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Re: Prescribed Ketamine intranasal about a month ago.. TriedEveryMedication

Posted by SLS on August 12, 2017, at 16:24:55

In reply to Prescribed Ketamine intranasal about a month ago.., posted by TriedEveryMedication on August 12, 2017, at 15:51:05

> a squirt in each nostril every 3 days. I feel intoxicated for about 15 minutes and then the effect is gone.
>
> Seems like it works ok for about a day and a half. Not great, but just ok. But then the remaining day and a half until the next dose is hell.
>
> I don't think it would be wise to take this every day.


Why not? I think it would be fine to dose every day.


> Anyone tried the intranasal? Does it take time to start working? My impression was it should be longer lasting.
>
> I have a feeling this is going to be another failed trial for me.


I'm sorry that you are having a difficult time getting ketamine to work for you. I have two thoughts.

1. Maybe you are taking too large a dose of ketamine. There is a therapeutic window with ketamine, above which it no longer acts as an antidepressant. The dissociation you experience might indicate that the dose is too high. I may not remember accurately, but I think keeping the dose between 20-50 mg works best. Perhaps you can titrate downward to find the highest dose that does not produce dissociation.

2. Add Lamictal (lamotrigine). It works. I'm not sure what the pharmacology is all about except that, like ketamine, it reduces glutamate neurotransmission. They might complement each other. Each works on a different glutamate receptor.

People who respond well to IN ketamine often have to dose every 5 days. I imagine there is some variability in this.

Perhaps you need to dose every day for awhile and then decrease the frequency if you can. If not, then do what works.

Good luck.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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