Ketamine For Depression? (Page 31)
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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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@citygirl I suspect you would be better off finding a 3 week period and following the established protocols. If cost is a major factor, why not investigate the Dr. in NY offering treatment for $250?

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I spoke with Depression Center in Scottsdale (about 45 minutes from the airport) and I thought I'd post the information I have.

Infusions are $750 each, with generous rebates after a certain number of treatments. Evaluations are done on Monday's and Wednesday's. Infusions are done on Mon-Wed-Fri. There is no wait. I could have an appointment on Monday if I call tomorrow, for example.

Roundtrip airfare to Pheonix is roughly $200 from Chicago. I am serously thinking about scheduling. I just can't be away from home for very long so that limits me to two treatments per trip.

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@Brian.... give us an update, please!

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@Brian No one knows yet, the finalized protocols are not due out till later this month. As with any nasal delivery, the dosages will be more variable than with IV or IM. As a note, IV will typically be most consistent, then IM then IN simply because of the intervening factors.

Ketamine has a very good success rate for acute cases, once a condition gets to the refractory stage the results are more ambiguous, but ketamine has shown excellent short term results even in refractory cases.

One of the biggest questions is going to be how the DEA looks at things. In Georgia and Florida the DEA is cracking down hard on prescribing doctors. 64 have lost their licenses or been forced to retire in the last 18 months in my little area alone. My local pharmacy is currently under intense scrutiny because someone was passing illegitimate scripts and a tech was knowingly processing them.

What really determines the success of something like ketamine is 2 fold:
The first issue is what is the cause of the depression?
Is it primary or secondary?
Is it originally Psychological or is it Psychiatric
Is it the result of 1 Neurotransmitter being out of balance, 2, 3, 4, 5?
Is it due to stress induced Glia cell damage?
Is it due to immune response?
Is it due to inflammation?
etc etc.

Your doctor can help you determine the above answer, if they do not think some of the above even exist, and you have had depression for more than 2-3 years, find someone who is willing to look down other avenues. Different treatments work best for different causes.

The second issue is your own personal biology and genetics.
If you are Caucasian (as I have stated before I mention caucasians simply because though I am a mutt [African, Ashkenazi, Amerind and Caucasian] but primarily Caucasian I am aware of the stats that affect me personally) you have a 1 in 5 chance of having a difference in a group of enzymes known as CYP450 which will skew your metabolism of many medications that affect neurotransmitters. For example, if your liver cannot produce CYP450 2D6 then amitriptyline (a tricyclic antidepressant) for example will not work for you.

Regarding Ketamine specifically, it looks like if you have primary depression that is Psychiatric with a root cause of stress induced Glia cell damage then Ketamine is the way to go. If not, it may or may not be effective long term.

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Very similar experience with K, as far as wanting to do more, but no physical withdrawal.
Use K for rheumatoid arthitis.
I live in Tennessee and I am not as lucky to be able to drive to get K
My biggest problem is trying to find a new supplier. I get one, keep them for six months toone year then have to find a new one. The hard part is trying to wade through the liars, crooks and scammers. You have to send them all some money for a test order. I have lost hundreds and hundreds of dollars trying to find a new one.
Do you have a source that will send me either multiple dose vials or ampules?
I also do not do any kind of powder or crystal.
It has to be in sealed AMPS or multiple dose vials.
I am a 100% disabled Marine and would love to have a source that is permanent .
Let me know.
Thanks,
Regards,
Larney

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Has anyone been to Dr. Steven Best in Deerfield, IL?

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Here's hoping!

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A reply to Paula plus a note of information to ketamine users.
First, I should have been more informative on the IV/IM use of ketamine.
I did use ketamine IV for pain almost exclusively. I had stopped because the more IV ketamine I used the less effective it became. Unfortunately this information came after the fact, but I had talked with this doctor who wrote a book on ketamine.
Also, this site I am going to share is a site by doctors who spend ther time experimenting and researching and most importantly fighting with the DEA.
They are trying to stop the DEA from putting drugs into the Schedule I Catagory
For those who do not know, this stops people from being able to do research on drugs in the CI Catagory.
They are also interested in the off label use of drugs including ketamine.
(sorry my finger joints are screaming in ain, I wish I could elaborate.

This link is the link for the book which I have read. I also wrote and talked with the doctor who wrote it.
The site address, incase it is lost is........MAPS.org

Warm Regards To All
Larney
Old Hickory, Tennessee

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So the adventure begins - picked up my ketamine and just now took 40mg nasally. So the plan is wait 2 hours and more than twenty years of depression will go away, right, at least that's the theory. Definitely exciting times, I hope I hallucinate that my dog is Angelina Joli !

To be honest I'm rather skeptical that it could all be so simple after being so difficult for so long but hey may as well be optimistic. By the way a note on cost - it was only $49 for a months supply of drug to be taken nasally. So IF it works it's clearly where the bang for your buck is. Ok just one hour forty five till I'm cured.

Happy vibes to all my fellow depressives, see you in the K hole or back on this message board in a little bit once I feel the super powers coming on.

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@Brian- Could you please provide more information about 'what' you are picking up this afternoon?? Please give some backround and as many details as you are comfortable with about your new treatment. @Keller- I became interested in IN Ket after an anecdote on this site reported efficacy, the first I'd heard. I have been on this site much longer than you Mr. Baby Newbie, so I am the grownup, lol.

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Hi, just reading your posts for the first time today. I pick up my first in approx three hours from now so I am excited. Reading the forum I am a little concerned at the numbers saying ketamine didn't work for them - what percentage do you guys think get long term success with ketamine nasal

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@Keller- it's all good! As for the person saying he gets the Ketamine IM for pain, I tried IM Ket and it did not work like the IV Ket. Not trying to discourage, just saying this was my experience. I used the .5mg/kg dosage multiple times to no avail. Still looking for someone in Chicagoland area to try intra-nasal Ket, if anyone has some info!?!

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@ Paula ... I live in the western suburbs og Chicago. Have you found a source for nasal ketamine or local infusions?

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10/15/13

Hello:
I am a disabled Marine and a former paramedic.
I have rheumatoid arthitis and have used ketamine I.M. for pain instead of the morphine and sulfasalazine I get from the V.A.
I must take warfarin for the rest of my life and sulfasalazine and warfarin is not the best mix. But I get it prescribed anyway.
The biggest problem with the ketamine is obtaining it. Once you find a source, it's fine, but the amount of scammers trying to sell this drug online is amazing.
I hope I live to see the day when you can go into a drugstore and buy certain drugs that now are either in the schedule I or III category.
Of course some drugs are dangerous, but to put a drug in a category that we know little about and are not allowed to do research on is dispicable. Our DEA should be ashamed.
I am really amazes how well ketamine works for pain. I hope people with depression get to benefit by the drug

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@Piotr Bhatkandi I am sorry to hear it is not as effective as you would like. There are of course several mechanisms at play in Depression. Some are affected by SSRIs Some by SNRIs, some by LDN, some by Ketamine. Some treatments are broad spectrum hitting more than one (MAOIs and Tricyclics tend to do this) Just a lot of possibilities.

There are hints that inflammation is causally tied to depression (treated by Low Dose Naltrexone in some cases). Other hints that the Glia cells are a substantial factor (this an the aspect Ketamine/ Glyx-13 seem to treat) and of course there are imbalances in neurotransmitters (particularly Dopamine, Serotonin and Nor-Epinephrine) which teh SNRIs/ SSRI's MAOIs and Tricyclics seem to treat. Of course there is also simple (meaning not involving these other factors not that it is in itself simple) depression which is purely psychological and has not progressed (and may not progress) into the medical side of things.

if you have not yet tried ldn, low dose naltrexone, and you have tried the standard treatments i would encourage you to speak with your doctor about it since ketamine is not working as you would like.

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I am surprised at how ineffective Ketamine is for me, presuming I have depression. Tolerability is good. I've had a few infusions at a clinic, I can't say the details for privacy reasons.

Didn't affect subjective perception of apathy, fatigue or motivation. I'm not particularly suicidal so that's difficult to ascertain. It may have improved my objective cognition but that was not my treatment intent.

Even non-responders "respond" to Ket infusion, I'd say I'm squarely in that category.

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OK here is the word from Emory's Psychopharmacology dept.

Treatment in the program is for Acute situations.

After the initial round, patients are referred back to their originating doctors for therapy and maintenance.

The initial dosing is IV .5mg/kg (standard) but is administered as inpatient. So if you have reason to need be able to say "I have never been a psychiatric inpatient" this is not going to be viable. You do lose certain civil rights after being inpatient treated.

Cost of the initial overnight treatment is ~ 3.5-4k

The full course is a total of 6 treatments.

Subsequent treatments are outpatient. The infusion runs ~650 each + physicians fees of ~200

Insurance is accepted, however the patient must advocate treatment to the insurance company. It was told to me that this appears to b case by case as the same insurance company has rejected and accepted similar patients.

Insurance in some cases has covered as much as 60%. Again coverage and advocacy are case by case.

total cost of a 6 round treatment appears to be 3750+5*(635+200) = ~8k. If you have private insurance (not medicare and or medicaid), and have a history of failed inpatient treatment you might be able to get that down closer to 3k OOP.

At this time, nasal ketamine is not an option at this facility as it requires a compounding pharmacy for preparation.

To compare: it has been reported that a Dr in NY is doing treatment at $250 each (unconfirmed by me) Following the published 16 session protocol that is $4k OOP. As anyone who has read my replies here is aware, I am a stickler (@Paula probably has a more accurate but not as nice term in mind... Laugh girl I mean it in jest) for following published protocols.

I will contact Dr. G in ATL and see if he wants to contrast his typical regimine.

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@paula Once again you open your mouth before thinking.

I addressed your very issue "There are scattered reports of people requiring more than one treatment to show any relief, but it is anecdotal"

Yes it happens, yes it is very uncommon.

I am glad it worked for you, it may work for others. The data shows the likelihood is much lower and this is exactly what I reported.

You like to contradict everything I post with no good reason. You complained about IN ketamine when I brought it up, now you are looking for it. You complained about my requesting protocols and that centers follow protocols. You just complain about things because I say them, then if someone else brings them up, you are for them. Grow up.

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@Keller- you are incorrect about the failure of remission after one Ketamine infusion! It took me 3 in one week ( Mon., Wed., Fri.) before I achieved remission after the 3rd one. As the study continued, I was able to maintain the remission with one per week. I was very disappointed when I felt no different after the first one, but voila, the third time was the charm! I hope this clears up any confusion.

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@ John- hi, sorry to hear you are feeling so poorly. I have good news for you though! I was in a Ketamine infusion study last year and it took me 3 infusions in the first week to have the full affect. Then they were tapered down, long story short, after I had the full effect I was able to keep it by having one per week. It would wear out though after about that much time so I don't know if that's really doable for most people. I'm thinking maybe once one has the infusions if the affects could possibly be maintained by intra-nasal Ket. I am going to contact Dr. Fanelli, a doc in East Chicago Indiana, to see if he is using Ket, I know he had a great interest in this med. I will report back on what I hear. It will be awhile as I will be on vacation. Good luck!

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