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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by alchemy on December 20, 2012, at 22:28:52
Maybe this is just the latest fad. I think i can finally actually go in for infusions. My excitement has dwindled when reading more studies and experiences. But i like that it works differently than other med approaches. Nmda receptors, glutamate...actually i dont remember. Does anyone have or know of any theories about what type of depression might be more responsive? Or maybe looking at how previous meds affected someone?
Posted by SLS on December 20, 2012, at 23:16:31
In reply to Ketamine- any indicators of who might respond?, posted by alchemy on December 20, 2012, at 22:28:52
> Maybe this is just the latest fad. I think i can finally actually go in for infusions. My excitement has dwindled when reading more studies and experiences. But i like that it works differently than other med approaches. Nmda receptors, glutamate...actually i dont remember. Does anyone have or know of any theories about what type of depression might be more responsive? Or maybe looking at how previous meds affected someone?
That's a great approach.
I don't know the answer to your questions. However, if you respond partially to Lamictal, you might consider trying other anti-glutamatergic drugs before hunting down a facility that offers ketamine infusions. You might want to explore adding minocycline, memantine, or N-acetylcysteine (NAC). Besides, with ketamine infusions, it seems that you need to repeat the procedure to maintain an antidepressant response. The addition of minocycline to my treatment regime produced a more robust antidepressant response for me than the other two drugs I suggested. I am a partial responder to Lamictal.
For what it may be worth, I have seen someone with chronic depression who experienced a partial response to a combination of Lamictal and Abilify achieve remission after adding minocycline. This person does not take any standard antidepressants.
- Scott
Posted by jono_in_adelaide on December 20, 2012, at 23:31:22
In reply to Re: Ketamine- any indicators of who might respond? » alchemy, posted by SLS on December 20, 2012, at 23:16:31
Would the drug be active oraly?
getting regular infusions would be quite inconvenient, but if the drug acts oraly, a compounding pharmacist could probably convert the IV solution into a reasobanly plesent tasting syrup to take by mouth.
No idea if this is effective in depression, but it was a thought.
Posted by Phillipa on December 21, 2012, at 9:43:25
In reply to Re: Ketamine- any indicators of who might respond?, posted by jono_in_adelaide on December 20, 2012, at 23:31:22
So far from what I've read it's IV only and the results only last a short time. But I think they could be working on a different delivery route. Phillipa
Posted by Hugh on December 21, 2012, at 10:15:06
In reply to Re: Ketamine- any indicators of who might respond? » jono_in_adelaide, posted by Phillipa on December 21, 2012, at 9:43:25
I've read that 52% of people are responders. These are people who have not previously responded to other treatments. And they usually respond within a couple hours of the first treatment. Remission generally lasts about one week. Dr. David Feifel at UCSD Medical Center is giving IV ketamine infusions to depressed patients two or three times a week for about two weeks, hoping that this will cause their depression to go into remission for a longer period. Dr. Nancy Sajben in La Jolla prescribes intranasal ketamine for depression. There are other doctors around the country who are doing this as well.
Posted by brynb on December 25, 2012, at 8:44:45
In reply to Ketamine- any indicators of who might respond?, posted by alchemy on December 20, 2012, at 22:28:52
> Maybe this is just the latest fad. I think i can finally actually go in for infusions. My excitement has dwindled when reading more studies and experiences. But i like that it works differently than other med approaches. Nmda receptors, glutamate...actually i dont remember. Does anyone have or know of any theories about what type of depression might be more responsive? Or maybe looking at how previous meds affected someone?
hi alchemy,it's interesting, because I use Tramadol as part of my med combo, and it works on the nmda and glutamate receptors. but, (I think ) Scott mentioned those who respond well to Lamictal would do well, and my response is terrible with lamictal. Nitrous Oxide also works on nmda receptors, and last time I had it at the dentist, I freaked out and had a depersonalization response. So I'm a bit baffled. sorry, don't know if I made sense, just connecting the dots from my experience.
-b
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