Ketamine For Depression? (Page 29)
(Newest replies 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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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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@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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@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 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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Hi, a quick update on my status. I had been put on nasal ketamine 40 mg every three days. Saw my doc yesterday and reported little or no positive benefits. He changed the regimen to a daily dose. I took a dose last night and about two hours later did feel better. I was able to go out to the the Casino and socialize for the first time in three months. So maybe it is working, I certainly want to catch a break 2013 has been a lost year for me, think I spent most of it in bed!

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@Bill you have my sympathies, I have experienced somewhat similar symptoms. I was particularly struck by you families unhelpful attitude but remember you can get a little moral support on the forums. I have found it helpful to push myself to maintain at least a couple of outside relationships - loneliness and isolation are for many of us a very heavy burden.
I just want you are not alone and wish you better times for the future.

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@Bill- the advice I was reading from your link (did not go to the link) sounds like it is from a charlatan and total jacka**. People who have never been depressed DO NOT UNDERSTAND! I have had many problems with family especially because they think if I just do this or that, I could be better. They blame ME for being sick. I have lost my career, my home, my marriage, my children and my family does not give me any emotional support. I literally have HATRED for these a**holes who say that some magical thing they want to sell you is the 'cure'. This is a medical problem, like Cancer, like Diabetes! It is not your fault!! We need medicine and compassion, just like any other illness. I wish you the best, I know how you feel. I wouldn't wish Depression on my worst enemy because the stigma and misunderstanding has not gone away.

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@Keller - Thanks for letting me and everyone else know about links.

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@bill you are welcome.

Please do us a favour though and don't post links to site like what you got in your inbox. The text is fine, but at the best having a link in a depression related forum will result in stupid sites getting ranked higher.

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Thanks @Keller for taking the time to answer my question.

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Hi @Everyone I just got this link in my inbox.

tomahaiku.com/youre-not-depressed-youre-selfish

"You're not depressed. You're selfish.
“Why do you stay in prison when the door is wide open?”
Depression is not real. It is something that exists in people's minds. It can not be seen or touched or identified by sight or spirit in the real word. It's all in people's heads. Psychiatrists, in stereotypical attempts to make what they do look relevant, identify endless causes for depression, and for each cause there is an unnecessarily complex solution. My contention is that there is but one true cause, and it has to do with your centre"

It seems the writer did not suffer any depression like the rest of us on this forum.

I would like to know what you think about this article ?

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@Bill, I wish I could accurately diagnose anyone from a short text blurb. I would be able to help a lot of people and probably make a lot of money in the process. However, no doctor could do such, and I am neither a doctor nor licensed to treat patients in your state.

I bet we have all been through the friends and family saying its all just in your head, you can choose to be better etc. For some people that is true, for many others it is not.

Bi-polar aka Manic Depression frequently exhibits at least 2 phases. The depressed phase and the manic phase. People with bi-polar disorder do not all show both sides nor do they necessarily show either side to the same degree. So one person may show mostly manic tendencies, another person severe depression and hypo-mania still another depression and full blown mania.

Manic symptoms trend to excessive energy, poor judgement and lack of concentration, so someone with ADD and depression could be miscategorized as bi-polar thats why a doctor and a number of tests along with a complete history are very beneficial if not necessary.

If you live in the US, most counties have a county mental health service. The price is frequently based on income so that should help some. Something else to consider is that with your age and the fact that you are male you could easily have a hormone problem. You could have low testosterone or low thyroid, or both. Either one could mimic the symptoms you list. Your pdoc can test for either or both. Has your hair changed of late if you are balding, testosterone is likely not a problem, if you are thin, thyroxine may not be an issue. Have you noticed any changes to your skin such as dryness or flaking? So many avenues.

I would check those two first, they are both common problems in aging men and are cheap to test and fix.

If both come back in range, then I would look at psychiatric meds. Have you ever had to take pain killers like opiods? If so did they relieve pain like the doctor said they would or did you have to take more/ they had no effect. If they did not act like the doctor said they would you may have “Genetic Opioid Metabolic Defect” (GOMD) which also affects psychiatric meds.

OK I suspect I am already on the path of giving you too much information. Tell a pdoc what you said about energy, depression, any changes in your libido, skin, hair etc and see if they will run a thyroid profile and testosterone panel. That is where I would start for a 50+ year old man. Rule out the easy cheap stuff first.

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@Paula, @citygirl if you have any input I do appreciate any help.

@John, @lahelp, @David we have not heard from you for long time,I hope you guys doing well, would you guys please share with us where you with your medication, IV, of Nasal treatment.

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@Keller,
I'm not sure If I have Depression , or Bipolar,so may be you could help with that too
My main problem now I do not have any energy to perform any task of job.

Thanks

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@Keller, Thanks for taking long time to respond to my question, I do agree with you Depression seems very complicated issue, and that way I'm struggling so much and frustrated may be like a lot on this forum.
All my friends and family members, said it is in my heads, I can get out of this bad situation if I want to, even sometime I think same way, what is wrong with me why I can not be like everyone around me!!!
I'm about 55 Years I was working and having family all my life till seven years ago, I been in depression in and out for 5 times and each depression last for 8-10 month. Now I'm financially strapped, no friends left, lost most if not all my works, and no insurance not even disability, and it is very hard for me to grasp all medications options. I did have very bad experience with a lot of pdoct, now i'm on Lexapro 20mg every day for almost month prescribed by Int Doc (in the past zolft,effxor).
I'm not sure when I got better was it my situation or the med which gave some relief for few month.
I have still children to take care of , but i'm very tired and confused about my situation ( it very hard to get out of bed), tired all day, and I keep postponing and task even a small one till later.
Thanks again @Keller, I do appreciate you help and knowledge and experience , i hope you could shed some lights

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@Paula I bet this is what you found (or something similar to it) ncbi.nlm.nih.gov/pubmed/15724143

Talking about 340mcg of l-thyroxine (yeah that's pretty darned high) on a small set of women. Though it looks as though it is specifically being investigated for the depression resulting from Bi-polar disorder, still pretty interesting. Fortunately the side effects for woman of high dose thyroid hormone are not as detrimental as they are to men. I will have to add it to my reading list of treatments. Thanks again.

This post may or may not appear before my original reply.. we shall see.

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@Paula, @CityGirl etc I have some replies currently awaiting moderation for you both. Seems every time I get wordy it has to be "reviewed" I am not ignoring anyone.

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@Paula
Thanks for the info, It is commonly known that one cause of depression is hypothyroidism I would suspect that treatment with levothyroxine (t4) (or armour which is t4 and t3) is targeting those individuals. I will certainly see if I can find any info on it though if it is something else. I know when you overdose someone with hypothyroidism by giving them too much t4 they get hyperthyroidism instead which leads to a whole other slew of issues.

@CityGirl
You are correct I skipped Nardil (Phenelzine) as I was being fairly simplistic and its inclusion would have caused me to have to split MAOIs into Transdermal and Gastrointestinal absorbed MAOIs and to be completely honest if someone gets to that point I expect their doctor will cover the problems with GI MAOIs before suggesting them.

As to where the order comes from (SSRI/SNRI/NRIs before MAOIs before Tricyclics before Ketamine and so on) it is both common practice and the result of a number of surveys done with regards to diagnosis and resultant treatments. As I stated, it is normally a side effect to benefit analysis and the order of side effects before the experimental treatments is SSRI have the fewest and non-transdermal MAOIs have the highest number of side effects. You will also notice that the order of treatment also is the reverse order of development generally. MAOIs are the oldest antidepressant, the tri-cyclics were next, then the SSRIs/SNRIs. The reason for the abandonment at each generation was at least in part due to better side effects at each stage.

I would be interested to know of any insurance that pays for TMS as a standard course as my contacts at Emory and UTSW (both facilities that utilize rTMS and TMS) have stated in the recent past that they know of no insurance that will cover it. There are always exceptions to coverage, one could convince a company to pay for a non FDA approved treatment (as Emory has reported for its Ketamine treatments) but it is certainly case by case if at all.

You may encounter a doctor who is 70+ years old and practiced when TriCyclics were brand new so uses MAOIs as a first line, you may find a doctor who is just in love with tricyclics and uses them as a front line etc etc. But GENERALLY it will go with the electives then emsam then tri's then nardil. Tricyclics have a very wide range of drug interactions and GI MAOI's require substantial diet changes else you risk a hypertensive crisis.

There is a LOT of information any doctor uses before prescribing a medication including responses to previous medication, family history age, gender, etc. All of those things can cause shifts in the order of treatment. "Drug G" may be perceived (or actually) work better for "Symptom Set B". so if a Doctor sees Symptom Set B he may start with Drug G as opposed to Drug A.

A classic example is someone who is a smoker. Probably the goto drug of choice for a smoker with depression is going to be Bupropion because it is also commonly used to work with smoking cessation. Cymbalta is commonly added to that mix as well as a co medication. On the other hand if someone shows signs of OCD they will probably go with a mainline SSRI like Luxox, Prozac or Zoloft then if those do not work jump straight to Anafranil (clomipramine).

So I was simply speaking in terms of refractory depression with no co-morbidities. Heck using my own situation I started on Lithium (they though I was bipolar due to a family history of bi-polar) then on to some anti seizure meds like Valproic acid and such. Of course drugs like Prozac did not exist in the market back then and Tri's would have killed me with the 2nd dose (I am missing a liver enzyme that breaks them down). It was not till the '90s that docs started giving me SSRI's the 00's for SNRIs trying to find something that worked. But I am pretty much the poster child for worst genetics ever with regards to psychiatric medications.

Did I cover your concern, or did I miss it completely?

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There are a number of off label meds used other than T4.

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@Keller- There is another tx I have heard of using high-dosage Levothyroxine (used for hypothyroidism). No I do not have a protocol. I have seen one online but not computer savvy enough to post a link. If you google it you will find it. This tx is not new, but not widely known and one would have to find a cooperative Pdoc.

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