Ketamine For Depression? (Page 18)

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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@brian did you start with IN Ketamine or IV Ketamine first?

I was talking to a doctor yesterday and she suggested IN takes longer to kick in and so may be better for maintenance. It was just her anecdotal thought, but your report made me think about it. The suggestion was that long term they will be similar, just the initial onset of relief will take longer

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@Brian-Could you please tell us what area you are from? What was the cost of the IN Ket? Yours is a very exciting post!

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@Brian, Thanks very much for your encouragement, as you know it is very hard to be in this situation, since nobody knows how destructive it is unless they experience it, and we still have to deal with our self blame.

I'm very happy for you doing better with the new IN treatment, I hope you keep getting better all the time.

Bill

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Hi all thanks for your comments. Paula, I am from Las Vegas and the ketamine is only about $49 for a months supply.
Just a word of caution - I don't want to mislead anyone at this early stage, I do still consider myself depressed, only time will tell if results are real and lasting.
Happy holidays!

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My BCBS will pay for TMS with a little fuss. It also paid for BOTH of my VNS procedures/devices with NO fuss at all. Go figure. I'd suggest ECT is generally used before things like ketamine. (Perhaps I misunderstood the order suggested.). Perhaps it depends on your location.

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Tomorrow (Monday) is my medical appointment for the GLYX-13 study. After a couple telephone interviews, I do not anticipate any obstacles and expect to start infusions within a couple weeks. The protocol seems very poorly written. Curious. I am grateful to have the opportunity and trying not to think of the impact if I find no relief. The lack of response to VNS was difficult. The lack of response to ECT was devastating.

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@CityGirl You are fortunate or something with regards to TMS being paid for by BCBS

But Ketamine would be used before ECT if it were available normally. ECT has a massive side effect with memory loss and personality changes. TMS, again, is typically not performed until after someone has failed ECT. TMS is still in the experimental stage and if you look at the trials they say you must have failed ECT first.

Doctors can, of course, prescribe in whatever order they choose, but most will take the treatments that are available in an area and apply them based on side effects to outcome ratios, with reversible side effects being preferred to irreversible ones. With ECT there is always memory loss, it is simply a question of how much is lost.

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@Brian-please check in and let us know if you are progressing! I know that with the IV Ket, it took three infusions in the course of a week for it to work. Thereafter, one infusion per week was good for maintenance. Sadly that was a study and I don't have access to the tx now. But I'm very interested in knowing how it's going with you! Thanks and have a nice Thanksgiving!

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@citygirl-I was not aware that you had the VNS surgery! Obviously it didn't work for you or you would not be on the site. I had 2 TMS tx and noticed no difference. It was quite an annoying experience. Again, don't want to discourage anyone, different things work for different people. No harm in trying it if ins. covers it. I would like some details about the VNS, if you would be so kind as to expound on your experience.

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I did not personally have TMS but I know a woman who did. We have the exact same employer based group BCBS PPO policy. I helped her with the insurance process because I had a good deal of experience dealing with insurance for my special needs child and for my depression.

@Keller... I agree a ketamine-like drug would come way before ECT if is was an approved treatment.

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I had a VNS implanted in 2006. Although I was enrolled in a clinical trial, BCBS paid for the surgery. The device was free as part of the study and the surgery would have been free IF my insurance would not cover. (If that isn't insurance fraud, I don't know what is.) After about a year it was clear to me something was wrong as I no longer felt it firing. In 2008, only after I insisted, a representative from Cyberonics flew out from Texas and met with me and the neuro surgeon at Rush. An x-ray clearly showed the lead was frayed. How that is possible, I have no idea. I wad scheduled for surgery to remove the original device and lead and to have them replaced. There was a great deal of scar tissue around the lead and the surgery took several hours longer than anticipated. My vocal cords took a beating and I lost my voice completely within 3 months of that surgery. My pdoc turned the device off and , fortunately, my voice eventually returned. We turned it back on a year later, but my voice began to deteriorate almost immediately. At that point I gave up. Additionally, since the 1st device was removed, I was dropped from the study and the cost of the VNS was on me. Neither Cyberonics nor Rush mentioned this. I assumed the 2nd device was covered under the study since it malfunctioned. I found out I'd been dropped when the bills came. I was very fortunate that BCBS paid the 2nd time as well- including the device. I filed a complaint regarding the co-pay and not being notified I was liable for the cost of the replacement device. In the end, it was a rather sad experience for me. I have pronounced scars on my upper chest and neck. I was very dissappointed with the surgeon as well as Cyberonics. The new lead is very tight and uncomfortable. (The original lead did not cause such discomfort.) I am not able to have certain MRI's (and was disqualified for several imagining ketamine studies). The device will need to be removed in the future if certain medical treatments are required. All in all, a bad experience but, had it helped my depression, it would have been worth it, of course.

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@brian-is your script filled at typical pharmacy and is it prescribed by md or psychiatrist?

also, anyone, is there any published info on recommended dosage?

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@Howard,
Hi, my script is prepared for me at a special 'Compounding Pharmacy' - it's no big deal it just takes a day rather than twenty mins to fill. I am on 40mg daily. I did poke around on the web but nothing consistent re dosing. I get my script from a shrink.

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Just a comment, I know this is a 180 degree change in conversation and I will speak only for myself. Drugs of course are useful but I did notice a real improvement in myself just by virtue of having to get my ass in gear to visit NY where I actually enjoyed a visit to my in laws. I will spend Christmas in Germany with my sisters family which I know will be good for me. So bottom line, I realize that depression is real but lifestyle, thinking and behavior can be important too. I acknowledge also my social anxieties and a very poor relationship with my father. It's more clear to me now that a little self examination as well as drug therapy is important at least in my case. So I'm going to look into some psychotherapy now that I am improving.
No offense to anyone who feels otherwise, I have shared your pain and wish you luck.
Happy Holidays!

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@Brian Talk, exposure, group therapies, friends, family, etc. are all useful in their place, but quite frankly if they were the way you implied none of us would be here. I suspect the ketamine is working for you, and that is good. What you appear to be doing now is returning to a normal life. It will likely take a period of time to move back into being normal again. Would you mind checking your dosage? I strongly suspect you are not taking as much ketamine as you reported. My reasoning is the anesthetic dosage for ketamine on the battlefield is 46mg IN if you are taking 40mg a day it is hardly sub-anesthetic

@Howard The IN dosage studies start next month. I suspect the answer will be:
(.5mg/kg / Genetics) / bio-availability

since genetics will vary it will be (and has likely already been) fudged into the .5mg/kg

the real answer becomes .5mg/kg / bio-availability

This springs and following studies will give us the IN bio-availability

What we know presently is that the availability of IM ketamine is roughly 1/2 that of IV with 11mg/kg giving ~25 minutes of anesthesia vs 6mg/kg for IV (very rough numbers with lots of variables)

Battlefield studies for IN ketamine show 46mg of ketamine to be an effective anesthesia for 3 hours. Given the average soldier masses 64kg we are looking at .71mg/kg

So likely more than .5mg/kg but less than .71mg/kg

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I contributed earlier in this thread b/c I tried both IV ketamine and about every other medicine, concoction, therapy ( including ETC) for my soul crushing life ruining depression - none of which helped in any substantial way. I am here to tell you that earlier this year I found something that appears to have worked - Iboga or also called Ibogaine or Iboga Tabernathe. I'm not going to BS anyone, the acute treatment is complete hell. Vomiting , ataxia, wild "waking dreams" and basically being scared as s*** for 4 days. But once you come out of it and return to normal the brain receptors for reward and who knows what else have been reset and the visions are extremely helpful many say it is like several years of therapy in a few days time. I can not disagree with this. It has not made my life wonderful but I used to have this deep sorrow about life and would buckle and crumble back into the depression so fast, now it has been 7 months without a dip, just living a more normal life with a more normal range of emotions. Also it is not legal in the US, but pretty much everywhere else on the planet it is. If one were so inclined it is easily gotten in the US though through overseas websites. I wish you all a speedy recovery from this most god awful torturous condition.

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Sorry. All these notifications went to junk mail and just found it. Regular meds 200 mg in morning lamictal. 2 ketamine spray in noise. At night 400mg Seroquel 400mg.

As needed 1mg klonopin at night. In the morning as needed 10mg to 20 mg of adderal.

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Interesting, similar regimen to myself, Effexor, Lamictal, Klonopin and IN Ketamine.
Happy New Year!

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Hi all,
I am a 50-yr-old woman who has had atypical depression (dysthymia to MDD) since my teen years. Have been on many meds. Tried ketamine infusions with Dr Glen Z Brooks in Manhattan. Unfortunately, they had no effect on me. (I am now looking into Scopolamine). However, I would like to highly recommend Dr Brooks to anyone in the NY/NJ metro area who is thinking of trying the ketamine. Dr Brooks is extremely caring, not at all pushy, answers all of your questions and has a great bedside manner. His website is ketamine4depression ; all the info on price and procedure is given there.

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Stillhopeful.... Thank you for the info. I am sorry ketamine didn't help you. I am in the GLYX-13 study, 6 treatments to date, and I have no improvement. I doubt I am getting placebo given the structure of the protocol, but I don't know. I hope I am getting placebo since the open label study is due to begin in April, meaning there is still hope.

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