Ketamine For Depression? (Page 3) (Top voted 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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I was never prescribed that particular medicine. There are some people who say it is
great for Depression. If it helps someone with Depression, that is amazing.

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You are seriously in luck. Janssen is recruiting in New Haven, among other places, for a long-term trial of intranasal esketamine.

clinicaltrials.gov/ct2/show/study/NCT02497287

Everyone interested should check this out.

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There are many Doctors that do ketamine infusions. Have you searched on google or you in the US? I've had 6 infusions that have helped me tremendously!

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We took part in the IMPACT study (me, my husband, and our two kids). We thought it would be useful, not only to us, but also to the research, if they had records for both parents and kids. You get a list which describes whether you are a fast, medium, or slow metabolizer for certain medications. It helps doctors understand appropriate dosages, and why certain medications may not produce typical effects.

Incidentally, on the advice of a depression meds specialist, I've switched to one of the older tricyclics. They wanted to know if ketamine worked for me (it did), but understood that my psychiatrist did not consider it a long-term solution (as I phrased it: "ketamine worked well on my depression, but caused severe anxiety in my psychiatrist') Many doctors ignore tricyclics, but they have a broader range of action, and comparatively good efficacy. They do take longer to kick in. They also put me on vyvanse, which acts on dopamine (reducing apathy, hopefully). I'm not sure how well it is working in terms of depression (I'm in rTMS therapy), but my mood seems good and my anxiety is so well controlled that I've started reducing the anxiolytics.

If you live in the Toronto area, I highly recommend taking part in the IMPACT study. People who have had trouble finding a depression treatment which works well and consistently are those who can help most, and who have the most to gain from the study. If you are in another area, find out about studies near you. Even if you do not find the treatment helps, you are assisting with research which is important.

Hang in there, guys..

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Nancy,

If you did the IMPACT study, you are presumably near Toronto. There is a mood meds clinic in Toronto Western Hospital (9th floor?), which will advise your psychiatrist or GP, giving them ideas for the next things to try. On the 7th floor is the rTMS clinic, which I am pretty sure is taking in people for studies. After 25 years of trying various antidepressants, one form of rTMS has proven consistently useful to me (the issue now is continuing access).

What you have posted of your experience sounds so familiar. It took me longer than usual to finish my PhD. I tried ECT once, when the depression was particularly bad and I had a toddler to take care of (wonderful results for depression, but can't remember the 2-3 months afterwards, even now). Ritalin also helped me some. Less than a month ago, the moods clinic led to me switching from 5mg ritalin in morning as needed, to low dose vyvanse regularly. As adjunctive therapy, it seems to help with cognitive symptoms, and when I can think and write, it really helps my mood. If you have not tried rTMS, I really suggest calling either Dr. Downar's clinic at Toronto Western, or CAMH on Queen Street, to get into a study.

Hang in there. We're all cheering for you.

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Maybe take a look at the Beck depression index, and ask him specifically about symptoms? I found I was able to look people in the eyes without cringing after the first treatment (by the time I left the doctor's office), felt as if I had hope, and my mood was generally better. I felt taller, because the world did not feel as if it was pressing in on me, and I could cope with more stimuli in general. Take a look at changes today, and what he notices as different. I was treated with oral ketamine, which you take every few days. With that form, you may need to change the dosage to get more complete results, but after the first dose either the improvement is definitely there or it is not. If you read some of the posts here, it should give you an idea if the same is true for infusions, or if the beneficial effects come more gradually. Best wishes to you and your husband.

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News story about depression and iv infusions:

wncn.com/2016/12/06/for-one-nc-veteran-ketamine-offers-a-treatment-breakthrough

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There are many Doctors that do ketamine infusion for $350 to $550 per infusion. Dr Giorgadze in Atlanta is most economical at $350.

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A veterinarian can get it for you for $7.00 a vial. It's only recently skyrocketed in price because of its efficacy. I believe it is just as effective any other route as intravenous. Docs have set it up for IV only so they get a piece of the cash flow. I'm serious and straight talking on this one. But it's life and it's the truth but damn all that if it works. It does work.

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A troch is a lozenge. The ketamine is absorbed in the mouth. One would need a compounding pharmacist to go this route.

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It's legal in America for doctors to prescribe ketamine, but there are *very* few doctors in the country who do prescribe it for home use. America is strange when it comes to classifying controlled substances. Money and politics are far more involved behind the scenes than they should be.

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I agree with you Paula. You hit the nail on the head. It is a chemical imbalance. So many out there think that you can just SNAP OUT OF IT!!! I suffered depression due to panic disorder. These diseases can go hand in hand.
Unless someone has experienced anything like these diseases, they should shut their mouths and do what they do best.
At this point, l do not think that herbs are the answer. Their is not enough study done on them and so many do not have FDA approval.
I have recently tried Rexulti given to me from my therapists for both of my problems. You might want to try it. Working very well in just one week. I have more energy and a lot happier.

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Erik, Jannsen is doing trials on an sketemine nasal spray. When I last read anything on this (a few months ago) they anticipated getting it to market by 2019. Nasal is not as effective as transfusion, but it has proven to be helpful so far.

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Unfortunately, Joseph, you're misinformed. In Toronto (or Ontario as far as I know), with any licenced physician's prescription, a compounding pharmacy (google "compounding pharmacy" - lots of them, just smaller than your typical Shoppers Drug Mart) will provide you with your doseage. Ketamine is a schedule 1 narcotic so you will be limited to 37 days of prescription use at one time. My work-related benefits plan even pays for my oral ketamine prescriptions. I prefer to get mine in 25mg. capsules so I can titrate within my 200-300mg range, every 2nd night before bed. Doesn't work as well as iv ketamine from my experience (it's also a bother to ensure my stomach is empty to increase bioavailability) but it's a less expensive stop-gap for me.

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You might try a pain clinic. Many psychiatrists don't do ketamine for depression because they don't have the skills. You might look for an anesthesiologist.

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hey guys-

really excited to see some people looking into ketamine for depression relief. i have been in a severe debilitating major depressive episode for over 2 years now. my first one ever. i'd like to try and get my life back, if i can. not sure how much a med can really do though since i've tried so many. as mentioned on the other thread i even tried a round of ect with no long-lasting relief.

as i woke-up this morning michael i was thinking about just going straight to ucla and skipping my appt w/dr sajben. i need some relief fast and i'm not so sold on this nasal delivery. unless of course you can persuade me otherwise. no pressure there! ha! :)

so, when you have the chance please fill us in on your current status with the nasal spray. i have made contact with 2 people who are using the spray. the one with dr. sajben is having some good success. the other person not so much. the later person is her pdocs's first ketamine patient, so that may be an issue. my feeling is dr. sajben has much more experience than most pdoc's w/this drug.

thanks again for setting this all up. i really appreciate it.

john

ps no need to get in touch directly. i'm sure we'll be able to communicate thru this thread.

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thnx again michael for your report.

i was supposed to se dr sajbem tomorrow, but she had to reschedule. argh...

meanwhile, i think i will contact dr espinoza and do the iv at least once.

could you tell me what the requirements were to get the iv approved by dr espinoza? i know this is off-label and not covered by insurance, but i am curious as to what protocol he uses to decide if you are a candidate for the iv ketamine.

like i said before, i know him from a few years ago when i had a course of ect done by him.

thanks again for all your help.

oh, i think it would be helpful, if you are up to it, to provide us reports on your progress with the nasal ketamine when you can.

john

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If I remember correctly, you need to have tried at least 5 commonly prescribed treatments for depression and not received any real measurable benefit from them. This would include SSRIs, MAOI inhibitors, ECT, etc...

Don't quote me on this, but I am pretty sure this was the major hurdle to be accepted for the IV ketamine treatment. I am sure there are others, like not having other major co-morbid psychiatric issues like Disorders schizophrenia, but you will have to discuss that with Dr. Espinoza.

Nothing really to report regarding the nasal route. Have had some success, but still working out dosing issues and proper timing between dosing. I will keep you all informed.

Best,

Michael

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What a great thread - thanks to Michael and all who are contributing.

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I had my primary physician contact Dr.Espinoza to see if I qualify the IV infusion and here was his terse reply...

"He needs to be under current psychiatric care and have his psychiatrist make the referral and provide full documentation of treatments tried and failed. "

dave

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