Meds authorized for compassionate use / expanded access?

I’ve tried almost everything under the sun for depression. I even tried intranasal ketamine for a while and then Spravato, but it doesn’t work for me anymore. Been off of ketamine for 4 months now. Does anyone know of any meds available for compassionate use that help with TRD? Or anxiety? I’m honestly at such a loss and I am quite frankly tired. Just tired of trying to find something that works. Covid halted a lot of good that was happening in the mental health med world and I hate it so much. My understanding of compassionate use / expanded access is that it’s something being tested in clinical trials and is at least in phase 3, and you have to have your doctor contact the company and ask for special permission for access to the drug. Also, does anyone know how soon psilocybin will reach phase 3 trials or how soon it’ll be until it’s accessible? I hear so many good things about it but am only comfortable if I can obtain it legally.


There’s a world of difference between ketamine taken via nasal spray and a low-dose ketamine infusion. Unfortunately, the latter is expensive and not generally covered by insurance, but if you cruise the forums you’ll find a lot of success stories from people for whom nothing else worked. The therapy typically starts with a series of six infusions followed by occasional boosters as required, so you’d probably be looking at a minimum of $3K out of pocket initially. Many people can’t afford that.

As for the psilocybin, I believe that it may be currently available in a couple of more enlightened states. What state do you live in?

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I’m in California

I know that OR has approved the therapy in principle, probably CA as well, but nobody appears to be offering it yet, at least within the continental US. If you can manage it, I’d suggest low-dose ketamine infusion therapy. It seems that is really your only option here as of yet, unless you want to go illegal. Don’t recommend that, obviously.

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Yeah, not willing to go the illegal route. I’ll keep my eye out though for whenever therapy rolls out. Is low dose IV ketamine cheaper than the hour long infusions we typically hear about?

They’re the same thing, actually.

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Hey Man…so did the spray or Spravato ever work for you…meaning achieving the K hole effect/getting some relief from depression? And did you say you have done infusions too? Jim


I have started with Spravato- the nasal spray method, which was a nightmare to achieve with insurance. I wanted to ask you about the world of difference, between a Keramine Infusion - and the Nasal spray Spravato?

I wonder if I am getting all the be benefits in the spray form. I was told Ketamine has a
Full spectrum - and Spravato Manufacturer Johnson & Johnson took the (for example) the top 4 active ingredients.

Thank you in advance!

I dissociate on both…just seems DEEPER with IV Ketamine.

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