Ketamine therapy

Sorry for the typos...

I'm in the same boat, OP. I would love to truly be able to feel laughter again, enjoy music again, etc. I'm keen to try esketamine (aka Spravato), but there's currently no facility available in my city. My GP says one is being built, but she doesn't know when it'll be completed. If it opens in the near future and I get to use it, I'll update you.

Thank you so much, R2. There is nothing where I live either (I think) but I'm willing to travel, even to another country, if there was any hope for relief. This is no way to live and I'm so tired.

I tried it every Saturday night for about 3 years 91-94.

I see a lot of medical records in my job, including ones from the VA. I had always rejected the idea of ECT from the horror stories of the 50s. But I've seen several VA patients who have responded very well to this therapy. This was for mood disorders and in many cases, lasted several months after initial treatment. Someone who has severe mood disorder that has been resistant to a variety of drug therapies should at least look into this seriously.

I've seen a ketamine therapy case as well, but the disorder was so confounded by other mental disorders that it was hard to see a benefit.

OP, I'm actually going to phone my GP tomorrow to ask about being prescribed either tianeptine or low-dose naltrexone, both of which are supposed to help with anhedonic depression. I can't see her being open to prescribing either of those (I don't even know if they're licensed for treating depression in the UK), but in the off-chance that I get a prescription I'll let you know if they're effective. I'll also ask if there's any update on when the esketamine facilities will be available.

I did “ special K” at a club years ago and it was amazing 🤩. Total uninhibited feeling

Thank you so much, R6!

Thanks to R5 too, I will definitely look into it, just wanted to hear some experiences.

Has Ketamine therapy been shown to help with chronic anxiety?

I've had mates that found success with ECT. It did take more than one session. a third had some memory issues but overall, found it helped their mental health.

And professionally, I've seen how microdosing and restricted illicit drug therapy has been effective in the treatment of other mental health conditions. right now in the U.S., the University of Arizona is leading the pack in research. . . tho, mostly with psychedelics.

When I was going through PTSD, being the stiff upper lip type, more extreme types of cognitive and exposure therapy helped; which involved a handful of retreats where I couldn't escape the triggering, which, for me, was necessary part in confronting it and eventually recovering from it.

Ketamine reduces anxiety and enhances sex

Sharon Osbourne credits K therapy with getting her through the aftermath of her firing and being (mis) labelled as a racist by The Talk.

Before discounting Osbourne, remember that she is a livelong depressive who was already on anti depression medications for decades and has several suicide attempts on her resume. She said the Ketamine therapy worked. Not that she's cured. But she's better.

Is it supposed to be administered once (several infusions over a month-long period, IIRC), or should it be repeated? Same question about ECT therapy. Just one series of shocks, or more?

You're welcome, OP, just wish I could be more helpful. Have you tried pramipexole (aka Mirapex)? It didn't work for me, but my doctor wouldn't give me a prescription above 2mg a day. There are lots of people with treatment-resistant depression who say it was effective for them at higher doses.

Never heard of pramipexole, R14. Will have to ask my doctor.

I took ketamine IM treatments for depression, anxiety, and alcoholism. It has been a miracle treatment, and my insurance even covered most of it. You are able to see your life and self from an outsiders perspective. I was able to go back and hug myself as a child in one session. I thought I was dead and stepped back to evaluate my life in one session (but from a very gentle non judgemental perspective). One time a voice told me that I was an alcoholic and I answered back that they were mistaken. I haven’t had a drink in 7 months (since I started treatments). I did 6 initial treatments twice weekly, then two boosters spaced about six weeks apart. I also purchased some troches online to try at home, but they didn’t work as well. It was too easy to get distracted at home, and the troches are not as potent (I was unable to dissociate at home). At home troches are convenient because they will ship the ketamine to your home. Check out Reddit therapeutic ketamine. They have an abundance of information.

R16, that post makes me want to try Ketamine. Thank you!

Aren’t k-holes a problem?

r13 With ECT, sometimes once is enough but most need a series.

With these kinds of drugs...

It's sometimes just microdosing - which takes on a variety forms and practices. It might just be like taking any other medication - some only do it in office, others allow home use or depending on susceptibility as they would with a full dose.

Other times they combine a full dose and usually with guided therapy; something that "looks" akin to hypnosis or meditation, often with a team on standby monitoring vitals and on hand in case things get out of control.

As contradictory as it may seem, ketamine therapy is often used in drug addictions. . . in those cases, it might just be administered via IV but over a long period with other fluids. It's also popular with extreme pain.

on that note, IV therapy has entered the commercial sphere with vitamin packs and fluid restoration. Mostly as the popular towns for them tend to be party destinations.

My tenant is going through it now. She was pretty buzzed after her first treatment. Since then, I’m not seeing much difference in her.

R20 what is she like in general?

Try TMS OP, works a treat. ECT did nothing for me, but everyone is different.

What is TMS, more info, please!

Trans magnetic stimulation. It's painless, lasts 20 minutes a session without the need to go under.

Transcranial Magnetic Stimulation sorry

Electroshock is demonised but it does actually work. It's not like you see in horror films.

r26 one can find many personal accounts of it - good, bad and beniign. Many books, blogs, videos, documentaries, a few social media accounts, etc. As well as TMS and various other alternative treatments. There's quite a few medical education and nursing videos too of the practices on youtube... if you'd like a more indepth understanding. like a search for "ect therapy" adding therapy tends to sort out clickbait.

Interventional psychiatry focuses on researching and repairing brain circuit dysfunction to bring relief to millions of people who have depression or other treatment-resistant mental illnesses. Listen is as experts in the field discuss how they are helping patients by using transcranial magnetic stimulation (TMS), psychedelics, and more. Recorded on 08/26/2021. [Show ID: 37288] University of California Television (UCTV)

Yeah I know R27, I've had it.

OP, do you have any particular spiritual beliefs?

I you're open to the idea, I would say try some regression therapy along with ketamine and/or electroshock therapy. Dr Brian Weiss (psychiatrist) has written a lot about it and his books may help you understand how it works.

I have depression and your average anti-depressant works for me, but I also mix it up with regression therapy.

I must say that I'm sceptical about regression therapy, R30. I'm sure it works, if it's aligned with your beliefs, but I've read too much about false memories and woolly psychiatric mumbo-jumbo to be able to take it seriously. Still, I hope it works for you and for many other people.

OP/ R31, a lot of therapy has to do with the skill of the therapist or psychiatrist leading the treatment. But anyway, if it doesn't interest you there's probably some other way to help you out.

My partner’s sister is on Ketamine (intravenous and troches), and it has decreased her depression, anxiety, and reactivity a lot. She actually sounds happy when I speak with her, which was never the case previously.

r21 - in general she's fine. She claims she has depression, but it's not like she's moping around wearing all black all the time.

Let's put it this way, I was surprised to learn she had depression.

I don't see that much of a difference. Maybe a little more upbeat, but I never thought she down that much to begin with.

I haven't noticed a change, but she may feel like she's feeling better.

My partner started ketamine therapy with Mindbloom. He's never so much as tried marijuana. It's going to take several months so no results yet but he enjoyed the session. No adverse reaction.

R35, what did he say about the session? Was it like a drug trip? How long did it last? How did he feel immediately afterwards?

ANYONE with long term mental illness/depression should stop looking for silver bullets. They don't exist. There are no miracles. Your brain is like a boat in a choppy ocean. Sometimes the waves will be big and overwhelming. Sometimes the water is calm. You do what you need to do to keep the boat afloat.

Ketamine therapy is supposedly wonderful. Its very expensive but is a once every 5 weeks kind of thing. Try it once. See how you feel for the next month. Don't buy a package or pay for more than 1 session upfront. Shop around. Find all the providers who are in your city or nearby and find the most reasonably priced one with good reviews.

If its something you do very well with and cost becomes an issue down the line, you can get creative about scoring K for your own dosing/therapy. I know a few people in LA who go to Mexico to get it because its cheaper and they know their dosages and that their body can tolerate it.

What cities are offering these treatments, and what (if any) insurance is covering it? Not mine..

To follow up on my post @ R6: my doctor is very reluctant to prescribe either naltrexone or tianeptine, as I predicted, but she suggested imipramine (aka Tofranil). I'm quite sceptical as I have been unable to find any studies suggesting this can help with treatment-resistant depression. If I decide to try it, I'll report back.

If you can't access ketamine therapy and your doctor is open to prescribing pramipexole, I would give it a try. I know it may seem strange for me to recommend medication that didn't work for me! But the reason my doctor suggested it in the first place was that she had another patient who had severe anhedonic depression (inability to feel pleasure and enjoyment) and it was extremely effective.

I found 2 doctors in my city who have done (experimental) ketamine treatments for depression. Trying to contact them now and will report back with news. Thanks so much for all the responses!

Blue cross blue shield covers it. The clinic called and got it approved for me.

R36 - I think it was a little trippy for him. He liked it. It lasted about an hour. My job was to quietly check in on him every 15 minutes for an hour to make sure he was okay. He did it through Mindbloom. Had a telemedicine doctor visit for the prescription and then they set you up with a zoom guide who talked him through the process.

From a recent NYT article:

And some patients skip the clinic entirely. Mindbloom, which launched in late 2018, is a telemedicine platform whose users get home delivery of ketamine lozenges. The company — among the fastest growing of several services enabling at-home ketamine therapy, like My Ketamine Home and TrippSitter — pairs its clients with psychiatric clinicians certified to prescribe drugs, who determine if the drug is appropriate for them. T

hen other employees, called “psychedelic guides,” meet with patients virtually before and after sessions to process the experience. There are no formal requirements to becoming a psychedelic guide, but most have completed training in fields such as mental health, life coaching or crisis management.

oops...what R42 said.

Psychedelic guide sounds so rad

Best of luck, OP. Let us know how it goes if you get the treatment!

I have heard that if you have a substance abuse history ketamine is contradicted. Something to look into perhaps.

I have been referring patients with depression for IV Ketamine treatment in NYC. IV Ketamine has been shown in clinical trials to treat depression, OCD and bipolar disorder.

It is NOT a miracle drug, however. I had a patient with severe depression who tried IV Ketamine and ended up suicidal and in need of acute hospitalization. Spravato (nasal ketamine ) is almost impossible to find. The burdens on the providers are excessive and costly. For example, after receiving Spravato, the patient needs to be under obs for 1-2 hours, so the practice would have to hire a nurse to do this, and the office would need an extra room to stick the Spravato patients while they wait the 1-2 hours. Most people don't want to have to wait 1-2 hours sitting around an office as well.

^contradicted=contraindicated.

R5, ECT is an extremely effective treatment for severe, treatment-resistant depression and is very tolerable. It is used far more in W Europe, where the doctors there do not have to be guided by fears of malpractice litigation.

It is not used as widely in the US for one reason: Malpractice litigation (frivolous of course).

R48 sounds like the protocol we use for Suboxone induction. But we are a clinic so have the staffing and space.

My burden in life is almost unceasing dread/fear/panic/grief sadness. I do get breaks from it, in which I enjoy food, sex, my pets, nature. Life. I do love life and don’t feel like a classic depressive. But I have a lot of past trauma that I can’t seem to resolve.

Can ketamine help someone like me? Can ECT?

CBT and meds sort of help but I’m generally white knuckling through life.

R51 I have been prescribing Suboxone for over a decade and in no way is prescribing Suboxone similar to the provision of ketamine in an office setting.

In fact, in my state, during Covid, I saw Suboxone pts via telemedicine: I send in a script to their pharmacy. There is no need for "induction" in 2021. That is a very dated practice. I see the patient, evaluate and diagnose and then I send the rx in. Most bup providers do not administer Suboxone in their office - yes we did that 10 years ago, but not today.

R51 are you in Canada or the UK? Because in the US, it is quite easy to rx Suboxone, without a need for an in-office appointment - all done via telemedicine. DEA has approved this, as has my state of NY.

We are in the US and have very strict protocols. Glad it is less cumbersome at other clinis.

R55 Yes you are practicing according to old protocols. Pity as many will die before they can get to a clinic and get bup!

R52 IV Ketamine may help you. You most likely will have to pay out of pocket, in NYC it is $400-500/per treatment and you will need 2-3 treatments for 1-2 weeks and then monthly maintenance. Now the FDA approved a nasal ketamine (that is impossible to find as to ridiculous rules around administering it to patients), so you might be able to convince your insurance to cover it, but you will need medical notes indicating the need for it. ECT has not been proved to be as effective for anxiety disorders, with the exception of PTSD and even then it is used cautiously.

I wanted to try Ketamine before I referred patients for this (this was 14 years ago) so I had an IV treatment with a really great anesthesiologist (BTW I don't use illicit drugs so I never had used it before or even used cannabis). I felt happy and relaxed afterwards, but I was not depressed going into it. It is a slower IV and takes about 40 minutes.

Thanks for the exhaustive info, R57!

Yes thank you R57

r52 Why are you asking anonymous strangers on a message board? You are why anti-depressants exist. Anyone with your symptoms should be seeing a therapist regularly, and a psychiatrist to check in every few months. If you lack resources to attain these through insurance or cant afford it, there are ways of seeing therapists at highly discounted costs. The only thing I'd suggest is staying away from the old school Freudian analysis types who let you do all the talking and just ask occasional questions. You need someone to be more pro-active in terms of suggestions and follow up to see if you are taking care of yourself properly (proper vitamins, exercise, sunlight exposure, etc)

You should be trying anything you can, safely and under the guidance of a professional.

R60 I am on meds and see a therapist monthly- wish it could be more frequent because it is helpful.

But I am still struggling so much and wondered if anyone in a similar boat was helped by ketamine or even ECT.

R61, I will certainly update if I manage to get into one of these therapies but it will likely take a few weeks. In the meantime, why don't you ask your therapist if they know more about these therapies - you could share with us if you like. We are in the same boat. Wishing you all the best.

Thank you R62

I’ve waited to respond to this thread and wanted to see how the tone played out over time. It seems mostly positive and helpful, so here goes. I’ve recently, starting last October, had 15 IV treatments in fairly quick succession starting with 2-3 per week then tapering to one per week then a couple more spread out every two weeks. I have major depressive and PTSD and have been on countless medications and behavioural therapies since my teens. I got my GP to write me a general referral letter stating I wanted to try newer therapies and was able to get in fairly quickly to a clinic. I’d suggest anyone interested read up on ketamine’s relationship to glutamate. It takes a different pathway compared to the more familiar serotonin focus. It has also had a lot of use in medical and military applications especially in lesser developed countries. So, it’s not exactly ‘new’, Has it helped me? Definitely, yes. I’m in a much better mood and able to enjoy life more. There does seem to be an ‘awakening’ within my pathways is how aid describe it in a very general way. I didn’t really feel the shift fully until after the 7th treatment. Is it a total cure, no, but it is a significant improvement. I’ve gone from a 2-3 mood to 5-6. I’m interested in my hobbies again and being much more social. I’m glad I did it and can always go for a ‘top up’ when needed. Fingers crossed for the long term. Wait and see. The downside is it’s breathtakingly expensive. I spent probably close to the equivalent of $9,000. Where so live, it’s not covered by National Health Service and private no insurance covers it. I’ve not taken a decent vacation in a few years, so my ‘trip’ was down the K-hole instead. Absolutely no regrets. Btw, the experience of disassociation was always positive for me (not everyone though) and it’s complete non-addictive. Keep in mind, it doesn’t work on at least 30% and benefits after only 2-3 treatments is the most optimistic outcome.

r52 These treatments are better reserved as a last case scenario. It's not a quick fix. The applications for these drugs are largely a new area of research and we don't quite know the longterm effects among different demographics and conditions, comorbids and health variables. But as prescription drug abuse takes the center stage, ironically, we find an increase in market demand to these substances as the alternative. . . but the pressures of demand may lead to a shortchanging of safety.

Have you supplementing your cbt with peer support groups? if religious, a pastoral counsellor? perhaps a life coach with a specialized background in special needs & disabilities focusing on time/life management and organizational skills? The latter can risk becoming obsessive and avoidant, however, it can significantly reduce stress by creating an ongoing detailed chart of your mental health and helping to integrate it's needs into the demands and responsibilities in your personal life. That helps in being able to give you visual data to more easily identify and navigate conflicts. It can also free up space to give time to crazy. Consider how many people are affected by changes between seasons... so, this has the potential of becoming a roadmap/timeline to help predict future episodic occurrences and build an individual care plan to schedule time or up meds or whatever to try to prevent it or manage the symptoms.

you can add a nutritionist to the mix, an endocrinologist (hormonal levels, more than just T&E, you know), there's a wide variety of specialists that may apply to your individual needs that can help soften your symptoms or give you the tools to manage them.

But of course, if these more aggressive treatments pique your curiosity, then take the time to research them and try to find an equal perspective in reviews/studies, i.e. seek out the negative ones and lawsuits.

Wait until people find out this is another Trump drug, like hydroxychloroquine and the vaccine.

[QUOTE] but she suggested imipramine (aka Tofranil). I'm quite sceptical as I have been unable to find any studies suggesting this can help with treatment-resistant depression

I took imipramine in the early 90s. It’s a very old antidepressant and a very good one, but the side effects are a bitch which is why the entire of class of medications (Tricyclics) are passed over these days in favor of SSRIs. First of all I’m talking about a therapeutic dose, I have no idea if microdosing imipramine would help depression but I know it’s effective for pain management. At the therapeutic dose range you can expect sleepiness, dry mouth, weight gain, and the tendency to feel faint when rising from a laying position. You could also get kidney stones, anorgasma, and erectile dysfunction. On the other hand, it will lift your depression so maybe you won’t give a fuck about the other side effects, like me. It’s also pretty cheap, your out of pocket won’t be terrible even without insurance. Oh and you’ll sleep like a baby and you’ll NEVER be anxious.

I'm surprised that so many people on DL suffer from mental illness.

R65 You are incorrect about Ketamine. There is a decade worth of research and clinical trials to support the efficacy of ketamine for certain psychiatric conditions. Go peruse PubMed for the clinical trial data. Nasal ketamine went through a rigorous process with the FDA before being approved as treatment for depression.

Ketamine is a glutamate receptor antagonist and yes, glutamate has been a "hot" receptor in psychiatry for the past decade.

OK, I got an appointment for Wednesday with the ketamine doctor. Wish me luck!

Keep us posted Op!

I work in a clinic that provides Spravato (esketamine) treatments. Obviously it doesn’t work for everyone but a majority of our patients have shown benefit, with improvement in both anxiety and depression. At first we had trouble getting insurance to approve and pay for it but lately it’s been much easier to get an okay, and quickly. The company that manufactures it issues copay cards if you have commercial insurance, so cost for the medication is affordable.

How much is Spravato out of picket R72?

I mean, out of pocket.

Around $1000 per treatment and it’s twice a week for 4 weeks, then once weekly for 4 weeks, then to be determined

With the copay card it’s $10

IM injections without insurance are $350 at my clinic. IM is much cheaper than IV and just as effective.

Spravato is a nasal inhalant

I live in Kentucky, is there any way to find out if any of these alternative treatments are available here?

Spravato has a web site where you can sure for the closest providers.

Search not sure

r48 I'm wondering about the timing between the patient's taking ketamine and suicidal behavior/thoughts. Like was it a day, a week, a month?

I'm in the same boat, OP. Unfortunately, ketamine treatments aren't available here. I wanted to try ECT and was referred to another facility by my therapist, but was denied the treatment, lied to by the consulting psychiatrist about the reason, and then charged $500 for said consult. She informed me that because my MDD and PTSD is due to severe trauma, the ECT would only be 20% effective which wasn't enough to risk the potential side effects of the treatment.

Come to find out, she actually denied the treatment because I couldn't get anyone to take me to and pick me up from the treatments (they required a "designated driver"). My family doesn't support me taking medication and seeking "secular mental health" treatment, guilts me for "depending" on pharmaceuticals to get better, and overall blames my issues on me basically being a "bad Christian" (not the actual words used, but in so many words, that's what I'm told repeatedly).

I don't share most details about my mental health struggles with friends because I'm not comfortable doing so, which is why I didn't ask any of them to give me a ride (I know...pride, fall, etc). Getting therapy is very stigmatized in my culture and seeking any sort of mental health support is, generally, viewed as weakness and only something "crazy and White people do." So, I mostly keep this shit to myself and indulge in distractions like video gaming to ignore the problem. :)

Sorry to hear about your situation R83.

You might want to find online therapy. I was working for an online US therapy/psychiatry company (Talkspace which I don't recommend) and I had some patients overseas. You could look for an online therapist in NY or LA on Psychology Today. You can look for therapists who have trained in trauma therapy.

Unfortunately, you would have to pay out of pocket for this, and I know the cost can be prohibitive. You can also check out the link below, the Open Path has gotten great reviews and is based on sliding scale I believe. And many of the therapists are available online.

R79...

R83 Just FYI in the US, you must demonstrate failure on at least 3 antidepressants to be considered for ECT. Have you not tried antidepressants at all?

SSRIs like Prozac and Zoloft cost pennies and are widely available across the globe. If you haven't tried medication, then that is your first step.

And finally, ketamine doesn't work for everyone. I had a patient with severe depression and suicidality who felt worse after IV ketamine and was hospitalized. Sadly, he did go to kill himself.

Where are you from, R83? You should do your best to fight the illness. Fuck the stigma and prejudice!

R83, where are you from, how old are you, what culture are you from?

I promised an update and here it is.

I went to the doctor who controls the ketamine program in my city. He asked about the full story of my depression and said that, before going to ketamine, we have to do several things:

1. Change my meds, as old ones didn't work anymore. The main one of the 3 he prescribed is Wellbutrin.

2. Do full blood analysis.

3. Do brain scan for possible "hardware" problems.

The blood results came in today and it turns out that I've developed diabetes 2, could possibly have brain tumor, have a vitamin D deficiency and a host of other problems. Safe to say it's not one of my best days and I'm very angry at the universe.

Next week I'll have the brain scan, after which I may be hospitalised (the doctor said) but I'm not sure to what end. Maybe for further examinations.

And only after all of that we will discuss ketamine and eectric shocks.

OP, I haven't tried it, but taking ayahuasca ended my lifelong obsessive suicidal thoughts. Ended them. It gave me a whole new outlook on life.

If you have tried everything else, then just try ketamine therapy. There's no reason to fret over it. Just try it.

BUT you do need to keep one thing in mind: ketamine without the therapist is not ketamine therapy.

Clinical research demonstrates high efficacy for ketamine treatment of depression and anxiety, but only when administered by a clinician. Taking ketamine without talk therapy does not yield similar results.

There are now online therapy options like the one I am linking here that will order you a single ketamine dose from a pharmacy and treat you through the experience virtually. I don't see any reason for you not to try it.

Ugh! I am sorry! I posted the response above after reading several early posts and I didn't see you most recent update.

Get the medical help you need.

Sorry about all the scary stress OP. Sending you well wishes.

Sending you love, OP, and everyone else who is suffering.

Have any of you ever thought that being constantly happy isn't a natural state either?

We go through stuff, most of it isn't great. Shit happens! And then you die

This is the most self obsessed belly button fluff thread ever.

R94, you sound like a real asshole who is ignorant and opinionated. Lacking empathy. Hope you never suffer major depression! Or ptsd! Cunt.

Everyone goes on and on about serotonin with mental health but lots of gays are dopamine dependent and have a fucked up GABA/Glutamate balance from drinking and drugs. Throwing a gay guy on an SSRI that takes sex away and doesn’t address the other imbalances is like trying to cure a housewife’s depression by telling her she can’t shop anymore. Balancing G&G will make a huge difference in anxiety and depression.

That seems to be a good point - lack of serotonin makes us depressed but the lack of dopamine maxes us anxious and restless. And what if you lack both? What to do then?

I’m trying it soon with my psychiatrist for anxiety and will report back.

Has anyone tried that Mindbloom site?

It says that it's "from $99/month" for new members, but then people are posting here about how ketamine therapy is incredibly expensive. How much do you actually end up paying through that site?

Reddit has a forum called Therapeutic Ketamine. Lots of good info. there including people sharing their experiences with various providers, Mindbloom among them.

OP at r89, please update us if you're still around.

I spent $600 with a psychiatrist. It was extremely relaxing and I felt great for a week. I sought it out for anxiety & OCD issues. He gave me 2 more tablets to take on my own while my partner is home as well to check in on me. It was not as life changing as others have reported but I will do the other 2 tablets about 6wks after the 1st trip. My biggest fear was to see “demons” or scream out my darkest secrets but neither occurred.

Is there a dr*g or herb for curing maladaptive avoidance? Turns out loud rock music and beating myself up is not working fam!!!!

LOL R103! If you ever find out - please let me know.

[quote] my biggest fear was to see "demons" or scream out my darkest secrets...

THIS is what I'm afraid of, too. I took some edibles last year (medical marijuana, have never done any drugs), and I thought I was losing my mind. My husband was worried for me, and apparently I shared some personal secrets I never wanted him to know. So if ketamine therapy is anything like this I can't.

R16 here. I fucked around and found out…you do need maintenance doses…possibly for the rest of your life. I haven’t had a session in over six months. I started feeling more and more depressed and anxious, starting about two months ago. I started drinking again, which fast tracked the anxiety, I’m not drinking as much as I did pre ketamine (I was drinking 2-3 bottles a night and now I max out at one) but I feel like garbage. They made me do another intake appointment because it has been so long, and they are now booked out for 2-3 weeks, so it will be a solid month before I can get back in. I’m just treading water for now, but it’s nice to know that there is something out there that can help me.

R106 that sounds worrisome. I wonder if going off ketamine can make issues worsen if not dosed.

[R105] - did sharing your secrets have any impact on your relationship? Does it feel at all freeing that the secrets are no longer secrets? Interesting experience.

R106, do you completely lose consciousness while on ketamine? Do you do weird things? Do you talk?

R109, I have fallen asleep before in later sessions (they increased the dose each time I went in). I told them to back off on the dose, and they did. I have never said anything or done anything weird while on it. Everyone who I have spoken to has reported the same. If you do them in person, you are alone almost the entire time. They give you the shot, then leave the room. They come back in 15 minutes later to check blood pressure and give you another shot. You don’t see them again until it’s time to leave. There are cameras in the room which are monitored, and there is a call button if you need help. Even if you did say something embarrassing, no one would hear you.

Thank you, R106 / R110! I was more worried about loss of control over myself. Like, doing something to hurt myself, or unintentionally stop breathing (I read this can happen on fentanyl). I know it sounds silly but it's a fear that I have.

Where I am, I will have to be hospitalised for the duration of the treatment and likely monitored during the IV sessions. That's what my doctor told me. I'm gathering up the courage to do it.

I was in treatment fit acute depressive disorder before and during graduate school and had excellent care. My psychiatrist used a combination of tricyclics and some older anti-convulsants “off label” to stabilize mood swings. I tapered off the meds but intermittently went back into care when situational challenges arose.

I hope I am always able to manage my depression like diabetes or another condition that necessitates self-regulation to maintain the conditions of your life (make and keep friends, earn money, grow and enjoy things).

My concern is really for the longer term. My North Star will be staying content with where I am in life, and protecting my autonomy and freedom. I think it would be hard for me to do that on meds that induce disinhibition. I have close friends who feel great jacked up on stimulants, and have full confidence in all their own onions and ideas, but also end up alone. Two close friends on ketamine ended up in trouble being too “open” to the world, tearful and messy, oversharing, and creeping out strangers. I hope people manage their meds, particularly psychopharmacological regimes, really carefully. I’ve seen things “feel great” but end badly, expensively. It’s hard to say that, but it’s true.

That’s meant to spell “for acute depressive disorder”, not “fit”

I have had treatment-resistant major depression for 40 years. Tried most medications and many talk therapies. Lost many jobs and am now applying for disability based on TRMD.

In desperation, a few months ago I tried IV ketamine.

It was easily one of the top-5 most horrific experience of my life. The doctor prefaced the infusion with an extensive intake interview that brought out many painful memories, and I was then shown into a room, hooked up to an IV, and then *left alone*. The dissociation was so frightening and I was shouting out for help (they did come in a few times). In the end I called 911 (twice, apparently), the cops came, I was unhooked and bundled off into a cab. I’m still having flashbacks.

The point is, your mileage may vary, but do NOT do an un-monitored infusion (and preferably make sure that it is monitored by a trained therapist who can help you to process the experience).

Horrific.

R114 I'm so sorry that happened to you. I have read that ketamine treatment has only proved therapeutic in clinical studies when a therapist is present and engaging the patient in talk therapy. Injecting you and leaving the room sounds more like a medical experiment at some clandestine lab. :(

Out of curiosity, do you think you have had any positive outcome at all from the experience after time has passed?

I ask because I had a horrific 'bad trip' on ayahuasca the last time I took it that left me traumatized and questioning reality for probably 18 months afterward. All my prior experiences with it were difficult but positive. This one was nothing but sheer terror. I died, basically, and I went to some other place that was entirely overwhelming and then I went to a place that was a total void. I was sure I was gone from my body and all organic life. I got back, and after time passed, I gradually reintegrated with this world and over time the experience has proven to have been life changing in a positive way. I needed a wake-up call to reengage me in life and to make me appreciate what I have here and I got it—I really got it. It beat the shit out of me, but I am alive now in a way I had not been since early childhood. Oftentimes, "bad trips" actually work out well psychologically over time, but they can be acutely horrific and even dangerous in the immediate term.

R115 thank you for your kind comments. My experience with the ketamine infusion was similar to what you described with the ayahuasca. I have not come to the other side, unfortunately, and I am still very traumatised by it all. Perhaps time will heal. On the positive side, at least I tried.

I don't think I'd be able to survive experiences like those described by R114 and R115.

No one would be more surprised than I am, r117 , that I’m still here to write these comments. It’s amazing what one can tolerate. Of course, I am now on massive doses of anti-anxiety, anti-seizure and a new anti-depressant. And, I do have some hope. At least I’m not drooling and babbling incoherently (I don’t think…)

I'm holding my fingers crossed for you, R118, and sincerely wishing you ALL the best!! Depression is awful but you sound like a strong and resourceful person. I hope you get your disability plan and are able to live in peace and comfort from now on. Hugs!!

Excessive use of ketamine can also also ketamine induced cystitis....which is like a chronic bladder infection that never goes away and can, ironically, end up making you spectacularly depressed- even suicidal....because of the pain. I think you need to take quite a bit of ketamine to do this- think "Party Monster" rather than going into a clinic once every 5 weeks. But it's still a risk to be considered.

Have you ever heard of TMS, OP? I've been thinking about trying this- it's much less risky and invasive than ketamine and the feedback from people will treatment resistant depression seems to be fairly good:

Have you tried it, R120? Any first-hand feedback?

No...but I did have a friend who was in the same boat as you and he eventually did EST. He was never really the same since...although I think it did help the depression a bit. But it came at a high cost, imo. There are many, many natural routes you can take that can help alleviate depression + anxiety. If you're interested in this route, I would suggest checking out Peter Smith's page. He's a little...er....severe.....but that's because he spend many years of his life severely depressed. He pulled himself out of it by learning about his own neural pathways and I think his website is pretty generous in the amount of info he makes available. I go back every so often + he's always adding to it. Hope that helps OP!

Thank you very much R122! I will check this page and hopefully it helps. I'm open to anything at tbis stage, to be honest.

Could you specify in what ways wasn't your friend the same after the EST treatment? What changed?

I have a friend who was never the same after Ayahuasca treatments. He said that it helped his depression, but he seemed to be a shell of who he was before. He almost seemed robotic. He was suicidal before, so I guess feeling nothing would be a relief.

Some of the technicians in these ketamine clinics can be careless when starting an infusion. I’ve had two different friends report that the ketamine solution went into the wrong body tissue, causing a massive swelling of the forearm and hand because the portal wasn’t properly inserted into a vein. They said the ketamine drip fluid merely seeped into the interstitial space in the tissues of the forearm and hand. It sounds really scary. That would freak me out. This has happened to two friends, in separate clinics in separate cities.

Some of these infusion centers feel like silent discos. They pop up on repurposed office spaces, and have infusion “suites”. You can sometimes request special music and also special LED ambient lighting, in colors like coral pink or pale blue or green. It’s a really different type of clinical experience. I can see why my friends look forward to their infusions. Some return to cities specifically for infusions, even though they no longer live in that City.

R30 I really like Dr Weiss. I use his guided meditations especially a healing one. I have chronic pain.

R94 Go screw yourself. Depression is an illness. People die of it. No one is asking to have a constant state of happiness. Do you tell someone with cancer not to be “self obsessed?” I’m going to block your sorry ass now.

ketamine hepburn was never an actress that impressed me.

It is also be tested for ALS

'OP, I'm actually going to phone my GP tomorrow to ask about being prescribed either tianeptine or low-dose naltrexone, '

Why would you take a drug that blocks all your endorphins, you spaz?