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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Monkeyrocks on November 27, 2018, at 20:27:06
Cross-posted by mistake.
Hello. I've had panic attacks and treatment resistant depression for 30 years. My first panic attack was at 3 years old and by the time I was 16 I was in the midst of a panic attack more often than I wasn't. I've been on Klonopin 2mg and Ativan 1mg for 30 years too - and at this point the breakthrough panic/anxiety is still Godawful. I've tried 27 psych meds, plus Taurine, Gaba, Insolitol, Kratom, Kava (but haven't tried Kava extract) blah blah blah and endless amount of supplements.
I also have chronic lyme disease. Depending on who you ask, might be the problem. Knowing that doesn't help though bc I've been in treatment for 5 years and am only getting worse.
Throw in Fibromyalgia and never-ending chronic pain and insomnia.
Given all of this I signed up to do 6 treatments of IV Ketamine nearby; it's $3K. But bc I have chronic pain And depression And anxiety - and want to see if the K can help any of them I need to get whichever dose is higher. I'm assuming (ha!) that if I get the dose that would cover pain it would also cover the mental health stuff. Or is the depression and anxiety higher? If so I would do that one and hopefully that would help the chronic pain?
I'm currently on Paxil, Elavil (for pain), 2mg Klonopin, Ativan PRN, LDN, 2 meds for hypothyroid (I felt No difference bw having a tanked thyroid and now having 'normal' levels which is strange). And many supplements.I've tried the nasal Ketamine and I was in a stupor for an hour but after that hour I felt 'normal' - and normal is shite.
I'm planning on trying phenibut if I can find any.
Sorry to write so much; I wanted to give a full picture at the beginning. If you're knowledgable about IV Ketamine I'd appreciate learning.
Thank you!!!
Posted by Hugh on November 28, 2018, at 11:42:41
In reply to Panic attacks, Pain - IV Ketamine Dosing Help Need, posted by Monkeyrocks on November 27, 2018, at 20:27:06
I believe that 0.5 mg/kg of ketamine is the standard dosage for both depression and pain.
https://www.ncbi.nlm.nih.gov/pubmed/28749092
Scott posted this about ketamine dosages:
http://www.dr-bob.org/babble/20160131/msgs/1086260.html
This slideshow is about NMDA antagonists for pain relief. Skip to page 30 and it discusses how ketamine and magnesium work synergistically. The kind of magnesium discussed in the slideshow is IV infusion, but there's a fairly new form of magnesium called magnesium l-threonate that, taken orally, can get more magnesium across the blood-brain barrier than an IV infusion of magnesium.
Here's the slideshow about ketamine and magnesium:
http://www.ndana.org/pdf/NMDAReceptorAntagonistslecture.pdf
An article about magnesium l-threonate:
Posted by Hugh on November 30, 2018, at 10:42:06
In reply to Panic attacks, Pain - IV Ketamine Dosing Help Need, posted by Monkeyrocks on November 27, 2018, at 20:27:06
Your low-dose naltrexone use could affect your ketamine treatment. A recent study at Stanford found that ketamine's antidepressive effects are tied to the opioid system in the brain. Naltrexone (50 mg) blocked the antidepressant effects of ketamine.
So your LDN use might enhance the effects of ketamine. But I suppose it's possible that LDN could have a disruptive effect on ketamine, since it blocks opioid receptors for a few hours after taking it.
Posted by SLS on November 30, 2018, at 21:15:25
In reply to Re: Panic attacks, Pain - IV Ketamine Dosing Help Need » Monkeyrocks, posted by Hugh on November 30, 2018, at 10:42:06
Nice find, Hugh.
I found the following. It supports your thoughts regarading LDN.
http://jpet.aspetjournals.org/content/jpet/300/2/588.full.pdf
- Scott
> Your low-dose naltrexone use could affect your ketamine treatment. A recent study at Stanford found that ketamine's antidepressive effects are tied to the opioid system in the brain. Naltrexone (50 mg) blocked the antidepressant effects of ketamine.
>
> So your LDN use might enhance the effects of ketamine. But I suppose it's possible that LDN could have a disruptive effect on ketamine, since it blocks opioid receptors for a few hours after taking it.
>
> https://med.stanford.edu/news/all-news/2018/08/ketamines-antidepressive-effects-tied-to-opioid-system-in-brain.html
Posted by Hugh on November 30, 2018, at 23:38:47
In reply to Re: Panic attacks, Pain - IV Ketamine Dosing Help Need, posted by SLS on November 30, 2018, at 21:15:25
Interesting study, Scott. Thanks.
You were considering trying LDN a while ago. Did you try it? If so, what doses, and what effect did it have on you?
> Nice find, Hugh.
>
> I found the following. It supports your thoughts regarading LDN.
>
> http://jpet.aspetjournals.org/content/jpet/300/2/588.full.pdf
>
>
> - Scott
>
>
> > Your low-dose naltrexone use could affect your ketamine treatment. A recent study at Stanford found that ketamine's antidepressive effects are tied to the opioid system in the brain. Naltrexone (50 mg) blocked the antidepressant effects of ketamine.
> >
> > So your LDN use might enhance the effects of ketamine. But I suppose it's possible that LDN could have a disruptive effect on ketamine, since it blocks opioid receptors for a few hours after taking it.
> >
> > https://med.stanford.edu/news/all-news/2018/08/ketamines-antidepressive-effects-tied-to-opioid-system-in-brain.html
>
>
Posted by SLS on December 1, 2018, at 13:46:16
In reply to Re: Panic attacks, Pain - IV Ketamine Dosing Help Need » SLS, posted by Hugh on November 30, 2018, at 23:38:47
> Interesting study, Scott. Thanks.
>
> You were considering trying LDN a while ago. Did you try it? If so, what doses, and what effect did it have on you?I never tried LDN, and don't have it on my list right now. Perhaps I should. Currently, my goal is to reestablish Parnate and allow my brain to stabilize. I've been through hell.
Where can I find naltrexone? Does it have to be compounded?
- Scott>
>
> > Nice find, Hugh.
> >
> > I found the following. It supports your thoughts regarading LDN.
> >
> > http://jpet.aspetjournals.org/content/jpet/300/2/588.full.pdf
> >
> >
> > - Scott
> >
> >
> > > Your low-dose naltrexone use could affect your ketamine treatment. A recent study at Stanford found that ketamine's antidepressive effects are tied to the opioid system in the brain. Naltrexone (50 mg) blocked the antidepressant effects of ketamine.
> > >
> > > So your LDN use might enhance the effects of ketamine. But I suppose it's possible that LDN could have a disruptive effect on ketamine, since it blocks opioid receptors for a few hours after taking it.
> > >
> > > https://med.stanford.edu/news/all-news/2018/08/ketamines-antidepressive-effects-tied-to-opioid-system-in-brain.html
> >
> >
>
>
Posted by baseball55 on December 1, 2018, at 17:28:38
In reply to Re: Panic attacks, Pain - IV Ketamine Dosing Help Need » Hugh, posted by SLS on December 1, 2018, at 13:46:16
It's sold in pharmacies by prescription. Opioid addicts will take a daily pill to block opiate receptors. It keeps people from responding to opioids for a few days.
I don't get the logic of LDN. All naltrexone does is preferentially block opiate receptors so opiates won't work at all. I took it for a year to break an opioid addiction. It had no psychoactive effects at all.
> Where can I find naltrexone? Does it have to be compounded?
>
>
> - Scott
>
> >
> >
> > > Nice find, Hugh.
> > >
> > > I found the following. It supports your thoughts regarading LDN.
> > >
> > > http://jpet.aspetjournals.org/content/jpet/300/2/588.full.pdf
> > >
> > >
> > > - Scott
> > >
> > >
> > > > Your low-dose naltrexone use could affect your ketamine treatment. A recent study at Stanford found that ketamine's antidepressive effects are tied to the opioid system in the brain. Naltrexone (50 mg) blocked the antidepressant effects of ketamine.
> > > >
> > > > So your LDN use might enhance the effects of ketamine. But I suppose it's possible that LDN could have a disruptive effect on ketamine, since it blocks opioid receptors for a few hours after taking it.
> > > >
> > > > https://med.stanford.edu/news/all-news/2018/08/ketamines-antidepressive-effects-tied-to-opioid-system-in-brain.html
> > >
> > >
> >
> >
>
>
Posted by Hugh on December 2, 2018, at 12:41:33
In reply to Re: Panic attacks, Pain - IV Ketamine Dosing Help Need » Hugh, posted by SLS on December 1, 2018, at 13:46:16
Some people get low-dose naltrexone from compounding pharmacies, but most people make their own liquid LDN. Naltrexone is water-soluble, so dissolve a 50 mg tablet in 50 ml of distilled water and use a medicine dropper to measure the dose. If refrigerated, liquid naltrexone will keep for several weeks.
Your doctor might be willing to prescribe it, or you can contact Crystal Nason, who keeps a list of doctors who prescribe LDN.
https://www.facebook.com/AngelInDisguiseLDN
LDN is usually taken in doses of between 1.5 - 4.5 mg, which can be helpful for some forms of cancer and some autoimmune diseases. But a dose far lower than this could be more beneficial for mood.
Ultra-low-dose naltrexone therapy uses micrograms or nanograms. It's even possible that doses down in the picograms could be helpful.
The lower the dose of naltrexone, the more effective it might be. The following quote is from
"Cotreatment with ultra-low-dose naltrexone at 16.7, 20, or 25 ng/kg, but not at 10 or 200 ng/kg, induced a significant CPP after this 2-h delay. This finding implies that, whereas the rewarding effects of morphine have dissipated by 120 min postinjection, ultra-low-dose naltrexone may extend this effect."
In other words, an extremely low dose of naltrexone enhanced the effects of morphine, and prevented tolerance to it from developing. And it prevented dependence and addiction from developing. A higher, but still tiny, dose of naltrexone didn't have these beneficial effects.
Even people not taking opioids might benefit from taking ultra-low-dose naltrexone, since we all have naturally occurring opioids -- endorphins. An extremely low dose of naltrexone, taken every day, might improve the brain's response to naturally occurring endorphins.
Those interested in trying ULDN should start with a dose of naltrexone in the micrograms. If that doesn't help, lower your dose to nanograms. If that doesn't help, lower it to picograms. Other than the naltrexone, all you need is distilled water to dilute it with and a calculator.
Posted by Lamdage22 on December 3, 2018, at 5:39:56
In reply to Re: Panic attacks, Pain - IV Ketamine Dosing Help Need » SLS, posted by Hugh on December 2, 2018, at 12:41:33
There are no studies for the low dosage. Its human experimentation.
Posted by Hugh on December 3, 2018, at 12:21:17
In reply to Re: Panic attacks, Pain - IV Ketamine Dosing Help Need, posted by Lamdage22 on December 3, 2018, at 5:39:56
> There are no studies for the low dosage. Its human experimentation.
Yes, there have been studies. Here is one of them:
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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