Ketamine For Depression? (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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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?

john

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

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Hey, Lee ash. I haven't done much research on ketamine for the last few months, but the last I heard there had been very few, if any, long term studies on the efficacy of long-term ketamine use, or in the possible complications and risk of addiction, associated with long-term use. One of the reasons ketamine is not routinely used in the treatment of depression is that many doctors are misinformed about the risk of addiction. As far as I know, when ketamine is used to treat depression it is administered in quite low doses. Ketamine is also a "party drug" and when used recreationally, etc, is typically taken in higher doses. This can certainly lead to addiction. A second reason why ketamine is not more widely prescribed for depression is that many doctors don't like the idea that in order to be effective, maintenance treatments are required. This is a rather silly objection because many people who have found ECT effective require maintenance treatments, and most people with depression take antidepressants daily, for years, decades, or the rest of their lives.

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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,

Michael

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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.

dave

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I just came across this article. I never take the time to write comments or product reviews of purchases on Amazon. I feel I need to contribute, because I have been using the ketamine nasal spray about 2 yrs.

I suffer from Bipolar manic depressant with rapid cycling. I didn’t get diagnosed till 22. I had tried every medication to stable my mood. I mean every medicine known to treat mood disorders. I don't remember the name but with one of them I had to do blood work every week for 6 months, then every other week for six more months.

During this time I had major weight gain and severe side effects all the above. I’ve always had a solid diet and have always been huge into working out. I was doing all the right things that were in my control (ie. routine, working out, eating healthy) Well about 2yrs ago my Dr came back from a conference and discussed Ketamine nasal spray. He had not treated anybody with it yet and didn’t know what to expect. I told him I’m willing to try. 2 months later I was able to taper off a lot of the medications I had been taking which in turn lifted side effects. It has been an amazing transformation that my close family all noticed. I’m very private and don’t discuss my condition with anyone other then close family. I just got to say this helped me get my life back. I’ve entered back into the corporate world and have had great success.

I do one spray in each nostril in the morning and one at night. Very minimal dose. Word of caution, I get mine from a local compounding pharmacy. It's in a glass bottle and each spray is extremely consistent. I did how ever use a CVS for 2 months. They gave me one in a plastic container that had to be refrigerated. The liquid amount in each spray was extremely inconsistent and my mood shifted towards depression. I switched back and everything leveled it self back out.

Do I still suffer from bi-polar, absolutely. But it’s now manageable without severe mood swings or the major side effects from drugs like lithium.

I am very thankful for this discovery. I would be happy to answer any questions if anyone has any.

Thank you for you time and I hope this helps.

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I recently completed 6 Ketamine infusions. I live in the Milwaukee area and drove to Arlington Heights, IL to receive them. Let me just say that for over 25 years I have been on basically every antidepressant known to man. A handful of them seemed to work for a bit but then not so much. Most of them had no effect on lessening my depression and the doom and gloom Persisted for years. Last fall I lost my job and fell into a severe depression. Always on the lookout for something to ease my symptoms I decided to try ECT treatments. I did 12 of them. They did absolutely nothing!!! NOTHING. I was beyond frustrated. I had been scowering the Internet for any new antidepressants on the horizon. That's when I came across Ketamine. My doctor told me nobody around here was providing that treatment (Midwest). I continued to check online frequently to see about Ketamine clinics opening in my part of the country. That's when I came across Midwest Ketamine Clinic in Arlington Heights, Illinois. Unfas most of you know, insurance does not cover these treatments. It's all out of pocket. My infusions were $675 each. I had them over the course of two weeks. They tell you that you won't feel better until the 3rd Infusion. I felt some relief after the 1st one. By the 6th one I felt much better. After my 6th Infusion they suggested I make an appointment for a booster infusion 4 to 6 weeks out. So I did. I will continue to report how I am doing since receiving my infusions. I am still on all of my antidepressants. Unfortunately, because I was feeling so much better I took myself off Saphris. My psychiatrist said I could quit cold turkey. Big huge mistake. Even with the ketamine infusions I was still struggling to keep it together. By far the worst withdrawal symptoms I've ever had. Constant flu like feeling. Sweating profusely. I changed my clothes upwards of 8 times a day. Plus I developed the most intense rage. It was awful. Not to mention the fact that I could not sleep they the night. I laid around with ice packs on my head and neck for 9 days before giving in and going back on it. I had been on a dosage of 20mg for almost 3 years. I should have known better! Sorry for going off topic discussing my ordeal trying to quit Saphris. Back to Ketamine, to anyone whose on the fence about whether or not they should try Ketamine, I give it a firm two thumbs up. The clinic I went to told us that after the 3rd Infusion they'd assess my progress. If I was feeling better we'd move forward and complete the last 3 infusions. However, if I felt no change in my mood, they suggested that I forgo the last three infusions and save my money. Lastly the clinic told me that after my 7 th Infusion, the booster infusion, I would be receiving a prescription for a Ketamine nasal spray. The purpose of the spray is to prolong the length of time between booster infusions. I just want to add that I was looking very forward to getting my first infusion. However during the treatment I became very scared. Ketamine puts you in a totally altered state. After the first one I was no longer scared and found them extremely relaxing and enjoyable. Each infusion lasted roughly 50 minutes.

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London, Ontario:
Dr. Kate Ower
Pain Management Program at St. Joseph’s Health Care London
Outpatient Ketamine Infusions
sjhc.london.on.ca/pain-management
(519) 646-6019

Toronto:
Dr. Pathak
Allevio Clinic
Lidocaine/Ketamine Infusions, Blocks, Injections
allevioclinic.com
(416) 840-5990

Hope this helps!

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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
STATE CITY DOCTOR ORGANIZATION PHONE WEBSITE/EMAIL

CA Los Angeles Thomas Leverone 310-209-6500 [email protected]
CA Los Angeles Joshua Prager Center for Pain Rehabilitation 310-264-7246 [email protected]
CA Los Angeles Linda Rever USC Pain Center 323-442-6202 [email protected]
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 rsdhealthcare.org
GA Atlanta Erik Shaw, D.O. Shepard Pain Institute shepherd.org
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 killpain.com
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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I have been taking 1.6mg/kg of ketamine orally once every three to five days for the past three months. The effects have been dramatic. Yes, there is a period for about 1-2 hours after taking it that you feel weird, not worried, but weird. That effect can vary each time, and changes depending on the dose.
As for the antidepressant/anxiolytic effect. I had tried antidepressants in every category but the MAOIs, dozens of combinations, never with lasting and sufficient effect. ECT worked, but I lost 2-3 months of memory. rTMS worked wonderfully under one protocol, but the study ended and the new protocol being studied did not work for me. I tried ketamine 1mg/kg orally in the doctors office (recliner chair, low lights, ambient soundscape). Before taking it I was anxious, pessimistic, distracted, unable to look people in the eyes. About 10 min after taking the dose it was as if the bubble's that defined the boundary between my personal space and outside, and the one farther out that defined the extent of space that I ignored, both popped. Sounds in the distance seemed louder. But I didn't feel that the area beyond my personal space was scary. 40 min in the doctor came in to talk to me. There was a slight lag between thinking and speaking, but I was able to explain how I felt. And I was already able to look him in the eye for thirty seconds at a time. Two hours later, I was feeling relatively normal. I could interact with people, I felt hope, felt worthwhile. I was not ruminating, and not anxious. It was not completely normal, but compared to two hours earlier the difference was amazing. We ended up increasing the dose so that the effect removed the depression completely and (hopefully) lasted at least three days at a time. I feel worthwhile, interested in life, I feel happy and sad (a full range of emotions) at appropriate times, I do not ruminate the same ideas over and over in my head which helps allow me to sleep, I am not anxious around other people, I hug my kids and feel good when they hug me back, I can read for fun and feel like working around the house. I do have a lower tolerance for chaos (want things to be more tidy) than previously, and I think I am a bit less risk adverse than before. I can talk to other people, and enjoy it. When people smile, I smile back. Food has flavour, sleep is restful. I feel as if there are good and bad things in my life, but on the whole things are ok, manageable. I feel normal.
Ketamine is a useful option if you have tried all the other ones. Recognize that what little research is out there shows that it is working for that small group of people who are severely treatment resistant (most tried a dozen or more combinations over a decade or more). It is quite possible that people in this group have a different biological problem than most people manifesting depression. So if you have not tried all the other options, there is little evidence that ketamine would work for you. Its long term effectiveness is unknown. And it does not reset the neurotransmitters, it masks the effects, and when it kicks back out...imagine going from fine to depressed in an hour. Not nice. You need to commit to not driving for 24 hours after taking a dose, and I strongly advise not cooking/ironing/doing fine motor work for a few hours afterwards as well.
I currently take between 1.6 and 2 mg/kg ketamine as an oral/sublingual syrup once every three to five days. It is doing wonders for my anxiety, and generally working well for the depression. Note that I am taking to medication orally/sublingually, which is different from how most patients in the U.S. take it. The anxiety effect tends to last at least three days, the antidepressant effect at some points in my menstrual cycle only last 2 days. So I am learning what depression without anxiety feels like, and also to identify what are early warning signs that the drug is wearing off. If you have control over timing of treatments you want to space them out as far as possible while still preventing the depression from recurring, and taking as low a dose as possible. This should reduce side effects and in theory make it more likely that the drug will continue to work. If I know the warning signs and none appear on day 3 I wait an extra day, if none on day 4 I wait till day 5.
Essentially you should know this: ketamine is a promising option for people with severely treatment resistant depression, it has annoying side effects for the first 1-2 hours, if it works for you it can be very effective, and it may not work for you. You also need to recognize that if you are prone to addictions, or find yourself increasing your dose, or taking it more frequently, not only are you likely giving up on the antidepressant effect, you need to see a doctor about getting off the drug before you hurt yourself.
Also note that if you are in the US (which most people on the board here are) you seem to only have the option of intravenous infusions which are ruinously expensive, or intranasal treatment. The nasal method can lead to loss of sense of smell and polyps, I think you are supposed to use a neti pot regularly if you use a nasal insufflator to reduce chance of problems. My experience is with a syrup that I hold in my mouth for 10 min then swallow. Less of the ketamine is bioavailable this way, but it is less expensive, controllable in terms of dose, and has predictable results (for me at least). My impression is that the infusion lasts far longer, but you are likely to only have access to it for a short time because of cost. Any compounding pharmacy can make tablets/capsules or a liquid. Ketamine is a generic drug, and most of the cost should be the compounding fee. If you can convince your doctor to do a trial of ketamine for you, consider the oral liquid. You can titrate the amount more exactly. Who knows, you might be one of the people who finds 1mg/kg oral every week is enough. From what my psychiatrist said, it appears that if it is going to work you will see some effect within the first 24 hours of taking the first dose. A quick response, like mine, is a good sign that the drug will have a beneficial effect at a reasonably low dose.
Depression is probably a group of problems. Certain antidepressants work because of the type of physical problem that manifests in depression symptoms. Before trying ketamine see if you are likely to be helped by existing antidepressant subtypes, because what little evidence is out there showing ketamine works is almost exclusively on people whose depression does not respond (or does not respond adequately) to any of the antidepressant groupings (alone or in combination).
Best wishes to you. I hope you find some help either with ketamine, with physical or cognitive/behavioral therapy, or with something like rTMS, or DCTCS. There are new pharmaceuticals in development based on ketamine. Hang in there, eventually something will work.

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Sorry to hear that some people have found only the initial infusion effective, or that efficacy tapered off quickly.

I've never tried the infusions. I have taken an oral suspension, either sublingually, or with a nasal aspirator. But I've been taking it 2-3 times a week since January, and the only times efficacy has trailed off have been because the compounding pharmacy had some sort of problem, or we were trying to figure out the appropriate dosage and schedule.

So far 3ml (so 150mg) liquid taken orally (hold under tongue and against cheeks for 20-30 min, then swallow) every second day has had the best effects. Higher doses don't seem to last longer for me. We went up to 200mg with a nasal aspirator every second day and it was less effective (basically the brain did not have time to recover so did not respond as well to the dose). It worked better taking the same dosage every three days (at least it worked well for 2 days). I am hoping to convince my doctor to switch back to the 150mg (3ml) orally every second day. It is a lower effective dose (in theory oral ROA provides less ketamine absorbed in a useful form), but it was not high enough to reduce dose effectiveness when taken that frequently, and frankly, I hate this rebound to apathy by the third day. So almost 1 year of continuing effectiveness.

So I'm sorry that some of you found the medication did not continue to be beneficial, but for those of you who found some benefit, it may be worth convincing your physician to modify the dose, frequency, or route of administration. Placebo effect can play a role, but if your depression is very treatment resistant were you feeling optimistic and expecting it to work? Personally, I was hoping, but was depressed enough that optimistic was simply out of my emotional range.

Best wishes to you all. Hold in there.

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Part of my post got edited out. What "disappeared "was what happened before getting kicked out on the street and my friends running away from me. My girlfriend and the only one I've ever felt true love, my best friend for years, was murdered by her jealous ex boyfriend. No one wanted to get within a mile of me. They all just poofed away. Who wants to support a friend through grief they couldn't possibly comprehend. Her murderer? After destroying evidence and lying to police for 2 1/2 years was given 5 years probation. Never saw a prison cell. He is married. Owns a huge home. Has kids. Sells real estate. Living a good life and claims he paid his debt to society. After a few months my father kicked me out onto the street.

A few years later I was diagnosed major depression. Been on every brand of the same drug. SSRI's. One after the other. None worked. Didn't matter. Prescribe another name of the same drug. Double the dose. Seizures? Add another drug. Still depressed? Try some more. Then after surgery on my back using ketamine I did some research on every part of my procedure I learned about ketamine being used to help those with my same exact symptoms. Anxiety, depression, chronic pain, hopelessness. I hired a new psychiatrist and asked about it after a few sessions. He agreed to try therapy with it.

I'd finally found a psychologist who realized I'd been misdiagnosed and I was dealing with PTSD. He gave me a trial ketamine therapy based on my diagnosis and I felt HOPE for the first time in over 2 decades. Of course it was off label and insurance freaked out and not only denied payment, it threatened my psychiatrist with legal action for abusive practice of off label use of a scheduled medication.
He had to stop therapy which was one 25mg IM inj. twice a week for 2 weeks and 1 IM inj. every week with a plan to titrate dose (20mg) down until we reached the lowest dose that still helped. This lasted 6 weeks until the hammer fell. He is now facing problems with the FDA (ratted out by UHC). I've been retroactively charged by insurance for all visits to this dr. even visits not related to ketamine therapy. He has been very kind and not charged me for the visits not covered. His lawyer says it's ultimately harassment coming from big Pharm.

They don't make profit from a drug that has an expired patent and takes me off drugs costing me hundreds a month. It's illogical, I know. You would think the insurance company would love a cheap medical solution. I'm not the one to figure that relationship between big Pharm. and big insurance. ( my psychiatrist told me how inexpensive the therapy really was, about $20 for the med and supplies plus some for a nurse to monitor vitals for the 15 minutes after inj.) One thing I know, the only thing that had helped in 20+ years has been taken away unless I drive 400 miles and pay a ketamine therapy dr thousands of dollars.

All I can say about where the system is right now is one word. GREED. Take profit out of healthcare. Period. Put one thing back in. CARE. Period. Now attack me for that sentiment. I will be attacked because almost all people get into healthcare for the money, not to help people get better. Call me a socialist. That doesn't bother me. If socialism belongs in ONE part of our world it is healthcare. Last post from me. I'm moving on. The fight is gone from me. See you good people on the next plane/dimension/whatever. Adios.

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I had an infusion of ketamine 6 months ago and know understand what they mean when they say treatment resistant depression.
No medication I have tried over the last 30 years has helped me!!!
I had an infusion as a trial member and got my very first look at what life is like without depression or suicidal ideations.
I felt like I was in a place that I could only dream of:
I was happy and extremely social, & didn't feel anxious, for the first time in my life!
The downside of it is that it doesn't have a permanent affect or whether you have a similar results.

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We did ketamine infusions at Georgia Ketamine in Gainesville, GA for 350 per, and had wonderful results! They are super professional, very accommodating and super nice. Beautiful office. We drive 3 hours just to see them!

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Joseph,

I was on the oral ketamine protocol for over a year. I tried the nasal squirt thing, and found the results in me tended to vary more. As far as I know, most of his early patients took caplets. I took a liquid because part of my stomach has been removed, and the remainder is less acidic, so a form which is more 'instant release' made sense. It certainly helped. At the starting dose, which I took in his office, within 90min I was able to make eye contact, and felt hope. A slightly higher dose worked wonderfully. The only issue I had (aside from the current problem of having a wonderful psychiatrist who is utterly against trying it again) was that it wore off more quickly that expected. Most people are just fine taking it twice a week. In my case, sometimes the effects lasted 4 days, in others only 2. Be aware that sometimes when it wears off the change can happen quickly. The first time this happens can be scary, but once you know what it is like, the situation is easier to handle. The catch is that ketamine does not fix depression. You will want to work on techniques to bring you out of depression. I felt no urge to take more than prescribed, and nothing happened when I stopped.

OK, there was actually another side effect, but I have no idea why it happened. While I was on the ketamine protocol I wanted to tidy and organize. This was probably a return to 'normal' human behaviour, but I have a high chaos threshold and hadn't felt like that for decades. Research and writing, I'm organized, the rest of my life, not so much.

If you look further in this thread, I have a detailed description of what the effects were like for me. I hope this works for you, and if not, that you keep going until you find something that does work. People who do not get depressed seem not to understand how wonderful it is to feel normal.

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Hey, JP in Toronto. Thanks for your perspective. It certainly is different from my research. I've been able to find one doctor in Ontario who might do IV treatment. She is in Ottawa, a looong drive from where I live. I did manage to locate a doctor in Toronto who would provide the protocol for oral ket to my doctor, but he was not interested in trying this. Where I live, progressive psychiatrists are in extremely short supply. Unfortunately, because of co-morbidities, high blood pressure, having had ECT, I don't qualify for any of the ketamine studies I've been able to uncover. So, I'm anxiously waiting for Jannsen's nasal sketamine to be approved. That might happen as early as 2019.

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I realize this post is from last July but I just had to comment. Opiates definitely helped ease my depression. No question. As a matter of fact I've talked to my psychiatrist about that many times. There has to be some correlation between the two. Because opiates helped lift my depression I neck addicted to them by self medicating. I wound up getting in trouble with the law. Things just went downhill in a hurry. I am on Suboxone. I have been on it for almost 4 years. Unfortunately I think because I've been on it so long, it's no longer helping my depression. I'd have to say that for me Ketamine is the next best thing. That said, for me, opiates are by far the best fix for my depression. I pray that researchers are looking into why this is so. It's just awful that so many of us have to struggle with debilitating depression day in and day out. I wish everyone luck in their search for freedom from depression.

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Emelie, I'll be honest...Ketamine, either orally or IV form hasn't been the panacea that I hoped it would be, at least for me. My first IV ketamine treatment (only after the 2nd infusion though) saved me from the worst depressive/suicidial thoughts I had in my life. However, after maintaining with oral ketamine 200mg, every 2nd night, for the past year, I've found it "lacking". It's been a huge problem for me to take it on an empty stomach before falling asleep (I find the disassociative effects if I'm awake distressing) just to get 20% bioavailability (any food in my stomach likely contributing to some ineffectiveness). I've also had 8 booster ketamine infusions in the US spread over the past 4 months and, in my opinion, the infusions have helped with the worst darkest depression and ruminations, but the anxiety that I have on a general basis and my chronic gloom and doom mentality has not been cleared. Granted, I'm exposed to a lot of sad/negative environmental factors, but so do a lot of people who don't suffer this disabling mental illness. I'm currently starting oral Moclobemide (300mg/day) for the first time as my primary antidepression med but I don't feel any effect after almost 2 weeks. After I've titrated to 600mg for a decent trial period, I'll be able to switch to trying oral ketamine troches (also compounded by pharmacies) which will increase how much gets to the brain without having to go through the gastric system. We'll see.

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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.

Mark

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dave-

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.

john

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