Compass Pathways Music vs. SPRAVATO®: What Patients Should Know

If you have been researching psychedelic-assisted therapy, you may have come across Compass Pathways — a clinical-stage company running trials with psilocybin therapy. Their music protocols have received attention in the mental health community. But if you are receiving SPRAVATO® (esketamine) treatment, the Compass approach may not apply directly to your sessions. Here is what you need to know.

What Is Compass Pathways?

Compass Pathways is a mental health care company focused on psilocybin therapy for treatment-resistant depression. Their COMP360 protocol includes a carefully structured music playlist that guides patients through a four-to-six-hour session.

The Compass playlist is divided into three phases — Onset, Peak, and Return — and has been used in clinical trials across multiple countries. It is one of the most studied music protocols in psychedelic medicine.

How SPRAVATO® Sessions Are Different

SPRAVATO® uses esketamine, not psilocybin. The two medicines work differently in the brain and produce different experiences. Esketamine sessions are also much shorter — typically 40 minutes of active treatment, followed by a two-hour monitoring period.

Because the session is shorter, the music needs to work faster. You do not have the luxury of a long, gradual onset. The music you choose for a SPRAVATO® session should be calming and grounding from the very first track.

The Compass playlist was designed for psilocybin's longer, more intense arc. Using it directly for SPRAVATO® may feel mismatched — particularly the later Peak-phase tracks, which are designed for a depth of experience that esketamine may not produce in the same way.

"The right music for your treatment is the music that helps you feel safe enough to let go."

What to Use Instead

The playlists on this site were curated specifically for SPRAVATO® sessions. They follow the same no-lyrics principle as Compass protocols, but are sequenced for esketamine's shorter, faster-onset experience.

If you want to explore the Compass approach out of curiosity, that is fine — but do not feel obligated to use their playlist for your esketamine treatment. Your sessions are different, and your music should be too.