Ketamine For Depression? (Page 22)
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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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MaydayMaydayMayday,

Like many of us You have multiple co-morbidities. It is of course important to take them into account when seeking treatment from your doctor. Anything more than 2.5 SD is classified as "Severe and established Osteoporosis" Our (muscadine's) general rule is that you should always be under the care of a doctor who is at the least aware of the medications you are taking and we strongly recommend that you have a prescription on file for anything not over the counter you are taking.

As for the Magnesium, avoid the Super Mag Instant as it contains Aspartate and Gluconate, two non essential amino acids that are frequently already present in excess in people with depression and can cause depression themselves. Carbonate and Citrate are fine, we prefer Taurate but it is a preference not a requirement. Magnesium Oxide is worthless unless you are making bricks.

Let me divert for a minute and explain something about Magnesium doses because there can easily be some confusion.

When we recommend 500mg of Magnesium we mean 500mg of Magnesium itself, not the compounded substance so take Magnesium Taurate for example just because I am most familiar with it. Magnesium Taurate (like any compound) can have a variable concentration of something (Magnesium in this case). Our most recent shipment is 8.45% Magnesium, but it can be anywhere from 7.4% to 9.2% so you have to figure out how much magnesium in in a gram of the compound. 1gm of 7.4% Magnesium Taurate is going to contain 74mg of Magnesium so if you are trying to take 500mg you need 500/74 Grams or 6.76 grams of Magnesium Taurate. If you happen to have 9.2% Magnesium then each gram contains 92 gm of Magnesium and you would take 500/92 Grams or 5.43 grams of Magnesium Taurate.

Short answer always take the % magnesium listed on the container, multiple it by 10 and divide that number into the dosage of magnesium you want to take. We do that as we package the stuff, but as long as you have a good scale you can do it yourself.

Also, we recommend that you take magnesium as a drink, powder (made into a drink) or in capsule form. This is simply because magnesium needs water with it for your body to absorb it and it needs enough water for the dose you took. 250mg of magnesium needs at least 8oz of water with it a bit more if it is a capsule. What you do not want is a mass of magnesium compound in concentrated form in your system as it will draw water out of your intestines and cause it to have laxative type properties.

If you are taking calcium and it is causing constipation, consider increasing the magnesium until it has laxative type properties. One of the Beta testers for our stuff is reporting that when she went to 1000MG a day of magnesium (the absolute top limit to what we would recommend) she was able to come off of her stool softeners that she was on because of the calcium she takes for her Osteoporosis.

Continuing with the magnesium side of things Magnesium is like many other things you may take where it interacts with calcium and iron. You want to make certain you take any magnesium at LEAST 1/2 hour before you take anything with Calcium or Iron and I suspect you already have been told to not take Calcium and Iron together as well, if not then let me suggest you do not, they should all be at least 1/2 hour apart from each other.

On to Naltrexone, it is as you know a controlled substance, ironically it has no abuse potential itself (it is mostly used to prevent abuse) but it is manufactured from opiates and so it is in that same classification. While it is possible to find it on the internet w/o a prescription, it is also possible to get ripped off or to get something else entirely and even if you do successfully order it you may get a "love letter" from the DEA and have it seized at the border. The best way to avoid all of that is to find a doctor who will work with you and prescribe the stuff, it is cheap and plentiful at any pharmacy. Should that fail to work, consider going to an addiction counseling service in your city/ county and asking for it. Explain why you want it and they may assist. Addiction counseling services routinely prescribe the stuff because it is used to treat alcohol and opiate addiction.

At the very least please make certain your pharmacist is aware of every medication you are taking, they can be your last line of defense for drug interactions, but again we would hope that you would have a good doctor with whom you can work with, if not consider finding a new doctor.

RKBrumbelow
The Muscadine Foundation

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Cai....I would really apprecate hearing more re/ the oral ketamine that is working so well for you. Hope you got the potency problem you experienced w/ a recent refill worked out. Is sub-lingual ketamine therapy a rare or common Rx from your Dr? I ask b/c you are the only person I have read about that is taking it.

Is it to treat mainly depression, pain or a combination of both? What type specialist should I be trying to locate to try this? You make an excellent point re/ the cost as well. Infusion is unaffordable on a monthly or twice a month basis even if able to obtain it! Wonder WHY oral ketamine is not used more often to at least provide partial relief of major depression?

mayday

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I know this thread is for ketamine and I will get to that later in the post, but there are at least three treatments (aside from ECT) you have not tried yet.

There are promising results for magnetic seizure therapy, as an alternative to electroconvulsive but without risk of memory loss or personality changes. I have not tried that personally, and you would need to join a trial which means a multiweek commitment to going in regularly for treatments. It also would most likely mean no cost to the treatments.

There is tDCS, which basically runs a minute current through two points on your scalp. If you are doing this at home it is essential to carefully calculate where to apply the pads. Basically it stimulates one area and de-stimulates another. So for depression with anxiety you are stimulating one area above the edge of your left eye and another closer to the center on the right side. I don't know which clinics do this. I found it had some good effects, but insufficient at safe levels. The research on it seems to show some efficacy but there are hardly any decent studies out there.

There is also rTMS in various modalities. I was in a study where they did both left and right side (basically a focused electro magnet system that produced a tiny microcurrent at a very focused point in the brain). It worked wonderfully on me and after the initial four weeks I went in once a week for a year and had an entire year without anxiety or depression. OHIP (Ontario Health Insurance Plan) covered it under compassionate care, then decided compassion only lasts nine months. After half a year of hell I got into another rTMS study which used a different pattern and focal point. They seemed to be having good results for the study population as a whole, and it brought the treatment time down from 45 min to 6 min, which is important if you are trying to get your government to cover it. But it did not work on me. We tried another focal point and again nothing. That is when the doctor tried me on ketamine.

There has been coverage of ketamine use in depression in the major newspapers in Canada and England recently, so you might want to print out the articles, search medline on the web and print out the abstracts, and take those to your physician. Give him medical studies on both the efficacy of the drug and the risks (what happens when people abuse the drug). The second should show him that the levels used in addicts are far higher and more frequent. Yes there are people who abuse the drug, but if it works for depression you will know. Ask him/her to simply let you try a single dose to see if it might work. Even if the dose needs to be adjusted you should know within 48 hours if it is going to have a beneficial effect. In my case the doctor could tell it was working within an hour, and before I left the office I felt better (able to look people in the eyes, felt calmer, hopeful). We needed to adjust the dose and frequency later, but the likelihood of it working your doctor will probably be able to see immediately. Tell him you are willing to take it in his/her waiting room (bring a sleep mask and earplugs or earphones with ambient music because you want to reduce stimulation during the first 1-2 hours when you go through the weirdness). This may be a drug of abuse but it is used as an anesthetic on children because it does not depress breathing. And if it does help your depression you put up with the initial hour of weirdness because once it passes you feel more normal (and people without depression sometimes fail to understand that feeling normal is marvelous). Unless you are prone to addiction these two simple facts should stop you from abusing the medicine. First, your brain needs time to rest between doses; if you took it every day it would not be effective. Second, if you crank up the dose your body would probably adapt, and then it would not be effective at a safe dose. So if you don't want to get depressed again, stick to the regimen your doctor advises.

Also if you come there armed with peer reviewed journal articles from respectable medical journals the physician will not only know his colleagues take this seriously, but that you know what you are asking of her/him.

Finally, and don't take this the wrong way, but be careful with megadosing in your diet and veering too far from the norms (whether vegetarian or not). Chemicals are chemicals. Just because they don't come in prescription bottles does not mean it is harmless. It does, however, mean there may not be sufficient information on appropriate dosage and interactions.

Best wishes. May you achieve 'normal' soon, and don't give up hope.

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RK, stillhopeful & Cai....Thanks for the info. There is an inflammatory component in my lifelong battle w/ depression. I suffer painful joints, knees, back, hands & feet. My right shoulder, arm & hand are a daily source of misery as is my back.

Fibromyalgia, Chronic Fatigue and MS have been mentioned for 35 years but only one or 2 ANA tests have ever been positive. Having trouble getting my newest MD to take me seriously because I look healthy, have low BP & appear to be 20 yrs younger than my age in his opinion.

I do Lose my balance often & have suffered many fractures from 2 serious falls over the years.

BTW...I have osteoporosis which is severe in my hips, 3.9 last Dexa scan & somewhere in the high two's for my spine. Don't know if that figures in.

No way my dr would Rx ketamine (nasal or oral) or LDN. So I looked online & ordered LDN two days ago myself by phone. Then receied an email saying it did not go through??? Due to holiday can't attempt re-order 'til Tues. If order goes through it will take several wks to arrive so won't know effect right away but will post here either way.

I take alot of Mag but can't find Mag Taur listed on containers. SUPER MAG INSTANT has Mag Gluconate, mag aspartarte, mag carbonate & mag citrate. \DOCTORS BEST brand is 100% Chelated mag glycinate/lysinate caplets.
Also have mag oxide....however if I understand correctly these are NOT the right kind???? Please advise as I am in brain fog.

All guidence will be very appreciated. I'm new to computers as well & online only to get depression info. The stress of finding & ordering Naltrexone online to try based on your kind advice left me excited when my order went through....then discouraged/exhausted/confused when they cancelled it!!!

Don't eat meat but do eat plain nonfat greek yogurt daily and foil packaged salmon several times per week for brain health. I drink Isopure Protein Powder daily as well. Lots of Brain Supps like Cognitex & vitamins for years but nothing helps.

No benefit from TCA's, SSRI's/SNRI's, MAO's over 40 years. I do suffer Terrible insomnia as well as the treatment refactory major depression.

Trying to save my life...Regards; mayday

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@stillhopefull

I have it because we are creating a drink based on it to fund Muscadine, so I literally buy it in 25kg lots.

As I said, I don't want to shill, but if you were to add {edited for privacy}

I already feel a bit to close to violating rule 4: (4) We do not allow our forums to be used for buying, selling, or for the promotion of a product or service.

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RK, just curious. where do you get your mag taur? I see 400mg mostly and then a whopping 2500 mg from vitacost...but many of the 400s include other types of mag as well

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@stillhopefull Right Aspartame is Equal and NutraSweet.

Splenda, Stevia, sacharine, sucralose etc do not become glutamate so under the glutamate model they pose no problems. Not to say that every sweetener doesn't have some drawback, but we are just talking about one model of depression.

Your body will always produce its own supply of glutamate, it is a non-essential amino acid after all, but IF you are one of the many with an over production/intake of it then any area you can cut back in will help. If you are not, well that just means you do not fit the glutamate model.

I do not want to shill products here, but let me also encourage you to try Magnesium Taurate. You can get a months supply for $40 or so and for those it helps, it works tremendously well.

Remember almost all the models simply function as stand-ins for deeper processes. To the best of my knowledge, it is entirely possible to fit more than one model so if you get some relief, don't be afraid to keep trying others till you are back to normal, or at least as good as you can be.

Maybe one day we will be able to instantly diagnose and correct depression and anxiety, we can all still be hopefull ;)

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Thanks RK. So aspartame is "Equal", so what about sweet n low or splenda? Are they ok from a depression standpoint? And I just looked up glutamate - oatmeal and peanut butter and soy are staples of my vegan diet. Yet in giving up meat and dairy, it sounds like I already tremendously decreased my glutamate (I was a cheese fiend). I wonder if that has something to do with the fact that I'm feeling better these days. I can easily quit the aspartame. Quitting the glutamate will be quite difficult. I need to come up with some alternatives to my top 3 foods - and I just added soy protein to my diet to make sure I'm taking in enough protein! I see my doc next week; I'll ask about the naltrexone. I wanted to talk to him about slowly trying to get off the lamictal, and if I'm still ok, then slowly getting off the emsam. I can't sleep without the klonopin,so that would be the last thing to try to stop. It would be a huge victory if I could. I've been on meds for at least 20 years

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The working better on women might be because most traditional antidepressants are tested mainly on men (or to use the legally approved non-sexist term, non-pregnable persons). Also women tend to get depression concurrently with anxiety and the ketamine, from my experience, helps with both.

I wanted to let you all know, since I appear to be the only person on sublingual ketamine in liquid form, that it works (although a smaller proportion is bioavailable) is far less expensive (150mg every second day is between $60and $100 dollars for a two month supply so approximately 1 year supply is the same price as 1-2 infusion treatments), and can be taken at home after the first few times. From what I've read here the duration of effectiveness is shorter, but most of my doctor's patients are taking it twice week. The catch is that, if possible you want the doctor/pharmacy to use the solution that the hospitals get, rather than have it compounded. I refilled my prescription a week and a half ago and it was seriously undereffective. Went slowly downhill for 5 days then on day six went from relatively normal mood to full depression in 2 hours. Argh that sucks. It makes you really notice the relation between depression and pain sensitivity, lack of taste in foods, changes in social behaviour, apathy, dulled thinking, sleep patterns, and all the other delightful aspects. I've had good results for over 6 months. Apparently the temperature used when making the suspension is important, and suspensions often do not completely dissolve the powder so the actual dose you take in can vary substantially. My new bottle appears to have been misprepared and underpowered. I will probably be switching to the solution the hospitals use (presumably at a lower dose). It will be more predictable, and comes at 50mg per ml, which is what the compounding pharmacy was making anyhow.

Anyway, best wishes to you all. For those of you considering trying this treatment know that the immediate wierdness wears off quickly (an hour or two), and that you may (or may not) have the depression come back suddenly if your dosage schedule is too far apart. Bear with it and let your physician figure out what works well for you.

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@stillhopefull Magnesium oxide is just magnesium rust and our stomach acid just doesn't have the oomph to make it bioavailable. In other words what you take in orally well it goes out he other side with no good to you.

Nancy Saibjen is a doctor in San Diego who has an interesting article on it:
painsandiego.com/2012/06/10/depression-ketamine-glia-and-inflammation

It fits with the inflammation model of Depression, so since the SSRI/SNRI (standard antidepressant drugs) model did not work for you and the NMDA (ketamine) model did not work for you, we know that you are refractory so the emotional model does not fit. Presumably you have had your hormones checked, so we can scratch that off. That starts to leave just the Glutamate model, Enzymatic (CYP450) Nutritional and Inflammation models.

Naltrexone works on a few of these, but I would defiantly cut out aspartame and glutamates from your diet. Aspartame is converted to Aspartic Acid which is then converted to glutamic acid then Glutamate and people with depression can have a surplus of glutamate. So, I would cut out Aspartame and glutamate completely and give it a few weeks to see how you are doing and in the mean time see if your PDoc or Psychiatrist will prescribe Low Dose Naltrexone. They will need to decide if you need 3mg or 4.5 mg daily. Of course if neither of them work then we can talk about the other models.

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Hi Rk, Thanks for the message. No, I haven't tried naltrexone. Perhaps I should mention it to my doc. I do drink diet iced tea with aspartame. Don't know much about glutamic acid. And I take magnesium, but it's magnesium oxide (500 mg)

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@stillhopefull Have you tried an anti-inflammatory regimen like low-dose naltrexone? I know it was mentioned to you back in January.
Have you tried eliminating aspartame and glutamic acid from your diet?
And have you tried Magnesium Taurate (500mg daily)?

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Dear mayday,
I too have tried many meds, including ketamine, over the years. Although apparently it has been a wonder drug for many, it did nothing for me. However, I have not suffered any debilitating depressions in the last several months. (And I got divorced in December, having thought that my marriage would last forever, so I have plenty to still be depressed about). Anyway, 2 things have changed during that time. One is that I have used the Fisher-Wallace stimulator 2x/day without fail every day. Two is that I've completely eliminated meat and dairy from my diet (I did this for animal welfare reasons after seeing a video on factory farming, but regardless, there are tons of antibiotics, hormones, GMOs, and even feces in many of today's factory-farmed meat and dairy products. So, which of these 2 changes has had an effect on my depression? I don't know. And perhaps tomorrow a new wave of depression could hit....but for now, and for the past several months, that hasn't happened. Yes, I am still on my meds (Emsam, Klonopin, Lamictal, Deplin), but in the past, these things weren't enough to prevent falling into a deep, dark hole of despair. I'll let you decide if either or both of these options might be worth a try. The stimulator was $600 (but I used my HSA to pay for it) and has a money back guarantee. I ordered it figuring what the heck; I've tried everything else. Anyway, I wish the best for you. FYI, the doctor who gave me Ketamine said it tends to work better on women than men

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@maydaymayday Ketamine has an excellent track record for refractory cases. Because of the NMDA mechanism it affects, added to a refractory case (what you refer to as TRMMD, refractory is the better term) the likelihood of Ketamine working increases. Not because of age or duration of symptoms though, but due to the refractory nature.

You see there are currently seen 8 different causes of depression. If SSRI / SNRIs are not working that eliminates one cause(neurotransmitter deficit). Likely you have had hormone tests, eliminating another (endocrine related). Duration eliminates still another (emotional), so we are down to 5 remaining and Ketamine affects 3-4 of those 5, potentially reversing 1-2 of them and positively affecting the other 2.

In fact the only other one [cause] (and it is early morning on the East coast so I might be forgetting something) that it does not affect is inflammation, so if you get no relief at all from ketamine that would be the next avenue to try with something like low dose naltrexone.

Oh yeah depending on your genetics a failure of SSRI / SNRI treatment could be due metabolic issues masking the drug and never allowing them to work, but that is less likely if you have tried and failed several meds. Keller would be mad if I did not mention the CYP450 issue which causes the metabolic defect.

- RKBrumbelow
Muscadine Foundation for Medical Assistance

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Hello;
I am a fellow TRMMD sufferer of many decades (no alcohol/drug issues) who has tried most all anti-depressant meds; some for yr's at a time, other ones over&over again just to please each new Dr who wonder if you gave the meds a fair trial. Plus Numerous costly therapies, all to no avail. My depression has never lifted.

After enduring a lifetime of this torture which was made even more painful by incompetent medical care and the S/E's from useless, expensive prescriptions I stopped all AD meds & Dr's a couple of years ago and that has been a hugh relief.

At the end of that last pointless, frustrating, humilitating Dr's appt two yrs ago I simply couldn't reach out to take the 'next month's appt' card from my Dr's outstretched hand. Irritated, she looked up from her laptop and made eye contact w/ me for the first time in years. Softly, using her first name I said "no ___".

Walking out I felt freedom from the false hope and pride in myself for stopping the mockery.

I always was a respectful, obedient, compliant (and often tearful) patient over the years...I'm severely depressed after all...however this last MD expressed little compassion and even less knowledge about depression. She suggested I light a scented candle when I confessed to feeling suicidal. Like so many other's who are not afflicted she just didn't get it.

Started in my youth on this painful journey and am now an old person. My final elderly parent recently passed away freeing me to end my own suffering so while researching humane methods I realize there is one stone left unturned, Ketamine.

Been told by an expert far from my home that the older you are & the longer you have experienced depression the less likely you are to respond to Ketamine.
Any older people w/ experience care to share their outcome?

Thank You and wish you all vitality! maydaymayday

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go with Brooks stay away from fruitman he's a crook Brooks has got a lot more knowledge of depressiongalso he has something call Nuedexta it's a medication used for something else but he uses it as a ketamine extender I've had treatments with him in the past some of work some has workedsam hasn't

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@RKBrumbelow

Thanks, I will forward info to the site on Dr. Fruitman. So far, only Dr. Brooks is listed for the NYC area.

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@Amber Try checking the map from "Ketamine Advocacy Network".

It lists where doctors are and what treatments they perform. Obviously if anyone knows of more doctors, add them please

R.K. Brumbelow
The Muscadine Foundation for Medical Assistance

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I'm looking for a neuro/pdoc who has prescribed Intranasal Ketamine for depression in New York City. Dr. Brooks & Dr. Fruitman offer infusions mostly and are costly, since I plan to have continuous IN treatment.

Any recommendations for doctors I could try in my area.

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Ketamine treats depression. My stepfather has suffered from PTSD and Bipolar disorder most of his life and Ketamine is the only medication that has brought significant relief to him. When he started the IV treatments, he began weening off some of his prescribed drugs and now he is doing better than ever. He is noticeably happier, more energetic, and has lost weight after stopping his other medications. Ketamine has not only saved his life but it has helped the family be whole again.

I found this page to be helpful and interesting: depressionrecoverycenters.com/why-are-you-still-depressed-4

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