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@kypaint75 ,
Yes esketamine is the FDA approved form of the drug that comes in spray form. It is approved by most insurances.
Have you tried trans-cranial magnetic stimulation? Or electro-convulsive therapy? Sounds like you are resistant to all the pharmaceuticals that you have been given.

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Replies to "@kypaint75 , Yes esketamine is the FDA approved form of the drug that comes in spray..."

I have tried ECT with no benefits at all just effected my short and long term memory greatly. No not transcranial. That’s the next and only other option I haven’t tried. I don’t hold out much hope as I really feel like my medication absorption is my main issue. My doctor would like for me to try it sometime in September or October.

Oh, no I haven’t heard of esketamine therapy. What does it treat? How does it work?
Yes, I’ve had 14 electroconvulsive shock treatments - did nothing except badly damage my memory. I’ve had pharmacogenomic testing and genetic testing. I carry 21 genes for bipolar and I have some crazy genes for my enzyme metabolizers, which make up about only 2% of the population that has mutations or carries 2 copies of the wrong genes. For example, most chronic pain medication like hydrocodone oxycodone and morphine codeine and tramadol have no effect on my pain whatsoever. But what medicines are supposed to work Arkansas Medicaid will Not pay for, so I’m looking at anywhere from $400-$1000 a month. There’s NO way. And did I mention I fell a couple of years ago and broke both my wrists and ruptured both thumb tendons - 7 screws and steel plate in my right wrist-broke it in 3 places - had to have metal removed, carpal tunnel release and thumb repaired = 3 surgeries. Haven’t gotten to my left thumb yet. They both ache and hurt every day all the way up to my elbows. So I constantly use biofreeze and wrist braces when I can to no avail. This on top of chronic pain, fatigue and fibromyalgia. I feel hopeless and I’m only 45......if Mayo won’t at least try to help me, what else can I do?