June 27, 2017 2:21 PM   Subscribe

Have you done ketamine infusions for depression? What were they like?

I have so-far treatment-resistant depression. To begin with, assume I'm telling the truth when I said I've tried and failed around ten different medications. I meet the criteria for ketamine administered at a psychiatric level, and there is a safe clinic near me run by well-credentialed physicians from our big hospital system, which I can afford out of pocket. I have survived a suicide attempt in the past.

All of that said, have you tried ketamine? Everything I've read about it sounds like some kind of a miracle, especially for depression that looks and behaves like mine. I'm aware that there's a lot we don't know about it yet, and may learn in the future, but what information does exist seems almost too promising to be true. If you took it, what was your experience like? What were the side effects? (I know every medication has side effects, and I'm not going into this naively) What happened that you did or didn't expect?

This is not something I'm for sure going to do, just something I am trying to consider from all angles. Thanks in advance for your answers and kindness.
posted by colorblock sock to Health & Fitness (15 answers total) 19 users marked this as a favorite
So, uh, I did a bit of ketamine recreationally. It's a disassociative anesthetic and at low to medium doses it can be quite trippy.. you feel somewhat disconnected from your body and can have kind of dreamlike hallucinations where it kind of feels like you're floating in another dimension. I've heard people describe it as being like a pilot inside your head trying to pilot your body via remote control.

At high doses it's more of an anesthetic, where you complete lose your connection to reality and can't move at all, and if you remember anything at all, the hallucinations/ dreams get much more vivid, including having entire conversations with imagined entities. It's not one of the drugs that induces euphoria or happiness.. I remember feeling almost emotionless.

I have no idea what a therapeutic dose is like, and I was also doing a lot of other club drugs at the time, so it's hard to say what the longer term effects are in terms of mood.

In terms of side effects, once it wore off, almost nothing. No hangover, no desire to immediately try it again or anything that would encourage dependence, at least for me. Though I did know some people who did it way, way too much.
posted by empath at 4:08 PM on June 27, 2017 [1 favorite]

Response by poster: Not to threadsit, but I realize looking over my question I didn't make it totally clear: I'm looking for ketamine experiences that were for mental health treatment, not recreational.
posted by colorblock sock at 4:42 PM on June 27, 2017

I won't say I've "tried" it but I have certainly been given it, and apparently a fairly heavy dose, after I woke from an operation that had gone for 4 hours when it should have gone for 1 because my gallbladder had become infected and fused itself to surrounding organs and tissue, and when I woke they asked me what my pain was on a scale of 1 to 10 and I immediately started sobbing and said "fifteen", they gave me a bunch of other stuff first and it honestly didn't make a dent, so then the K came out, and wow.

My recollection may have grown fanciful as this was many years ago, but my consciousness was basically separated from my body and the severe agony I was in was completely dispelled. Pretty much everything was dispelled apart from an awareness that I, and the colour white, existed. I was in hospital for four days for an overnight procedure, but was never given it again, sadly. In retrospect I understand why, but, Christ.
posted by turbid dahlia at 4:45 PM on June 27, 2017

I have a relative who did this. It's effective. Memail me if you want me to connect you.
posted by songs_about_rainbows at 5:00 PM on June 27, 2017 [2 favorites]

Erowid is one source for these kinds of testimonials, though in terms of reliability it is the same crapshoot as every other drug-experience internet forum.
posted by juliplease at 5:31 PM on June 27, 2017 [2 favorites]

Best answer: Recreational or anesthetic use of ketamine is not the same as the protocol for treatment for mental health disorders. I don't think that information is useful to the OP.
posted by DarlingBri at 5:32 PM on June 27, 2017 [4 favorites]

I should point out, the Erowid link I posted is for someone whose depression was clinically treated with Ketamine. I posted the disclaimer about the site since it is usually about recreational experiences and not heavily moderated (I don't think?) but they certainly cover medical experiences as well.
posted by juliplease at 5:35 PM on June 27, 2017 [4 favorites]

Have you seen this article: The Ketamine Club? It details several different treatment experience with ketamine and also has a bunch of useful links about therapeutic ketamine treatment.
posted by mogget at 6:11 PM on June 27, 2017 [3 favorites]

I know a person who suffers from severe depression and also survived two suicide attempts. He and his wife were very hopeful, and he tried three or four infusions administered as part of a hospital protocol investigating ketamine's efficacy for severe depression, but in the end it was not helpful. Like other medications, some are helpful and some not, so his experience probably doesn't mean much about how you may respond. If you decide to try it, I hope it helps. Good luck.
posted by citygirl at 6:26 PM on June 27, 2017 [1 favorite]

Best answer: Yes, I currently get medical infusions. I started 18 months ago for a round of 4 but since it was a 2 hour drive my work schedule didn't permit the maintenance treatments. So this month I started again and have received 5 more infusions so far.

Please PM me any questions you have. I almost made this thread the other day but didn't think it would get many responses. I will say that I have tried every antidepressent that is commonly prescribed and even some of the older ones, everything short of ECT. SSRIs/SNRIs etc are completely ineffective and only make me feel worse (and I always take them for 8 weeks minimum to give them a chance).

Ketamine infusions are not covered by health insurance and even though I pay less as an established patient, they are still not cheap. They are worth it though because while SSRIs have less than a 10% success rate, not much higher than placebo and far less than even simple exercise, ketamine administered through a slow IV infusion works for atleast 75-80% of patents ( and keep in mind we are talking about people who have likewise tried everything else without success). And it is a profound improvement that lasts longer than the ketamine stays in your system.

It is important to go to a good clinic. If you take benzodiazepines they need to know because benzos like valium, klonopin etc necessitate a higher dose. They are better at it in general then they were even 18 months ago.

Again, please PM me about any questions, details, etc. If you can afford it, do it. I don't say that lightly. It will almost certainly work, and it works IMMEDIATELY, no second guessing. The treatment is not scary, and most people usually find it pleasant if anything. The results from these ketamine clinical trials and the few centers that administer it in the US have all but proved that the serotonin/dopamine/norepinephrine imbalance theory of psychiatry that SSRIS and SNRIs depend on is not as important as thought, and that the NMDA receptor that ketamine acts upon is more likely the key for targeting future antidepressants that actually work for more people than not.

The center I go to in Arizona was either the 1st or 2nd in the country and most centers base their practice off them, but some differ. Some for example offer IM injections, but they simply aren't as effective. Please PM me, and please give it a shot. Remember that if it does work for you, you will know during the first treatment and are not obliged to pay for further treatments if you happen to be one of the very few that it doesn't work wonders for.
posted by WhitenoisE at 7:36 PM on June 27, 2017 [20 favorites]

For those unfamiliar with ketamine as an antidepressant, it is administered in FAR lower doses than you'd use recreationally or as an anaesthetic, and done through an IV. Sketchy clinics are rampant and you'll find doctors giving out pills (which don't have the same effect) or too high doses, or otherwise administering improperly. You can't buy it off the street as depression treatment.

OP, I've been investigating its use a lot but haven't tried it as of yet. Everything I've read indicates if you're not making progress after the first month of sessions them further treatment is probably moot. The really dramatic, overnight improvements are for patients who are in the midst of a serious depressive period. Like, if you have MDD and are depressed all the time normally, but are going through an extra dark time you'll especially notice improvements then.
posted by Anonymous at 10:56 PM on June 27, 2017

Response by poster: WhitenoisE: I'd love to discuss this further with you but your mefimail is disabled. Could contact me instead?
posted by colorblock sock at 8:10 PM on June 28, 2017

Yes, there is at least one doctor (in NY) that administers pills to be filled at a compound pharmacy. Ketamine is not very bioavailable orally and therefore requires gigantic oral doses compared to injection. This is especially bad news because large amounts of the metabolite norketamine are produced when metabolized orally, and norketamine is the main agent responsible for bladder fibrosis.
posted by WhitenoisE at 5:05 AM on July 1, 2017 [1 favorite]

Response by poster: Thank you so much to everyone who commented here, especially the people who memailed me. It was enormously helpful. I'm getting my first infusion at the end of August, and while the process of getting approved and all the paperwork through was a nightmare, I'm going into it feeling hopeful and informed. I may update on how it goes in case anyone needs this thread in the future.
posted by colorblock sock at 5:50 PM on July 30, 2017 [3 favorites]

Response by poster: Some months on it feels like I should come back and give an update. I do feel like the ketamine is working for me, and so does my doctor. It is the first thing I can say that about other than Wellbutrin (which I stopped taking because I'm allergic to it.). Ketamine is a miracle for some people, I wouldn't say it's a miracle for me, just an effective way of keeping myself level and out of the pit, which is still huge. My doctor estimates 35% of people go into full remission out of the 80% who it effects, and within that 80% that's people of huge variation - basically all over the "this is working" scale. That information was not readily available to me before beginning the process, and I think my expectations weren't necessarily too high, but did need to be adjusted.

I think it's also really important to look past some of the hyperbole and be patient, and not give up, and expect a certain amount of fluctuation and differences in individual response. If you are a high-functioning depressed person (ugh, I hate that term, but you know what I mean), it's harder to notice changes because it's not like you couldn't get out of bed or do work and now you can. That's where I've found family and friends keeping an eye on me to be helpful.

Overall, the future is still open. I'm at a good dose for me but I just got there, and it may work even better with an adjunctive MAOI I'm considering trying and less anti-anxiety medication or a higher dose. I probably need it more frequently than most people, that's just how my body is taking it. That means bi-weekly infusions for the foreseeable future and that's expensive and time consuming. I do have side effects that day of the infusion: dizziness, nausea, fever, fatigue/brain fog, feeling worse for a bit before I feel better emotionally. Sometimes maintenance infusions, after the initial six, just crap out for reasons nobody is sure of and you need another. It doesn't work during my period.

ALL THAT SAID, if ketamine is feasible for you, you should try it, and anyone who does or is thinking about it is free to Memail me. More fun facts: even if it doesn't help depression, it can still eliminate suicidal ideation. That in itself is worth it, I think. I hope this helps someone, there is so very little out there outside the Ketamine Advocacy Network, and what information there is, is incomplete. It's a brave new world.
posted by colorblock sock at 8:03 PM on November 29, 2017 [5 favorites]

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