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Dr. Bob is Robert Hsiung, MD,
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Posted by Twinleaf on February 10, 2012, at 11:33:12
In reply to Re: Ketamine: Replication of previous studies. » Twinleaf, posted by SLS on February 9, 2012, at 19:40:29
The: dosage of ketamine was 100 mg. once daily in the AM initially; he is now maintained on 200 mg. daily. On this dosage he feels slightly high and spacey for about an hour ( no dissociation), and then settles into feeling normal for the rest of the day.
Posted by Roslynn on February 10, 2012, at 12:49:30
In reply to Re: Ketamine: Replication of previous studies., posted by Hugh on February 9, 2012, at 17:18:07
Thank you so much for giving me this info!
Roslynn
>
> Riluzole. It's been used for over fifteen years to treat ALS, and is extremely expensive. Sun Pharma received tentative approval from the FDA to manufacture a generic version, which would be much cheaper. That was over a year ago, but generic riluzole still isn't available.
>
>
Posted by phidippus on February 10, 2012, at 12:53:11
In reply to Re: Ketamine: Replication of previous studies., posted by SLS on February 9, 2012, at 5:37:08
I was on a Ketamine infusion
0.5mg/kg IV over 40 minutes.I exeprienced no psychosis or otherwise undesriable cognitive effects. Just this slight derealization.
Eric
Posted by SLS on February 10, 2012, at 13:10:20
In reply to Re: Ketamine: Replication of previous studies., posted by Twinleaf on February 10, 2012, at 11:33:12
> The: dosage of ketamine was 100 mg. once daily in the AM initially; he is now maintained on 200 mg. daily. On this dosage he feels slightly high and spacey for about an hour ( no dissociation), and then settles into feeling normal for the rest of the day.
Thank you for looking into this.
- Scott
Posted by roversreturn on February 14, 2012, at 14:23:43
In reply to Re: Ketamine: Replication of previous studies., posted by Twinleaf on February 10, 2012, at 11:33:12
It should probably be noted that premilinary evidence studying long terms intranasal users of Ketamine (and I'd expect taken as a pill as well) seems to lead to bladder damage.
Therefore, unless you are suicidal then I would probably not recommend taking it on a long term basis any other way but through IV treatment. I must state that I am merely stating what the literature seems to suggest and I am by no means adverse to trying more 'exotic' treatments, as mainstream medication seems to be ineffective for many.
Rover
Posted by JohnLA on February 14, 2012, at 18:02:38
In reply to Ketamine - bladder issues, posted by roversreturn on February 14, 2012, at 14:23:43
hi rover-
could you cite some references to this bladder issue?
please take a look at this;
about half-way down she mentions the bladder issue. (she is a neurologist.) she cites several references for the use of ketamine in pain management/depression. she also sates that the amount of ketamine she uses to treat depression is much lower than the amount used in iv delivery. if you read all the way thru she questions the bladder issue you discuss. as with all medications there are risks. still, i think ketamine may lead to new meds for us suffering from depression.
there are several studies (some at the phase 2 level) trying out ketamine nasal spray for depression. let me know if you'd like me to site them.
i'll keep you posted as i am going down to san diego in hopes of 'scoring' some ketamine nasal spray. ; )
take care.
john
Posted by Iansf on February 15, 2012, at 10:20:11
In reply to Re: Ketamine - bladder issues, posted by JohnLA on February 14, 2012, at 18:02:38
> please take a look at this;
>
> http://painsandiego.com/2012/01/25/ketamine-intranasal-for-rapid-relief-of-pain-and-depression-opioids-fail-to-help-pain-care-reform-is-urgently-needed/
>
> about half-way down she mentions the bladder issue. (she is a neurologist.) she cites several references for the use of ketamine in pain management/depression. she also sates that the amount of ketamine she uses to treat depression is much lower than the amount used in iv delivery. if you read all the way thru she questions the bladder issue you discuss. as with all medications there are risks. still, i think ketamine may lead to new meds for us suffering from depression.
>Since ketamine is a widely used "club drug," under the rubric Special K, I've been wondering why there has been so little evidence of experiments with its intra-nasal potential. All the studies I had previously come across involved i.v. administration, while all discussion of intranasal ingestion referred to "misuse" for the purpose of getting high. Since i.v. treatment is not practical for most of us, it's good to know at least a few doctors are examining the potential of oral and intranasal use.
I live in Mexico, where ketamine is available legally without prescription, but I've always been wary of trying it. A friend of my roommate used it to get high, and his behavior while under its influence made it seem both risky and not particularly appealing. Perhaps a much lower dosage is the key. Unfortunately, given the methodology I'm aware of for sniffing it, I wouldn't have a clue how to regulate the dosage to achieve a safe but effective level.
Posted by roversreturn on February 15, 2012, at 20:07:54
In reply to Re: Ketamine - bladder issues, posted by JohnLA on February 14, 2012, at 18:02:38
> hi rover-
>
> could you cite some references to this bladder issue?
>
> please take a look at this;
>
> http://painsandiego.com/2012/01/25/ketamine-intranasal-for-rapid-relief-of-pain-and-depression-opioids-fail-to-help-pain-care-reform-is-urgently-needed/
>
> about half-way down she mentions the bladder issue. (she is a neurologist.) she cites several references for the use of ketamine in pain management/depression. she also sates that the amount of ketamine she uses to treat depression is much lower than the amount used in iv delivery. if you read all the way thru she questions the bladder issue you discuss. as with all medications there are risks. still, i think ketamine may lead to new meds for us suffering from depression.
>
> there are several studies (some at the phase 2 level) trying out ketamine nasal spray for depression. let me know if you'd like me to site them.
>
> i'll keep you posted as i am going down to san diego in hopes of 'scoring' some ketamine nasal spray. ; )
>
> take care.
>
> john
>
>
>
>
>
>
>Ok this is a link to a news article on it
http://news.bbc.co.uk/1/hi/england/bristol/7867449.stm
and a study, albeit with a very small sample size.
http://www.hkmj.org/article_pdfs/hkm0708p311.pdf
As i said, I wouldn't discourage anyone suicidal from trying it out of desperation, although regular use could cause problems, but how big the risk is I really don't know.Good Luck
Rover
Posted by JohnLA on February 15, 2012, at 23:30:08
In reply to Re: Ketamine - bladder issues, posted by roversreturn on February 15, 2012, at 20:07:54
thanks rover.
appreciate you posting the links.
the amount used in the nasal spray is much less than used by drug addicts/abusers that are cited in the studies you posted.
the doc told me it's a very small percentage of what is need to get high.
thanks, too, for the 'good luck' wishes.
john
Posted by SLS on February 16, 2012, at 2:06:05
In reply to Re: Ketamine - bladder issues, posted by JohnLA on February 15, 2012, at 23:30:08
> thanks rover.
>
> appreciate you posting the links.
>
> the amount used in the nasal spray is much less than used by drug addicts/abusers that are cited in the studies you posted.
>
> the doc told me it's a very small percentage of what is need to get high.
>
> thanks, too, for the 'good luck' wishes.
>
> john
Are there any existing protocols for intranasal or oral administration if ketamine? I am still curious if intermittent administration with a larger dose is more effective than daily administration with small dosages. There is so much more work that needs to be done in this area. For instance, if one is suicidal, will the oral or intranasal routes for ketamine provide adequate therapeutic effect, or is a drug like Zyprexa a better answer for now?
- Scott
Posted by JohnLA on February 16, 2012, at 21:35:13
In reply to Re: Ketamine - bladder issues » JohnLA, posted by SLS on February 16, 2012, at 2:06:05
great questions scott.
i'm not sure of the answers. my totally non-medical opinion is that the iv would be used for severely depressed/suicidal people and the other 2 delivery methods would be more for those that are depressed, but treatment resistant.
again, i'm not a doctor so i really don't know.
i have made contact with 2 doctors who treat with ketamine. spoken with one who only does the nasal spray and sublingual delivery of ketamine. the other i have yet to speak with, only voicemail. i think he only does iv treatments. i'll try and get some more info from the 2nd doc.
the doctor i am seeing requires you to spend a week with her trying out different doses to find the correct dosage (nasally or sublingually). i see her next month.
i am tempted to drop some serious money (about $1000) and go to my shock doc at ucla and try the iv route. ironically, my last period of depression free symptoms was following sinus surgery. i had absolutely no depression for 3 or 4 days following the 1 hour surgery. i didn't ask, but i wonder if they used ketamine to put me out.
i'll do my best to keep you posted on what i find.
john
Posted by SLS on February 17, 2012, at 6:27:43
In reply to ketamine dosage, posted by JohnLA on February 16, 2012, at 21:35:13
Hi John.
> i'll do my best to keep you posted on what i find.
I'm sure the forum would be grateful if you did.
And...
Good luck!
- Scott
Posted by ed_uk2010 on February 17, 2012, at 13:50:12
In reply to ketamine dosage, posted by JohnLA on February 16, 2012, at 21:35:13
>I wonder if they used ketamine to put me out.
Probably not. Ketamine is not routinely used in anesthesiology. Most anesthetists only use it in special clinical situations.
Ketamine is widely used by veterinarians. A vet friend told me he finds it highly useful for cats! A cat on ketamine can tolerate anything.
Why does an injection of a low dose of a cheap drug cost you $1000? It this profiteering?
Posted by Phillipa on February 17, 2012, at 18:19:18
In reply to Re: ketamine dosage » JohnLA, posted by ed_uk2010 on February 17, 2012, at 13:50:12
Ed welcome to the US!!! PJx
Posted by JohnLA on February 17, 2012, at 19:09:10
In reply to Re: ketamine dosage » JohnLA, posted by ed_uk2010 on February 17, 2012, at 13:50:12
hey ed, scott and all others (phillipa :))
i have a good friend who is a orthopedic surgeon. he uses ketamine quite a bit with his pediatric and elderly patients when doing surgery. so, the 'urban myth' that it's a horse tranquilizer isn't 100% correct. at least not here in the usa...
and! i did finally get thru to my old shock doc at ucla. not a $1000 per shot, but $1200 per shot! yeah, it's a lot of money. lots of reasons for the big bucks; doc, anesthesiologist, and a nurse. plus, they keep you there for a few hours after.
i'm going in for a consult first, which is covered by my insurance. the ketamine though is not. his nurse said that some people have come in for one and and a few have gotten as many as 3 to 4 'treatments.' she could and would not elaborate what kind of results these people were getting.
as i said earlier, i have made a appointment for next month down in san diego with a neurologist who works with psychs who prescribe it as a nasal spray or sublingually. she charges an initial $400, but after that it's a 15 min meeting every few months, if the stuff ends-up working. oh yeah, she also expects you to stay in the san diego area for at least a week to figure out dosing. luckily i have a good friend i can stay with down there. not sure what that will all cost. but, the nasal spray is about $40 to $60. also not sure what the sublingual ketamine cost is, but she mentioned it is 'not expensive.' she seemed to suggest that both treatments were not a daily dosing deal. that would keep price down too.
i'm leaning towards trying the iv at least once. i do like the doc. his name is dr espinoza. you can look him up at ucla and even on youtube. the guy is highly respected.
again, i will keep you all posted as this plays out.
thanks again for the good wishes.
john
Posted by ed_uk2010 on February 18, 2012, at 11:35:44
In reply to @ ed, scott and others interested..., posted by JohnLA on February 17, 2012, at 19:09:10
>i have a good friend who is a orthopedic surgeon. he uses ketamine quite a bit with his pediatric and elderly patients when doing surgery. so, the 'urban myth' that it's a horse tranquilizer isn't 100% correct. at least not here in the usa...
Some anesthetists certainly use it, it's just one of the lesser used anesthetics. Seems to be useful mainly as an adjunct to improve pain control. Also, some emergency departments use it to relieve severe acute pain. It is still used in equine surgery but also for a variety of small animals.
>lots of reasons for the big bucks; doc, anesthesiologist, and a nurse. plus, they keep you there for a few hours after.
Plus a healthy profit - very healthy! At the doses used, it isn't likely to take up much time or effort on the part of the anesthesiologist. A nurse could administer it with back up in the unlikely event of a serious reaction.
I hope it works really well for you :)
Posted by ed_uk2010 on February 18, 2012, at 11:36:35
In reply to Re: ketamine dosage » ed_uk2010, posted by Phillipa on February 17, 2012, at 18:19:18
> Ed welcome to the US!!! PJx
Ha, I was thinking that. It would be cheaper to have you inject the ketamine!
Posted by Phillipa on February 18, 2012, at 18:35:20
In reply to Re: ketamine dosage » Phillipa, posted by ed_uk2010 on February 18, 2012, at 11:36:35
No problem!!!! PJxx
Posted by avenarius on February 19, 2012, at 21:27:23
In reply to Re: ketamine dosage » ed_uk2010, posted by Phillipa on February 18, 2012, at 18:35:20
I'm trying to get into a ketamine trial. Hopefully I'll pass the screening two weeks from now. And then I'll have to hope that I don't get the placebo.
Posted by jhj on February 20, 2012, at 23:06:13
In reply to Re: ketamine dosage, posted by avenarius on February 19, 2012, at 21:27:23
Good Luck
Posted by avenarius on March 8, 2012, at 19:06:01
In reply to Re: ketamine dosage, posted by jhj on February 20, 2012, at 23:06:13
I have been accepted into a ketamine trial. Now I have to decide if I want to do it.
Maybe I'd be better off seeing that doctor in San Diego instead.
Posted by SLS on March 9, 2012, at 6:20:33
In reply to Re: ketamine dosage, posted by avenarius on March 8, 2012, at 19:06:01
> I have been accepted into a ketamine trial. Now I have to decide if I want to do it.
>
> Maybe I'd be better off seeing that doctor in San Diego instead.
Does the doctor in San Diego give infusions? How much will they cost you?
I guess the major drawback of a randomized clinical trial is that you might be given a placebo the first time around.
- Scott
Posted by Avenarius on March 12, 2012, at 20:27:38
In reply to Re: ketamine dosage » avenarius, posted by SLS on March 9, 2012, at 6:20:33
It's a double blind, 12 weeks of intravenous ketamine(-like substance).
I have a 1/3 chance of getting the placebo since there are two possible doses of the drug in the study.
It would be 12 weeks of once-a-week doses.
The thing is, even if it works I'm out of luck when the study ends... unless I see the doctor in San Diego and work out how a way get the intranasal ketamine. So perhaps I should skip the study and go straight to California.
Posted by SLS on March 12, 2012, at 23:38:23
In reply to Re: ketamine dosage, posted by Avenarius on March 12, 2012, at 20:27:38
> It's a double blind, 12 weeks of intravenous ketamine(-like substance).
>
> I have a 1/3 chance of getting the placebo since there are two possible doses of the drug in the study.
>
> It would be 12 weeks of once-a-week doses.
>
> The thing is, even if it works I'm out of luck when the study ends... unless I see the doctor in San Diego and work out how a way get the intranasal ketamine. So perhaps I should skip the study and go straight to California.
Wow. What a difficult decision to have to make.It is an appealing idea that a single course of ketamine infusions will make one responsive to drug treatment such that further ketamine therapy is no longer necessary. Some people talk about ketamine "resetting" the brain. I have no idea how valid this proposition is.
What drugs are you currently taking? Will they allow you to continue taking them during the study?
- Scott
Posted by avenarius on March 13, 2012, at 10:09:32
In reply to Re: ketamine dosage » Avenarius, posted by SLS on March 12, 2012, at 23:38:23
I'm not counting on the 'reset' idea; in fact I'd say it's highly unlikely.
The study is using ketamine as an adjunct for treatment resistent depression, so I can continue to take mirtazapine. As far as clinical studies go it's pretty ideal, except for the IV delivery method.
This is the end of the thread.
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