Ketamine For Depression? (Page 2)

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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Glad to hear that you are taking any and all necessary steps lahelp. Stay on the path and keep us all informed as to how you are doing.

All the best,

Michael

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More food for thought...

Ecstasy shows great promise in treating depression, and like ketamine, it appears to work must faster than current the "Big Pharma" treatments with far fewer side effects. Besides all that, it seems like it can even be pleasurable ;-) Too bad the stuff on the streets is such crap.

npr.org/blogs/health/2012/06/14/canadian-health-official-says-pure-ecstasy-is-safe

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good to hear lahelp. i'm trying for the same. how was the initial intake interview w/the san diego doc?

thanks for any info.

good luck!

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john, use their contact form to have them remove or edit the post. I had similar issues with a post and they were quick to correct it.

As far as the Ketamine nasal spray goes. I'm probably going to quit it. It doesn't work for me. It just makes me dizzy & leaves me with a dull headache no matter the dose.

I'm still on the LDN though. This stuff is amazing. I'm down to 17%-18% body fat without even trying. Pain down. Libido up. Concentration up. I'm pretty sure the effects are due to increase in testosterone levels somehow related to the LDN. I'm sticking to this protocol for a while. If you pay a visit to Dr.S and live in the great state of California, don't leave without a script for Naltrexone even if you aren't sure you need it.

Now if only I can get my hands on some pharmaceutical grade E. I've taking steet-E in the past that I love the feeling. It puts me a in a feel-good place and definitely love to revisit it.

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My doctor diagnosed me with bipolar depression. My daughter is now 18 years old and since then I suffered with post traumatic disorder and since then I was using anti depressants.In the year 2009 I was admitted in the Bloemfontein hospital for 2 weeks for major depression. The psyciatrist treat me with Wellbutrin and Venlor. I can't afford it because the medical aid didn't cover it and was exhausted. I was seeing another psyciatrist again in 2010 and he subscribe Epitec 200mg and Venlor 125 mg in the morning and Epitec 100 mg and Serequel 100 mg at night. I don't want to go back to the same psyciatrist because he scream at me and has no patience. Th eside effects is that I have short term memory can't even remember the detail of the book I just read. Can't even identify the route I was driving. The problem is I can't drink any pain tablet because after 1 day I was I was taking it I'm feeling very depressed. Even I can't use the birth control tablets and any form of antibiotics in tablet form than I'm getting very depressed. Even when I'm using cough medicine. Can you please help because I want to know which medicine is prescribed for persons with bipolar disorder..

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thnx 888

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Hi LILA. From your post, it sounds like you suffer from postpartum depression. I'm no doctor and I know little on the subject of postpartum depression, but could your depression be caused by a hormonal imbalance? As I mentioned in an earlier post, I'm on LDN - Low Dose Naltrexone, 4.5mg every morning. From what I've read and from what I'm experiencing, it allows the body to normalize hormone levels. It's fast acting. It helps with depression and with pain. I would suggest you look into LDN. It's inexpensive, even more so when you are prescribed the 50mg tabs and dissolve them in water for low dose administration. It's a prescription drug but I've seen LDN sold online. It's relatively safe with little to no side effects. It would be pretty easy to convince your doctor to prescribe it to you.

BTW, this thread is about Ketamine treatment for depression. It's experimental and suppose to have a high success rate, but for me it just didn't work. I would not recommend it to anyone unless all other options have been exhausted.

But definitely read up on LDN, Low Dose Naltrexone. There is plenty of info on it on the internet.

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lahelp;

how are you doing? did the infusion have any positive effect on you? i hope so.

john

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hey john, thanks for asking - the answer is a resounding yes - 100% - depression GONE - as someone suffering from treatment resistant depression yourself, you can imagine the relief and amazement I'm feeling after a dozen years and dozens of failed medications - it's not that the treatment has made me artificially happy - it simply wiped away the ever present weight that, for no particular reason, was always there and has needlessly caused me so much suffering and sadness - I feel now (one week since the infusion) how I imagine "normal" people usually feel, and that difference is so incredible it's making me giddy - not sure if I'd be able to handle actual happiness now that I have the opportunity to enjoy my life, but I'm willing to risk it :)

Anyway, I was already planning to return to the board to write up the details of everything that's happened (I had the infusion in SD and have since met with Dr. Espinoza at UCLA regarding the possibility of future treatment, if required) and to answer any questions people might have.

Note that I am in no way saying this is the miracle cure-all for anyone with depression nor that I believe I've been cured forever (all those standard caveats are true and remain), just that at this point it's been a resounding success and I am so glad I was able to make it happen. As you know, there's very little reliable, accessible info out there for people who might benefit from this treatment, and message boards like these are pretty much the best resources available - they provided invaluable help in a time and work-intensive process, and I want to give back to make it easier for those seeking treatment to get it

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what great news lahelp. man i am happy for you.

i am scheduled for july 25 down in san diego...i am tempted, very tempted to call dr. espinoza to se if i can get in earlier at ucla. it's just that san diego is less than 50% of the cost.

i'm wondering if ucla will be lowering their cost?

also, did the san diego doc mention any maintenance schedule?

finally, and i'm not sure you or anyone else can answer this, but my depression came on as a result of several life stressors. i wonder if ketamine would have the same effect for 'situational' depression. regardless, i'm gonna do it.

again, really happy you responded. god i hope i get some that response too.

john

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lahelp, can you tell us what Dr. you went through to get the infusion in SD?

That's great news that it's working for you. Please keep us updated on your progress/regression.

As for me, I'm still on the Ketamine nasal spray. I was just about to give up on it. As a last ditch effort I went ahead with a no holds barred approach to dosage and kept increasing the max sprays each time I dosed. I'm up to 10 sprays at night, 5 in each nostril. I'm dizzy and light-headed for about 40 minutes but after my head is clear. I no longer experience the headaches that were present when I first started K. So far this feeling only lasts for about a day so I'm going to be trying out different dosing protocols in conjunction with the LDN to try to get the "normal" feeling to last. For now, I'm doing the K spray every couple days, and the 4.5mg LDN daily.

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"what great news lahelp. man i am happy for you. "

Thank you, and thank you for contributing to the threads that helped me get the treatment

"i am scheduled for july 25 down in san diego...i am tempted, very tempted to call dr. espinoza to se if i can get in earlier at ucla.

it's just that san diego is less than 50% of the cost."

Call Dr. Espinoza now - there is no downside. Before I found the SD option (I imagine you're seeing Dr. David Feifel - who is great - as

I did), I only knew about UCLA. There were some frustrating delays with my regular psychiatrist getting my referral for treatment to Dr.

Espinoza (which the doctor requires in order to see new patients). In fact, it ended up it taking me leaving a voicemail message

explaining my situation (including my doctor not getting around to calling in a timely manner and then UCLA for whatever reason

apparently not finding his messages long after he left them) which led to Dr. Espinoza's administrative assistant calling me back and

kickstarting the process. The earliest an initial consultation could be set up was for in a month's time, after which (if I satisfied

Dr. Espinoza's criteria as a patient for whom the treatment would be appropriate) - I would be prescribed a panel of lab tests

(bloodwork and EKG) I'd need to have done prior to the day of the actual infusion (I don't know the timeframe for how soon after the

initial consultation this would be scheduled).

Anyway, I of course agreed to whatever they could offer me but, like you, I really didn't want to wait another month+ if there were any

way to get help sooner. I kept researching, found out about SD and starting pursuing that, and by the time I had my consultation with

Dr. Espinoza had already had the infusion and been depression-free a full week.

"i'm wondering if ucla will be lowering their cost?"

It's possible they will at some point, but the program is still new (started last summer) and there currently isn't much wiggle room in

terms of cost - the lionshare of the expense is not the cost of the ketamine (which is nominal) nor even the doctor's fee, but the

administration of the treatment which - at UCLA - includes the administration, monitoring and facilities of an anesthesiologist. This

too was how things used to be at UCSD, but over the past two years Dr. Feifel has been developing the program which just relaunched (I

was the second person to receive an infusion). Now a nurse administers the IV, meaning it can be done pretty much anywhere (in this case, Moores Cancer Center in La Jolla).

Dr. Espinoza mentioned that he is working on trying to set up a clinical trial at UCLA - I have no idea if this is close to happening, but I have to imagine that if it does, it would be offered at no cost or at least a reduced one.

"finally, and i'm not sure you or anyone else can answer this, but my depression came on as a result of several life stressors. i wonder

if ketamine would have the same effect for 'situational' depression. regardless, i'm gonna do it."

Like you say, there's no way to know except by trying (just like with all treatments for depression, unfortunately). I will say that while there is clearly a very strong physiological component to my depression, it was a major life stressor (break up with first serious girlfriend) that led me to seek treatment for the first time back in 2000 and another one (break up with second serious girlfriend) that led me to go all in on getting treatment this time as a preemptive measure since the past 12 years have taught me that, while my depression is always there regardless of what's going on, traumatic events can make it get MUCH worse (pattern seems to be every four years or so I find myself close to a shut-in and barely functional for a span of months before I realize how low I've gotten and seek a major change in treatment).


"again, really happy you responded. god i hope i get some that response too."

Me too. Please let me know if I can answer any other questions or help in another way.

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"lahelp, can you tell us what Dr. you went through to get the infusion in SD?"

David Feifel (here's a link with his contact info: psychiatry.ucsd.edu/faculty/dfeifel.html) - he's a very caring and good man.

"That's great news that it's working for you. Please keep us updated on your progress/regression."

Will do.

"As for me, I'm still on the Ketamine nasal spray. I was just about to give up on it. As a last ditch effort I went ahead with a no

holds barred approach to dosage and kept increasing the max sprays each time I dosed. I'm up to 10 sprays at night, 5 in each nostril.

I'm dizzy and light-headed for about 40 minutes but after my head is clear. I no longer experience the headaches that were present when

I first started K. So far this feeling only lasts for about a day so I'm going to be trying out different dosing protocols in

conjunction with the LDN to try to get the "normal" feeling to last. For now, I'm doing the K spray every couple days, and the 4.5mg LDN

daily."

Are you doing this on your own or at the instruction of a doctor? I hope it's the latter and, if it's not, that you consider having it be. Before I was able to set up my infusion in SD, I started researching alternate means of administration including intranasal and found out it would be easy to have a compounding pharmacy fill a prescription for nasal spray from my psychiatrist (who was open to writing me one).

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David Feifel (doc in SD)

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lahelp, I'm working with Dr.Sabjen down in SD. I went to see her earlier this month, June 2012. So I've only been taking the Ketamine spray on/off for the past month. I was seeing no effect on the low doses but have had significant results from high doses. I'm considering having her call in a script to the compounding pharmacist to have a higher dose Ketamine spray made.

I tried to make an appt with Dr.Espinoza at UCLA but since I'm not currently being treated by a psychiatrist, I did not qualify under Espinoza's treatment criteria. I have a history of depression for the past 15 yrs stemming from a bad breakup with a girlfriend. I've been on and off meds (prozac, paxil, wellbutrin, effexor) but never really consistent on any of them and all prescribed by a primary doc, and not a psychiatrist. All meds would leave me not quite For the past 15 yrs I've just been dealing with my depression day to day.

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888 -

Try contacting Dr. Feifel at UCSD. While I can't say if he'd be open to treating your or setting up a consultation to determine if he would, I don't recall his having any explicit requirement that referrals for prospective patients come from psychiatrists (as opposed to primary care physicians).

If - based on what you've read here in researching the treatment - you think that your history with depression makes you a good candidate for an infusion, there is no harm in placing a call. The admin who handles Dr. Feifel's appointments is also very caring, so I'm sure if there's something she can do to help, she will.

I'd recommend discussing the infusion with your regular doctor to see if s/he thinks it would be good for you to try, organizing your medical and treatment history as best as possible and calling UCSD.

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Figured I should give and update, even though this one isn't good: my depression is returning. Just as everything just felt different when it had been wiped away, everything feels different now that it has returned (no as dramatic a change, but just as clear).

Doc in SD agrees the next step is series of infusions (typically three per week for two weeks). I'm going to contact UCLA to see if they will be a local option.

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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.

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

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

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

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.

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

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I'm sorry your depression is returning, but it is exciting that you were able to obtain relief for two weeks from one infusion (where other medications had failed). Gives hope that we are on the right track to better and longer acting treatments. Thank you for sharing.

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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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