My First Treatment/Experience With Spravato (Ketamine)

Hi everyone. Since so many people have asked me and are following about the new drug trial I am doing with Spravato (a medicinal type of ketamine), I thought I would share how my first treatment with. And since I am awake at 1:30 a.m. (as usual, because I rarely sleep), I figured this was as good a time as any. Plus I have an enormous amount of stress and anxiety going on so maybe writing will help, although I'm only going to talk about the medication part.

My psychiatrist is the first in my metro area to be approved to use the drug, as it has newly been approved by the FDA for treating medication resistant depression. Although I have Bipolar II, I have been in a depressive state for about three years, and nothing is helping. The Spravato needs to be taken in combination with anti-depressants and mood stabilizers (or in my case Latuda and Lamictal). Everyone, including my doctor, was in the separate relaxation room (required for after care and monitoring) because I am the first and so far only patient they have using this medication so everyone in the office wanted to see its effects and how to administer it and such.

It is administered as a nasal spray, twice a week for the first four weeks, then determination is made on whether it is helping or not. I have only had the one treatment so no news on that part yet, which makes me feel a little bit like I let people down. Like people were expecting me to magically not be depressed anymore, but it's going to take more than one dose. The medication is expensive (about $1,000 per treatment twice a week) but I was approved for patient assistance and get the medication for free. I still have to pay my doctor copays, and since I didn't have the money for that, my wonderful daughter stepped in and said she would pay for them because, if not, she would always wonder if maybe this would have helped me.

There was a "practice nasal inhaler" to use to get the feel for how to administer it. It is pretty much a basic inhalation. You do one in each nostril, wait five minutes, then do another dose in each nostril. I knew about the extensive and expected side effects since about 70% of patients experience them. I just didn't know how it would feel.

When I did the first spray, the only thing I felt was a burning in the back of my sinuses and top of my throat. Uncomfortable but tolerable. No other feelings. Then I took the second dose, and things started to hit me. First I felt dizzy. Then I immediately felt like I was drunk and loopy. Then the dissociation started, and that was the weirdest part. A few minor hallucinations. But I was able to talk to my mom and daughter throughout. I was drowsy but couldn't sleep. Next time (Friday) I will try to immediately fall asleep after the dose, but I have a sleep disorder which keeps me from sleeping much. You have to have someone with you because you can not drive yourself or really do anything for the rest of the day.

The dissociation is hard to describe. It felt like I was outside my body. I was talking, but it was like it was coming from someone else. It wasn't really unpleasant, just weird. When I touched my face, it was like after going to the dentist and getting novacaine. When you touch your face, you feel it in your hand, but not in the area where it is numb. I felt like that, but numb all over. It lasted about 45 minutes, but it felt like hours. Again, not unpleasant like I was worried about, just strange. My blood pressure also spiked a bit (hence the monitoring) but not too much or for too long.

After about an hour I started to come down and feel more "normal". I could feel the effects wearing off. I was just lying in a recliner with a blanket on me, and my mom was there. You can't drive or do anything for the rest of the day. By the time I left, after two hours of monitoring, I felt mostly the way I usually feel, just tired and a little groggy. I came home, and after a while I was able to sleep for about an hour, but that's it. I've been up pretty much all night, and now my day has started. But that part is normal for me with my sleep disorder and not an effect of the medication.

So now I know mostly what to expect. I will keep going to the treatments twice a week for four weeks and evaluate and see if my depression is responding, at least getting me to a stable place. My psychiatrist was a little nervous, since I have bipolar not major depression, that there was a possibility for mania, so it is definitely contraindicated for Bipolar I. But I had no mania or hypomania.

That's my experience. I am trying not to get my hopes up that it will work when everything else has failed, but at least I am trying something new. And now I know what to expect, so it isn't so scary for the next time. I will keep you posted as I go along on how the treatments may be affecting my depression. Keeping my fingers crossed that it starts to help. Hope that gives you all some information if it is something you are thinking about trying or just wanting to know about my personal experience.