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Ketamine treatment

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Phil   
Phil

I thought this might be worth posting:

 

http://neurocritic.blogspot.com/2010/08/ketamine-for-depression-yay-or-neigh.html

 

I know someone who is going to take part in a trial of ketamine for his depression, and to be honest I am concerned for him. Ketamine supposedly causes dissociation and releases glutamate? How can that be a good thing?

I dont fully understand the chemical side of it, maybe someone else can explain.

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Altostrata   
Altostrata

You just have to be skeptical about ketamine as an antidepressant.

 

Many things seem to raise mood, for a while, recreational drugs included. There's no reason to believe ketamine will be any more effective than current antidepressants, or have fewer side effects.

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Phil   
Phil

According to some comments on that blog it may induce schizophrenia if used longterm. Pretty scary stuff.

 

I'm more concerned for this person I know because he has been on and off various antidepressants, so is probably suffering the same effects many of us here are, ie. withdrawal syndrome, sensitive nervous system. Adding ketamine to the mix sounds very dangerous to me.

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compsports   
compsports

According to some comments on that blog it may induce schizophrenia if used longterm. Pretty scary stuff.

 

I'm more concerned for this person I know because he has been on and off various antidepressants, so is probably suffering the same effects many of us here are, ie. withdrawal syndrome, sensitive nervous system. Adding ketamine to the mix sounds very dangerous to me.

 

And those folks who are on Kentamine long term will all of a sudden have unmasked schizophrenia. Just like what ADs do to make people BP who aren't.

 

I don't blame you for being scared for your friend.

 

CS

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Altostrata   
Altostrata

Phil, people can drop out of clinical trials. Most of us have free will about what we put into our mouths.

 

If he does drop out, he should take care to taper.

 

If he's lucky, he might be on the placebo, if they have a placebo arm.

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Jemima   
Jemima

Oh, great. Now we can get our brains crippled even faster. Both Scopolamine and Ketamine are extremely dangerous drugs and I would encourage anyone who is tempted to try either to read up on both of them first. Ketamine is an anesthetic, for Pete's sake, and Scopolamine is used by criminals to "zombify" their victims. Legitimatizing these drugs for depression is right out of 1984 by George Orwell.

 

Another variation on the chemical imbalance theory, but even scarier than SSRI/SNRI antidepressants.

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compsports   
compsports

Oh, great. Now we can get our brains crippled even faster. Both Scopolamine and Ketamine are extremely dangerous drugs and I would encourage anyone who is tempted to try either to read up on both of them first. Ketamine is an anesthetic, for Pete's sake, and Scopolamine is used by criminals to "zombify" their victims. Legitimatizing these drugs for depression is right out of 1984 by George Orwell.

 

Another variation on the chemical imbalance theory, but even scarier than SSRI/SNRI antidepressants.

 

"People come in urgently wanting to kill themselves," he says. After a low-dose ketamine infusion, "the sense of urgency goes away."

 

Hey Dr. Shelton, you can get the same results by taking either vitamin D, Fish Oil, B Supplement, St. Johns Wort. Side effect profile is alot better. :rolleyes:

 

Or here is another novel thought. How about talking to the patient about what is bothering them without judgment or labeling? Amazing how that works.

 

But nah, making alot of money from drug companies is more important to you than patient welfare. Silly me for even thinking your patients was your number one priority.

 

CS

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Barbarannamated   
Barbarannamated

IF this is used short term in only emergent, life threatening, situations while a medical workup and psychotherapy are being started, I see some advantage over drugs that take weeks to have minimal, if any, effect. The other option - if person is imminently suicidal - is physical restraint.

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MostlyWater   
MostlyWater

"The aim is to make this available to people, but at the same time to very carefully document what happens and to publish these results as soon as possible."

 

"I am just happier and want to participate in a lot more things, which I never used to do," she said.

"I used to wake up and think I can't be bothered, now I think 'just go do it'. That is a major difference, a good difference."

 

"When you think about taking your own life - you can't get much more down than that - to where I am now, it has been so good."

 

"Each treatment costs $150, with patients requiring five treatments of the drug administered via injection"

http://www.abc.net.au/news/2015-01-21/ketamine-hailed-as-new-treatment-for-long-term-depression/6032306

 

What are your thoughts? 

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alaskamom   
alaskamom

Isn't Ketamine a horse tranquilizer?!  I think it is used frequently as a street drug and perhaps rape drug?  Sounds like a bad idea to me.   :blink:

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mammaP   
mammaP

Haven't we all been in that situation where we have been promised that a drug will be the one that helps?

ADs have helped in some cases but it isn't real. What happens when the trial ends and people are addicted?

It will not be licensed and people will have to quit cold turkey. What will happen then? It is a dangerous drug

and is sold on the black market to addicts. SSRIs are losing popularity so lets make a party drug legal! 

Heroin and cocaine make people feel great after one dose too. .....

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cymbaltawithdrawal5600   
cymbaltawithdrawal5600

We have quite a few topics started on this, apparently it has caught people's fancy.

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Altostrata   
Altostrata

merged related threads.

People love the idea of a new wonder drug for the pains of life.

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Henosis   
Henosis

There is a lot of scare mongering here. Ketamine is safe when given in a controlled setting. The reason ketamine research is important is not because it will be a cure unto itself, but to identify and understand what is happening with glutamate and NMDA receptors that leads to instantaneous relief from both depression and OCD. Given my own OCD, I've been more interested in that angle. Current research for OCD (and to a lesser extent depression) is focused on glutamate signaling abnormalities... Many glutamate modulating drugs developed for dementia/Alzheimer's (Riluzole/Memantine/etc) have showed some promise with OCD in recent trials. It makes sense that Ketamine would do something similar.

 

As someone who is struggling terribly with getting off of Paxil and who will never touch an SSRI again, it would be quite exciting if progress were made for depression/OCD treatments that don't touch serotonin.

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NoMoreADs   
NoMoreADs

You know psychiatry has reached a new low when they are now encouraging patients to use recreational drugs.

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scallywag   
scallywag

There is a lot of scare mongering here. Ketamine is safe when given in a controlled setting.

 

Henosis, you do recognize that Surviving antidepressants is NOT a controlled setting?

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Henosis   
Henosis

 

There is a lot of scare mongering here. Ketamine is safe when given in a controlled setting.

Henosis, you do recognize that Surviving antidepressants is NOT a controlled setting?

The OP in believe was discussing a controlled medical trial, Although at this point there are ketamine clinics popping up all one the United States to treat intractable depression, OCD and chronic pain under Doctor supervision

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VitaminB   
VitaminB

I was given this drug in the emergency room. It paralyzed me and I was vomiting from the visual hallucinations it made me have. It felt like I was on the ocean witnessing glaciers move and morph in front of me at a rapid pace. Instead of snow it was more like legos. Anyway, the nurses had to prop me up or I probably would have died of my own vomit. You seriously can't move. I have been appalled at the propaganda for this drug. As they wheeled me out of the ER they said I had hypokalaemia or low potassium. I wasn't in the ER for depression, they gave it to me because they said they were going to send me to the mental hospital and I got up out of my chair and started to pace and say, "No!" The Doctor threw up his hands and said, "All right" with a "I told you so" tone to it. Next thing I knew I had this anesthesia as a shot. I came in with low potassium and they gave me a "medicine" to continue vomiting. Thanks a lot big pharma! 

 

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Area1255   
Area1255

Ketamine is garbage, it's a horse-tranquilizer and it does induce psychotic symptoms by blocking glutamate-receptors, in that way, it's no different than abusing PCP.

Look at what PCP does to people and some of the weird things that people start thinking while on it, in fact anything that blocks glutamate in such a way tends to create delusional and visual symptoms or at the very least, dissociates people and alters their inhibition/behavior. Another example is benzodiazepines, they enhance GABA but reduce glutamate and as a result, often induce reckless, fearless behavior and addiction seeking, all associated with low glutamate activity.

 

 

Drug- Induced Behavioural Disinhibition | Paradoxical aggressive reactions to benzodiazepine use: a review.

 

PARADOXICAL REACTIONS TO BENZODIAZEPINES by Dr.Richard Hall.

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Henosis   
Henosis

Utilizing ketamine in a clinical setting is A FAR CRY from ketamine abuse. The dosages are far less than those people use to go into a dissociative "high".

I suggest you do some more research into clinical use...

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FeralUrban   
FeralUrban

I am not going to comment on the variety of opinions above.

 

I will simply state that I use a very low dose nasal spray ketamine to relieve the severe neuropathic pain that makes my arms and legs and one side of my face feel like they are on fire. The dose is not where near the levels of IV infusion, nor, I would assume recreational use, or criminal drugging of victims.

 

I only  take it at night, or when I'm in too much pain to move. Otherwise I put up with the pain.

 

Without ketamine, there would be no sleep. I can fall asleep with deep joint pain, muscle spasms, but with nerve pain --sleep is impossible.

 

Having had a period in my life where I stopped sleeping due to PTSD nightmares I can say that without sleep I did become psychotic and unbearably suicidal and ended up in the psych hospital for 3 months and on the f-ing antidepressants. So I'm big on getting sleep as a baseline self-care.

 

I am careful to take a break 1-2 days a week so I don't build tolerance. 

 

I don't particularly like the idea of taking any drugs -- but here I am,  my peripheral nerves fried by venlafaxine, and stuck on this venlafaxine neurotoxic substance while I slowly wean myself off it it, all the while it is continuing to do it's damage to my nerves -- spreading to new parts of my body little by little

 

I have observed that low-dose ketamine does quickly alleviate withdrawal symptoms (though I do not use it for that -- it was simply an observation when taking it for the neuropathic pain it quelled the rage and inability to control my bodily movements and other things that happened when I had very bad withdrawal)

I have observed that ketamine loosens the binding of self-identification, which when one is in excruciating pain is a good thing, and it definitely lessens the pain. The unbinding of the state of self-identification allows me to meditate and pray myself to sleep. 

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Henosis   
Henosis

I'm assuming you are getting a special compounded spray prescribed off-label? (Are you in the USA)?

I know clinical trials have occurred and one of the major pharm companies is developing a ketamine nasal spray to send through the FDA for depression, neuropathic pain, and possibly OCD.

It's interesting to hear that it was helping withdrawal symptoms. I have heard ketamine infusions can either help or exacerbate SSRI withdrawal. this is in addition to the fact that there are a handful of ketamine derivatives (NMDA antagonists) being developed for the same conditions that don't have the dissociative effect but seem to offer Instantaneous relief.

Thanks for your input.

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Henosis   
Henosis

these following journal articles both show that AD withdrawal partially caused by overexpression of NMDA receptors. Which would certainly explain if some people are getting help from NMDA antagonists like ketamine infusions/nasal sprays, which I've been considering despite the expense.

 

Anyone else have experience here?

 

https://www.ncbi.nlm.nih.gov/m/pubmed/12020747/?i=2&from=/14625154/related

 

https://www.ncbi.nlm.nih.gov/m/pubmed/14625154/

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FeralUrban   
FeralUrban

Yes, it is a special nasal spray from a compounding pharmacy, and not covered by my insurance. About $75 for a month's worth.

 

the script is for 50 mg / ML.

 

I can see how it would cause psychosis of sorts. At times when it's just kicking in, before it takes me "down" into rest, there is a period where I have nonsensical thoughts. I'll be having them and then recognize them as nonsense and then have some more. I can't actually remember any of them, but do know it's just pure random fabrication from different thought bubbles margin in my mind. I'm making this up, but they are like this,  "The 3 Kings of the Orient who visited Jesus are coming over to cook dinner for me, and I realize this means that I should at least make an effort to clean the kitchen. And then I'm imagining setting a dinner table that I don't have and in a house I don't live in, etc." 

Last night was the worst for Neuropathic pain in about 6 months. It took 16 doses to get me out of intractable pain over most of my body. I hated having to take that much, but it definitely was the one option if I wanted to stay out of the ER, where I would be given drugs that are not as safe. 

My normal dose, when needed is 2-4 sprays in each nostril. Occasionally 6, rarely 8. 

It seems like the neuropathy attacks have bundled themselves with withdrawal symptoms, as I just went down a bit on dosage, after a too short hold of one week. during which I was feeling good enough to to "too much." Too much is so little that it is extremely easy to do to much!

Or perhaps the craniosacral treatment I had stirred up stuff. Who knows. 

 

This morning I woke up with the pain already started, which is definitely a bad signal. By 2 p.m. I was started get toward the level 8-10 pain, and not wanted to use ketamine so soon again, went back to what I consider a much more dangerous remedy: two benedryl  and a promethazine suppository. Both are serotonin boosters -- but it did allow me to rest for 6 hours, in and out of sleep, but at least not having my mind overtaken by pain.

 

Feeling trampled. Going to post aa bit of this in my intro thread as well.

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Henosis   
Henosis

What are withdrawal effects are you experiencing and which ones are the ketamine helping?

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FeralUrban   
FeralUrban

My venlafaxine withdrawal effects: 

Tearfulness, which can escalate to agitation which can escalate to rate

Low energy, exhaustion, both insomnia and hypersomnia

Cognitive issues.

Slight vertigo, unsteady gait

Muscle twitching, muscle cramps (could be the venlfaxine itself, rather than withdrawal)

Sore eyes, ringing ears

 

Ketamine helps with agitation, insomnia, muscle cramps and twitching.

 

My neuropathy symptoms:

Nerve pain -- burning, stabbing shooting, feeling bruised.

Alodynia: any air movement of sensation of coolness triggers searing pain in that body part.

In the following body parts.

  • Right side of face and head 
  • Right arm and hand
  • Right trunk
  • Right leg and foot
  • Left lower leg
  • Left hand

Plus migraine.

And before I reduced the venlfaxine do se significantly, I had Autonomic Nervous System signs of peripheral neuropathy -- temp up and down, BP up and down, heart rate  up and down, sweats, chills, rapid unexplainable weight loss.

 

I have to admit that with ketamine, you are committing yourself to laying down and doing nothing for a period of time, as after the 3rd dose, walking is inadvisable. So it's not even at this low dose a cure for WD symptoms. But there you have it.

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Henosis   
Henosis

From my admittedly amateurish understanding of neurological processes, this makes sense. If you are in a state of glutamatergic hyperactivity because of the widthdrawal, the NMDA antagonizing effects of ketamine could/should relieve that. Overactivity of glutamate in a particular part of the frontal cortex is associated with OCD (which I have) and which ketamine and other glutamate modulating drugs seem to help. Sorry to hear it wasn't a "cure all" or help the cognitive issues. I wish you the best.

 

Ketamine helps with agitation, insomnia, muscle cramps and twitching.[/font]

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FeralUrban   
FeralUrban

However, from RxISK

Ketamine has recently been reported as producing dramatic benefits in people with severe depression. There no serious complications reported from giving ketamine to patients with depression or other conditions, but when people with SRI withdrawal are given ketamine it produces bowel problems including vomiting, temperature dysregulation and pain sensitivity.

 

http://rxisk.org/guide-stopping-antidepressants\

 

It doesn't do that to me, thankfully.

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Henosis   
Henosis

However, from RxISK

 

Ketamine has recently been reported as producing dramatic benefits in people with severe depression. There no serious complications reported from giving ketamine to patients with depression or other conditions, but when people with SRI withdrawal are given ketamine it produces bowel problems including vomiting, temperature dysregulation and pain sensitivity.

http://rxisk.org/guide-stopping-antidepressants\

 

It doesn't do that to me, thankfully.

 

Fantastic .. Ugh

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mollyminx   
mollyminx

I study neuroscience and have also suffered from depression. Ketamine has been shown to be an extremely effective antidepressant in many clinical studies, however the mechanism is as poorly understood as the mechanism of other antidepressants. What we think we know about it is that it stimulates glutamate, which in turn triggers production of brain-derived neurotrophic factor (BDNF), which causes the growth of new neurons and connections between neurons, particularly in the hippocampus, the seat of memory in the brain. Based on the current theory of depression, a loss of neurons and connections in the hippocampus is what causes the symptoms of depression, so ketamine essentially instantly reverses the process (within a few hours), which is why it is given in ER situations where a patient is thought to be suicidal - this stuff saves lives! I have not tried ketamine myself, but it is a very promising drug because it is administered in an acute, rather than chronic fashion: that is, you get a dose of it once for a few hours, and then don't have to take it again for a while, rather than every day like with regular AD's. So, in theory this means that the side effects would also last only a short period of time, rather than taking something daily... After all of the problems I have had on traditional SSRI's, if I ever needed something again, I would definitely opt for Ketamine therapy. Currently it is only available as an outpatient infusion treatment, and is quite expensive (~$3000) for a full round due to the fact it is not covered by insurance. But several derivative pharmaceuticals are set to hit the market in the next few years which should be covered. Hope this info helps!

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Henosis   
Henosis

It sounds like an effect quite similar to NSI-189 which appears to promote neurogenesis in the hippocampus, but through a different mechanism than direct BDNF release.

 

However, that doesn't explain Ketamine's usefulness in OCD (my primary issue). Perhaps the simple NMDA antagonism is muting the prefrontal glutamate overactivity hypothesized in OCD symptoms? Im currently taking Memantine, glutamate modulator which has been shown to be helpful for OCD (and I'm hoping will help with the glutamate hyperactivity from Paxil withdrawal)

 

In either case, I continue to see mixed reactions to ketamine for those in SSRI withdrawal.

 

I study neuroscience and have also suffered from depression. Ketamine has been shown to be an extremely effective antidepressant in many clinical studies, however the mechanism is as poorly understood as the mechanism of other antidepressants. What we think we know about it is that it stimulates glutamate, which in turn triggers production of brain-derived neurotrophic factor (BDNF), which causes the growth of new neurons and connections between neurons, particularly in the hippocampus, the seat of memory in the brain. Based on the current theory of depression, a loss of neurons and connections in the hippocampus is what causes the symptoms of depression, so ketamine essentially instantly reverses the process (within a few hours), which is why it is given in ER situations where a patient is thought to be suicidal - this stuff saves lives! I have not tried ketamine myself, but it is a very promising drug because it is administered in an acute, rather than chronic fashion: that is, you get a dose of it once for a few hours, and then don't have to take it again for a while, rather than every day like with regular AD's. So, in theory this means that the side effects would also last only a short period of time, rather than taking something daily... After all of the problems I have had on traditional SSRI's, if I ever needed something again, I would definitely opt for Ketamine therapy. Currently it is only available as an outpatient infusion treatment, and is quite expensive (~$3000) for a full round due to the fact it is not covered by insurance. But several derivative pharmaceuticals are set to hit the market in the next few years which should be covered. Hope this info helps!

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Sugar   
Sugar

I recently learned of Ketamine being a possible treatment option for refractory depression for which no antidepressants have helped.

 

http://www.pbs.org/video/2365778897/

 
It is quite expensive and no insurance covers it as yet.
 
Also, there is GeneSight and GenOMind genetic testing being offered
 
Is there anyone in his forum who has experience with any of these?
 
Thank you.
 

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antidepressantsNoMore   
antidepressantsNoMore

So long story short, there has been a debate about the street drug known as Ketamine or special K to treat resistant depression or one that does not respond well to SSRI's etc.

 

I was going to be a participant in a study at a well known hospital and treated with Ketamine. It was a government study. The last second, my mother convinced me to not do it. However, I wish I did. I have used DXM and think Ketamine has some excellent benefits to treating major depression.

 

Articles for thought:

 

http://www.webmd.com/depression/news/20140923/ketamine-depression#1

 

http://www.npr.org/sections/health-shots/2017/03/20/520169959/ketamine-for-severe-depression-how-do-you-not-offer-this-drug-to-people

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