Ketamine For Depression?

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Michael Says:

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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john Says:

thanks michael-

yes, i am very interested in hearing about your experience so far with ketamine. both the iv application and the nasal route. i'm not too keen on the nasal route, but like i said, i will try that first due to cost.

so, how you feeling?


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Mark Says:

Thanks for setting up this Discussion Michael! I hope we can share experiences here to help everyone. The cost of getting relief from this common drug is prohibitively expensive for many people struggling with chronic pain issues, and I have found get marginalized socially and economically due to no fault of our own. I'm curious to hear about other experiences. Thanks again.


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Mark Says:

And for Depression too, which goes hand and hand with chronic pain issues.

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dave Says:

I have scheduled a visit with my Dr. in June. I'd like to know how your experience was. I consulted with her over the phone and she told me to expect to see her Monday, Wednesday, and Friday. All of this is out-of-pocket so I'm more than hesitant. I was quoted $400/hr for the initial visit, $250/hr for following visits, and $110 for the inhaler.

Michael, can you provide us with an update on how your treatment is going? How many days did you visit her? Did you receive the nasal inhaler immediately upon your initial visit? How often are you using your nasal inhaler? How long does each dose last? How does it compare to your infusion experience?



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john Says:

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.


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

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David Says:

When it comes to severe depression, I find it is very essential that the underlying causes of your depression be treated for you to feel true relief without the use of medication. I too suffered from severe depression for a little over 2 years. Only recently have I been able to overcome the struggle of dealing with it on a daily basis and getting by without faking a smile.

Changing my environment helped me to change my state of being and diet; which directly affected my mood and everyday sense of well-being. I know what works for me may not work for everyone dealing with depression, but ultimately, medications just cover up the feelings temporarily, and doing something about how you feel is in my opinion the best way to get 'long term' relief from depression.

I do think Ketamine is a good alternative though, for those who have pain issues as well., so hopefully these people have good things to say about it.

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Michael Says:

Hi everyone!

It's been a busy weekend so I haven't been able to write anyone back regarding this thread.

If you go back to the Scopolamine thread, you'll see a bit about my experience with the ketamine infusion. It was actually pretty remarkable and made a big difference in both my depression and my anxiety for me for a little over a month. It was done at UCLA and my doctor for the treatment was Dr. Espinosa.

After doing a bit of research, I decided to look into the nasal application of ketamine due to the expense of the infusion and the closest person I could find at the time was Dr. Sajben, but since the list of doctors was posted in the earlier Scopolamine thread, I discovered are a few people in the LA area.

My meeting with Dr. Sajben was great. She had a great deal of compassion and I really felt like I was in good hands. Unlike many doctors out there, she is open to alternative treatments like ketamine and doesn't just want to sell you the latest SSRI, none of which have worked for me anyway.

Anyhow, she did prescribe nasal ketamine for me and was given both the medication during my first vist as well as given dosing instructions.

Apparently, each person has a different reaction to the medication and Dr. Sajben helps you find a dosing regimen that works for your specific needs.

So far, I am still working to find a specific dose as well as how often I need the medication. I have had some positive reaction to the medication, but so far I haven't had the sort of "on switch" of relief from my depression that I did from the infusion. But it is early on in my use of the nasal spray and I have heard that sometimes it takes a bit of time to find your dose and judge how long that the medication will last. I have had about five good days since I last did the dose and I will see how this goes.

Anyhow, I hope that I find relief from the nasal spray even if it doesn't last as long as the infusion just due to the reduced cost. $1250 every month out of pocket is just too much for me to pay whereas the nasal spray is only $80 for several months of medication even though the initial vist with Dr. Sajben was around $800.

I don't know what would be best for anyone, but from my experience, the infusion worked very well for me and was effective for a decent amount of time. If you can afford the infusion, I would go ahead with it. But if you want to at least try the nasal route, it seems to be working for me; I just haven't found the most effective dosing strategy yet.

All the best,


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john Says:

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.


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Michael Says:

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.



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Craig Says:

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

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dave Says:

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. "


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john Says:


just my experience, but i found dr. espinoza to be quite kind and caring. maybe it was because i was having ect! seriously though, his 'bed-side manner' was quite good. maybe you got him on a bad day.

also, he is at ucla which is a huge hospital. i wonder if that reply came from dr. espinoza's secretary?

regardless. sorry you got a very lame reply.

on another note, i may be cancelling this week's appointments w/dr. sajben. i suffer from nasal polyps and saw my ent today. i will be having my 3rd sinus surgery in the next few weeks. my ent thinks it would be useless to use any nasal med at this time because all my sinuses are filled w/polyps. argh! i contacted dr. sajben to see about sub-lingual delivery of ketamine which she has listed on her site. i'll keep you all posted on that.

back to dr. espinoza. his secretary told me he will be out of town for the next few weeks and not be available to do ketamine infusions until after the 4th of july...

finally, michael how you feelin'? any progress since last week?

hang-in there everyone. i'm learning that this is all new for both patients and docs.


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john Says:

hi all-

just back from san diego and a 3 hour + session with dr. sajben last night...

first the good;

she is extremely kind, thorough and very professional. very detailed oriented which i appreciated. she even took my primary care doc to task on some other health issues that were evident in my latest blood work and faxed-off a request for several things to be checked by my doc. my primary doc has a rep for not following-up w/her patients. anyway, it was kind of doc sajben to 'educate' me on some health issues i have outside of my depression.

i have been to so many doctors these past 2 years in this battle. this is my first ever severe depressive episode. i feel qualified to grade pdocs now. most have been good, some have been bad, and a few have been excellent. i put dr. sajben in the excellent category, even though she is not a pdoc.

she claims to be having some very good success using ketamine for depression. i believe her. she is unique compared to the other doctors i have seen because she really approaches depression from the physical/biological side. this impressed me.

now, for the not so good;

price! she is very expensive. i feel she is worth it, regardless if the nasal ketamine works. (oh yeah, i decided to go w/the nasal ketamine in the end. more on that later.)

next, not so good, is that, as i was spending 3+ hours with her i realized that this is all experimental. she even admits it. she is having success. but, i realized that it is just like many of the pdocs i have seen and the drugs they presribe. it will work for some, not for others. she also has no real set protocol for dosing. she told me it is very individual when it comes to dosing and that she will work with each individual to find the 'right' dose.

the application is fairly easy. the mixture comes out in a fine mist. she tells you to do your best to not swallow it and let your sinuses absorb the mixture. it does have a nasty taste when a bit of it drops into the back of your throat.

ok, here is what matters; does it work? i don't know and it is way too soon for me to know. i do know i felt a calmness after my initial 2 sprays. driving back-up to LA along the coast as the sun was setting felt calm and good. on the way down i was crying quite a bit to some songs on my ipod that were triggering past memories. this is a big part of my depression. this did not happen on the way home except one little tear-up. who knows if it was the ketamine, the gorgeous california coast/sunset, or me just being out of my bed/house and having had a 3 hour plus conversation all about me, but again, i did feel calm and dare i say it; less depressed. this was also the farthest i had travelled since my depression hit.

i took a few sprays last night when i got home and several more today. i can say i have had no bad side effects. is it working? again, too early to tell. though i do feel quite calm. that may be the klonopin though. ;)

i mentioned flip-flopping on the delivery method. i was going to do sublingual delivery and then decided on doing intra-nasal. i changed because i read on the drug forms that most of the ketamine is lost when delivered under the tongue. (again, this info was from a few recreational drug forms...not the best source i know!) i asked dr. sajben about this and she said either way could work. still, i decided to go with the nasal route for now.

which brings me to my final point. as i mentioned before i suffer from chronic nasal polyps. i have lost my sense of smell due to the polyps. it's a real bummer and one of the several reasons i am depressed. i did a search on polyps and nasal ketamine and found a study on someone who was prescribed nasal ketamine and eventually lost their sense of smell! argh! this patient was on nasal ketamine for pain. this concerns me. i'm scheduled for my 3rd sinus surgery to remove the polyps. i do get a bit of smell back for a few months after surgery and am hopeful that i might get my smell back someday. there is a high correlation with loss of smell and depression. never knew that until i became depressed. just like depression is hard to explain to someone who has never experienced it, it is very hard to express what the loss of smell has done to the quality of my life. when i get just a few whiffs of smell after my surgeries it is absolutely amazing emotionally. sorry to ramble on this, but i would hate for someone to lose their sense of smell. it can be devastating. i will look in to this further and post more.

ok, long post sorry. right now my gut feeling is i am going to go with the infusions sooner rather than later. mostly because it seems there is more experience/success with this use of the drug at the present time. since i paid so much though i will try the nasal spray for a bit. how long? not sure.

again, sorry for such a long post.

keep-up the fight everyone!


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Michael Says:

Glad to hear you are fighting the good fight John!

I know your struggle. Give it time with the inter-nasal.

I myself am not sure it will give me the relief that I experienced via the infusion, but I am having some success. Chances are, we might just find the right dose and dosing regimin and if so, in the long run inter-nasal could potentially reduce the cost of our treatments. If it doesn't work for you, you can always go for the infusion.

All the best to you fellow traveler ;-)


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john Says:

thanks so much michael. appreciate your good words.

is it possible to ask where you are at on dosing?

absolutely no prob if you'd rather not answer. i'm just real curious! :)

thanks again. hoping we all find some peace soon.


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lahelp Says:

Hi Michael, you mentioned that you found some other Los Angeles area doctors as alternatives to Dr. Sajben. Did you contact them / can you post their names?

I have an initial consultation for the IV treatment with Dr. Espinoza for late June, but am still looking to see if I can find alternatives in the area who could see me sooner. Additionally, I've talked to my regular psychiatrist over the phone and his open to writing me a prescription for receiving a compounding pharmacy to prepare for taking the drug orally or nasally. However, this would be his first time prescribing ketamine for a patient and was researching dosage the same way I have been - the Internet. Could you elaborate your intranasal dosage history? Thanks.

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dave Says:

Just a quick note to all. I just finished a week of consultation with my Dr. and have used the Ketamine nasal spray starting from 8mg (2 sprays in each nostril) and working my way up to 40mg (4 sprays in each nostril). All resulting in varying degrees of dizziness and lightheadedness. There has been absolutely no relief in my depression, and I have not experienced any of the "normal" feeling that's been reported with Ketamine.

After seeing little to no results from the Ketamine nasal spray, my Dr. prescribed a Low Dose Naltrexone (LDN), actually its the full 50mg but cut up into pieces, and I have experienced noticeable improvement in my well being. One first night after taking the initial dose, I felt an overwhelming sense of calm over come my mind; I was no longer dwelling on negative thoughts, nor was I experiencing a sense of euphoria which I've experienced in the past when Prozac worked for me. This was around 2am. I was extremely alert as if a switch was turned on in my mind. It took about an hour for me to get back to sleep, but at 6am I awoke immediately with the same alertness and calmness. As the day progressed I can tell that the benefits were waning, but returned after taking my second dose at 5pm.

I'll be off Ketamine for the next few days just to see how I do with the LDN alone. Then I'll slowly work in the Ketamine to see if there are any changes to my mood. Will report back of any dramatic changes.


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Michael Says:

Hi lahelp,

This was the list I was referring to. It was originally posted by Dave on a thread about using Scopolamine (a drug that acts on the same glutamate system in the brain similar to ketamine) regarding doctors who are using both the infusion method as well as inter-nasally and sublingually.

Doctors/Institutions Providing (Subanesthetic) Ketamine Treatment for CRPS / RSD

CA Los Angeles Thomas Leverone 310-209-6500
CA Los Angeles Joshua Prager Center for Pain Rehabilitation 310-264-7246
CA Los Angeles Linda Rever USC Pain Center 323-442-6202
CA La Jolla Nancy Sajben Scripps Memorial 858-622-0500 oral Ketamine
CA Santa Anna Lawrence Miller 1450 17th St, STE 200 714-953-6000
CA San Francisco SF Kaiser 415-833-0095
CO Univ. of CO Alan Brewer 720-848-1970
DC Dr. Chin Geo. Washington Hosp. 202-715-4599
FL Hollywood Dr. Kaufmann Joe DiMaggio Children's Hospital 954 360 6383
FL Sarasota Doanld Erb, DO Institute for Advanced Medicine 941-917-5111
FL Tampa Anthony Kirkpatrick 813-435-8206
GA Atlanta Erik Shaw, D.O. Shepard Pain Institute
IA Des Moines Steven Quam,DO Metro Anesthesia and Pain Management 515-221-9222
IL Palos Park Renata Variakojis 708-631-5550
IL Chicago Timothy Lubinow Rush Univ. Med Cntr 312-942-6631
IL Rockford Medical Pain Mang. Serv 815-397-8400
KY Louisville Christopher Nelson Bluegrass Pain Cons. 502-423-1021
Kas Leawood Dr. Simon Mid-America Physiatrists 913-599-2440
MA Boston Arnold Pain Center 617-278-8000
MA Boston Christine Peeters-Asdouria Beth Israel 317-278-8000
MS Jackson Kenneth Oswalt University Pain Management 601-984-5950
NC Winston-Salem James North Carolina Pain Institute 336-765-6181
NE Hastings Mark Brosnihan/John Dungan Manny Lanning Mem. Hosp. 402-463-4521
NJ Marlton Philip Getson 856-983-7246
NJ Morristown Edward Zampella Atlantic Neurosurgical Specialists 973-285-7800
NJ Camden Pain Management 856-983-7246
NV Carson City John Di Murro 775-841-4057
NY NYC Vadim Kushnerik Downtown Hospital 212-312-5247
NY Dr. Durkin 631-638-0800
NY NYC Seth Waldman Hosp. for Special Surgery 212-606-1015
NY/DC/VA Nameer R. Haider, MD see website
NY NYC Ron Hertz Roosevelt Hosp. 212-523-6357
NY Syosset Northshore Hosp. 516-496-6506
NY Stony Brook Brian Durkin, DO Stony Brook Hospital 631-638-0800
OH Mayfield Hgts. Teresa Dews Hillcrest Hosp 440-312-8599
OH Centerville Amol Soin, MD Ohio Pain Clinic 937-434-2226
OK OK City Jack Marshall 405-775-9355
PA Bryn Mawr Matthew Kline Center for Pain 610-527-9500
RI Pawtucket Pradeep Chopra, MD Interventional Pain Mang, Ctr 401-7294985
TX Houston Everton Edmondson Interventional Neurology 713-797-1180
TX San Antonio Kaleb Shaw, MD Univ. of Texas, San Antonio 210-450-9850
UT Salt Lake City Andrew Tallbutt Life Tree Pain Clinic 801-261-4988
WY Casper Tuenis Zondag Neuroscience Center 307-265-7246
WA Yakima Waters Edge Pain Relief Institute 509-574-3805
New Zealand Aukland Greenlane Hospital (09) 638-9909

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Michael Says:

And regarding dose and dosing regimen, Dr. Sajben specifically asked me not to go into detail on this since it is a bit experimental and could be potentially legally problematic for all involved, but I am sure that she would be more than happy to interface with your doctor should he or she call her. Her name and number is on the list that you requested. I posted it this morning, but I believe it may take a day or two to make it to this thread since the web administrators need to vet it since it contains telephone numbers and personal information. It will probably be up in a day or so though since I found it on an earlier thread on this same website.

All the best everyone and have a great weekend.


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lahelp Says:

Thanks for the reply, Michael. I'm going to hold off on going the intranasal route because I was actually able to schedule an infusion for next Wednesday in San Diego. Will see how/if I respond to the procedure and, if positive, look at options for a long-term treatment plan

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