Ketamine For Depression? (Page 11) (Top voted first)

It was recommended by the members of a separate thread that one be started that directly relates to ketamine and it's use to treat depression.

If anyone besides myself would like to discuss it's use as a treatment for depression, feel free to post your questions, answers and experiences here.

This thread is an offshoot of a related one that discussed a treatment of Scopolamine for depression.

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"that's a real bummer to say the least lahelp. my current pdoc is not that enthusiastic about the ketamine deal due to exactly the relapse rate being so high. "

That's a shame, because (as you know) nothing comes close to it in terms of the 1) rate 2) speed and 3) degree of response among those with treatment-resistant depression. Sure, the duration of benefit isn't great, but any period of relief - no matter how short - from a state like you describe is valuable for so many reasons. If it allows you to get back on your feet for a while and back to your life, you'll be able to so many things you can't now which could kickstart positive feedback cycles that pay dividends even if the ketamine
wears off. Perhaps it gets you to a place where medications that aren't working now have a better chance of managing your mood.

"does dr. feifel do multiple infusions? i only ask due to the cost difference between him and dr espinoza."

I imagine that he does (as he is the one who recommended I proceed with multiple infusions as a next step). You should certainly ask him, though of course you and he wouldn't explore that route before finding out if you respond to your first infusion. Regarding cost, while the procedure is much less in SD, the expenses of the trip itself (hotels and such) ended up costing me as much as it would with Dr. Espinoza, not even counting missing three days of work. Of course, I wouldn't have to go down for three days next time (pre-evaluation, procedure, post-evaluation), so it would be less in the future. But still, I'd pay the extra cost of convenience to go to UCLA if going down to SD and back in the same day were not an option (I don't know if it is). Though, we are talking about a lot of money either way, so I can understand not having that luxury.

"also, do either doctors have experience about doing 'maintenance' infusions over an extended time?"

Since Feifel's new program just recently launched, I would say no for him (at least not in this incarnation of the program), though I imagine he plans to do that with patients who respond well and then relapse. Dr. Espinoza indicated to me that he has seen some patients more than once (one, in fact, who came back to him a month after her first infusion and then four months later after that for a third, which he considers very successful). But, again, his program just launched last year, so there's been little opportunity for him to treat anyone for an extended period.

"you mention 3 x's a week for 2 weeks. is that a standard protocol by either doc? "

That was what Dr. Feifel recommended to me. I spoke with Dr. Espinoza today, and he did not think it made sense - said he could see doing trying two a week for two weeks. Because there is so little clinical research on ketamine infusions for depression (and none for more than one infusion), no standard protocol even exists. Hence, it is treated very much on a patient by patient basis and, apparently, can differ significantly from doctor to doctor.


"in my research i have read a few case studies where some very treatment resistant people were going in about every 2 to 4 weeks continuously for an infusion which kept them in remission. again, curious as to what either dr. espinoza or dr. fiefel would say about this practice."

Dr. Espinoza's concern regarding the 3 / week x 2 weeks approach is that it could potentially accelerate the development of tolerance to the infusions without providing added benefit great enough to make it worthwhile. I imagine both doctors would aim to perform infusions as infrequently as possible that the patient continues to derive benefit. Unfortunately, with no rule of thumb by which to estimate what that frequency might be, it takes trial and error to find out.

"again, i am really sorry you didn't get longer lasting relief.


if i could get a month of remission at a time i think it would viable both emotionally and financially.

guess i need to take the first infusion first and go from there.

please keep us posted about your future plans on all this. and, thanks for helping us out here.

hang-in there.

john "

Thanks. I also want to let you and everyone else know that I found another treatment option in California today: Thomas Leverone. His name is first on the list of doctors from page one of this thread, as is his correct email address (I don't know whether the phone number is accurate). He also has a website which you'll find if you do a search for the first part of the email address - I don't want to type it out here because I believe that automatically triggers a hold on my post while it awaits review instead of showing up right away).

He charges $1,000 flat for an infusion and, by luck, he will be in L.A. Monday through Friday of next week before heading to San Francisco for some time (apparently, his calendar is heavily booked with infusions in Northern California). Anyway, if you contact him now, it's possible that he could treat you next week (contingent, of course, upon his reviewing your answers to his depression questionnaire and him deciding to treat you). Like Dr. Espinoza, he requires you to submit the results of a recent physical, EKG and panel of blood work tests prior to treatment (I got all of mine done today). Even though you have the SD appt scheduled, it can't hurt to find out if he would be an option for you, even if only for down the road. The contact form on his website doesn't work seem to work, so I'd recommend writing out your answers in a text document so you can then copy paste them into the form as well as into an email to him.

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lahelp-

thanks again for such a thorough synopsis of your experience and answering all my questions. really appreciate it.

i guess i was just really disappointed you didn't get more relief...but, you are absolutely correct that even a short-term break from my depression may pay huge dividends.

i will plan on seeing dr. feifel on the 25 july. hoping that the procedure works and then go from there.

you make very good points about time/cost, etc. regarding ucla and ucsd. i will hopefully cross that bridge when i have to.

getting anything done right now is such a herculean task for me. blood work, ekg and a full physical. i need to do it anyway, but, just the thought of it is a bit much for my depressed mind. but, i will get to it. i see my primary doc on 20 july and will push to get all those things done. would you believe i have basically been in bed for over 2 years now? just a bad dream and i am not much of a fighter...

thanks again for all your help so far.

you really are a 'lahelp!' :)

as usual, if you can please keep us posted of what is happening with you and the infusions that would also be greatly appreciated.

take care of yourself.

john

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Tomorrow I'm going for my first Ketamine treatment to Dr. Fruitman in NYC. Hope it will work

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I'm going to have two infusions next week at UCLA and then two again the week after that. Dr. Espinoza as well as the person who who handles payment for services both mentioned they would file a request with the hospital for a discounted treatment if this ends up becoming a regular maintenance plan for me. I have no idea what that discount might be, but it was at least good to hear things could be a little cheaper if I'm having to do this often.

John, I'm really sorry you're in such a bad place. I'm glad that you are hanging in there and are going to have the chance to see if the ketamine infusion works for you. I've also had times when I can scarcely find the motivation to leave my bedroom, though nowhere near what you're describing. I'm in the city and I have a car - if there's something I can do to help, let me know.

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New article from Bloomberg:
bloomberg.com/news/2012-07-08/special-k-for-depression-renews-hope-in-hallucinogens.html

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N2V,
I hope you don't mind if I ask a few specific questions.

Are you seeing Dr. Edward Fruitman? Will you be getting nasal spray, or a ketamine infusion? How much does it cost?

I've tried the ketamine nasal spray and it didn't work for me.

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Does anyone have any personal experience with both the spray and the infusion? What differences if any are you experiencing between the two?

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I am also trying the nasal ketamine and still trying to figure out correct dosing. Can anyone share what they have tried, amount and how often. Curious to know if anyone has had success with the nasal ketamine for depression. At this point the best I have experienced is a calming effect.

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lahelp-

thanks my neighbor. i appreciate you kind offer. would you believe i have 2011 vw gti that i bought brand-new 2 years ago that has only 3k miles on it so far? that's less driving than my 90 year-old mom does. ;) i use to love to drive...

seriously though, thanks again for your generous offer.

i am actually driving down to san diego on 24 july for my infusion on the 25th. so, i got me some 'wheels' and hope. i will be staying down there, like you did, for 3 days.

if i respond to the infusion i will be quite thrilled. if i don't, i'll be pretty bummed to be honest. though i know there are many more things for me to try and do.

but, if i do, i think i will then follow your steps and work with dr espinoza again at ucla. wonder if there is a special discount for former ect patients of his. (lame joke.) hearing that they might give a price break is encouraging. i need to find-out first if i even respond to the infusions, then i will work on the money stuff and ucla at a later point.

if you can lahelp please keep us updated on your progress with the multiple infusions.

good luck!

john

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I've seen Dr. Fruitman couple of times before and was pleasantly impressed with his knowledge of the subject. I've received Ketamine intramuscular- 2 shots within 15 min- 0.5mg per kg of my weight, and it really worked!! Wow! I feel like myself again. My protocol is- twice a week for 4 weeks, then once a month for 5 months.

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And my cost was-$250 for the initial consultation and $250 for each cession.

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Are these intramuscular injections for chronic pain or for depression?

I thought that only intravenous infusion worked for depression.

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I'm having my third infusion (likely, of four) tomorrow at UCLA - I'll post an update after that

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Dang! That's a really good deal N2V, especially compared to the $1250 I paid at UCLA. That's why I have even been trying the intranasal route, even though it isn't nearly as long lasting.

Anyone know of a doctor in the Los Angeles area who is as cost effective? I'd give up the intranasal if I could pay that sort of rates. $1250 is just outrageous.

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It looks that IM works basically the same as IV at least on me

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What's it feel like during and after your ketamine dosing? I'd like to hear your experience.

I can tell you that with the nasal spray, between 10-16 sprays, I'm immobilized for about 2 hrs. I lay in my bed with my eyes closed, mind drifting into a world where I'm a totally different person -- confident, ready to take on the world. This is the person I remember myself to be before the depression hit. If I open my eyes, the room is spinning. I always hope that the confidence from the K experience will cross over into reality but I can't say that it does. It's difficult for me to tell if the K is having any effect on my depression, personality, outlook, mental health, except during that 2 hour time frame when I'm in the proverbial k-hole.

I feel that I have to remind you that I'm dosing with a prescribed nasal Ketamine spray about twice a week, or when I feel that my thoughts are becoming uncontrollable.

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Well I can say that I feel almost exactly the same. The closest feeling I can describe is like after 4-5 shots of good scotch. But effect is even better after. I'm confident without being high.

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Hello,

I am a nurse with a Master's Degree. I am 43-years-old, and have suffered from clinical depression since 1991, or for 21 years. I have tried at least 20 different antidepressants, a number of other psychiatric medications, multiple kinds of therapy/counseling (including CBT, EMDR, and even hypnosis), and ECT. I have had inpatient treatments, outpatient treatments, therapy, and alternative medicine. I have seen primary care doctors, psychiatrists, psychologists, acupuncturists, hypnotherapists ... you name them, I've seen them.

Since 1991, I have spent the majority of my life in a horrible grey blur of depression and hopelessness, interspersed with hospitalization for suicidal ideation. In December of 2011, I did attempt suicide with an "exit bag," but was stopped by my family. I was so distressed upon being interrupted that I attempted to complete my suicide with a knife - but was unsuccessful.

I am ready to give up. I can hardly work, had to drop out of law school, divorced, and most times barely function. I ended up on disability.

My family has become frustrated by my ongoing lack of response to treatment, and sometimes I feel that they have given up on my ever getting better.

As I write this, I have been in bed for almost two weeks, too depressed to do anything but hide in my bed and cry.

I honestly started to make arrangements to commit suicide, reviewing my life insurance and will, writing emails to be delivered after (which included instructions for my family), and looking for a loving home for my dog.

However, I keep thinking about the research I have read on this new potential treatment - an in particular the words of other patients whose treatment resistant depression was finally resolved with the use of Ketamine.

I am smart, educated, kind ... I could do so much with my life and for myself and my family if I could just get rid of this depression!

How can I get this treatment? I have read all the posts in this thread, but don't see contact information for the 3-4 doctors mentioned in California, and 1 in NYC. I did see a list at the end, but it as for pain doctors who use ketamine, not psychiatrists.

I live in Arizona, but am willing to travel and/or relocate (either temporarily or permanently) if it means getting effective treatment for this terrible disease that has taken over my life. Mental health care in Arizona is extremely poor.

Please let me know if this treatment is available in Arizona, California, or Washington - or anywhere else - and also if you have an idea of what the costs are and whether they are covered by insurance.

I AM DESPERATE & HAVE NOTHING TO LOSE! I AM OUT OF OPTIONS AND HAVE NOWHERE ELSE TO TURN.

I would sincerely appreciate any information or referrals you may be able to provide.


Thank You!

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N2V,
please let us know how things progress with the ketamine injections if you can. Thanks, and good luck.

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Em,
I searched for the doctors mentioned in this thread and came up with the following info:

Dr. David Feifel at UCSD Medical Center is using ketamine NOW to treat depression. A single IV infusion of ketamine alleviates depression for about a week. At UCSD, they're giving multiple infusions of ketamine over several weeks, hoping that this will have long-lasting benefits.
A video (and a transcript) of Dr. Feifel discussing the use of ketamine for depression is at this site:
medscape.com/viewarticle/736133


Randall Espinoza, M.D., M.P.H.
Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA
(800) 825-9989 Resnick NPH Access Center

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