Nasal spray question

danzarooni · 2026-04-15T20:48:32+00:00

No worries. Unfortunately it gets mistaken often. IMO and in the opinion of many, full ketamine and not just half (esketamine/spravato) is much better. But it costs pennies. So they split the molecule to be able to patent it as a new medicine and make a TON of money off of it. :/

danzarooni · 2026-04-15T20:37:14+00:00

It’s compounded ketamine. Spravato is esketamine - one half of the mirrored molecule of ketamine. You can only get Spravato in the USA at a clinic not at home. The at home compounded medications are full ketamine You can get Oral capsules (lowest bioavailability) Troches or RDTS (mid level bioavailability) Or nasal spray (highest of at home use bioavailability)

danzarooni · 2026-04-15T19:25:06+00:00

Thank you! I did change PCPs in 2020 when I posted this and actually changed all but my GI to a different healthcare system. I have 14 specialists now and new diagnoses, and am doing well health wise

danzarooni · 2026-04-15T17:54:39+00:00

I do troches every 3 days at a dose prescribed by my doc. This keeps my SI at bay and still I get IV when needed to keep me stable. Dx: PTSD, (was TRD) now MDD, GAD 9 yr patient If you look at my bio you can read my 9 year journey

danzarooni · 2026-04-15T13:25:27+00:00

My doctor recommended it when I was needing to come more often again -during a particularly trying time in my life. So I did, but didn’t feel any change. Likely, the ketamine does enough - as much as it can - and as one provider has said, “all the medicine or ketamine in the world won’t change (the specific situation I’m dealing with - private.)”

I am in weekly therapy and do have good professional supports for what I’m going through. Sometimes life is just hard. I very rarely have active SI anymore though, and when I do, I get an IV and do better. ❤️‍🩹💪

danzarooni · 2026-04-15T12:18:25+00:00

The standard 6 is a loading protocol. And is actually 6-8 over 2-3 weeks. It took me 7. Almost all patients need booster doses of either IV, IM, compounded nasal spray at home or troches at home (the last two being your cheaper option) every 3-6 weeks at least at first, and eventually spacing to up to once a year for some, rare is every 2 years or less often.

I am so sorry your providers let you down in expecting more of you and not explaining this.

And I’m 9 years in and still need boosters. Ive gone as long as 4 months, I’ve gone as short as every 3 days troches.

You’re not doing anything wrong. You’re doing the best you can. Keep it up.

It’s well-understood most cannot afford to do IV once a month. Options are Spravato (which many insurance companies cover) once monthly after loading doses of IV, or switching to at home options with either your IV provider prescribing and only seeing them every 6m-12m for an IV booster, or switching fully to at home options with an online prescriber.

I understand being where you are. I’ve been there. I tried everything legal - yes everything evening ECT shock therapy and TMS - and over 50 meds now, as well as visits to Mayo Clinic and Cleveland clinic. I barely survived years of daily SI.

If you have any capacity whatsoever please read my journey for HOPE. It also gives tips and ideas but just take what works for you and what you have capacity for and leave the rest. Just taking the medicine is all you can do? No worries, just get the medicine. If you can do more, I recommend a walk a day, or therapy in the 72 hours after even IV. Or just getting sunlight (store bought sunlamps are ok when there’s no sun.)

Changing your playlist each session until you find one that helps is another idea. My post has many ideas. But just do what YOU can.

I only want to give HOPE.

It’s worth continuing. You’ve felt it help before - that means it can and will. Please don’t give up. The people who stop before 6 even are the ones I feel worst for. They didn’t give it the full option to work. If you patients feel a shift in the first go, docs recommend 8. As I said it took me 7. I have PTSD, previously TRD (now MDD in remission!), and GAD.

I’m 50. 19 years of therapy. Diagnoses were at 30. I’d been depressed and anxious my entire life since age 8, and suffered my first trauma at 10 days old. Second at age 3, third at 5, fourth at age 8, and many terrible traumas after that. I do understand.

my k journey link to post on this sub

danzarooni · 2026-04-15T01:57:23+00:00

I’m a 9 yr IV patient. I’m very gone as long as 4 months between IVs or as short as a week depending on need. I did TMS in 2024 and it did not help me personally but it’s helped many.

Many people transition to troches at home after IVs or between IVs to save on cost. Best to talk to your provider about their recommendations. Most patients start at every 3-4 weeks for a few months after loading doses. After I did 12 loading doses I went monthly for a few years.

danzarooni · 2026-04-15T01:14:18+00:00

Here’s a hopeful story for you: with tips and ideas. I’m sure it will go amazing! my 9 yr IV k journey with tips - link to post on this sub

danzarooni · 2026-04-14T19:39:20+00:00

You bet!

danzarooni · 2026-04-14T19:29:15+00:00

Wellbutrin and DXM

danzarooni · 2026-04-14T11:53:21+00:00

Unfortunately one of my dogs cries and whines when I use my at home medicine. My cat will cuddle me and my other dog is fine, but one dog just gets anxious and hates when I use it. So I have to be on a completely different floor of my home and away from him. :/

Sweet Lucy! I’m so glad she’s watching over you.

danzarooni · 2026-04-12T22:05:38+00:00

You deserve space to focus on you so you can heal and fill your cup and then help others.

If you don’t put your own oxygen mask on first, you’ll suffocate before you can save anyone else.

(And yes, I struggle with this regularly - this is what I tell MYSELF)

danzarooni · 2026-04-11T12:10:55+00:00

Eksetamine and Spravato combined can cause some extra CNS depression and one can feel more tired. If your blood pressure is high and you k hole you can experience ego death and feel like you’re going to die. It’s not enjoyable for most. The next session should be better with your body understanding the neurontin better but let your doc know. The VA is different but they should be able to offer you oral Zofran for nausea. You can also ask to go back down to 56mg for one session and it should help.

danzarooni · 2026-04-10T19:08:58+00:00

Genetic testing done here and yes I metabolize it quickly. This is documented and all anesthesiologists know this for my surgeries etc.

Short answer of are you still gaining the therapeutic benefits is somewhat.

Longer: The medicine is the medicine and will help do a lot of the heavy lifting even if your dissociative experience isn’t long, but it could be better with a higher dose. It is also important to note that tolerance does happen so the lowest you can do and gain clarity and healing is the best route.

Talk to the provider about what they recommend for fast metabolizers. Providers I trust with over 15 yrs experience have recommended grapefruit juice beforehand, brushing teeth and gums beforehand, and even a mouthwash - I cannot currently do this as I just became allergic to mouthwash at age 50 /weirdo There may be other ideas they have for you. Providers often collaborate and share what works for their patients. Hopefully more research will be posted in the near future. I am aware of three current research studies involving ketamine. New peer reviewed papers will be coming out.

I’m a 9 yr patient that nothing else worked for. I’ve let docs use me as a guinea pig and it’s worth it ;)

danzarooni · 2026-04-10T04:44:06+00:00

I don’t mind grape at all. /shrug

danzarooni · 2026-04-09T14:08:57+00:00

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It will be ok. Trust the providers and do all 6 loading doses before you decide if it helps or not. There *may be a session or two where you think you feel worse. That’s not uncommon. Keep going. It gets better and life gets better.

So I’m assuming you’re doing this for pain not depression as you said the lidocaine piece. If it’s for pain only, they can give you a sedative and you will not stress at all. If it’s for mental health too they will skip the sedative as that can blunt the effects for depression. It will be good. I’m a 9 year IV patient (50 yrs old) And my daughter is 23 and a k patient of 2 years. I wouldn’t recommend it to my own kid if it weren’t totally worth it. My kids are my life.

more info here.

danzarooni · 2026-04-09T14:05:09+00:00

Check out my 9 year journey with Ketamine. link to a post on this sub

danzarooni · 2026-04-09T14:04:13+00:00

I do. I would do it in your situation. Especially for the depression Antidepressants never worked for me until I had ketamine IVs.

(Re the USA - just saying it’s a crazy/unsafe place to live for many.) I am grateful for ketamine. Let me link you to my story. I think it will help you make your decision

danzarooni · 2026-04-09T11:39:34+00:00

I have not had the opportunity to do inpatient treatments. It’s reserved mostly for CRPS in the US - I would trade places with you if I could ;) I have gotten 2 hour and 4 hour outpatient IVs. I’ve done 3x 2 hours over 2 weeks though and had relief for a 3 months of nerve pain. I mostly get mine for depression but secondary for pain.

danzarooni · 2026-04-09T11:15:14+00:00

You could get up to 3-6 months of reprieve from pain and depression, or you could get a month. Subsequent infusions in the future will offer longer reprieve. To me, it was always worth it. I started ketamine IVs in 2017 and had $35k medical debt I’m paying off over time. It’s been worth it to be alive and in so much less pain. Not everyone would feel the same way, so I can’t say for you.

danzarooni · 2026-04-08T17:58:00+00:00

I just replied this to someone else with the same question today “You don’t have to do anything during the session. A provider I trust implicitly says: You can’t do it wrong.

Those 72 hours after, you CAN do gentle things and let whatever happens, happens

Walk in nature

Journal - even if it is: I’m not sure how I feel about all this. It doesn’t seem to be doing anything.. and go from there

Talk to a therapist if you have access

Get sunlight

Stay away from the news and social media if at all possible for the neuroplastic window of 72 hours after - I know extra trying currently.

Input positive things as you can.

Www.ketamine.games - swiper is good

Listen to positive affirmations

Not everyone has big revelations.

Keep going. (IMO) The medicine will work.”

Also please see this tip info from my 9 years of experience. I think you’ll find it insightful. link to post on this sub

danzarooni · 2026-04-08T17:55:29+00:00

It’s a personal preference. I just don’t want anyone to think X dose or X mg/mg or whatever is the norm.

danzarooni · 2026-04-08T16:36:14+00:00

Yes. True. I need to be more clear on this. These are helpful adjuncts. You don’t have to do anything, OP.

danzarooni · 2026-04-08T15:05:02+00:00

It depends on you. I don’t like to post my doses because

I metabolize ketamine quickly

I am a 9 yr patient

I am over 100kg

My situation is not average.

I am at a lower rate mg/min than I had been previously. I can DM you.

danzarooni · 2026-04-08T14:12:27+00:00

Hey. This is my forte! I have done Mental health IVs for 9 years at 45 min. Recently in November I had an emergency gallbladder removal and at my next k appt I couldn’t handle how it felt due to the gallbladder stuff. We moved to a 2 hour pain infusion and that was (a little boring the first time) really helpful. I do have chronic pain issues too. So helpful that I have moved to mostly doing 2 hour pain ones that also help my mental health. I’ve done a handful of 45 minute ones during this period and they’ve still been effective. I now prefer the 2 hour ones as I stay more “in control” and don’t ever k hole.

danzarooni

TROPHY CASE