Are Pdocs Currently Using Ketamine For Treatment Resistant Major Depressive Disorder?

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JackiesGone Says:

I know this is in the clinical trial phase to some degree but have been reading about people who have seen their doc for a ketamine infusion or nasal spray for treatment resistant Major Depressive Disorder (MDD).

I guess what I don't understand is if the clinical trials are only to learn how ketamine rapidly produces positive effects on people like myself, who've been treated for many years with many drugs and never found anything to relieve my MDD.

Does anyone know where I can find a doctor in my state, AZ? I saw a list in the Ketammine for Depression forums of doctors who use it for depression but I can't afford to drop in to UCLA Medical center for a shot at treatment.

My MDD has lasted over 20 years with very short (6 week) remissions. The past 6 years I've had no remission at all and the situation has reached a critical point.

To make matters worse, I've exhausted every financial resource I had over the past 18 years on finding a medication that helped. All to no avail.

Now I have no resources outside my state (state insurance won't cover me if I'm traveling), they don't cover Ketamine for depression, and I haven't been able to work for so long, I don't have a way to earn any money for treatment much less the basics like housing.

And, no I don't collect disability because I never worked enough credit hours to pay into the Social Security system. I applied for SSI but was denied & told I should seek the help of a professional in that field to reapply. But again, I spent almost $100,000 over 15 years seeking help and am no better today than the day I first set out to get better.

The reason I ask about Ketamine is because I've spoken to the NIMH about their study and read the study results up to this point & was impressed with a 71% success rate providing some or all relief from MDD symptoms. The research seems to show the frontal cortex of the brain which is slowly damaged if a person suffers with untreated MDD for extended periods of time; MAY SHOW a reversal of that damage when Ketamine is given. That is a study still in progress so that statement is to be taken as hopeful but not proven medical fact until the study releases it.

Lastly, I want to mention I am NOT advocating the illegal "club" drug Ketamine one might buy on the street. This form of Ketamine has been altered and is typically infused or used via Nasal Spray.
Buying Ketamine without a doctors prescription is against US law as well as many other countries laws.

The street Ketamine causes horrible side effects that can kill or permanently damage the human body. The way the study & psychiatric Ketamine was explained to me, it is not made the same way the street drug is and therefore received FDA approval for clinical trial on humans in the US.

If you are like me and suffer the most severe type of MDD, please do not try to use this drug without a doctors supervision, not only can you die, but even scarier to me, the MDD may get even worse.

Any idea of how to Google search for AZ doctors who use it for MDD (not pain as it's not my chief complaint) please advise!
I've searched for hours and all I can find is a couple pain clinics and clinical trials.

I'll find a way to pay for it but travel to CA is not an option even though it's only 5 hours by car.

Thanks for your help!!

After having tried 78 medications, 5 doctors, and 7 counselors, I'm at the end of the line. Can't live with this anymore & personally I don't feel I should have to. Thanks.

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g saint Says:

hope things improve for you,jackiesgone.this is off-label use, therefore any doc can prescribe and administer it. the i.v. pack costs 13 bucks wholesale, you can pay out-of-pocket for that. your state insurance will pay for doctor visits and the i.v. administration. if doc charges you his/her cost for i.v. pack you're fine. you need to convince doc of the need to utilise ketamine hcl i.v. for your TRD (thus far, i.v. is the best protocol). pain clinics might be good route since they are set up for delivery of i.v. medications, and not skittish about prescribing powerful medications. you might go there there and get interviewed. but you can appeal to any doc that will listen. photocopy info on ketamine from the research and put a file together to present to your doctor. make list of past treatments; dosages, length of time on each treatment. your now shopping this treatment welcome to the Sales Dept. also make case to state health they should pay for your treatment. you're TRD and i'm giving you more work, sorry. let me know how you fare. kind regards.. g saint

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Jackiesgone Says:

Actually my visit to the NIH answered the question for me. I'm told this drug will never be used as a treatment for major depression.

The only goal they have toward FDA approval is for emergent use only. Such as a suicidal patient showing up in the emergency room.

They would give them Ketamine to stabalize them then refer them to a facility where the depression can be treated.

The Ketamine, per the NIH docs, doesn't work for everyone and if it does, it only provides relief for a very short time-2 weeks or less.

Most participants in the NIH study told me the relief they got, if any, was closer to 2-3 days max. No one I met got 2 weeks of relief after one 40 minute ketamine infusion during the 8 week study.

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g saint Says:

reply to jackiesgone...some of the information that was provided you, incorrect. ketamine now being prescribed for mental illnesses via off-label use. as per your self description, you have already been prescribed many medications and combinations in the past. some of these were prescribed to you via off-label use. doctors have this discretion. it is however likely true ketamine will never be approved by the fda for any mental illness, as it cannot be patented, and no profit can be derived from it's sale. currently NAUREX and other drug makers are experimenting with drugs that have some faint similarity to ketamine. if they prove to work, and if finally approved by the fda, it could take ten years before they are brought to market. the persistence of anti-depressant/anxiolytic effect after initial ketamine dose varies in each clinical trial. this is a crucial area of study. are there cumulative effects after one year of chronic treatment, for instance? if the average time between treatments was one week, some patients might say that weekly doses of ketamine that rid me of depression and anxiety are not good enough results for me. for those patients who have been on many medications and combinations and all have failed, what are the alternatives? wait a decade or more for a new medication to be approved and hope that it actually works? go back to being experimented upon with multiple drugs prescribed off-label? or, since no medications work, then re-arrange one's life around no medications. in other words, learn to ride bareback. good luck in your endeavours...kind regards...g saint

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jackie Says:

g saint, I am NOT surprised at all if the NIH provided me with incorrect information seeing as how they outright lie when recruiting and aren't held accountable at all.

One thing I did find out that I know was correct is that Ketamine will never get a label use for long term depression treatment in its current formulation.

If they reformulate someday, maybe, but I know the studies being done are only to have it in use for emergency situations, thats current studies only, who knows what future holds.

Thanks for your kind works, I appreciate it. Something needs to change and very fast!

I have been trying to get to a pain doc or get the insurance to cover a pdoc that uses ketamine and they said "it will never be covered unless the state redesigns the plan". I'm on state sponsored insurance since I can't work and don't have any resources to pay for insurance or any more treatments for that matter.

It's so frustrating when you have a case so severe and so treatment resistant, the records go back 20 years showing all the medications they tried and treatments that didn't work. All on my dime, hence I spent over $70,000, my lifes savings and retirement to get some relief.
Unfortunately, that never happened. What can you do???

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g saint Says:

hello jackiesgone, re:state insurance (a.k.a. medicaid)...medicaid will pay for psych visits. as you know, it's usually only hospitals and clinics that will accept medicaid. you might seek out interviews with many psychiatrists (or possibly other m.d.'s) until you find one open to prescribe and administer ketamine. what happens in your psych visits is privileged. if hospital charges cost for i.v. pack, you pay out-of-pocket for that (cheap). do not attempt to utilise your insurance card to pay for ketamine. your visits are paid for by medicaid, this is the most expensive bit. it is possible your state insurance might limit the number of visits per annum, your doctor can file a request for increase utilising a simple form. the greatest difficulty is to either find a doctor who is open to the idea, or convincing one w/ research literature that you are a good candidate for this off-label use of ketamine. what i have previously described is legitimate off-label use, a procedure utilised for millions of prescriptions per annum in the u.s. and elsewhere. doctors have discretion, which is why it is called the medical ARTS. wishing jackie all the best in your endeavours. kind regards, g saint

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Jackiesgone Says:

II did meet 2 patients who said they wished they got Ketamine every day during the study. They couldn't elaborate but they said it worked, although only temporarily.
I was referring to what the NIH told me the goal of the study was for, not what doctors are using it off label for. I know some people are seeing doctors and getting ketamine for depression but the costs are through the roof.
I'm used to having to work hard for everything so it's not a big deal. I found my primary doctor looks at me as if I have 3 eyes when I asked about Ketamine. They said they never heard of it and prescribed zoloft which I've had 4 times before and it didn't work.
It's very frustrating, people seem to think it something you can just live with but they don;t realize I can't live with it anymore, I'm really tired of years of being sick and not having a day of relief in 6 years has really worn me down to the point I can't go on much longer.
Will try again and see but I don't think they'll help, can't even get the referral for pdoc and it's been 6 weeks already. I call every 3 days and still no referral.

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g saint Says:

hello jackie,
firstly, assignment of psychiatrist essential. state has failed you. you write quite well. suggest you request by post that you urgently require psychiatrist, send by usps w/ signed return receipt. also utilise any complaint processes for state insurance. do not threaten nor use the word "emergency', you might lose your freedom that way. create a paper trail, photocopy everything. keep in mind your intent is not to build a case against them, merely to "encourage" them to do what they should have done from outset, if you wish ketamine, collect and compile evidence to deliver to your psychiatrist. limited research indicates the following compounds in very low dose show promise for depression and anxiety; ketamine, psylocybin, and mdma with it's analogues. patented, approved medications based on these findings may not be available, if ever, for some time. if your insurance, or your clinic/hospital provide a patient advocate, avail yourself of this person. hoping the universe moves more in your direction. kind regards, g saint

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Paula Says:

I do not believe that they only want to use K on emergent basis. I was in a study in my local area of Chicago through Alexian Bros. Mental Health Center, Hoffman Estates IL. I was the first patient in the study, so I knew I would not receive placebo. Super nice, caring people, and they are still recruiting! I'm pretty sure there a quite a few other Medical Centers around USA that are doing this trial as well.

I received 3 infusions per week x3 weeks, then 2x per week for a couple weeks, then 1x, then every other week. I did experience the miracle! It was unbelievable to not feel the 'hole in your soul' as I call it. In terms of it not working for everyone, I have read in several articles that it is especially effective for people with a family history of alcoholism, which my Father was. Now it's over and back to 'life is a s**t sandwhich and every day is another bite'.

What I believe they are trying to determine is how long do the positive effects last, and does it make you into a more productive person. I was asked this question directly at the end of the study. Also I believe they are studying if the K improves cognition, as I was given computerized tests on certain weeks. I have lost at LEAST 20 points from my IQ from this damn disease, but it was SO fantastic, it really did improve my cognitive abilities, I was so happy, hopeful, witty, problems just rolled of my back, I was so full of LIFE!! I don't get why some docs give it, there is one guy in my area that gives it, $300 for consultation, $300 for TMS that he gives (the research doc says it doesn't work well) and $300 for the anesthesiologist to administer. It was STAFF NURSES administering during the study! I had NO adverse effects, just a little tired after. I don't get why so many different ways to give it and only certain docs give it and others are scared of lawsuits. This is what my pdoc said, that he was afraid of a lawsuit. I said I would sign a waiver, he saw how well I was doing during the study, now the last time I was in his office crying. He said himself "Oh, you were doing so well!" He is older, nice man, but don't think I will be able to talk him into anything. Anyway, they are advertising on the net for this study, google 'depression' last time I looked it was on there, cuz I wanted to see what was offered, but it was the same study I already had done. Good luck, I hope someone else can try this study and benefit. And if anyone knows of docs that will help with this Ketamine issue please enlighten me.

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Brian Says:

are there any people out there who have had success with the .5mg ketamine injections, and who once the effects wore off, just continued gettting more injections. i realize the financial cost is generally outrageous, and this keeps most from being able to do this. but are there any out there with chronic major depression and/or anxiety, ptsd etc, who have regualrly had the injections for a year or more? and if so, has the ketamine (at the same dose, and at the same frequency of injection) maintained its efficacy? perhaps there's someone out there who either can financially afford this, or who has special circumstances allowing for regular injections, who could answer this? my example would be that say if ketamine injection works well for 10 days, but by day 11 it generally starts losing its effectiveness for someone, and so then the person uses this as their schedule of injection (.5mg injection every 10 days); does the drug tend to maintain its efficacy? or do people generally need higher doses or more frequent shots over time? or perhaps the opposite; as synapses form and neurons repair (and whatever else the apparrent NMDA antagonism /glutamate modulation etc does), perhaps people over time began to build sustainable lasting benefits from the ketamine, and can then began spacing out injections/titrating off until it's no longer needed? this would of course be the ideal. does anyone know of cases where the drug atleast maintains its efficacy over a year or longer with regular scheduled injections? i am told by a very reputable psychiatrist that this can very well be the case. and that it's only the cost, inconvenience, and potential discomfort (hallucinatory etc) of the injection administration that keeps this from being performed. he tells me that at this dosage and at no closer than 10 days between shots, there is NO reported lab abnormalities, bladder or kidney problems,,,and that the drug generally keeps its efficacy indefinitely (for those who it works for initially). is there anyone out there who could confirm this, or provide any info of known cases that supports this line of thinking? i already know that of course ketamine doesnt work for everyone, but for those who it does help......any data on above questions? any patients recieving regular longterm injections out there??

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rs Says:

Brian, did you mean .5mg/kg, instead of just .5mg?

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lovesanimals Says:

If ketamine isn't prescribed by the majority of doctors, which it seems not to be, what in the world have "they" been doing to try to help us these last few years?? There's absolutely NOTHING new to try, and nothing has worked for me for years and years and years.
I'm existing rather than living; getting older; and seem to be just waiting to die in order to feel better. Thank goodness I believe that in Heaven there's no sickness or tears.... otherwise, I would have put an end to this kind of "life" 2 decades ago!!

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Paula Says:

Yeah, I sure know how you feel! I have tried EVERYTHING EXCEPT ECT for my 17 year long battle, NEVER achieved a remission except when I participated in a Ketamine infusion drug trial, after the 3rd infusion my horribly negative existence completely changed and it was the miracle everyone hears about. Problem is, drug trial over, so remission is over. I paid 1k each time from a 'neuropsychiatrist' in the area, 2 infusions, I got VERY high during the infusions (never happened during trial), unpleasant dissociative symptoms, 50mg infusion #1, 100mg infusion #2, no lasting effect except on my bank account.

A close friend has put me in touch with a pdoc he knows well, says he is VERY open-minded. Gonna try to get a script for Ketamine and do self-administered injections, don't want to get high, just want to be happy. Used to be the life of the party. The way I feel now, too much trouble to get out of bed for a party...will keep all posted on what happens.

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rs Says:

Paula, Have you had your hormones checked out? Sometimes them or the thyroid are the cause. I've been reading over at steroids about their findings and I didn't know that low hormones or thyroid could make one feel so bad. Think I'm gonna have to get some bloodwork done.

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sharon Says:

does anyone know exactly which hormone tests should be done?
the ones most doctors ask for are not expansive (for lack of a better word) enough to show up an "abnormality" associated with depression problems. IIf a hormone imbalance is the key to what's causing the depression, I don't think it's going to jump out at the doctor. I think it's probably going to be something very subtle that shows up in a hormone test...something that a GOOD doctor will notice and investigate. And most doctors, even endocrinologists, only do perfunctory hormone checks which won't show anything out of the ordinary. there are very few good endocrinologists out there... especially in regard to major depression symptoms and possible treatment.

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rs Says:

You could look at the site: thehiddendisease and you could look at the hormone replacement therapy section in the forums on the steroid has some gals there that could advise you and possibly help.

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Vadis Says:

To JackiesGone: have you ever tried ECT? It's a lot safer and more refined now than 50 years ago. Some permanent memory loss is possible, but it can be very effective for treating people with treatment resistant depression. Some studies show that at least 50% of TRD patients who do ECT go into remission. If you're desperate, I would definitely consider that and find a very good doctor and clinic that administers it. There's a lot variability in ECT clinics, so do your research and find a good one. IV Ketamine is indeed a hassle and expensive. If that is impossible, then you could try to get a doctor to prescribe intranasal ketamine. Compound pharmacies that specialize in making specific treatments like this can and have made sprays for ketamine. They'd mail you the spray, so you could do it from home. It may not be as effective as IV ketamine, but it has worked for some people and is worth a try. It's also safer, and so a doctor may be more willing to prescribe it. You could also consider a clinical trial with Alkermes new drug, ALKS-5461.

Brian- it's far from ideal but you could try checking zoklet, bluelight, or drugs forums for people who use ketamine illicitly. A few of them do use it for depression and may have the most experience at using this stuff long term.

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Paula Says:

Yes, had thyroid and hormones checked, have been placed on thyroid med to give more energy, hormones just proved that my ovaries are dead. But do want to check out if any hormone therapy could be helpful.

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Paula Says:

I have done a quite a bit of research on these types of sites, if a pdoc won't cooperate, well I don't plan to endure 10 more years of HORRIBLE SUFFERING when I have already had the medication that CURED ME! Big Pharma doesn't give a DAMN about suffering, they care about lining THEIR pockets!!! F**k THEM! I will do what I have to do, if LE wants to punish an impoverished mentally ill woman trying to become a productive member of society like I once was, someone who has nothing and no one to lose, I am already in prison!

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Zachary Says:

Please, I beg you, do not recommend ECT to anyone. ECT nearly destroyed my life. I am a Yale graduate and had my ECT performed at Yale (along with some aging professors). This is the scam: You are anesthetized. You are shocked while under. You awake with a headache and with your memory in tatters. A loved-one takes you home and you spend a couple of days in a haze b/c of the aneshthesia and the shock. After 3 or so days, you begin to come to your self again and realize that you feel no better. In fact, you may feel much worse since your brain is functional enough at that point for you to realize that there is a significant toll being taken on your memory and cognition, but you are told that it will work - eventually and to just stick with it, have faith, etc.... And guess what, right about the time you begin to awaken to these facts, you are scheduled for your next round of treatment.
There is NO scientific (that is, the gold standard for testing drugs and procedures) applied to this treatment. Its supposed efficacy is almost completely anecdotal. It may no longer break bones and require a diabetic coma for administration but I can assure you it is just as brutal a treatment as ever. I should point out that nurses and anesthesiologists make MASSIVE amounts of money from this procedure. They are able to treat scores, if not hundreds of patients per week, and they are paid as if they had assisted in surgery. There is no disincentive on the part of the medical establishment (since ECT is generally performed in a private lab or section of the hospital and is really quite hidden from the rest of what goes on - even in the psych ward. It is also seen as a last-ditch effort anyway and is, therefore, easy not to even take under consideration)
I want to point out that (in spite of the fact I used the term "medical establishment") I am in NO WAY against psychology, psychiatry, medication, etc.
ECT, however, qualifies as an evil. I do not mean to say that anesthesiologists and nurses knowingly inflict an evil upon you when they administer this "therapy". They should, however, be scolded for their laziness and unwillingness to do their homework and see if there is any justifiable science behind the practice.
I went, against my psychiatrist's advice to have this treatment done. It has been 3 years. My ability to hold down a job is nil as both my long and short term memory is trashed. I have raise 3 wonderful boys. It's a good thing we took pictures b/c I have lost half of my memory of that experience - The most important, rewarding, wonderful experience of my life.
Avoid ECT as you would Ebola.

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Marcia Says:

Ketamine infusions have made a huge change in my life. There is a doctor in New York City. His name is Glen Brooks and he charges only $480.00 per infusion. The amount given is based on your weight. He gives it over a 45 minute time period and you rest afterward. I got the best resuts receiving three infusions, one every other day. A doctor in Princeton recommends every other day, with 6 treatments over a 12 day period. I believe that (6) is the best way to do it. Dr. Brooks will do three infusions over 5 days but if you see him, I strongly urge you to do it every other day. Some people receive an anti-anxiety with the ketamine to cut back on the hallucinations but I found that it did not help my depression when it was included. Now, I go every three weeks for one infusion and it works. The weight lifted, the fog left, I can think clearly and have the desire to live again. I am no longer attached to my bed. I have suffered for over 30 years and have been on every single medication , including electric shock therapy.
Google, Dr Glen Brooks Ketamine NYC and call the number.

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