Has anyone tried esketamine nasal spray ... - My MSAA Community

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Has anyone tried esketamine nasal spray for clinical depression?

CatsandCars profile image
27 Replies

Hi, everyone.

I value you all and I sincerely hope you are enjoying the holidays. Awkward change in topic: has anyone tried Spravato nasal spray for depression? I cannot tolerate the oral medications, and six weeks of TMS 5x a week failed to yield much improvement.

(Wondering what TMS is?

mayoclinic.org/tests-proced... )

I've been angry and depressed, but in my normal way, and I didn't feel any particular urgency when this was pitched to me as a solution. But my MS has been kicking me around since I had Covid in September, and recently, I was put in a situation where the pressure was too much for my mental and physical health. Add in a little getting together with family and the attendant ghosts-of-Christmas-past thing, and suddenly treatment is looking like something that should be happening sooner rather than later. I'm not in any danger of hurting myself, I just can't hold it together enough not to cry, or feel furious and yell at someone, for long at all.

Anyone with any experience would be appreciated. Has your second cousin's best friend's mechanic tried it? Sure, let me know what they thought.

Thank you, my friends. ❤️

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CatsandCars
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27 Replies
Xvettech profile image
Xvettech

I have not tried it. I hope you are enjoying your holidays too! I’m sorry you are experiencing all that! I wish you the best in every situation!

CatsandCars profile image
CatsandCars in reply toXvettech

Thank you, you're very sweet! ❤️

Xvettech profile image
Xvettech in reply toCatsandCars

❤️. Your welcome 🤗

RomCom87 profile image
RomCom87

My husband used ketamine along with therapy. He didn’t use a nasal spray. I will ask him about his experience and share it with you. I am so sorry that you are dealing with this. I’m sending positive vibes your way. 🤗

CatsandCars profile image
CatsandCars in reply toRomCom87

Thanks so much, my dear friend! I appreciate it very much. ❤️

RomCom87 profile image
RomCom87 in reply toCatsandCars

I’m glad mhepler531 was able to explain the difference between Ketamine and Esketamine. I asked my husband about his experience with ketamine and he highly recommends it. I drove him to his appointments but I was never asked to join him. It may not have been the protocol for patients to bring a loved one. I do know that he wouldn’t have wanted me there. I am sure he discussed our relationship. We have a great love for each other but every couple has issues and MS is one of ours, among others. I did EMDR when I was going through a depression and it was very helpful. I did it for about two years. I hope the esketamine helps you!

CatsandCars profile image
CatsandCars in reply toRomCom87

Thank you, RomCom87! I'm so glad that the ketamine helped your husband. I'm not sure of all the differences between esketamine nasal spray and IV ketamine, except insurance generally does not cover the IV ketamine. I normally would prefer an IV - just hook me up and get it over with! But due to sun exposure and repeated high dose steroids, the poor skin on my forearms is so fragile that any kind of adhesive or tape required for an IV leaves bloody-looking marks that take a month to heal. It looks like I've been mauled by a mountain lion. So, at this point, I'm okay with trying nasal spray that's covered by insurance. 😛

I've been seeing a therapist who specializes in EMDR for a while now. She doesn't think I'm "ready" for EMDR. She says doing it if I'm not in the "right place" it can be too much for some people. I really like her. But she has me doing sand therapy, which feels a little silly to me. I used to rescue cats for years, and if "working in the sand" really helped, wouldn't I be better by now? 🤣 Just kidding, it's much more guided and intentional, but it does seem a bit ironic. I am glad to hear that EMDR helped you, and that ketamine made a big difference for your husband.

Having MS as a third party in a marriage can be a challenging, or at times, it can be a horror show. I am married to a really good, kind, and decent man who is very helpful and, when he can understand what I'm feeling, quite supportive. He's been a great father to our two kids. He works hard, and we have a ton of things in common. His job even comes with excellent health insurance. I feel really guilty to be blessed with all of that, and still be quite miserable and angry at times, because he can't really understand or empathize with the damage I have from my past, and it seems like he is inadvertently triggering that trauma on a daily basis. I'm afraid to go to therapy because I am sure that things will come up that would be painful for me to hear. But the status quo doesn't seem to be working very well, so I realize that the band aid will need to be ripped off at some point.

You have shared about some of the problems that you and your husband have dealt with, and it has been a lot. I really feel for both of you. I give you a lot of credit for doing everything you could to make things better, and I wish both of you the best. ❤️

mhepler531 profile image
mhepler531

Ketamine is an infusion. Spravato is Esketamine and is given through nasal spray.

The first few weeks is two nasal spray doses given five minutes apart. The first month you go twice a week. Then you go to three doses per visit given five minutes apart. The frequency of visits is based on how the treatment is going for you. I can tell you it can be like a miracle.

Each appointment lasts two hours and you can not drive home or for the rest of the day. Over the two hours you are checked on multiple times and your BP and heart rate are taken at regular intervals.

I have a family member who has been getting the treatments for almost a year now. I drive them to and from the appointments and actually go in the treatment room. We are both so glad that I have. Many events and incidences have been worked through, including some that had been the cause of PTSD. Many people don’t talk at all during treatment, but my family member does. The first few times I took notes and then typed them up. Then they were taken to a regularly scheduled counseling appointment where the therapist read the notes aloud and they could then discuss what came up during the treatment. I had trouble keeping up, especially when the topic was very emotional. I began recording the sessions and transcribing them word for word. I didn’t want my notes or abbreviations to be inaccurate or color the counseling appointment where. This has worked really well and even some repressed childhood trauma has come to light.

A few providers who were offering the Spravato in our area are putting three people in a room at the same time and don’t allow anyone else in the room. Had we gone there the most important events would never have been known because my family member does not always remember what has been said. I can’t stress enough to go to a provider you trust for the treatment….and someone whose protocols you are ok with. The Spravato website lists all providers offering the treatment. It truly is an amazing treatment and you really have nothing to lose and everything to gain by trying it. I’d be glad to answer any questions and discuss any of this privately. Best of luck to you!

CatsandCars profile image
CatsandCars

Wow, thanks so much for all that info, mhepler531. That's an amazing amount of detail. I didn't realize I would be somewhat unaware of what goes on after I've been dosed, or that my mutterings (not to be flippant, I just can't think of a better word at the moment) could help with breakthroughs in my therapy.

I don't think that the place I'm going to (I had TMS there) allows you to bring someone, although I was planning to ask. It seems like if you aren't fully cognizant of what's happening and could potentially experience distress, that it wouldn't be ideal to be alone. Then again, the two people I would consider asking to come with me would probably be the ones I would be likely to talk about. That seems like it could potentially be problematic.

I'm especially grateful to know that it can be really effective, and that I can check out other providers on the Spravato website. (I corrected my post to say esketamine, too.) I really appreciate your input. I will definitely let you know if I have more questions!

AquaZumbaFan profile image
AquaZumbaFan

I have not tried either of the treatments, but when I was helping my daughter and her last class to get her psychology degree… I had just retired from the hospital and was thinking that I might be able to assist with her neuropsychology class( that was the most difficult class I ever tried to assist on)... we learned quite a bit about ketamine therapy.. My daughter was experiencing a severe depression at the time herself so I was paying close attention to this particular part of her class. The docs were giving my daughter multiple medications, strengths and combinations... (after a few years )She has finally stabilized. She also does the DBT Therapy as well.. She certainly still has some bad days.. I don't think I would hesitate to try the ketamine regime . What I was learning about in the class had to do with iv therapy with the Ketamine.. it sounds nothing short of miraculous for some people.. I'm really sorry that you're going through all this. I have been through a major depression back in 2015. I've had some pretty dark days... fortunately I was able to recognize the dark days so we could get my daughter help years later. You always wonder why you're having to go through of thing… I would do it again if doing so would save my daughter.. sending you big hugs..Best of luck!

CatsandCars profile image
CatsandCars in reply toAquaZumbaFan

AquaZumbaFan, I'm so sorry to hear that you went through such a serious depression. The fact that you were able to use your experience to help your daughter is wonderful, though. It's always amazing when something really good comes from something so bad. I'm sorry that she suffers from it, and that she still has bad days. But with you in her corner, I hope and pray that she will continue to do well.

Thank you so much!

AquaZumbaFan profile image
AquaZumbaFan in reply toCatsandCars

Thanks so much.. the family had suffered a very long string of loss of life of various family members from beloved nephew who was like my first child..to my beloved father, favorite aunt.. etc.. I was always trying to be so strong and when it got to my mom's death 3 months after being diagnosed with a very aggressive cancer.. I just shut down. The doctor in the hospital where I finally had to go to stabilize called it "the perfect storm". Luckily I came through even stronger than before.. I am very blessed to have a strong support system and it was worth it all to be able to recognize some of what I had been going through and get fairly prompt care for my daughter.. I still have a counselor that I started talking to a couple of years ago. Ironically she has MS as well.. I feel that was nothing Short of a divine intervention. I'm sure you have great folks that you talk to.. hopefully you have a counselor that you trust who you can literally just " spill your guts"..never hesitate to reach out to me.. 🤗

CatsandCars profile image
CatsandCars in reply toAquaZumbaFan

I recently read an article about DBT being used for teenage girls and thought about my symptoms, like irritability, crying, and getting angry...it occurred to me that there are similarities. 😁

AquaZumbaFan profile image
AquaZumbaFan in reply toCatsandCars

Absolutely!! I even do one of my water classes where there is a lot of shouting we are working out in the water with 12 inch weighted PVC pipes.. usually at least twice in the class. We have a timed session,Where we are beating the surface of the water as hard as we can… Many of us are moaning, shouting, or whatever it is the best way that I have ever experience to get my frustrations out.. I do this every Friday 😆 at the end of the hour I am so spent, but feel so amazing! And I'm doing it all in the water so there's never any fear Getting unbalanced or falling.

CatsandCars profile image
CatsandCars in reply toAquaZumbaFan

I am so sorry for all of the losses you and your family have experienced. 💔 As an immunocompromised person, the Covid pandemic, what with the fear of death and isolation, had me in a bad place, along with a lot of other people. Then I lost my grandmother, who I had been super close to my whole life, in 2021. She was 101.

A few weeks later, my dad died, and that was more complicated because I had a different experience with him from the rest of the family. Listening to them talk about how much he meant to them and he wonderful he was made me wonder if we were thinking/talking about the same person. That was when I really started spinning out, and because of Covid, therapists and psychiatrists were really hard to come by. There were waiting lists, and it seemed like if you could get an appointment, it was because the provider was, shall I say, not what I was looking for. When I looked up the Spravato providers near me just now, one is the place I'm going to now, where I got TMS, and two others were places that I have been a patient at for either medication management (which is a joke, because I can't tolerate any antidepressant meds) or therapy in the last few years, and wound up leaving. The psychiatrist at one was notable in that she recommended that I get ECT, or shock therapy, even though I was mostly back to functioning by then, even if I wasn't doing cartwheels. You should have seen my primary care doctor's face when I told him that she recommended that. Don't get me wrong; if I really couldn't function, or couldn't eat, or was having thoughts of harming myself, I would do it. It just would have been overkill in my situation.

I do have a therapist I reaĺly like, although I'm not sure if the modality (sand tray therapy) is really what I need right now, but we also do a lot of talking.

Wow, the yelling in your Aquazumba class sounds amazing! And much more helpful than venting at loved ones. No guilt, and no having to apologize. 😊 The group aspect sounds really powerful. I'm sure that all of that exercise has probably helped ward off depression as much as anything, and good for you!

Thank you again for sharing your experiences, AquaZumbaFan. I really appreciate your input. ❤️

AquaZumbaFan profile image
AquaZumbaFan in reply toCatsandCars

Thank you so much for sharing catsandcars... I can relate more than you know to your "father stuff get them "I didn't put with the death of my mother.. there was a time when we were super close, but there was a time when were estranged.. that was a painful time, but it seemed like it was the best thing for my mental health and to protect my young children from things that we didn't want to expose them to .After one of my docs what the hellthat I worked with for years and years, met my mom. Professionally… He told me that my mother exuded, niceties but I exuded warmth.. I think that kind of summed it up.. the few months that we had before she died we tried to just move forward not really addressing all of the issues from the past.. I think there just wasn't enough time for us to work through all this stuff and maybe I would not have had such a hard time with it. I'm so glad that you're getting some help that you need and that you have someone that you can talk to...

CatsandCars profile image
CatsandCars in reply toAquaZumbaFan

I'm sorry that things were so hard between you and your mom. That must have been very painful, especially since you had been close previously. At least it sounds like you were on speaking terms when she died? But it's hard to have unresolved stuff between you and someone else, and then that person dies. I think experts call it 'complicated grief," which for once is exactly what it sounds like!

AquaZumbaFan profile image
AquaZumbaFan in reply toCatsandCars

My family and I did a 360 the last 6 months of her life.. we totally tried to rescue her from the situation that she had created.. but you are so correct.. we never had time to completely resolve many hurtful issues.. we were exceptionally close for many years , at one point I even helped to financially support her on my little full time job.. I took a part time job as well. I used to take her to the store every week as she did not drive., We went to so many festivals and events together when I was single.. I took her to the beach that otherwise she never would to do. She made some choices that were not family friendly... She did not choose us. I'm really glad we were able to help her when we did though... I think the grief would've been even worse.. I really wish we could've worked it out before then. Thank you for your understanding.🤗

CatsandCars profile image
CatsandCars in reply toAquaZumbaFan

We all have so much in common, AquaZumbaFan. Thank you, as well. ❤️

AquaZumbaFan profile image
AquaZumbaFan in reply toCatsandCars

🤗❤️

Greentime profile image
Greentime

Oh my goodness CatsandCars, you have been suffering. I have had this experience in the past. I truly hope you get some relief with this treatment, something I know nothing about. Thank goodness mhepler531 has shared so many details. 🤗

CatsandCars profile image
CatsandCars in reply toGreentime

Thank you, Greentime! I'm sorry to hear that you have also struggled with depression. I keep hearing that MS patients are more likely to experience depression, but hearing my friends tell me they've suffered really brings the point home. I am grateful to mhepler531, too!

JTZES profile image
JTZES

esketamine could work as an antiperspirant. It is a horse tranquilizer, so it would bring your depression down but it is addictive.

CatsandCars profile image
CatsandCars in reply toJTZES

Ketamine is the one vets use, and psychiatrists administer it via IV to people for depression. I wonder if the horses or other animals who have had it for anesthesia wake up feeling happier?

The providers have protocols in which

you take it in the prescriber's presence. Hopefully, the dosing schedule was designed to minimize the possibility of addiction.

Tazmanian profile image
Tazmanian

Happy holidays I haven't tried it but good luck and let us know how it works for you

CatsandCars profile image
CatsandCars in reply toTazmanian

Thank you, Taz. I hope it's okay if I address you that way? I remember you saying on a thread about choosing a screen name that Taz was one of your first choices. Anyway, I really appreciate your good wishes, and if I try it (which I am leaning toward) I will be sure to let everyone know how it goes. 😊

Tazmanian profile image
Tazmanian in reply toCatsandCars

You can definitely call me Taz and good luck

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