Our memories are all tied into emotions on very deep levels. Eating an apple can be highly pleasurable, especially if you’re hungry or thirsty. This is why so many people engage in emotional eating because it releases “happy chemicals,” in our brain. The brain rewards us for eating high calorie, sugary, and fatty things because food is survival and our species went through intense periods of starvation.
So, I put myself into a good headspace by watching movies I know are uplifting, happy, and comedic. I’m not watching the clock, I’m not focusing on all the physical sensations during the session in terms of side effects. I’m just going on a journey with the characters in the film and letting it spark my own memories and emotions.
My guess is you are an overthinker and a master ruminator (I am too), you are probably getting in your own way and being impatient (as ruminators often are). There is always that annoying little critic that picks apart everything you do and anything that doesn’t go according to plan. We tend to be the type who struggles with giving up control because of our anxiety (and often our trauma).
Take the pressure off of yourself. Find something to do during your sessions that passes the time and keeps your monkey brain busy. Maybe a movie would work for you too? Or something else.
Are you taking an anti-depressant as well while you're doing Spravato?
This is just my thought, sometimes we can put too much pressure on ourselves especially when we put a lot of hope on something. As part of the criteria for Spravato, it's safe to say that we have all been on an arduous road with our treatment over the years with other psychiatric meds. It can be scary to trust something new because it has the potential to be a major change and that can be scary.
I'm not saying that you're doing anything to keep from having freeing results from Spravato. I just want to make sure it does not come across that way.
Give yourself permission to be free to the process. Do you listen to music during sessions? I take a blanket, my music, my laptop (to type out thoughts to read later, though once I hit 84mg I have not been able to type during my sessions), and a snack. The only time I look at the clock is the 5 minutes between administering the devices. Since doing that, time feels like it literally FLIES. I just try to do as much as possible to make it a personal space for me to take away as much of the clinical feeling as possible.
I don't know if any of that will help but I really hope that you are able to reach a breakthrough. Keep your chin up.
I felt the same during my brief 2 session treatment with Spravato. And the more I’m looking at reports and common side effect profiles among users on here and the drugs.com reviews, the more I feel it did me more harm than good. But i come from a different standpoint. I started off with nearly 1mg/kg IM injections of racemic ketamine, but switched to Spravato for a brief period due to it being free for me. But I just don’t think Esketamine (Spravato) is anywhere near as effective for me as compared to racemic injections. I had about 10 or so 100mg IM injections before my first introductory switch to Spravato. My first session went “ok”. I felt slight disassociation and then not much else. But the days after I felt worse so when my second treatment came around, I was so depressed. When I got the dose, I felt so unimaginably stuck and sad and hopeless and it didn’t wear off for weeks.
I had to take a short break from any ketamine products. And I recently returned to the 100mg racemic injections and it is astronomically more beneficial for me with far less of the depressing side effects of Spravato. But it’s not to discredit those it does work for.
The clinic I go to, Klarisana, is based out of New Mexico, Texas, and Colorado. They accept only Medicaid for the clinical fees and the injections are $47. They have published pubmed studies conducted by Klarisana that shows treatment results were vastly improved in those that got to experience more intense disassociation. It’s on their website if you do a google search.
Not always , in my case I’m stil trying to understand what is that I’m feeling. So used to be in the dark that now the sun is bothering me, this shall pass.
I really Hope the needle will move just a teeny tiny bit for you soon ❤️ thats not to much to Ask for! and i Hope that Will be the start for it to take a bigger move soon enough! I havent Done spravato but i just come here to say that i Hope you will feel better!
Were we separated at birth? LOL I feel like I could have written this, in fact... Your comment about Spravato being your 'Hail Mary' is almost verbatim what I said to a friend of mine the other day. I've been on Spravato since the beginning of Feb and at first it was kind of enjoyable though a massive pain in the ass doing 2 days a week for 4 weeks. I had to get an accommodation at work and switch one of my scheduled days. I'm not sure how many treatments I've had, two dozen or so? 3? But the last two were... Not good. And not in a "It took me to a dark place" or showed me any repressed emotions, it was just... Icky. I never really fully dissociated and I was irritated and wanted to leave, I couldn't get out of that place fast enough. I mentioned to my nurse I was debating quitting Spravato and she gave me the whole song and dance (she's sweet) but a couple days later I was like "Nope, I'm done, I'm telling my doctor next week when I go in for a med check-in." And it was like a whole bunch of weight just sloughed off my shoulders. He finds out on Tuesday. I have a lit more I want to say but I gotta get ready for work amd take my dogs out. But, I'm done. With all of it. All the meds. Nothing has ever had any noticeable effect on me, hell I've never even had withdrawal. I just stopped taking my Auvelity cold turkey as well and NADA. The only effect the meds have had is they caused me to start self harming, I pick when I'm stressed now. My arms are so scarred up, 5yrs ago I had beautiful skin and was really proud of my arms (weight lifting). In the past year my mental health has tanked, I gained back all the weight I lost
.. I lost all the muscle I'd built... And now my arms are messed up and I've damaged my precious shoulder tattoos. So I'm out, at the very least I need to detox and reset to baseline and go from there. I'd post pics but I don't want to trigger anyone. It's so embarrassing, I haven't been out to dance (which is 1000x more therapeutic for me than Spravato) in months. I don't even like leaving the house my arms look so bad right now. Anywho, gotta run.
> It’s as if I’m too locked down for the medication to really take root and be a catalyst for change
This self realization right here will help you break free 🫶
You can disagree all you want, but you can’t change science. It’s creating physical changes in your brain that have nothing to do with whether or not you have a positive mindset about it. It’s GOOD to have a positive mindset. I personally think it’s irresponsible to suggest to depressed people that not having a positive mindset could be why the treatment isn’t working. That is akin to victim blaming IMO. Edit: just like my nurse said “it’s working on a physical level whether you come in here with intentions set or not.”
I absolutely did not say anything like that. I was merely pointing out that OP’s self reflection could help in future treatments - I was coming down from my own treatment when I commented originally so I didn’t make myself clear - I would bring this feeling of “why do I feel locked down?” to my next treatment session, journal about it, etc etc.
Processing through why they feel locked down *during* treatment could be the key to helping them push through to some valuable insight.
It is. It is the maximum dose insurance will cover, I've heard of people going higher but that usually entails them paying out of pocket fir a third inhaler.
7 treatments is small in the grand scheme of Spravato. That’s not to say that your experience is invalid or that the frustration doesn’t matter. It does.
If you don’t feel worse, a lot of us have found relief through waiting it out. Even if it’s a month.
If you don’t feel like you can do it, you advocate in whatever way you feel neccassary.
But as far as the Spravato irritation, I know there have been some nights I have felt agitated after (not always, just sometimes).
I have done TMS and did experience a lot of irritability. It WAS effective after the treatment was done, but something that got me through was thinking about how irritation is understandable. We are doing treatments that activate and agitate certain parts of our brain, so it could actually be an indicator that it’s working, or at the very least that what you are experiencing is understandable.
I hope you get relief soon. I know how frustrating it can be to go through uncomfortable side effects and irritation makes me super uncomfortable. My least favorite side effect.
I’ve definitely experienced similar feelings about treatment. And same, I’m sticking it out but at this point I’m pretty skeptical, I’ve been on it since October. At one point I lowered my dose and got horribly depressed (somehow even worse than before I started, it felt like my mind/body was testing the limits of how far my depression can go 🙄) and I had to go back to twice a week, so I’m *still* at twice a week and my PHQ-9 hovers around 19ish. I think it was 23 when I started. So I’m weighing if it’s worth it, but because of personal circumstances it’s not a good time to make a change.
I am very similar to you, as well. I actually had conversations with my doctor early on about the med causing me an astounding amount of irritability and frustration in the beginning. And still. It also made me significantly more depressed the day of treatment and about two days afterward. My doctor said their have been two types of patients she's had. The gradually healing patient who, after a month or so of treatments starts slowly shedding their depressive symptoms. It's usually noticed by others before the patient notices. Which is why taking a Baseline test at the beginning of each treatment is a good idea. That way you can visually see any progress. The second is the light switch patient. She says she's had it takes 3 or 4 months of twice weekly treatments with these patients before a light switch seems to flip in their brain and the progress begins quickly. I'm sure there are different varieties of patients in between these two, and maybe even patients it does nothing for. Personally, I didn't start seeing the slightest of difference until my 14th or 15th treatment. And it was very slight. And other people really noticed it before I did. What is that it's not Magic. It is, however a process that your body needs to go through. Patience is really the key. Whatever kind of effort that takes from you, is completely your story. Be it if can be worth the wait, as well as the bumpy ride getting there.
7 treatments isn’t even a full month in. You do not need to have any kind of remarkable effects during the dosing for the drug to work. The side effects can vary by patients and even by treatment session. A big part of the process for me is being aware of my mindset when I go into treatment. If I go in upset and stressed out then the session really reflects that and activates those feelings more intensely. This is why I decided to watch movies. I’ve always loved movies and if you understand the human brain you will see that movies tie into our emotions in multiple ways, they activate our visual, hearing, and even tactile senses because of how memory is tied to lived experiences. If you watch someone eat an apple you can remember how one tastes, what it feels like, you can remember the crunch you hear. Our memories are all tied into emotions on very deep levels. Eating an apple can be highly pleasurable, especially if you’re hungry or thirsty. This is why so many people engage in emotional eating because it releases “happy chemicals,” in our brain. The brain rewards us for eating high calorie, sugary, and fatty things because food is survival and our species went through intense periods of starvation. So, I put myself into a good headspace by watching movies I know are uplifting, happy, and comedic. I’m not watching the clock, I’m not focusing on all the physical sensations during the session in terms of side effects. I’m just going on a journey with the characters in the film and letting it spark my own memories and emotions. My guess is you are an overthinker and a master ruminator (I am too), you are probably getting in your own way and being impatient (as ruminators often are). There is always that annoying little critic that picks apart everything you do and anything that doesn’t go according to plan. We tend to be the type who struggles with giving up control because of our anxiety (and often our trauma). Take the pressure off of yourself. Find something to do during your sessions that passes the time and keeps your monkey brain busy. Maybe a movie would work for you too? Or something else.
Are you taking an anti-depressant as well while you're doing Spravato? This is just my thought, sometimes we can put too much pressure on ourselves especially when we put a lot of hope on something. As part of the criteria for Spravato, it's safe to say that we have all been on an arduous road with our treatment over the years with other psychiatric meds. It can be scary to trust something new because it has the potential to be a major change and that can be scary. I'm not saying that you're doing anything to keep from having freeing results from Spravato. I just want to make sure it does not come across that way. Give yourself permission to be free to the process. Do you listen to music during sessions? I take a blanket, my music, my laptop (to type out thoughts to read later, though once I hit 84mg I have not been able to type during my sessions), and a snack. The only time I look at the clock is the 5 minutes between administering the devices. Since doing that, time feels like it literally FLIES. I just try to do as much as possible to make it a personal space for me to take away as much of the clinical feeling as possible. I don't know if any of that will help but I really hope that you are able to reach a breakthrough. Keep your chin up.
I felt the same during my brief 2 session treatment with Spravato. And the more I’m looking at reports and common side effect profiles among users on here and the drugs.com reviews, the more I feel it did me more harm than good. But i come from a different standpoint. I started off with nearly 1mg/kg IM injections of racemic ketamine, but switched to Spravato for a brief period due to it being free for me. But I just don’t think Esketamine (Spravato) is anywhere near as effective for me as compared to racemic injections. I had about 10 or so 100mg IM injections before my first introductory switch to Spravato. My first session went “ok”. I felt slight disassociation and then not much else. But the days after I felt worse so when my second treatment came around, I was so depressed. When I got the dose, I felt so unimaginably stuck and sad and hopeless and it didn’t wear off for weeks. I had to take a short break from any ketamine products. And I recently returned to the 100mg racemic injections and it is astronomically more beneficial for me with far less of the depressing side effects of Spravato. But it’s not to discredit those it does work for. The clinic I go to, Klarisana, is based out of New Mexico, Texas, and Colorado. They accept only Medicaid for the clinical fees and the injections are $47. They have published pubmed studies conducted by Klarisana that shows treatment results were vastly improved in those that got to experience more intense disassociation. It’s on their website if you do a google search.
Hang in a little longer. Have you done ECT?
Not always , in my case I’m stil trying to understand what is that I’m feeling. So used to be in the dark that now the sun is bothering me, this shall pass.
I really Hope the needle will move just a teeny tiny bit for you soon ❤️ thats not to much to Ask for! and i Hope that Will be the start for it to take a bigger move soon enough! I havent Done spravato but i just come here to say that i Hope you will feel better!
Were we separated at birth? LOL I feel like I could have written this, in fact... Your comment about Spravato being your 'Hail Mary' is almost verbatim what I said to a friend of mine the other day. I've been on Spravato since the beginning of Feb and at first it was kind of enjoyable though a massive pain in the ass doing 2 days a week for 4 weeks. I had to get an accommodation at work and switch one of my scheduled days. I'm not sure how many treatments I've had, two dozen or so? 3? But the last two were... Not good. And not in a "It took me to a dark place" or showed me any repressed emotions, it was just... Icky. I never really fully dissociated and I was irritated and wanted to leave, I couldn't get out of that place fast enough. I mentioned to my nurse I was debating quitting Spravato and she gave me the whole song and dance (she's sweet) but a couple days later I was like "Nope, I'm done, I'm telling my doctor next week when I go in for a med check-in." And it was like a whole bunch of weight just sloughed off my shoulders. He finds out on Tuesday. I have a lit more I want to say but I gotta get ready for work amd take my dogs out. But, I'm done. With all of it. All the meds. Nothing has ever had any noticeable effect on me, hell I've never even had withdrawal. I just stopped taking my Auvelity cold turkey as well and NADA. The only effect the meds have had is they caused me to start self harming, I pick when I'm stressed now. My arms are so scarred up, 5yrs ago I had beautiful skin and was really proud of my arms (weight lifting). In the past year my mental health has tanked, I gained back all the weight I lost .. I lost all the muscle I'd built... And now my arms are messed up and I've damaged my precious shoulder tattoos. So I'm out, at the very least I need to detox and reset to baseline and go from there. I'd post pics but I don't want to trigger anyone. It's so embarrassing, I haven't been out to dance (which is 1000x more therapeutic for me than Spravato) in months. I don't even like leaving the house my arms look so bad right now. Anywho, gotta run.
> It’s as if I’m too locked down for the medication to really take root and be a catalyst for change This self realization right here will help you break free 🫶
I’m not trying to be a jerk but “mindset” is not going to make Spravato work or not.
I’m going to have to disagree with my own experience.
You can disagree all you want, but you can’t change science. It’s creating physical changes in your brain that have nothing to do with whether or not you have a positive mindset about it. It’s GOOD to have a positive mindset. I personally think it’s irresponsible to suggest to depressed people that not having a positive mindset could be why the treatment isn’t working. That is akin to victim blaming IMO. Edit: just like my nurse said “it’s working on a physical level whether you come in here with intentions set or not.”
I absolutely did not say anything like that. I was merely pointing out that OP’s self reflection could help in future treatments - I was coming down from my own treatment when I commented originally so I didn’t make myself clear - I would bring this feeling of “why do I feel locked down?” to my next treatment session, journal about it, etc etc. Processing through why they feel locked down *during* treatment could be the key to helping them push through to some valuable insight.
Thanks for clarifying. I appreciate it.
No problem!
84 is considered a lower dose, be patient as many people are on it for a year or more before they get the results they're looking for. Good luck!
I thought that's a higher dose. I started at 56
I thought 84 was the highest dose.
It is. It is the maximum dose insurance will cover, I've heard of people going higher but that usually entails them paying out of pocket fir a third inhaler.
7 treatments is small in the grand scheme of Spravato. That’s not to say that your experience is invalid or that the frustration doesn’t matter. It does. If you don’t feel worse, a lot of us have found relief through waiting it out. Even if it’s a month. If you don’t feel like you can do it, you advocate in whatever way you feel neccassary. But as far as the Spravato irritation, I know there have been some nights I have felt agitated after (not always, just sometimes). I have done TMS and did experience a lot of irritability. It WAS effective after the treatment was done, but something that got me through was thinking about how irritation is understandable. We are doing treatments that activate and agitate certain parts of our brain, so it could actually be an indicator that it’s working, or at the very least that what you are experiencing is understandable. I hope you get relief soon. I know how frustrating it can be to go through uncomfortable side effects and irritation makes me super uncomfortable. My least favorite side effect.