I have a long history of depression, medicated for the last 30 years with uneven success. I am currently on several prescription medications and lots of nutritional supplements (vitamins and amino acids) that used to help. The last few years, it feels like nothing is working anymore.
I am reading about ketamine and looking into a clinic here in Charlotte.
Anyone have any experience with it or does anyone close to you have experience with it?
As a teenager and young adult I fucked the shit out of my serotonin levels by doing waaay too much speed, lsd, coke, ecstasy, and I ended up being serious messed up in mid twenties.
I’ve been cycling Prozac & Sertraline every 3/4 yrs. it works ok. It leaves me being able to get up in the morning and not want to slit my wrist when I open my eyes. It does leave me feeling ‘dull’ and I sometimes come off the meds just to feel Life and emotions.
I believe it’s microdosing ket, I’d be happy to do a trial but as I’m in the Uk I think this is probably 10 years away :mad:
Somebody close to me with treatment resistant depression tried ketamine for several months. The initial few doses might have been with a doctor, but after that it was self administered nasally at home. The report was 15-30 minutes of light headedness and possible intoxication (“a bit high”). Once that faded there weren’t any side effects. Unfortunately it wasn’t effective as a treatment. At this point the depression had been severe enough and long term enough, that it might have been beyond ketamine’s ability to deal with.
Given the low level of side effects, and relative expense (more than generic antidepressants and vitamins, but way less than in-patient treatment) it might be worth trying. Obviously, discuss it with your psychiatrist and care team. The medication came from a nearby compounding pharmacy (they mix the inhaler there), and wasn’t covered by insurance, as it’s still experimental. I want to say it was about $80 per bottle, but I don’t remember how long a bottle lasted.
In the case close to me, the only effective treatment was electro convulsive therapy. The side effects and life disruption are significant, but it was incredibly effective where no other treatment had done anything.
I’m not a clinician, so I don’t even know if these are the right thoughts. It may be more effective for somebody trying to stabilize her mood, rather than interrupt a depressive episode. Just because it didn’t work on my person, doesn’t mean it won’t work on you. Just because my person didn’t have any bad side effects, doesn’t mean you won’t.
So 1.5 stars. It didn’t work, but no big side effects. It might have been fun, except the depression kept anything from being fun.
I opened this thread to mention this option. Modern ECT is much improved over the earlier versions, and can give amazingly good results for individuals who have failed other interventions. A physician friend of mine feels it saved his life, after decades of meds, counselling, talk therapy, and other modalities. Now he didn’t try ketamine, but he did try benzos and opioids along with more appropriate anti-depression meds, mood stabilizers, and so forth.
I work in the MH field, in NC. PM’ing you. 
I am having ketamine infusions to deal with intractable migraine. This is a much higher dose, administered over several days. You might check into this option. I’ve heard good things about it for depression.
The psychiatrist running the clinic says the biggest problem is that people don’t try it earlier. Additional months of depression trying to figure out if higher a dose of bupropion might work, is needless suffering when ECT is a therapy that will almost certainly work.
I feel that he was minimizing the side effects. ECT is not a treatment that can be done alone. The short term side effect is temporary dementia that require 24/7 babysitting through the worst of it. The patient doesn’t need help dressing, eating, and bathing, but might need reminders to dress, eat, and bath. Also somebody to take the phone away before giving the scam caller a credit card number.
As soon as the number of treatments drops, that dementia clears, and what’s left are the long term side effect of memory loss. Oh, and a brain free of depression. The change is remarkable, and the patient is likely not to see it. The patient looks at the three months lost to ECT, and doesn’t understand why it was necessary. Everybody else in the patient’s life looks at the previous years lost to depression and says, “good to have you back.”
I can totally see why people call ECT life saving.
So 4 stars. It works like nothing else I’ve ever seen, but it’s also got quite a kick.
echoreply, your description of ECT is why I’m leaving that as a last resort. I don’t think my depression is bad enough, at least not right now, for me to give up 3 months of my life to dementia and subsequent memory loss (my memory is already patchy), plus I have no one who would be able to take care of me for that length of time. And I work full time.
I really wanted to try it after reading up on it. But it wasn’t covered by my health insurance and I don’t have 4K to spend on it. All treatments were by IV and obviously administered at the clinic.
I don’t see why it wouldn’t be covered. They’re declining a month of treatment versus a lifetime of prescriptions.
The FDA-approved ketamine formulation for depression (esketamine a.k.a. Spravato) is administered by nasal spray at a health care facility (not at home). Patients’ mental status and vital signs are to be monitored for two hours afterwards to watch for untoward effects (i.e. on blood pressure/heart rate). Clinical effects could be seen in hours to days (a response commonly takes weeks with traditional antidepressants).
It’s good there’s another option for treatment-resistant major depression. It’s noteworthy that of the four clinical trials of the drug, only two showed statistically significant effectiveness greater than placebo.*
*also worth noting: in all of the trials, patients took an oral antidepressant plus esketamine, except that in the placebo group the oral antidepressant was given with an inert placebo nasal spray. In most other antidepressant trials, the drug being tested was compared to an actual inert placebo.
**the above information comes from the 9/17 edition of the Journal of the American Medical Association.
I’m curious as to whether the OP decided to try it. Or anyone else, for that matter.
I am the OP and I will update. I had 6 IV infusions over December 2019 and a booster in January 2020 and the treatments worked pretty well. I had a booster in August 2020, and another in November 2020. This last one worked the best and I had the best holiday season I’ve had in years. I was upbeat, had lots of energy and really enjoyed the season.
The first clinic I went to was a disaster. I found it online and had done all the pre-screening and medical records transfer. I ended up walking out of my first appointment before the treatment because the place seemed shady and the nurse still hadn’t shown up 45 minutes past my appointment time. So glad I left.
After that, I found another clinic that I love. The doctor who runs it is an anesthesiologist. During the IV infusion, they monitor blood pressure, heart rate and pulse ox. During the second treatment, I freaked out a bit, so after that she put me to sleep with propofol and had propofol in the IV to keep me asleep. This worked wonderfully. They also had someone in the room with me at all times in addition to the surveillance camera in the room. There was an ER nurse on duty as well just in case. I felt very safe there. The doctor also prescribes ketamine lozenges to use in between treatments. They are expensive but last several months. I cut them up because a whole one is too strong. They create a bit of a floaty feeling, pleasant, with no side effects or hangover.
The treatments are $425, not covered by insurance, and I have to pay for transportation on top of that, since you cannot drive yourself there or home and I have no relatives or friends in the area that I feel comfortable asking to drive me. My driver gets me there, then also picks me up after 2 ½ hours and takes me home. It’s expensive but he is very punctual and reliable and actually comes up to the doctor’s office to get me and help me to the car, since I’m still woozy.
Unfortunately, the doctor has recently had some kind of medical trauma that will require a long recovery time and I am trying to find another clinic. There are several in the area that I am checking out now.
With the caveat that the site hosting the article is hostile to the use of medication in treating depression, this is disturbing.