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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Stargazer2 on January 25, 2020, at 22:19:23
I would have thought anyone with TRD would be getting IV Ketamine when they reached a point where their depression is so severe it becomes too risky to not go that route.
Has anyone tried it with any degree of success?
Posted by undopaminergic on January 26, 2020, at 8:01:23
In reply to Why is no one on Ketamine?, posted by Stargazer2 on January 25, 2020, at 22:19:23
> I would have thought anyone with TRD would be getting IV Ketamine when they reached a point where their depression is so severe it becomes too risky to not go that route.
> Has anyone tried it with any degree of success?No, but I've tried memantine which has the same mechanism of action. It worked great for depressive symptoms, but actually it was too good, because it resulted in a state comparable to mania. There was an elated mood, less need for sleep, impulsiveness, and loss of critical thinking leading to the formation of delusions.
Ketamine is fine for occasional use, but chronic exposure to it can harm the bladder, and at least in studies on rats, it can cause damage to the retrosplenial cortex, also known as "Olney's lesions".
-undopaminergic
Posted by greg rizzo on January 26, 2020, at 10:26:57
In reply to Re: Why is no one on Ketamine?, posted by undopaminergic on January 26, 2020, at 8:01:23
My daughter tried it at Mayo. I think 4 injections at $500 bucks a pop. Despite the reported success rate,she had no response to the treatment.
Posted by linkadge on January 26, 2020, at 15:38:53
In reply to Re: Why is no one on Ketamine?, posted by greg rizzo on January 26, 2020, at 10:26:57
I'm in Canada and have no doctor and no insurance.
I'd like to try it at some point.
With our health care system, it'd probably be cheaper (and easier) to get it in a club.
Linkadge
Posted by Stargazer2 on January 26, 2020, at 19:35:56
In reply to Re: Why is no one on Ketamine?, posted by greg rizzo on January 26, 2020, at 10:26:57
Heres what I know about Ketamine. I dont think 4 injections is the recommended number according to my doctor. I was told 8-10 was recommended. It is a complex process and the dosage starts at 0.5 mg/ kg (I believe). The best response is when your treatment has a dissociative reaction without being hallucinagenic. I dont know anything about menantine. What is that?
All I can say is it you are suicidal it is the best treatment out there. That was the only reason I did it. I would not recommend it for severe depression without severe suicidal ideation. Before Ketamine other treatments should be tried first especially MAOs.
As far as the cost goes, the cost is what you will pay for a chance at life.
Posted by beckett2 on January 26, 2020, at 22:24:51
In reply to Why is no one on Ketamine?, posted by Stargazer2 on January 25, 2020, at 22:19:23
There may be a doctor soon in my area. If so, I'll look into it. I'm doing ok. There's that, too. I doubt my miserly insurance plan covers even a portion.
Posted by beckett2 on January 26, 2020, at 22:25:50
In reply to Re: Why is no one on Ketamine?, posted by Stargazer2 on January 26, 2020, at 19:35:56
My pipedream is to maintain on ketamine and dc my AD.
Posted by undopaminergic on January 27, 2020, at 2:44:12
In reply to Re: Why is no one on Ketamine?, posted by Stargazer2 on January 26, 2020, at 19:35:56
> I dont know anything about menantine. What is that?
Memantine is a NMDA-glutamate receptor antagonist (like ketamine) typically used for Alzheimer's. It is marketed as Ebixa and Namenda.
-undopaminergic
Posted by undopaminergic on January 27, 2020, at 2:58:28
In reply to Re: Why is no one on Ketamine?, posted by Stargazer2 on January 26, 2020, at 19:35:56
> All I can say is it you are suicidal it is the best treatment out there.
In my experience, stimulants (eg. methylphenidate) work at least as fast, almost totally eliminating suicidal ideation within 15-45 minutes if taken orally.
-undopaminergic
Posted by Hugh on January 29, 2020, at 10:52:59
In reply to Why is no one on Ketamine?, posted by Stargazer2 on January 25, 2020, at 22:19:23
You might find this thread about ketamine interesting.
Posted by undopaminergic on January 30, 2020, at 10:03:35
In reply to Re: Why is no one on Ketamine? » Stargazer2, posted by Hugh on January 29, 2020, at 10:52:59
> You might find this thread about ketamine interesting.
>
> http://www.dr-bob.org/babble/20130124/msgs/1036949.htmlI read the whole thread.
It seems to me ketamine for depression isn't as effective as I had thought, but requires treatment as often as twice a week and, even so, more than one injection per session.
-undopaminergic
Posted by pedr on February 4, 2020, at 21:38:45
In reply to Why is no one on Ketamine?, posted by Stargazer2 on January 25, 2020, at 22:19:23
I tried 4 IV sessions and it did nothing with my TRD ¯\_(- -)_/¯
Posted by Stargazer2 on February 9, 2020, at 21:43:05
In reply to Re: Why is no one on Ketamine? » Stargazer2, posted by Hugh on January 29, 2020, at 10:52:59
IM Ketamine is not the Ketamine I am recommending. Not the same at all. Doesnt cross the blood brain barrier or cause immediate dissociative effects which are indicated for most effective results. The dose should be titrated for this effect at each treatment. Start at .5 mg/kg and increase accordingly.
This is the end of the thread.
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