Ketamine For Depression? (Page 6) (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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Hi, i'd like to jump in here. I have been receiving ketamine from a doc near LA since Oct 2013. I've been refractory with severe depression since early adulthood and I am married with three kids. I have struggled mightly with this illness and have been on perhaps 25 different drugs. With G-d's help, Ketmamine is the first thing whereby I have seen a light at the end of the tunnel but I require maintenance dosing.

To the point. I am in the St. Louis area and travel to LA every few weeks. I'd love to find a doc here in St. Louis and wondering if anyone knows somebody below or above the radar who might be able to help me.

I really appreciate having this board. I think we need to poll our efforts and start to move in a direction that will allow more direct access to the ketamine for people with refractory states. I am open to productive discussion.

I hope that for each one of you who is suffering from this debilitating illness that G-d gives you strength to find the right agent that will bring you to wellness of mind and spirit.

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@ City Girl- I have an appt Saturday to see the Pdoc who said he might be willing to prescribe the intra-nasal Ket. He requested that I send him info about it and I had some great articles. He was already talking about a compounding pharmacy he has used in the past. He got the best rating out of all the Pdocs in the area. Very friendly guy. I have an appt. for Saturday at 1pm. Will update you after I see him. Trying not to get too excited, I think it's likely he will work with me on the Ket, but I don't know if the intra-nasal will work, although I had a great response to the IV. However, even if it doesn't work for me, it could work for you. I will give an update after I see him.

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Hello Folks,
If any of you survived my last novel regarding the effects of intranasal and I saw quite a few responses that I thought interesting. I will be brief. For one I have heard our happiness is relevant to our choiçes and wishes. I can say b s*** to that or. I can say that the good people that wrote in and are wanting to try this drug. Go for it. Just don't overdo it or you will "sort of trip". I forgot I did 2 sprays and did one more one time and I was back at woodstock,,,,, the first one. It only lasted an hour or so and if your in to that then fine however I looked at it as this. One, a new prospective on life for sure. As Carly Simon says "take another picture" don't look at things the same old way" etc etc. And two, quite possibly two fold uses. Depression will not exist because of some way the drug goes through neurons. Over my head. Different pathways ( help me here???) A last thought and please forgive my abruptness but I think the transfusions are a final straw by some practitioners to make a buck off of the remarkable effects to some folks on this drug. This drug has been here it seems for a while so there is not a lot of interests from our good friends the bottom feeders at Nasdaq these days so some folks are selling transfusions. This irritates me for they accomplish much better results with intranasal and obviously over a more convenient ( for the patient this time ) and affordable ring than getting a transfusion. Come on. I may be wrong. One bottle that should hold 40 ml of 10% ketamine should last for about 20 to 30 days. The "compound" cost 49.00 a month at a local "compounding pharmacy", I was prescribed it for extreme pain and all of a sudden ( within 4 days a 40 year depression was GONE. I wish all of you the best luck and hope in the world. It seems that hope went South in this room. You are all intelligent people that are going through some bad times right now with your health and I would be naive to say I understand. However, If you can just remember you all are worth it, and things can change in a day. They did for me. I have hi hopes for you all. regards and if there is anything I can do to help let me know.
md

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Paula: I'd just like to say thank you very much for the recommendation. We were able to meet with Dr. Berent. He was fantastic and very thorough. I would highly recommend him to anyone. We'll be starting the treatment this week. Wish us luck!

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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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@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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I'm a 9/11 first responder and have been suffering from severe depression since 2002. I was also recently diagnosed with PTSD. I've tried every single antidepressant on the market. I've also tried Transcranial Magnetic Stimulation, and ECT. Nothing worked. Finally, in May of 2014, I went to see Dr Glen Brooks, who runs the NY Ketamine clinic located in downtown Manhattan. My depression had gotten so bad, and was truly at the end of my rope. After my 3rd infusion, my depression had completely disappeared. I couldn't believe it. Dr Brooks literally saved my life. He's a great Dr and a very caring man. I now receive 1 monthly infusion and have been depression free almost 6 months!

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It's great to hear success stories. But we did not have success for our son. We took him to Dr. Levine in Princeton, N J.; about 700 hundred miles from here in southcentral Indiana, stayed a week and had three treatments with no improvement; also no side effects. This is a very nice clinic with wonderful doctor and staff and apparently typical success rate.

So we are still searching.

This morning I saw a report from ScienceDaily--"Commom anesthetic procedure dramatically improves well being of veterans with PTSD". They state that a single application of a procedure called (SBG) stellate ganglion block, could be the answer to alleviating anxiety, depression and psychological pain in those suffering from PTSD. This study was presented at the ANESTHESIOLOGY 2014 annual meeting. Go to ScienceDaily to read more and search SBG.

howard

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Ketamine is working, sertonin1, nmda receptor. I always can't feel happy, everyday all the time. i think this is completely a genetic reason. I already tried to commit suicide 4 times. cuz everyday all the time, I'm not happy, and then I can't trust everybody. When I was junior high schooler, I couldn't eat my mother's meal. cuz I suspected poison. my brain is so crazy, so my brain makes me always unhappy so much.

From graduating high school to now,I tried in so many things. i entered Japanese military forces, I did exercise every day, I did meditation, zazen, 2-8hours everyday, I did fasting for about 20 days, Shikoku Henro, I tried engaging in job at foreign country.
These matters made me so much better and my problem almost disappeared. But I feel my limit. At first, my brain is crazy. this fact is fact. never changes.

That's why finally I decided to use ketamine. I will go to the states to meet a doctor for ketamine.

My name is toshiharu {edited for privacy}

Maybe Namenda or ketamine is good for me. That's why I need it now. I'm fed up with bulls***.

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MD,
I don't think you will find any takers here. First, this is a medication that is off-patent, which should make it lower cost as a treatment. For patients this is a good thing. Second, there are large pharmaceutical companies already doing research in this area, either trying to parse out which components provide benefits and which are related to unpleasant side effects, or finding related compounds, or chemicals that interact with glutamate receptors. So there is big money behind this research. Third, the cost of drug trials to get something through the FDA that could be directly marketed as a treatment for depression are phenomenal. Even the smaller, research-focused, pharmaceutical laboratories often need to work with (sell patents or their companies to) big-pharma because they have the resources to get through the FDA trial procedures. You are not going to put together venture capitalists for that amount of money, and for a process that will take many years before it has even a hope of paying out. Fourth, my understanding is that ketamine treats or masks depression, it does not cure it. The underlying condition persists, although you may be able to make changes in your life and behaviours because of the ketamine which have more lasting effects. Fifth, unless you are coming up with a new chemical compound or formulation you can't patent it, and cannot make claims about its use to treat any medical condition.

So instead of telling those on the board that we do not get the point, maybe accept that we see your enthusiasm and would love to see venture capitalists getting together and researching, examining, and marketing an inexpensive and useful variant of ketamine, but you probably need to read up on the process before proceeding further.

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Which reminds me, during almost all of my ect treatments (over two dozen, I'm sure) they added ketamine to the anesthesia chemicals. Made falling asleep feel interesting for a second or two but didn't result in a noticeable response.

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lahelp, I'm also an earlier poster to this thread.

Look into Ayahuasca. This has helped me the most. I've tried Ibogaine which led me to pursue Ayahuasca. I've posted my experience with both psychedelics in a separate thread on this site.

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There is no brand name for ketamine inhalers, the doctor writes a prescription and a compounding pharmacy makes them 1 off.

If your doctors want to know more, have them contact the ketamine advocacy network, or one of the research sites or clinicaltrials.gov. Ketamine nasal, iv, im, oral has not yet been approved (and may never be because of glyx-13) for the treatment of depression. That does not mean it doesn't work, it is simply still in clinical trials.

Serotonin syndrome is very uncommon and results when a patient or doctor mixes to many/much anti depressants. Example: the patient only takes his meds 2 times a week instead of every day but takes 3 pills on that one day but even that is hard to get serotonin syndrome from because of the half lives involved. The only way to get it is either due to a failure of your doctor and pharmacist resulting to a massive overdose or reaction with another med OR abuse by the patient OR in very rare cases a particularly strange combination of liver enzymes that would allow the pro drug to move to the active drug, but not allow the active drug to be metabolized.

There was a guy here, who was working for an educational/ funding group but he seems to have up and left for reasons undisclosed, so your best bet again is the ketamine advocacy network and clinical trials.gov

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Thanks NWV. I Find that disappointing that they have to be made 1 at a time.
Any idea of dosage in the inhaler?
This is new territory for me. Usually I take the "anti depressant " prescribed but noticed a profound sensitivity to the widely prescribed "safe" drugs when mixed accidentally with a usually safe medication like Tramadol or others.
Two stays in ICU and I'm seriously looking to find an answer. (Besides praying for God to forgive my sins that have caused this devil into my mind) as one preacher/doctor suggested as I was in ICU.

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Kaiser San Fransisco has a Ketamine clinic. I know because my psychiatrist is referring me there. Kaiser Oakland is setting one up.

Strange how secret it is. Does NOT come up on any web search.

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Hello All, I just popped in and read some of the posts that are appearing such as one person stated a doctor/preacher told him that the depression was from his contribution to the sins. Good lord I hope he is not from my home town. To whomever wrote that I say your depression is real. I am sorry for what you are going through. All my life I have heard bible pushers and the like talk sins from a podium as if they were Abbi Hoffman b****ing about the war in Vietnam. And as much as I appreciate Abbi's once strong voice I often wonder why in the hell they would ever allow someone like that get in front of a microphone. Perhaps cutting their tongue off would be the thing. Depression is real. We all deal with it in our own way and by god if intranasal ketamine or plain old horse s*** in a bucket helps then by all mean give it to people. Whoever posted that about the i**** with a megaphone please forget that. No one has ever walked in any one else's shoes and until they do where do they get off saying crap like that. Life is hard enough on a daily basis without some creep selling lies at a homecoming. There are a lot of folks that believe depression stems from a filthy life and to these geniuses I ask what does your life provide you. We are all individuals. We are all on a quest it seems. And I honestly believe that perseverance of a partitioned thought process that reaches a goal or objective is of importance. IE We strive to build our dreams and if we direct that energy in the right way it happens. Even with all the greedy s***heads that have shifted to the word "contractor" and "1099" instead of and opposed to shake my hand and allow me to be an "employee" they believe in and think they are worth the 7.65% of your social security they have to pay instead of using the word outsourcing like a Chinese restaurant. Ive owned companies and the employees were my number one asset for without their intelligence, along with the ability to utilize their strong points they made my company what it was. Nowadays men say they are opening a business when all they are engulfed in is creating a liability if you get hurt on their sites. Not fair. If an employer cares about the people that make his business possible they need to show it by treating their employees like the men they deserve to be treated like. To subsidize my last request is to ask these doctors performing these "pricy" "infusions" for thousands of dollars you make me growl. A 40 cc 10% bottle of intranasal compound should be around 49.00 US. I don't know why these clinics have to make outrageous profits from infusions. Possibly because ketamine is cheap and they have to justify their high prices somehow. Why can't we all work together without a motive of profit to give good folks in our country an inexpensive solution to their depression instead of inventing some story line as to why an infusion would be better. Only for the clinic offering it. As for all the physicians that do not know about this drug I find that inexcusable. Doctors should know all about different regimens of different things when the SOS clearly isn't working. I thought Doctors wanted to get their patients better as opposed to massaging the shoulders of the Drug Enforcement Administration and their need to allocate budgets. Some doctors are saying now that 4 to 6 month of pain meds is all one needs. Something tells me these talkers are not going through what I see a lot of folks are as well as myself or there minds would change drastically. Again DEA, if you have systemic lupus please consider that pain meds and any med at the discretion of a licensed doctor should be a palette to help as oppose to control. And one last thing. Myself and a great deal of the folks in this room I have seen only want to live their life the best way they can carve out for themselves. To try to harm or regulate a provider or doctor's viewpoints please make damn sure your college education outweighs the doctors in medical concerns as oppose to the law. The only ones you are hurting is ourselves.

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Used up,

I'm on year 25 of off-and-on depression. It looks as if the combination of sequential bilateral rTMS and ketamine, mirtazepine, lamotragine, and buspirone does the trick. I know how frustrating it is to keep going through try after try to find something that works. But there are new meds in the pipline and coming out. Some are quite innovative in their presumed mechanism.

So, if you can, try ketamine. From what I've read it tends to work on people whose depression is periodic and who, if they have tried ECT found that it worked. If possible, get your doctor to play with the dose and frequency of ketamine. And if that doesn't work, remember there are other options, and unless you stick around keep trying you really have no hope of a cure. So hang in there.

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Just to note the single usage is described in: aacp.com/Pages.asp?AID=11629&issue=February_2014

It is only a single usage however. To date only one clinical trial has been performed, by James Murrough of Mount Sinai School of Medicine from 2001 to 2014 you can find the abstract here: ncbi.nlm.nih.gov/pubmed/24821196?dopt=Abstract

Note that this study was for a very short term (2 days), not for ongoing therapy and did report a 44% success rate.

For the time being, on what is an experimental procedure, the standard for long term care is IV, not IM, IN or Oral

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@Deijivan If you are in Brazil, why not go to Uruguay where Ketamine is legal and is much closer to home.

As for dosages and treatment. Unless I have seen a published protocol, I will not answer

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I assume some of the psycho/social models are among the eight?

1 commonly called the Psychology or emotional model. In psychiatry, medicine/ biology is the key and so Psychology is the redheaded stepchild.

Ketamine has at least 3 (likely 4) methods of action. NMDA antagonism (blocks glutamate), Inflammation (reduces glia cell inflammation and so assists in glutamate removal), & Monoamines (neurotransmitters). There is evidence that ketamine also reverses depotentiation in certain brain structures, however this is not presently considered an area of primary depression, rather secondary

As for the link between estrogen and serotonin, to my understanding there is no primary link. Instead hormones (endocrines in general in fact) work along the HPA axis so it is at least tied to the inflammation model.

This is one of those places things get wonky. So physiologically there are 2 major overarching models of depression. Inflammation and Monoamines. If you have too little of certain monoamines like serotonin or nor-epinephrin you will be depressed or if your 5HT genes are wonky and not accepting the monoamines then depression... maybe turns out mice with no serotonin receptors are not depressed so ... well lets say studies are ongoing. Inflammation is the other elephant in the room when cells become inflamed, a number of bad things happen, including depression.

What the models tell us is that the pathway is related to depression. Think of it as a multi-car accident on a busy highway. You are at exit 12 trying to get to exit 3 all you see in front of you is stopped cars. Is the problem at exit 7? Exit 2? All you know immediately is that where you are traffic is not moving. Each model in the current model system covers at least one exit, treatments frequently cover 1 exit, and help out at others. To extend the analogy, traffic is like inflammation, it will improve if more lanes are added, more exits are added, cars get smaller.

As a side project, I am working on an infographic showing each model and how/where each treatment affects things. I suspect with all my free time, it will never be complete, or if it is it will be immediately outdated.

As to MF's comment, Doctors are constantly bombarded with novel drugs and treatments. Usually for whatever has just been approved. It is very difficult for a Psychiatrist to keep up with the broad field of Psychiatry and effort is frequently not consumate with results. Insurance dictates frequently just how much time a doctor has with a patient, frequently between 15m and 40m. Plus there is documentation, so lets say a doctor has 30 minutes per patient 15 face to face, 15 notes and such. In an 8 hour day that is 16 patients, 80 patients a week, 320 patients a month how many conditions do you think manifest? How many patients are identical (hint: none). Doctors are human, many put in far more hours than 40, just with patients. Research is often poorly understood or contradictory. So what does a doctor do who is not highly specialized? Optimize time to help as many people as well as can be. Engineers frequently claim the last 10% takes 90% of the time. In Psychology, 70 % of people are helped by the standard treatments, so you focus on those standards, when they do not work you seek out help/research/treatments that may work, but lines have to be drawn somewhere. Most patients are not candidates for clinical trials and most doctors are not research practitioners.

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