r/Spravato

My album Desire Path from my band Casts is out today. I wrote the album to guide my Spravato therapy with an upbeat entry point that dives into ambient and contemplative electronic songs. When writing it, I kept coming back to Reddit for opinions on what works for people. Everything flows into each other like one long song so there’s no abrupt transitions. I adjusted it so the cellos and clarinets come through to really feel the resonance during treatment. It’s been helpful for me and I hope it can play a part in your treatment, too.

Is this a Spravato thing? I’m not complaining I mean. lol

Rant / vent because I’m honestly at a loss right now.

I’ve been doing Spravato treatment and tomorrow morning was supposed to be my 6th session. So far I’ve done 5 sessions and overall the experience has actually been positive and I was just starting to notice some real progress.

Tonight around 5:30 PM I got a text from someone from my clinic saying they noticed my prior authorization apparently expired on 5/16, and because of that they had to remove me from tomorrow’s schedule so I wouldn’t get stuck with a massive bill. She was apologetic and admitted this should not have happened. She also said they’re trying to get the insurance team involved immediately.

What’s frustrating is that during intake they specifically emphasized how important consistency is during induction. They literally told me to make sure I had no vacations planned, no major conflicts, and that I needed to commit to the schedule because missing sessions early on can reduce effectiveness and even affect insurance approvals. They made it sound very serious.

So I did exactly that. I structured other appointments and my schedule around these treatments.

The confusing part is I thought the authorization already covered the initial 8-session induction period. I remember seeing the authorization date ending on 5/16 when I was approved, but I assumed the clinic was tracking that in the background because the sessions themselves were already scheduled past that date. Nobody ever told me “hey, your authorization expires midway through induction and we’ll need to renew it.” With other treatments I’ve had, like Zepbound, the office proactively warns patients ahead of time when a PA is close to expiring.

Now because they’re closed for Memorial Day, if this isn’t fixed quickly I could end up with an 11-day gap between sessions while still in the induction phase. That’s the part freaking me out the most because I’m only halfway through treatment and was finally starting to feel some benefit.

The receptionist I spoke to was actually very understanding and admitted it appears this may have been a “clinic oversight.” They’re trying to get me in Saturday if they can resolve it in time, which I appreciate, but I’m still just really upset this happened in the first place.

I’m trying not to catastrophize, but it’s hard when the clinic stressed from day one how important consistency was, only for the interruption to come from the administrative side rather than me missing sessions.

Has anyone else had something like this happen during Spravato induction? How badly did the gap affect your progress? or just any words of reassurance would be appreciated. I honestly can’t believe a clinic would forget and do this to someone. they’ve been great up until this, the treatment has been making me feel better and I just hope they can rectify this for me.

Is anyone out there interested in discussing what they are perceiving as a spiritual "trip" or experience on spravato. I'd like to share with someone(s) who isn't being paid to listen.

Howdy! I have been on Spravato for almost exactly 6 years now (June 2020), and my depression has been in COMPLETE remission ever since I was about one month into treatment. Truly life saving! Being able to experience joy for the first time in my life was and is such a novel, incredible experience, and it will never get old for me.

I will start by saying I would not trade this treatment for the world. Again and again, in every lifetime, I would choose Spravato. But. There’s a big but. Has anyone else who has been in treatment long term experienced any cognitive decline that they can only attribute to Spravato?

This cannot be the brain that got me through grad school to earn a masters degree. My cognitive function has fallen so low that I am disabled. After 2 years on a waitlist, I am scheduled for a neuropsych eval this Thursday (FINALLY, huge sigh of relief). This will be a huge component of my application for disability, as I am completely unable to work and I don’t foresee myself ever being able to hold down a job again. While I am no longer completely disabled by crippling suicidal depression, my brain no longer works the way it should and Spravato is the only trigger that I can think of. I’ve had no injuries, no major illnesses, no substance use history current or former. It’s like my cognitive abilities just said “nope!” the minute I started Spravato.

I’ve been through 3 different clinics and they’ve all told me, in oddly similar verbiage, “the 5 year studies show no cognitive impact.” So I’m about to go on a deep dive with this tonight—I loved being in school because I LOVE research and data. Science! If my brain still worked and finances were of no concern, I would pursue my doctorate of social work and go into research because seriously, I would have so much fun with that life! So I’m looking forward to doing my own reading tonight but I wanted to reach out to other long term patients and see if anyone has a personal experience that aligns with mine at all.

Like I said, I absolutely do NOT regret my decision to start Spravato and I will continue to wholeheartedly recommend it to every friend, loved one, and stranger who I think has even a slight chance at benefitting from it. I am still in treatment, and I expect treatment to be lifelong for me (as long as my insurance keeps covering it). I would absolutely never trade my status now for my status before I started—I’d rather have zero cognitive function and be truly happy like I am now, than be suicidally depressed for the rest of my life with a functioning brain. It sucks that I’m disabled (to say the least) but at least I can experience joy, I can be present with my kids, I can wake up every day motivated to try to be at least half the person that my dog thinks I am 🙂

My earliest memories in life are of being sad and anxious, I’d say I became aware around age 3-4, and things just never got better. I can’t even relate to folks who say treatment gave them their old selves back (great for them!) because I had no old self to go back to—for as long as I can remember, I wanted to die. Spravato gave me a level of mental health that I had simply never experienced before. I was 34 years old. I’m now 40, and even though it’s been 6 years, the feeling of happiness is still just so new and novel for me. I truly love that for me haha I hope the newness never goes away!

I used to be in a patient support group on Facebook that seems to have disappeared. There, I seem to remember folks talking about new onset cognitive difficulties, but my memory is foggy—that’s one big thing for me, my memory is absolutely awful. I know a lot of that may be natural damage from a lifetime of complex trauma and untreated mental illness, which certainly doesn’t help, but I simply don’t know how much of it if any can be attributed to Spravato.

Please let me know your thoughts 🙂 if you happen to have any good literature or research studies on hand, feel free to send them my way!

I've had two sessions and I am starting to feel positive effects, which is wonderful.

I'm also noticing that I feel self-conscious about expressing my newfound ability to be in a good mood.

Does anyone have advice on how to allow those emotions flow and be expressed, rather than hold them in a bit because of self-consciousness about others noticing a change?

I've struggled with inhibition in terms of things like dancing and being free for most of my life. Maybe I made myself smaller because I was depressed since childhood and was not accepted by my peers. I think numbing might have something to do with it. Have others broken though that sort of inhibition?

Maybe allowing myself to let go and be vulnerable in that way is something I can focus on in my next session.

Thanks in advance!

I had my first full dose treatment yesterday. As soon as I started to dissociate all I kept thinking was stuff like “I’m doing this wrong” and “I’m never going to get better because I don’t know the right way to think”. After I came down I just cried for an hour thinking that. I’m still feeling really emotional and down this morning.

I don’t know if I just expected to immediately feel happy then panicked when I didn’t? I am just wondering, has anyone felt worse after treatment? Everything I’ve read has said it’s uncommon to worsen depression. Any input? Thanks.

Everyone in my life is against it and thinks I’m being crazy to do this. I’m constantly invalidated by them. Not just in this. But everything. Bc they see funny functional me. And think I’m over here being lazy. I can’t function. I don’t want to sit here and cry everyday. I microdosed mushrooms for a year and some change and it really helped. They hated that too. But mushrooms aren’t sustainable bc they get blocked by certain meds. And I’m taking some of those now that I have to take. So I want to try spravato. I want my family to have my back instead of talking to me like I’m dumb for not being able to just get up and function like they do. I want to do that. How can I help them stop treating me like this and understand that this is a legitimate treatment option.

Really upset and desperate for answers please. Spravato hasn’t been a total game changer, but in 27 years it is the only thing that has made a dent or helped even a bit with my depression which considering nothing else has was a huge relief. It really made me feel hopeful for the future, more likely to initiate tasks, and have almost no SI. I have not had any treatments in about a year and when I inquired about maintenance treatments since I am not doing well, I was told I have had 85 treatments which is “a very high number” and since it doesn’t seem to be “sustaining me long term” they cannot recommend returning for additional Spravato sessions. Has anyone else had an experience like this? I am devastated, it literally was the only thing that has ever made any difference at all. I don’t know what to do anymore! Thank you for any and all insight, much love!

I got back from my 5th session (3rd week) and they upped me to the higher dose. I was already having an anxious day before going over there, but ended up having a full blown panic attack about 30 mins in.

Ive never experienced a dissociated panic attack like this - time felt slow and I felt stuck in place with a huge cycle of emotions repeating over and over and over.

Has anyone had this happen? Im scared to do anymore treatments. None of the other times felt anything like this.

Wish my brain luck that I’ll be okay. There’s some difficult life circumstances I don’t want to talk about but I have to switch clinics and it makes me sad because I love my nurses.

I’m scared because the last time I missed even just one week I got ideation so bad and was crying a lot.

Don’t you hate when you spray and there’s literally nothing in the first spray but a huuuuge globule in the second spray that tickles your brain 😭

I had spravato treatments for over a year in 2022-2023 and started back up a couple months ago after having a baby. It felt exactly like it had before when I first started, but now the last 3 treatments have been oddly weak. I actually hated the dissociative feelings in the beginning, but then I got used to it and used it positively. Now I'm basically bored during my sessions and only feel mildly like I've taken something. Has this happened to anyone else?

Hey everyone! I’m in my induction phase of Spravato. Week three I think? I was supposed to have a treatment today, but I called to cancel because I’m sick with what I think is a sinus infection. When I told the nurse why I was cancelling she said it “wasn’t a valid reason to miss an appointment”. I have to be honest that I was taken back by that response. 1. I physically don’t feel good and don’t want to make the hour trip up to the office and also sit in a chair for two hours. 2. I might be contagious and don’t want to bring my germs in 3. I’ve read that it can make your “trip” a lot worse. Am I wrong for feeling kind of weirded out about it?

My provider who treated my ADHD and mild depression has stopped therapy and private practice and moved solely to Spravato treatment. He offered this to me at our last traditional appointment (I come in just 1 to 4 times a year, and usually when a major life stressor happens, or if I get ground down by my horrible job.) but I have had bouts of depression of all severities for the last 45 years (most of my life) and failed several (all) classes of anti-depressants. I just think that now I'm able to cope better due to having a solid life and foundation. I just took the MADRS and came out with a 16, most of the points from lassitude and inner tension. No SI at all, can sleep and eat fine. Not too bad.

I can't tolerate psych meds at all anymore, and they did nothing or else made things worse for me. I'm thinking a little CBT, sleep hygiene, and more walks out in the sunshine and glasses of wine with friends would work just fine, but this is intriguing. It would be approved, and I have the time to do it, but I'm not interested in many cognitive side effects, anxiety, or a month long ramp up to notice any difference.

I do, however, need to get the heck out of bed sooner and stop feeling put out and having a tantrum over the most basic elements of my job (which is maximally stressful)! And I need to get rid of these swirling anxious horrible throughs and anxiety. Thoughts? It seems like a big commitment for mild depression with possible anxiety. I do like tripping, though...

So I’ve been with spravato for about 8 months now. It definitely has had its place affecting me in life changing ways that I won’t get into here.

But I definitely agree with my research that some sessions are better than others. My problem is my nose is always so dry, as I work in a cold dry air controlled climate warehouse.

My nose bleeds if I blow it, and hurts most days. Today it’s to the point of being raw on the inside, I need to use some aquaphor. Spravato stings. I feel like the Spravato does not “stick” very well either when my nose is this bad. It just drips out the front or down the throat. I still get some, I have found if I can smell that sweet Spravato smell (it has distinct scent) then it works really good and has stuck perfectly in my nose.

But most sessions its the same as how my nose runs all day at work. I use a humidifier in my room and it helps but not a fix. I just don’t know what to do I guess. Does anyone experience that when the nose is like this, it doesn’t stick and dissolve optimally?

My thoughts are that I have several dehydrating meds everyday for bipolar, then Modafinil for sleep apnea chronic fatigue, extra drying, 1000mg caffeine a day extra extra extra drying. Writing this out I know that’s why my nose is so dry.

I guess what I want to know is, am I having so much trouble with this spray not sticking in my nose from dehydration? Edit: I also try using saline spray here and there and that feels nice. But my nurse said to not use it before spravato

Edit again: I had one session where my nurse had to walk me to the bathroom that’s how much it was affecting me. But most days I am sober and normal like nothings different. I know it still works in the background and what not. But I just feel like I’m wasting it and possible additional benefits

Final edit: I always have white crust on my nostril tips every single spravato session as well that I have to wipe in the bathroom each time. I’m guessing that’s waste too?

Oggi è stata la mia ottava sessione con lo Spravato, e ha riportato alla luce tanti ricordi di quando ero adolescente in Brasile con la mia famiglia. Ricordi dolci, teneri, ma anche molto dolorosi, che mi hanno fatto piangere tantissimo.

Sono nata e cresciuta in Brasile. Purtroppo, è lì che ho vissuto alcuni dei traumi più grandi della mia vita, all’interno della mia famiglia.

Oggi vivo in Italia. Sono sposata, ho un figlio di 5 anni e un marito che amo molto. Qui ho costruito una famiglia, una bella casa, una vita. Ma durante la terapia mi sono mancati profondamente il Brasile, la mia mamma, i miei fratelli, le mie sorelle, le mie amiche, la vita che avevo prima.

Oggi in Brasile non ho una casa di proprietà, non ho un lavoro — prima ero pedagogista in un’importante università di San Paolo — e mi sembra di avere soltanto una montagna di debiti.

E allo stesso tempo, qui in Italia oggi non lavoro, non ho vere amiche e spesso mi sento molto sola. Mi manca profondamente la mia cultura, la mia lingua, la musica brasiliana, i cibi della mia terra, il modo di vivere, il calore delle persone, la sensazione di appartenenza.

A volte sento di essere bloccata tra due mondi. Da una parte la vita che ho scelto e costruito qui. Dall’altra la nostalgia enorme per chi ero prima di partire.

Convivo con la depressione da tantissimi anni, e devo essere sincera: all’ottava sessione speravo di sentirmi meglio. Invece oggi mi sento ancora molto fragile, ancora molto giù. A volte mi attraversa persino una sensazione di fallimento,

I've struggled my whole life with depression and I was doing fine on my antidepressant (pristiq) for most of my 20s and i ended up experiencing a trauma that set back my depression by a ton, like quitting my job and dropping out of school because i could not lift a finger due to the insane weight of depression on me. I was put on wellbutrin in addition to pristiq, which has had zero effect on me. I started spravato beginning of april and had high hopes for its success, especially because my depression leans on a core belief that i should not exist, i've been focusing on ways to change that core belief during sessions, tried forcing myself to journal reasons why i want to live but it would always turn into a stream of consciousness about why i dont want to live. now i just go into the sessions knowing i will feel no better at the end of it. i know the session is a side effect not the treatment but in general my depression keeps getting worse and worse and i cant do TMS because i cant drive 30-40 minutes there and back every day. i'm hurting so bad and ive been in contact with a crisis center too often. i've had really horrible experiences with hospitalizations and will do anything to keep myself out of one. i am not addicted to anything but my brain keeps telling me to drink to relieve the pain and i've been trying so hard not to fold but it's getting to the point where i feel out of control and i need to feel some sort of relief because i am literally suffering. im writing this mid mental breakdown if you can't tell because i genuinely feel i cannot live another day with this painful sadness and will take any advice. Ive been on every type of med and have been in therapy my whole life. Maybe i need to do more therapy about the trauma i experienced but it could be months of it before i feel any different. Anyway thanks for reading and if you have any words of encouragement that would be appreciated.

Hi Reddit Readers,

I actually completed my 8th session today and I have my 9th session on Thursday. Then I go up to the 86mg dose. I'm feeling depressed is this normal? I think I misunderstood and thought this treatment would be faster. During treatments I get super emotional and I don't enjoy the ride. I try to relax. The clinic I go to just recently moved it from private to two other patients in the room. I do not like this. What am I doing wrong? I take 20mg of Lexapro daily. I don't drink or smoke and I try to get enough steps and eat right. I'm just worried I won't find happiness again.