Ketamine treatment could offer new hope to patients with severe depression

I’ll talk about mine if anyone wants to hear it. Never talked about it before

Its very clearly a dissociative. I didn’t understand the term until I’d insuffalated a sufficient amount of ketamine. I ended up having very genuine deep conversations with both close friends and new ones while on it.

Time felt choppy. My consciousness felt very divided. My body felt drunk in a way but my mind felt more.. absorptive? Clear? I didn’t feel drunk. I felt like I was dissecting common patterns of my own thought in a way that allowed me to be disattached from the outcomes of those thoughts - in the same way that people have found MDMA useful for dealing with PTSD by making the brain capable of dealing with issues without invoking the flight or fight response, I felt like I was capable of thinking about the way I was thinking in a hearthy constructive way rather than a destructive judgmental way that might happen soberly.

It all in all was quite interesting. I can’t say I can remember all the details of the conversations I had, but I do to this day feel connected to them. It was not a waste of time or effort or “brain space” or whatever.. it was a worthwhile experience.

But I will say that it wasn’t necessarily fun. I don’t want to go out of my way to do it again - it requires mental effort and made me mentally tired. To me that makes it non-addictive, but I could see why some people might get attached to it.

I have had ketamine infusions (approximately 15) under medical supervision, where a general practice MD, in his office, but in consultation with my psychiatrist, administers a specific dosage (usually starting at 0.50mg/kg, going up to 0.80mg/kg) calibrated by your weight and previous responses using an infusion pump, set to deliver the dose under an exact 40 minutes. Each session in (my case) costs $600 cash, out of pocket, with no insurance reimbursement, other than (in some people's' experience) potentially a small portion refunded (the "office visit" portion).

The infusion is conducted in a quiet, darkened room, and I'm checked in on periodically over the 40 minutes. The session makes you feel somewhat "out of it", but not "trippy" or "dissociative" or "psychedelic" in any way. It seems to give you an ability to put things that are causing depression or anxiety "in their place" so they cause less ongoing turmoil. There is conflicting evidence as to whether any of the perceived effects of the infusion have any of the antidepressant benefits or whether the benefits are solely chemical (and not in any way a function of any of this "enlightenment" that may be provided by the infusion).

It's a somewhat enjoyable experience but not "fantastic" or one that makes you feel like you want another infusion right away. The poster who insufflated the ketamine likely had a much higher dose over a much shorter period of time than the dosage used for an infusion, and reputable doctors generally give the infusion over 40-60 minutes, not all at once, and not via insufflation. Some doctors will prescribe a ketamine nasal spray or lozenges for use between intravenous sessions, but they are few and the evidence isn't really there for any potential benefit to this practice.

I have noticed a positive effect on my mood and depressive symptoms generally recently, but I have also had a full course of TMS during the same period of time, so it's difficult to attribute the benefits to one modality over the other. TMS, unlike ECT, does not involve anesthesia or shock therapy, and unlike ketamine, TMS is usually covered by insurance. However, it generally requires 30-36 visits to see improvement, so the timing is distinctly different from ketamine when ketamine works. I would think I'm a medium responder to ketamine and a medium responder to TMS.