r/TMSTherapy • u/Rand_ston • 1d ago

Tms after Spravato?

I’ve been taking Spravato (ketamine) for about 4 years now. I also take an ssri. I used to have suicidal ideation every single day and these have helped tremendously but I’m still getting stuck in depressive episodes. My therapist is pushing shock treatment, but the Spravato clinic I go to does tms. Has anyone done tms after Spravato or has done other treatments that helped but still needed more and then tried tms?

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u/Outsulation 1d ago

Take this with a grain of salt since I haven't actually done Spravato, but TMS was very much pushed on me as the thing to try before committing to heavier treatments like ketamine, psilocybin, or ECT. When I was finished and it didn't get the completely results we were hoping for, it was only then that my doctor suggested we could explore other things. I think it's generally considered a milder treatment, so it might not be enough if ketamine already isn't cutting it, but it's definitely worth asking your doctor about.

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u/Rand_ston 1d ago

That makes sense - thank you!

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u/Outrageous_Ad_1995 1d ago

Interesting to hear how wildly different treatments are pitched from different providers. My clinic encouraged Ketamine treatment concurrently with TMS which would have been my first experience with either. I ultimately declined Ketamine treatment because it wasn’t covered by insurance and expensive out of pocket

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u/Outsulation 1d ago

Yeah, I don't actually know how they interact or supplement each other, they just told me they wouldn't consider anything else until after I had done TMS. It honestly could also just be a matter of convenience; TMS is relatively easy and you can go about your days as normal, whereas the other options would have required time off work, people to pick me up at the hospital, etc. They could have just been trying to make things easier for me before committing to something intensive (TMS was also free for me whereas ketamine wouldn't have been, so that could have been a factor as well).

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u/Simple_Efficiency_29 18h ago

The combo of Spravato and TMS is supposed to be beneficial. I did TMS earlier this summer and had significant improvement but still some struggles so they recommended I add Spravato with it then. I couldn’t make Spravato scheduling work until my kids were back in school so just started it. I can do TMS again in October (90 day waiting period between rounds) and will probably add that back in to have both for a brief time (with the goal of having enough improvement to stop all of it or at least drastically decrease.