Ketamine For Depression? (Page 35)

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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Chadv,

I don't think you will find anyone doing the infusions in Ontario. Are you willing to tell me a bit about your situation? I assume your depression is off and on, and this has been going on for a long time? Do you have manic episodes at all? My understanding is that ketamine tends to work best in people whose depression comes and goes, even if it does not have a really predictable cycle. Apparently people who have tried ECT and responded well to it (as in depression went away, even if the side effects were a problem), also tend to respond to ketamine therapy.

You have tried medications from different categories, and combinations? I ask because your doctor will probably only try this if the other options have already been tried and failed. Also, if they haven't all been tried, there may be an atypical antidepressant, or adjunctive medication that would help you, and have a longer track record and be more likely covered by insurance. Do you have a regular psychiatrist or does your family doctor manage your depression? I know lots of people in Ontario don't have a family-practice doctor, and getting in to see a psychiatrist is nearly impossible. But if you have a doctor who is already aware of your situation you probably want to work through him/her. I'll try to look back at the board in the next few days. Hold in there, it may take a while to find something that works, but its well worth hanging on.

Best Wishes,
Cai

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Hi guys,

Nice to see some activity on this blog after a long time. I was away on a religious trip so didnt check my online messages.

Best wishes

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So how are you all doing? Are you still taking ketamine, and if so is it working? I just finished the intensive part (every weekday for four weeks) of rTMS, which works beautifully. I had thought the understanding was that afterwards I would be on once a week maintenance, but found out I only have ten weeks (which would bring my likely crash right at Xmas). So I am trying skipping every third week, which so far did not work well.

So ketamine therapy is my backup plan. Because it has such a quick effect I can wait until things get bad, and only take it then. For those of you concerned about addiction, let me say that I have not felt any desire to keep taking it when the rTMS was working. I'm not prone to addiction, but the only time I took it was early in the process when their machine broke for a week (less than a week into treatments), and once to see if the residual symptoms (poor concentration, fatigue and similar) were depression (in which case the ketamine should have fixed it) or endocrine (hyperparathyroid suspected). Apparently it isn't just depression, which is probably a good thing because if it is hyperparathyroidism it is quite fixable (probably a one year wait to get to the actual surgery).

So my current plan it to take ketamine once or twice if the two week gap in the rTMS treatments become really bad, and I guess I will need to turn back to it in January, when the only treatment I've tried in 26 years, that caused full remission for a full year, is not longer available to me. I had hoped to get a normal life, be able to plan for things more than three months in advance, find a permanent and full-time job, but no such luck. Ketamine works adequately, and although it tends to be a bit of a roller coaster at certain points in my cycle (if I space doses 3 days apart), and taking it during the day reduces my productive time. At least I am able to keep going and generally enjoy the process.

Which brings me to a question for everyone. I find that I cannot do a ketamine treatment after 2pm or I will not sleep that night. It seems to stop my circadian rhythm for a day, so I can't take it at bedtime when it would not interfere with getting work done during the day. Has anyone found something similar? Have you found anything that helps reduce side effects in general?

Hope you are all hanging in there. Best Wishes,

Cai

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Dear Cai,

Thank you for your reply. I have unfortunetely just returned from the ER for the 4th time this week. Last night was because of a severe bladder infection with blood in the urine and fibrosis. I believe the ketamine is destroying my bladder and have stopped taking it. None of my doctors will get back to me and if they do they say they are scared to prescribe me more than just the 3 Oxcontin a day. I was original on 4 OxyContin and 7 Oxycodone with Fentynal lollipops as needed. That doctor moved to Texas. He was about to put me on a diluted pump before he left me. I have been reading up on Lidocaine infusions and I think that is the route I am going to try next. Btw I will be 53 October 16th. Last Sunday I got real bad bad pain and went into a seizure. My parents finally called 911 and on the way to the hospital we had a minor accident but they didn't strap me in and I got a concussion and hurt my back.,when I got to the hospital I was treated like a mental patient and left in the hallway with people laughing at me for 5 hours.,the accident wasn't reported and I was in so much pain I forgot to mention it. I need a good lawyer for Rockland county New York and a decent doctor who is not afraid to treat a woman with Complex Regional Pain Syndrome, MS, Fibromyalgia, and CPTSD. The good news I have is that I was prayed over and healed from the suicidal depression. I still have the depression but have no desire to take my life. My daughter and her boyfriend have still not left my house and the lawyer helping me has left me hanging. I have been living with my parents since June but my dad has cancer and they have asked me to leave because it is too much for them to have both of us sick. So on top of everything else I am pretty much homeless. My faith in the Lord is saving my mind right now but I have never been so scared in my life. I keep you and the rest of our group in my prayers always and when I feel like not a single person cares if I live or die I think of all the kindness that has been shown to me by you all and I thank God for each one of you. Thanks again and God Bless, Mary

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So good to see your message. I was worried about you all. I hope the religious retreat was helpful. I wouldn't mind making one myself. I had done a retreat when I was 15 and it changed my life quite a bit. I know that I am loved always and never alone. I try to live my life as if each day were my last and try and act accordingly. Basically what i mean is I try and be the best person I can possibly be so I can go to Heaven when this life has past. I'm sorry to anybody that is not a believer but its what saves me and if anybody can get that sale peace I wish to share that feeling with anybody that's interested. Really glad your safe and in good hands, Mary

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I just got to NYC last week and am going to undergo Ketamine infusion with Dr. Brooks starting tomorrow. I really want this to work so all fingers crossed.

I'm so sorry to hear about your troubles. I hope you are doing better than before. I totally hate it when the health issues screw up one's life in totally unimaginable ways. But please hang in there. You'll make it through!

Best wishes

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Mary,

My heart goes out to you. I hope you can see how strong you are, to keep going when faced with that adversity. It is a big deal, not being suicidal. I hope the lidocaine treatment works. Have you looked into scopolamine treatment, or rTMS, or magnetic seizure therapy? The last one seems, from the early evidence, to give the benefits of ECT without the problems of memory loss or personality changes. I'm glad you ended up in ER, because you don't want to have UTI pain, even if the staff were jerks. I hope stopping the ketamine fixes the bladder problems.

We keep hearing about the benefits of electronic records here, so the ER knows your full history. I worry that people on psychiatric meds will get taken even less seriously, as I've found that some doctors seem to switch their brains off as soon as they see you are on an antidepressant. I think it gives them an easy 'out', as they can write off pretty much anything as complaints based in depression. Have you found a new place to live? I hope you will post again, to let us know if the new treatment works for you. At least, if the ketamine worked before you developed side effect problems, it suggests similar compounds might also provide some relief from depression.

Stay strong,and hang in there. I'll be thinking of you.

Cai

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Hey guys,

I found out about a new proprietary ketamine infusion procedure. Please research for ketamine institute online and you will find the procedure called "RESTORE Ketamine Infusion Therapy". It looks promising but I haven't seen any reviews or comments about it online except for the website. Has anybody heard of this before? If so, is the procedure actually what it claims to be?

Personally, I'm hesitant at this time to try it due to the aforementioned reasons.

Thought I'd share this info with you all.

Please feel free to chime in.

Regards

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Dear Cai:

Thank you for your response. Dr. Brooks is insisting the ketamine did not cause my bladder infection and wants me to continue with the ketamine trouches. I have my insurance giving me,permission to see a Dr. Datta in Hackensack, N.J.. Praying it comes through this week. I have never tried the TMS therapy. I have heard about it but my insurance didn't cover that either so I just forgot about it. I will bring it up to the new Dr when I finally see him. Thank you for saying I am strong. I have to admit I realized that the other night. I know the strength only comes from my faith in God and the comfort He brings me, and I also have to say I get a lot of comfort and strength from our group here, especially you my friend. My temporal lobe damage has been getting worse from the CRPS/RSD but no one believes me. Unfortunelty I've forgotten your whole message and can't remember everything you said. Maybe the fact I just turned 53 doesn't help either. I do remeber you said the TMS therapy is working for you. I pray it continues to do so. Thank you for you continued support. Love, Mary

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Thank you Iron, I wish you the best of luck. You will definitely love Dr. Brooks. I'm excited to hear how you do.

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Just a short post to say thank you for your help.
I'm doing extremely horrible at the moment and everything is just hopeless.
Anyway, I know that is off the subject and I'm too miserable to think about anything else but, I really wanted to say thank you for taking the time to help. Its truly appreciated.
With the RTMS I don't understand. What do they do with that insturment, stick it in your brain? What does it do? Is it like ECT? Is it painful?

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Nihilissa,

Sorry to hear things are going badly. I know you had tried a wide variety of antidepressants, mood stabilizers, and adjunctive therapies. If you look farther down the list you can find some info about rTMS. Depending on the way it is done is can sting a bit, but I think those approaches they gradually increase the stimulation. Nothing is put in you, the coil rests on your forehead.

From your post I wasn't sure if you have tried ketamine therapy and it failed, or have not tried it because you don't have access, or are looking for more information. I will try to watch for posts this evening (we are having an election in Canada today), in case you post. Hold in there. I know it seems to take forever when you feel horrible and worry that it will never lessen. But hang in there, there are new treatments being developed, so not only is there hope that some combination of existing treatments might work, there will be new possibilities in the future. I wish I had a simple answer. I don't know if it helps, but when I'm depressed I try to figure out what non-depressed-Cai (that's my name) would do. I imagine it is tougher when you are battling pain even when not depressed, but what would your non-depressed self tell you?

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Ironsheikh,

That 'Restore Ketamine Infusion' and the Ketamine Research Institute site looks off to me. It looks as if it is run by an anesthesiologist (Dr. Glass), who probably has lots of experience in using ketamine, because it is used in surgery (I think mainly for children). But I don't see signs of experience with ketamine in treating depression. I can't tell if the place has just opened or has a track record. The way they describe their 'advance' is similar to stuff I've seen when reading about the history of bogus medical inventions (vague, overly broad, claim total conceptual advance, no outside verification), and I do not see signs of anything that would change how the infusions have a longer effect. I'm cynical about sites that throw around terms like 'synergistically' with little specific data, and a promise that their 5 year research program is just about to make its way into the medical journals. To me that says any research done, and there is no proof of what might be done, has not been published. Dr. Grass's journal articles seem to relate to the pain side, but not depression. Personally, if I didn't have access to somebody who is already known in the field, I would try working with my GP or psychiatrist. If you want to look into him, I'd suggest checking board certifications, then medscape for articles. He may be simply doing infusions like other places and the 'multimodal' may mean he follows up later as needed with a puffer or something similar.

Let me know if you find out more.

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I have never tried ketamine. I wouldn't even know what kind of doctor to go to to get it and, if I just walk into any psychiatrist office and ask for ketamine they are just going to treat me like I'm "drug seeking" . the same way they do when I ask for Xanax or Ativan which I have been taking on and off for many many years and, have never ever become dependant on them. I can and do stop taking them quite often and, I have never asked for early refills or any of the things drug seekers do. In fact, most of the time I don't even get my refills on the day that I'm able to because I always still have some from the previous refill. That is not addict behaviour. But, they always act like I'm drug seeking if I ask for a particular med instead of just leaving it 100% up to them and just saying yes doctor and not have any input about my own care and what goes into my own body. I think doctors think THEY are the authority over what drugs I take and they forget that WE hire THEM to help us and ultimately WE are the authority over our bodies, not them. But, I think they get egotistical about it. I have enough problems just getting them to give me pain meds when I live in so much physical pain every day that I can't hardly even stand up sometimes. But my every moment I'm in pain. It finally got to the point that I just had to go down to the methadone clinic like a common junkie. I just got SOOOO TIRED of pleading with the doctors every month. After my last doctor got arrested, I couldn't even FIND another pain doctor that would even accept me as a patient much less prescribe me anything cuz as soon as I tell them what I have been taking for the past several years they practically laugh in my face and treat me like a common drug addict instead of like a person that's having their entire life destroyed by constant unbearable pain. So I have to go to the methadone clinic every week with all the other drug addicts. Its either that or just be in pain because I'm tired of going to doctor after doctor and getting told no. Since I HAVE TO go to one of the doctors on the list my Medicaid program provides and, there's only 5 pain doctors even ON the list. What am I supposed to do when the only doctor on the list that will even accept me still won't prescribe pain meds? If I go in asking for ketamine I'm afraid they will laugh me right out of their office. And if one doctor says no so, I try another and that one says no so I try another and so on , then they say you're "doctor shopping" and that also makes you an addict. Which is stupid. Doctors are something we SHOULD shop for!!! We shop for things like cell phones and cars but, when it comes to the person we trust with our bodies and our LIVES we aren't supposed to shop? That's the most important thing we SHOULD be shopping for. I just don't have the strength or energy anymore to get on that endless merry go round again. I really just feel like giving up to be honest. Anyway, I know that's off subject and this isn't the place to go on about that so, I won't elaborate any further on that subject. I REALLY want to try something I haven't tried yet because I already tried everything else and, not just once either. I have tried it all several times over. Since I was 17 and I'm 40! That's a really long time especially when your whole life sux.

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Nihilissa,
It is a strange system where doctors have little oversight after they get their credentials. If you do try ketamine, be careful because I've been told that it can make your body return to a naive state, such that your dose of pain meds is now dangerously high.

That could however, be one way to broach the subject with a doctor, because trying ketamine because it might work for depression, but if nothing else might reduce your need for painkillers. This would show that you would like to need fewer drugs, or lower doses. I can only imagine what it is like to deal with pain for that long. I've had the year-long headache/migraine, but that finally went away, and two years of almost constant hives. In theory, there is no reason why your general practitioner can't prescribe ketamine as an oral compound (capsules or liquid), but it may be hard to convince them. But it sounds as if you are actively considering giving up, and that is a strong case for the need to try something new, and which might produce results quickly.

Just so you know, I started getting 2 week bouts of depression when in my mid-teens, and was 42 before I found something that worked consistently (rTMS), but could not have access to it after a year of wonderful depression-free life. It wasn't until I was 43 that I was put on ketamine, which for me does not work as well as rTMS (with weekly touch ups), and takes up too much time, and is a bit of a roller-coaster because some times in my cycle the oral liquid seems to kick out after 2 days, but at least means that most days I can enjoy life, feel interested, make decisions, and look forward to things. I tell you this just so you know you are not alone in feeling that a quarter century of trying to find something that works is hellish. But sometimes, even after waiting that long and trying what seems like everything, you might find something that lets you experience normal again. And having suffered depression you know are probably like me in appreciating how wonderful feeling normal is.

Do you have gaps between bouts of depression, and if so, how long does it usually take to start coming out of it? Have you found anything that still feels good? Or that has helped in the past? Are there any seasonal patterns? Do you like to read? Does it help to push yourself to get out and be among people, even if not interacting? Going for walks? Chocolate? Having a pet to stroke and pat to get a bit of physical interaction (raising oxytocin levels)? When I had a bout of depression and it started getting worse than previous ones, I got a cat, in part for the interaction, in part because I worried about becoming suicidal, and figured I couldn't do it if there was someone depending on me. Do you have a GP at least who you could bring information to and ask about trying one of the newer depression treatments, having ketamine as one thing on that list, and letting her/him know that one benefit could be getting to reduce your pain meds, possibly making them more effective?

I'm planning to go to bed soon. We've got a pretty good chance of a new government here, and it looks like a majority (more than 2 parties), so I can relax and hopefully get a decent sleep. I'm trying to get back to a regular schedule, because it tends to help if I get enough sleep, but don't oversleep. I also find that if I create things (writing fiction, painting, even cooking or sewing), it makes me feel a bit better. I will look for a message from you in the morning. Hang in there. There are some of us who finally find something that works at 43 or later. I hope this is your year.

Cai

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My depression is constant. It doesn't matter how much or how little I do it don't sleep. I have never had any relief. I also have very severe social anxiety and, never leave my house. In the past 7 years the only time I ever leave is to go to pick up my meds. And there a real quick in and out type of thing for the most part. So, being around people doesn't hep, if anything or makes it worse. I have several different disorders I have been diagnosed with. I have major depression with psychosis. And I also have OCD and PTSD. I HATE life and, can't WAIT to die. There is absolutely nothing good about my life at all and, nothing that even makes it worth living. Not that I "live" , I haven't "lived" for many years, I simply exist. Pointlessly. And not a single soul alive or dead gives a rat's ass if I love or die. Well, there's probably a few that would be pleased to learn of my passing but, that's about it. I hate even having any emotions at all and, I wish I didn't. The only 2 emotions I really experience are sadness and, very intense rage. I'm pretty much apathetic or despondent and melancholy. I resent the fact that I was even born.

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Nihilissa,
You don't know how glad I am to see you post. I've been worried for you. I don't think I would be strong enough to keep going if I had depression that didn't relent periodically. You are strong.

If you have had a bunch of diagnoses, and take medications, you must have a doctor of some type. Are you up to calling her/him and making an appointment to talk about other options? Apathy makes it hard, but from what you are saying I get the impression you want things to change, and are willing to try finding a treatment that might work (my impression is that it seems overwhelming even to care). If you let the doctor know that you feel life is not worth living, he/she will have to take the situation seriously. If you are coping enough, please try getting to your family doctor, or psychiatrist. Explain that the current treatment is not working, and that you have been told there are other options. If you mention ketamine, mention that your interest is partially because, if it works, you would know quickly (and waiting 6-8 weeks to see if something new works might be risky in your situation), and also that it might let you lower any pain meds you are on.

If you are feeling suicidal, go to emerg, or if there is a mental health center go there, as they are more likely to know all the options (and to take you more seriously). If you can't find a doctor who will try you on ketamine, or if she/he figures there is a reason why you should not try it, there are two other options that have a rapid response. ECT has a bad reputation, but a lot of that is from decades ago when they did a different type of treatment. I am not claiming it is problem free, but it is worth considering. I tried it once (I had a pre-schooler and toddler to take care of, could not wait 6-8 weeks for something to kick in, and that bout was worse than previous ones) and after the first 'dose' my depression was gone. I still wonder what would have happened if they stopped then, but that doctor believed (and he had lots of experience and was probably correct) that you needed to do six treatments for the effects to last. I remember everything up to the third treatment, then there is a blank for two months. It made a mess of grad school that term (history requires strong memory skills), but after that things were normal, and my family assures me that aside from memory issues I was enjoying life and functioning well during those two months. ECT, as far as I know, still has the highest success rate of any depression treatment. Not everyone has problematic side effects, and personally, it is something I would try again if I ever got actively suicidal and felt there were no better options. MST (Magnetic Seizure Therapy) is similar, but more controlled (tiny seizure in a specific, focused, part of the brain), and early evidence suggests it may have the benefit without the problems. It is experimental around here, but that means any studies in your area would provide free treatment.

I know that feeling, when you want to stay in an enclosed space, curtains shut, and it is hard (when you get outside) to raise your eyes, or even walk in the middle of the sidewalk. I used to feel that everyone was watching and seeing me as weak and a failure. Then I had an 'atypical' reaction to one of my meds (seeing terrier dogs where there were none, and hearing telephones ringing) and ended up in the hospital for 6 weeks. Everyone who knew me learned I had depression. It was what I feared, but their reactions were unexpected. Most of them made a point of talking to me, because they had gone through a bout themselves, or something similar, or had relatives who were depressive or manic-depressive. I realized most people sympathize, they feel uncomfortable because they don't know how to help. When you look at the numbers, most people know somebody with depression. I may feel embarrassed when I can't make eye contact without pain, and tend to stick close to the walls and edges, but I no longer feel judged and found lacking. So please, push yourself to get to your doctor (or a series of doctors if that is what it takes), because it is the path that eventually will lead you out of depression and beat back the apathy. You deserve to feel better.

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Hi folks,

I had the IV treatment about 2 weeks ago and felt better after the treatment. I had some very bad side effects (increased need for being intimate frequently), insomnia and loss of appetite while on IV. I was then put on oral ketamine tabs where I developed chest pain, insomnia and headaches and had to discontinue those meds. I've been trying to reach my Dr, Dr. Brooks but to no avail so far. Dunno what else to do now. Maybe have a different route of administration or a replacement for ketamine is what I'm thinking. Anybody have any suggestions?

Regards

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Ironshiekh,

Having any desire for intimacy sounds like a step away from depression :) I'm not sure how often you are taking tablets, and whether others have experienced chest pain. Like many things you mention, it could be related to changes in eating pattern. More on that in a moment.

The protocol my doctor put together says most people take their dose at night, to reduce disruption of their lives. Personally, if I take my dose after 4pm, I won't sleep. I'm not sure if it is a circadian rhythm issue, or just that once the initial effects wear off I actually want to do things. It has become a bit of a hassle, trying to keep a normal life going, while taking three hours, mid-day, two or three times a week. Right now I'm getting rTMS treatment (once a week, two weeks out of three), and only taking ketamine as needed. rTMS stops at the end of the year, and I'm trying to avoid thinking about how to juggle taking ketamine mid-day (so I can sleep) and having a normal-ish life. I guess, all I can suggest is asking if you can try taking your dose early in the day once or twice, and see if it reduces the insomnia.

I can't offer insight on the loss of appetite as I had stomach surgery and the remaining portion (I used to call my stomach Irving, now it is just Irv) has not re-developed the ability to harass me for food. I've learned to just eat at certain times of day (sometimes more successful at remembering than other times). Is the problem you are facing lack of appetite as in no hunger? Not enjoying tastes or textures? Feeling sick at the thought of eating, or if you actually eat? The headaches might be linked to lack of appetite. Are you getting enough liquids? Enough calories spaced out through the day? Lack of potassium can cause muscle pains. I know it sounds silly, but if your doctor wants you to try again, eat a banana first (potassium). If you are able, can you keep track of what you eat and drink (general amounts and times) for a few days? It might help identify a problem. At worst it would rule out some possibilities.

I hope you have a good sleep tonight. Best wishes,
Cai

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Dr Manish Sheth : Achieve Medical Center, San Diego
They offer low dose IV ketamine infusions. It is in a private clinic setting : with a nurse and done right.
I had a family member get the ketamine treatment at Achieve Medical Center , La jolla ; she had a good response after trying/failing practically everything

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