Help me decide whether to try ketamine therapy for depression
February 11, 2019 11:11 PM Subscribe
I have dysthymia (chronic low-level depression) and am considering ketamine-assisted therapy. But it's very expensive ($3000) and from online research I can't decide whether it's likely enough to help to be worth the expense. What does MeFi think?
I've been mildly to moderately depressed my entire adult life. Therapy and medication haven't helped. Reading online about ketamine it seems to be extremely effective for some people who haven't been helped by other treatments. But the reports I've seen are kind of frustratingly vague and I don't have a sense of what kind of person it tends to work for, how it works or even what the experience is like. There's a clinic here in the Bay Area that offers a treatment course for $3000 which includes three ketamine sessions plus counseling and integration sessions. (I haven't looked for other possibly cheaper options, mostly because I know some of the people at this clinic and feel that I can trust them and would be comfortable having the treatment there; but from what I've heard this seems to be more or less the going rate.)
$3000 to me is a very substantial expenditure. But any expense would be worth it to live a life free of depression. (I know a single course of treatment may not achieve this long term, but if it was effective to the extent that I just needed occasional boosters, I could do that.) I worry that it would either not be effective or be effective for a very short time and then wear off (this was my experience with MDMA-assisted therapy, which I've tried in the past). I'm finding it very hard to make this decision, especially not having a clear idea of what I might actually experience during a session. So if any MeFites out there know someone who's tried this treatment, or have tried it and are willing to share your experience, or have other possibly helpful thoughts, I'd love to hear.
I've been mildly to moderately depressed my entire adult life. Therapy and medication haven't helped. Reading online about ketamine it seems to be extremely effective for some people who haven't been helped by other treatments. But the reports I've seen are kind of frustratingly vague and I don't have a sense of what kind of person it tends to work for, how it works or even what the experience is like. There's a clinic here in the Bay Area that offers a treatment course for $3000 which includes three ketamine sessions plus counseling and integration sessions. (I haven't looked for other possibly cheaper options, mostly because I know some of the people at this clinic and feel that I can trust them and would be comfortable having the treatment there; but from what I've heard this seems to be more or less the going rate.)
$3000 to me is a very substantial expenditure. But any expense would be worth it to live a life free of depression. (I know a single course of treatment may not achieve this long term, but if it was effective to the extent that I just needed occasional boosters, I could do that.) I worry that it would either not be effective or be effective for a very short time and then wear off (this was my experience with MDMA-assisted therapy, which I've tried in the past). I'm finding it very hard to make this decision, especially not having a clear idea of what I might actually experience during a session. So if any MeFites out there know someone who's tried this treatment, or have tried it and are willing to share your experience, or have other possibly helpful thoughts, I'd love to hear.
I hesitated to answer because I know you're looking for people with experience with Ket, but my own research concurs with yesbut. TMS has way more data behind it, and the data is solid.
posted by DarlingBri at 3:44 AM on February 12, 2019
posted by DarlingBri at 3:44 AM on February 12, 2019
Most likely Ketamine will be FDA approved for depression this year. If you've tried other treatments it's likely your insurance will pay for it.
https://mixmag.net/read/new-ketamine-variation-for-depression-news
I haven't tried Ketamine or TMS, but I have tried everything else including ECT. The only thing that's worked for me is an MAOI. I have to watch my diet but it's been a life saver for me.
posted by Grumpy old geek at 5:06 AM on February 12, 2019 [4 favorites]
https://mixmag.net/read/new-ketamine-variation-for-depression-news
I haven't tried Ketamine or TMS, but I have tried everything else including ECT. The only thing that's worked for me is an MAOI. I have to watch my diet but it's been a life saver for me.
posted by Grumpy old geek at 5:06 AM on February 12, 2019 [4 favorites]
If you can get TMS covered by your insurance, I would try that first. If that doesn't help, I'd check out ketamine. There's no way to know what's going to work for you without trying them - at some point all of us with chronic health issues become our own science projects and that's hard, but sometimes you find something good. Both of these can be absolutely life-changing for depression, I'd just try to get whatever you're doing covered.
posted by bile and syntax at 5:59 AM on February 12, 2019 [1 favorite]
posted by bile and syntax at 5:59 AM on February 12, 2019 [1 favorite]
friend of mine tried it and it worked wonders. did have nausea after one session though.
posted by evilmonk at 9:02 AM on February 12, 2019
posted by evilmonk at 9:02 AM on February 12, 2019
Mine's been fortunately manageable with low dose standard meds. That being said, I was given a high does of Ketamine in an ER while my tibia/fibula were broken and poking out of my leg, while I waited for surgery. I went down what is referred to as a K-hole, and I'm writing to tell you because the experience was worse than my badly broken leg, which was far and away the worst pain I ever experienced in my life.
I did a lot of research after the fact because it was such a traumatic experience and I wanted to understand it in order to process it better. Ketamine is commonly mis-referred to as a horse tranquilizer. While it is used by vets for animal pain management, a horse would get a much larger dose than a human. Human use was first explored in the Vietnam war - it was favored because it has little-to-no effects on critical biological functions like breathing or heartbeat. It fell out of favor, however, because of the POWERFUL negative psychedelic side effects, generally referred to as the aforementioned K-hole.
"'Falling into a K-Hole' is slang for how it feels when you take a high-enough dose of ketamine that your awareness of the world around you, and your control over your own body, become so profoundly impaired that you're temporarily unable to interact with others—or the world around you."
The best definition for what I went through that I found online was that the experience is generally described as feeling somewhere between extreme inebriation and coma / death. For approximately 3-4 hours, I was awake, with my eyes open, but unable to move or speak. I was CERTAIN that I was dying and that if I closed my eyes or fell asleep I would never wake up again. I was unable to ask to see my wife or child to tell them that I loved them before I slipped away. In retrospect, I was fine, but I didn't know that in the moment and I had no one to tell me that.
My sister who is an ER nurse told me that if and when they had to use ketamine on a patient they would never leave the patient alone, instead a nurse would stay with them to coach them through the experience and try to avert going down the hole. I'm certain if you were doing therapy with licensed providers, they would know about these risks and know how to help you manage them, but for me, I'd probably never resort to ketamine, because the downside is just way way WAY too down for me and I never want to go through that again.
posted by allkindsoftime at 11:25 AM on February 12, 2019 [5 favorites]
I did a lot of research after the fact because it was such a traumatic experience and I wanted to understand it in order to process it better. Ketamine is commonly mis-referred to as a horse tranquilizer. While it is used by vets for animal pain management, a horse would get a much larger dose than a human. Human use was first explored in the Vietnam war - it was favored because it has little-to-no effects on critical biological functions like breathing or heartbeat. It fell out of favor, however, because of the POWERFUL negative psychedelic side effects, generally referred to as the aforementioned K-hole.
"'Falling into a K-Hole' is slang for how it feels when you take a high-enough dose of ketamine that your awareness of the world around you, and your control over your own body, become so profoundly impaired that you're temporarily unable to interact with others—or the world around you."
The best definition for what I went through that I found online was that the experience is generally described as feeling somewhere between extreme inebriation and coma / death. For approximately 3-4 hours, I was awake, with my eyes open, but unable to move or speak. I was CERTAIN that I was dying and that if I closed my eyes or fell asleep I would never wake up again. I was unable to ask to see my wife or child to tell them that I loved them before I slipped away. In retrospect, I was fine, but I didn't know that in the moment and I had no one to tell me that.
My sister who is an ER nurse told me that if and when they had to use ketamine on a patient they would never leave the patient alone, instead a nurse would stay with them to coach them through the experience and try to avert going down the hole. I'm certain if you were doing therapy with licensed providers, they would know about these risks and know how to help you manage them, but for me, I'd probably never resort to ketamine, because the downside is just way way WAY too down for me and I never want to go through that again.
posted by allkindsoftime at 11:25 AM on February 12, 2019 [5 favorites]
I stopped after about 20 sessions. I did get some relief after some sessions, but it didn't last. Despite the "propaganda" that the treatment centers put out, the relief seems to last for a couple of weeks at most. I've tried the nasal and other things to prolong, to no avail
Keep in mind that everyone is different.
Send me a message if you have questions
posted by kbbbo at 11:55 AM on February 12, 2019 [1 favorite]
Keep in mind that everyone is different.
Send me a message if you have questions
posted by kbbbo at 11:55 AM on February 12, 2019 [1 favorite]
I tried it because of my treatment-resistant depression, and it did nothing for me. The actual experience of being on the ketamine was very unpleasant for me (the room became dark, and colors and shapes were constantly coming at me), and that lack of a sense of control was difficult.
posted by Four-Eyed Girl at 12:29 PM on February 12, 2019
posted by Four-Eyed Girl at 12:29 PM on February 12, 2019
I've been on ketamine for a little over a year. Feel free to MeMail me.
posted by colorblock sock at 10:46 PM on February 12, 2019 [1 favorite]
posted by colorblock sock at 10:46 PM on February 12, 2019 [1 favorite]
I would do it, but not for a patently exorbitant price that triggers my "scam" detector as hard as anything ever has.
Unless that price is for many sessions, it seems more like the stem cell scammers than best practice ketamine treatment.
posted by wierdo at 6:22 AM on February 14, 2019
Unless that price is for many sessions, it seems more like the stem cell scammers than best practice ketamine treatment.
posted by wierdo at 6:22 AM on February 14, 2019
I found the feedback on this thread to be very helpful as I am considering Ketamine myself right now. It looks like there are more negatives than positives. I would appreciate hearing more feedback on this subject from anyone who cares to chime in.
posted by htm at 7:53 PM on April 17, 2019
posted by htm at 7:53 PM on April 17, 2019
« Older Navigating the TriMet system (Portland) | Tips for Hadrian's Wall lodge-to-lodge hike in... Newer »
This thread is closed to new comments.
Personally, I'm wary of it. From what I've read, most people who try it do need further / maintenance treatment. Also, the difficulty with the treatment is that the effective dose usually is high enough to have psychedelic side effects, which many subjects in the experimental research found too much. Apparently it has had an unusually high drop-out rate in the research.
I'd be more tempted by TMS. It's a variation on a form of treatment that already has great evidence to support it - electric shock therapy - without the same extreme side effects. Alternatively, $3,000 would let you try a different form of regular talking therapy, assuming you haven't tried them all already.
posted by yesbut at 1:40 AM on February 12, 2019 [2 favorites]