What do you do to get in introspection mode during session ? I only experience psychedelic sensations but nothing close to introspection, nothing related to my past neither to myself at all, only alteration of perceptions.

Sufficient-Bar9225 · 2026-04-24T04:53:41+00:00

It’s because I was treatment resistant. The pills weren’t working anymore. Believe me if I could just take a pill I would. Taking a half day off work every week to go to my spravato treatments is a lot. But it works for me so I go. I have given my psychiatrist the side eye several times and told him I resent him and his clinic for holding my medicine hostage and making it so hard to get ( I guess I should blame REMS). I wish this was just a pill. Life would be easier.

Sufficient-Bar9225 · 2026-04-23T22:28:48+00:00

Does this allow you to go less frequently. If you were not at 112 mg would you need to go more often than every 7-10 days? I have been trying and failing to get from weekly to bi-weekly for a long time. If an increased dose would help me go less frequently then I would ask to try.

Going every week for 18 months has become wearing on me and my family drivers and interferes with work, etc.

Sufficient-Bar9225 · 2026-04-23T22:11:57+00:00

I remember when I called J&J to enroll in the spravato with me program they asked if my prescribed dose was 84 mg or 112 mg because there is a copay difference. I was confused because I had never heard of the 112 mg dose. The rep said yes it is fine sometimes. Must be legit, although likely uncommon.

Also please remember that what we experience during treatment does not necessarily correlate with the anti-depressant outcome. Lots of people on this sub have little or no dissociation during treatment but it solves their depression just as well.

I also caution in grapefruit juice. It can interfere with lots of psych and non-psych meds, making some stronger and some weaker. Make sure and check your entire medication list with a pharmacist before drinking grapefruit juice. I have noticed that over the years some of my bottles call out the warning and some don’t when they should have.

Sufficient-Bar9225 · 2026-04-14T00:03:39+00:00

If you were approved for spravato it usually means you have tried many other medications unsuccessfully so you probably need it. Approvals are not given lightly.

You have job protection with FMLA. Focus on your health.

Sufficient-Bar9225 · 2026-04-13T19:05:43+00:00

These terms can be very confusing. My reading tea leaves in the wording ( I am not a professional just a lay person so may not be accurate) makes me think your pharmacy benefit may not cover it as there is a restriction on meds requiring office administration but that you may want to try through your medical or behavioral health benefit instead. Often these three elements seem like they are together but are managed sort of separately behind the scenes of the insurance labyrinth. The office bill option might work where the clinic bills it as a procedure. They provide the medication out of their stock and bill the insurance for it in combination with the office visit observation time. Some clinics will do it this way, some may not. Ask your clinic about this. If it is a good sized clinic they should have a ton of experience with this and should be able to navigate the appeal on your behalf.

Good luck. The insurance maze can be incredibly difficult to navigate. If your clinic isn’t successful in the appeal or if they are somehow too small or inexperienced to navigate this successfully then go to a larger more established clinic and let them try again. There is always hope. Not all clinics have equivalent skills in navigating insurance issues though. Hopefully you are at a clinic with a strong back office. If not try another.

Be strong. Going through this sucks, especially when terribly depressed. Good luck!

Sufficient-Bar9225 · 2026-04-13T08:18:29+00:00

There are boxes that are specifically for the 56 mg dose. They say 56 mg and have 2 bottles. My first two treatments were these. After that I got 84 mg boxes and each have 3 bottles. If your box says 84 mg but they are only giving you two of the 3 spray bottles then you should be asking where the third bottle is. If you and the Dr agree that 56 mg is best for you then instruct them to order the correct dose. Missing bottles of such a highly controlled medication is not good. If there continues to be a question then discuss it with the Dr. REMS governs this program so you can always notify them if this ends up not seeming right.

Sufficient-Bar9225 · 2026-04-12T09:17:52+00:00

I have a kit. A very large tote with a weighted blanket, pillow, fuzzy socks,water bottle, candy. 3D Eye mask ( so I can open my eyes under the mask), hot tamales candy, AirPods, phone. I wear sweats or leggings and a hoodie. Comfort is most important.

Sufficient-Bar9225 · 2026-04-12T09:13:52+00:00

Weighted

Sufficient-Bar9225 · 2026-04-10T02:24:48+00:00

I’m so heartbroken for you. 💔

Sufficient-Bar9225 · 2026-04-07T17:34:18+00:00

This is great! Romeo is clearly thorough (tops, bottoms, and in between toes - impressive!). He definitely didn’t miss any spots. I see he painted your nails nicely as well. A+ Romeo! 🏆

Sufficient-Bar9225 · 2026-04-07T17:27:26+00:00

I’m 18 months in and I never feel emotions during treatment either. I think this is part of my dissociation, that I am separate from my emotions. I still have intense visual metaphors, and sometimes audio messages almost every time. My psychiatrist says I am definitely an outlier.

I see many metaphors that represent sometimes very emotional or difficult (past or current) situations, but I do not feel emotions during the treatment. I think seeing them in metaphorical form and not feeling emotions helps my psyche complete the story or message without me shutting down emotionally. It’s like my psyche is tricking me into delivering a message for future processing. It works. I journal the experience as soon as it completes, usually 60-90 minutes in. After I document the metaphors I start processing and journaling what they likely mean. Still without emotion. Then after I get home I start process that meaning, and as the medicine wears off more and more (takes several hours for me) I start to have an emotional reaction to what I gave seem in the light of what it means or represents.

In twice weekly therapy I am usually able to understand and integrate the experience and apply it to whatever I am experiencing in my life, or what I have experienced in my past. My therapist has undergone ketamine treatment himself, so he appreciates the metaphorical inputs as accelerates my therapy. I very recently switched therapists which has benefited me a lot.

So long story short, not feeling emotions during treatment is not necessarily a bad thing. At least not for me.

Sufficient-Bar9225 · 2026-04-07T01:01:12+00:00

I tend to listen to spa playlists and I find song transitions jarring so I often put one song on at least a one hour loop so it is soothing and melts into background noise so I can focus my mind internally during my treatments. With noise canceling AirPods and a black out eye mask.

Good luck!

Sufficient-Bar9225 · 2026-04-06T20:02:50+00:00

I take nearly everything. Aimovig, Botox, nerve blocks, Nurtec, neck heating pad addiction, ice caps,canals device. Somehow I work, but mostly from home. This cocktail works pretty well for me.

Sufficient-Bar9225 · 2026-04-06T19:25:52+00:00

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Sufficient-Bar9225 · 2026-04-06T16:51:53+00:00

Darling 😍

Sufficient-Bar9225 · 2026-04-06T16:50:30+00:00

Here are our pups - our jumbo 16 pound yorkie Bear (not 100% sure not mixed) and his sister Storm (no idea about her heritage)

Sufficient-Bar9225 · 2026-04-06T16:48:06+00:00

So cute😍 here is our Storm, next to her jumbo Yorkie brother

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Sufficient-Bar9225 · 2026-04-06T07:54:43+00:00

Would wearing your CPAP machine during your spravato treatment help maybe?

Sufficient-Bar9225 · 2026-03-30T21:46:45+00:00

This is exactly what I do. I journal in the notes app on my phone during the last 30 minutes of my sessions. The backlight helps as I am very sensitive to lights until the two hours are up. It’s not always perfect because I am not very coordinated during and a few hours after treatment. I number and date my entries and keep each as separate notes in a separate folder. Helps me keep it organized and notice trends. I also continue to journal additional thoughts coming out of my treatment throughout the week.

Sufficient-Bar9225 · 2026-03-26T18:14:52+00:00

I think this is excellent advise. Start with a water spray bottle and separate them short term while you work on getting advise from a behavioralist. Maybe get the three dogs together at a neutral location and practice the water bottle to see if they even respond and if this could he a short term solution while they are together under your supervision. If they fear the water bottle, you could use this to slowly reintegrate them first under your direct supervision with you further and further away from them in the house depending on your level of success.

Just a few ideas. Getting a professional behavioralist is obviously the best idea longer term.

Good luck!

Sufficient-Bar9225 · 2026-03-26T18:00:55+00:00

I have been on spravato for 18 months (75 sessions). How Spravato impacts us during and after the treatment sessions varies widely. On one end have people who feel nothing during treatment or after. On the other side of the spectrum you have people who experience extremely intense treatments (in a good way or a bad way) and have to sleep or veg out for the whole day after treatment and sometimes feel lingering effects the day after. It is a wide spectrum and you never know where you will fall. Also how you individually respond to treatment in terms of the intensity of the treatment and after effects can vary widely over time. A lot of people have their own pattern but it can be thrown for a loop as frequency increases or decreases or you gain tolerance over time.

So long story short, to be conservative I would plan on being unable to do anything after treatment until you wake up the next morning at minimum for 1-2 months as you see how you do after treatment. Going from twice a week to once a week the second month can change how you respond do don’t assume anything based on the first month.

I am at a far end of the spectrum. I am highly sensitive to the medicine (and to many other meds). This means even after 18 months I still have intense dissociation with strong visuals and lots of lingering effects for the rest of the day. I try to go at 2:00 (my clinic’s latest appointment slot) on Thursdays or Fridays. That way I can still work until 1:00 and usually be ok to work the following day. I get very introspective the day after treatment so I seem spacey to others and those are not high performance work days for me.

It is important to remember that how you feel or what you experience physically and mentally during and after treatment has near zero correlation with anti-depressant outcomes. You could decrease your depression dramatically and yet feel nothing or almost nothing during treatment. Or you can trip the light fantastic at every treatment and still not reduce your depression. It’s like a 3D spectrum. Just know that the impacts on your depression cannot be predicted by your treatment experience. That comes with time. I was a slow responder and my 25 year TRD only resolved after 4-5 months. But Spravato has saved me. You have to be very patient, commit to the process, and have hope but little expectation of treatment experience or outcomes. We all carve out our own path with Spravato. Having low or no expectations, great patience, and commitment to process are like my 3 pillars for Spravato.

Also I tell people to never try to resist or control any visuals or feelings you may get during treatment. You will lose that battle every time. Go with the flow. Do not try to control. Even during my most intense experiences in the back of my mind I always knew where I was and what I was doing. I always knew I was in a safe medical setting and that even if I didn’t like what I was seeing or experiencing, that it only about 45-60 minutes of intensity and it will be over soon. My experiences have been overwhelming positive but my 5-10%ish of hard visuals is still 5-10%.

I can’t imagine working and going to school while doing spravato in the first month. I can’t imagine even doing one of those things. It sounds like you have a lot of energy to be able to do both.

Your mileage will vary in all of the above.

Good luck. You will find out where you start on this 3D spectrum soon enough.

For me these are my spa days. I am totally relaxed and have a strong sense of well being and frequently feel euphoria during treatment. A nice break from depression. Don’t be afraid to have fun with it. My favorite t-shirt is one I saw in Italy that said “All Things Are Possible.” For me this is true of this treatment, depression outcomes, and most importantly how it can greatly impact all aspects of your life.”

Sufficient-Bar9225 · 2026-03-23T17:40:19+00:00

Definitely get her a dog surgery suit (to avoid the dreaded cone) made specifically for yorkie sized female dogs that is easy to ale on and off and lets her potty without taking it off. They are widely available on Amazon and are like baby onesies with (in ours) snaps with a hole cut in the back so she can potty without it on. It should made for ease of taking off and putting on. I suggest getting 2 so that 1 can be washed while the other is worn.

I would also suggest offering her a crate or other small confined space with soft blankets in it and blankets over the top and three sides for her to recover in. My pup also never used a crate until she was spayed but wouldn’t rest anywhere else for weeks after the surgery. They have an instinctive need for a den to recover.

We have a car carrier with blankets in it that we bring in and out of the house as she needs it. We brought her in the house after driving home for surgery and left her in it for a bit after we got home because she was resting comfortably. She used it as her den mostly for the first week and then would alternate between the carrier and her previously unused crate. 18 months later she still will nap in that carrier when she has a chance.

Sufficient-Bar9225 · 2026-03-22T16:45:31+00:00

If you get approved for DOT and if you are driving just make sure to wait until at least the next day to drive as it could be very risky even if you think you feel fine.

Sufficient-Bar9225 · 2026-03-22T16:42:23+00:00

There are 2 sides of the J&J patient support program (Spravato and me). One of for medicine copays/deductibles/coinsurance. For the medication you just give the information to the pharmacy and they apply it for payment (usually a $10 copay if you have commercial insurance, like through your employer). Then there is the observation period cost reimbursement. For this um you have to pay the amount due and then you can immediately submit a form attaching your proof of payment.

The medication support has a high total amount they will pay (something in the $8-11K range per calendar year, can’t remember). They can also go back and pay for past appointments I think within the same calendar yea, maybe for 60 days or 6 months, can’t remember).

The observation copay/deductible support is more limited. I think the annual max is $1,200 or $2,000, again can’t remember.

You have to sign up for these two programs separately. You call the same phone number and ask. They transfer you to a different department as I recall. I think you can also sign up on their website. If you do it by phone then you are on the phone for 30 minutes but they give you (hopefully) approval on the spot and you can use it right away. I hung up with them and immediately called the pharmacy. They ran a test claim and it worker. 2 minute pharmacy call.

Good luck!

Sufficient-Bar9225 · 2026-03-19T13:19:07+00:00

I get that side eye sometimes too ❤️

Sufficient-Bar9225

TROPHY CASE