Psycho-Babble Medication Thread 1119828

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Started oral ketamine

Posted by Beckett2 on June 3, 2022, at 19:13:13

Week one so far so good! Mail order is somewhat affordable.

 

Re: Started oral ketamine » Beckett2

Posted by SLS on June 3, 2022, at 20:16:15

In reply to Started oral ketamine, posted by Beckett2 on June 3, 2022, at 19:13:13

> Week one so far so good! Mail order is somewhat affordable.

That's great! What kinds of changes / improvements have you noticed?

I'm not up to date on things. I didn't know that ketamine was administered orally as a treatment for depression. With I.V., and perhaps with intranasal administration as well, the treatment does not work well unless someone reaches the threshold of mild dissociation. Too little doesn't work - of course. However, too much doesn't work either according to early studies.

I hope you respond as well to oral ketamine as my friend has to intranasal ketamine. Compounding pharmacies in the United States will make up the prescribed ketamine solution for intranasal administration inexpensively. You might get 2-3 months out of one batch for $75.

Now that I think of it, oral ketamine treatment might behave similarly to I.V. or intranasal. People often find that taking a single dose every five days or so does the trick. Pulsing ketamine might be more effective long-term than taking it every day.


- Scott

 

Re: Started oral ketamine » SLS

Posted by beckett2 on June 4, 2022, at 16:51:11

In reply to Re: Started oral ketamine » Beckett2, posted by SLS on June 3, 2022, at 20:16:15

> > Week one so far so good! Mail order is somewhat affordable.
>
> That's great! What kinds of changes / improvements have you noticed?
>
> I'm not up to date on things. I didn't know that ketamine was administered orally as a treatment for depression. With I.V., and perhaps with intranasal administration as well, the treatment does not work well unless someone reaches the threshold of mild dissociation. Too little doesn't work - of course. However, too much doesn't work either according to early studies.
>
> I hope you respond as well to oral ketamine as my friend has to intranasal ketamine. Compounding pharmacies in the United States will make up the prescribed ketamine solution for intranasal administration inexpensively. You might get 2-3 months out of one batch for $75.
>
> Now that I think of it, oral ketamine treatment might behave similarly to I.V. or intranasal. People often find that taking a single dose every five days or so does the trick. Pulsing ketamine might be more effective long-term than taking it every day.
>
>
> - Scott

Hi Scott, I take a dissolvable lozenge. It tasted shockingly bad at first, but it's fine really. A mail order pharmacy compounds a month's supply for $40.

I was prescribed one every three days, but I've extended that to at least four. The process is 24 hrs because I take it around 6 pm and am very tired the next day. (I have another chronic illness. I don't think this is the case for an average user.)

It's like not having been depressed. At first, the feeling was very strange, like, wtf? As someone w bipolar ll, there is no hypomania.

I've been dysthymic etc since maybe 12?

Thanks for your support! :)

 

Re: Started oral ketamine

Posted by SLS on June 6, 2022, at 6:09:29

In reply to Re: Started oral ketamine » SLS, posted by beckett2 on June 4, 2022, at 16:51:11

Hi, Becket.

Please keep everyone apprised of your progress with ketamine. The information will be incredibly valuable.

Again, I want to stress that you might find ketamine more effective when it is pulsed every 5 days or so rather than dosing it every day.

Also, ketamine has a therapeutic window that might not be too hard to find. One of the research clinicians who worked with ketamine early on found that his patients did not respond well unless a dosage was reached that produced a mild dissociative state. It doesn't last very long, though. Maybe an hour? Increasing the dosage beyond this threshold yielded a loss of efficacy.

This doctor was at Yale at the time. His name is John Krystal. I haven't kept a close watch on ketamine for quite a few years. Perhaps his initial findings were inconsistent with what has been learned about ketamine since.

Good Luck!

This stuff really works wonders for some people.


- Scott

 

Re: Started oral ketamine

Posted by undopaminergic on June 6, 2022, at 10:30:21

In reply to Re: Started oral ketamine » SLS, posted by beckett2 on June 4, 2022, at 16:51:11

>
> It's like not having been depressed. At first, the feeling was very strange, like, wtf? As someone w bipolar ll, there is no hypomania.
>

That's interesting. I'm bipolar and while I've never had the chance to try ketamine, I've used memantine, another NMDA-glutamate antagonist, and it induced a manic state leading me to do very stupid, impulsive things that landed me in hospital (first somatic and then mental).

As SLS suggests, I think you're right not to take it every day, both to avoid potential issues with tolerance and loss of efficacy, and for reasons of safety. In rodents, ketamine (and PCP and MK-801 but not xenon or memantine) can induce neurotoxicity (known as Olney's lesions) in the retrosplenial cortex. Chronic use can also destroy the bladder in humans.

-undopaminergic

 

Re: Started oral ketamine » undopaminergic

Posted by beckett2 on June 7, 2022, at 21:16:13

In reply to Re: Started oral ketamine, posted by undopaminergic on June 6, 2022, at 10:30:21

> >
> > It's like not having been depressed. At first, the feeling was very strange, like, wtf? As someone w bipolar ll, there is no hypomania.
> >
>
> That's interesting. I'm bipolar and while I've never had the chance to try ketamine, I've used memantine, another NMDA-glutamate antagonist, and it induced a manic state leading me to do very stupid, impulsive things that landed me in hospital (first somatic and then mental).
>
> As SLS suggests, I think you're right not to take it every day, both to avoid potential issues with tolerance and loss of efficacy, and for reasons of safety. In rodents, ketamine (and PCP and MK-801 but not xenon or memantine) can induce neurotoxicity (known as Olney's lesions) in the retrosplenial cortex. Chronic use can also destroy the bladder in humans.
>
> -undopaminergic
>

That is interesting. It's 'generally' considered BP safe (I think). You sound like BPl. Have you had psychotic symptoms (only if you don't mind sharing!)? I'm wondering if the type of depression I have, which is part of other issues, fatigue and fibromyalgia, is well targeted by ketamine, which is an anti-inflammatory. (This is probably too much of an oversimplification.)

The ketamine was shockingly easy to acquire. I had a facetime w a doctor, he asked a few questions, and that was that. Not sure he looked at any health records. (He did ask if I had bipolar, so that's good.) I'm hoping this casual approach, which worked for me this time, doesn't result in a lawsuit and then greater federal scrutiny.

I'm aware of possible side effects, although everyone says it's not much of a problem on therapeutic dose and protocol. I don't know if that's true, so I'll keep an eye out. Thank you for the caution.

One medication that caused an episode for me was Saphris, an antipsychotic. Go figure.

 

Re: Started oral ketamine » SLS

Posted by beckett2 on June 7, 2022, at 21:22:26

In reply to Re: Started oral ketamine, posted by SLS on June 6, 2022, at 6:09:29

> Hi, Becket.
>
> Please keep everyone apprised of your progress with ketamine. The information will be incredibly valuable.
>
> Again, I want to stress that you might find ketamine more effective when it is pulsed every 5 days or so rather than dosing it every day.
>
> Also, ketamine has a therapeutic window that might not be too hard to find. One of the research clinicians who worked with ketamine early on found that his patients did not respond well unless a dosage was reached that produced a mild dissociative state. It doesn't last very long, though. Maybe an hour? Increasing the dosage beyond this threshold yielded a loss of efficacy.
>
> This doctor was at Yale at the time. His name is John Krystal. I haven't kept a close watch on ketamine for quite a few years. Perhaps his initial findings were inconsistent with what has been learned about ketamine since.
>
> Good Luck!
>
> This stuff really works wonders for some people.
>
>
> - Scott
>

Thank you, Scott. I'll update as time goes on. I'd encourage people who are curious to investigate.

The time between doses as prescribed is every 3 days. I've lengthened it to 4 and might consider 5 if residual fatigue doesn't improve. At 200 mg, induces
about the right amount of disassociation in my case.

I hope you are still doing well. Thanks again for your support for me and on this board.

 

Re: Started oral ketamine

Posted by Hugh on June 8, 2022, at 13:41:20

In reply to Re: Started oral ketamine » SLS, posted by beckett2 on June 7, 2022, at 21:22:26

Using virtual reality while you're in a dissociative state might significantly improve the efficacy of ketamine therapy.

https://www.freethink.com/technology/virtual-reality-ketamine-therapy

Cedars-Sinai Medical Center in Los Angeles is doing pioneering work in using virtual reality to treat pain and anxiety. They've treated over 3,000 patients with virtual reality, which has a quieting effect on both the sensory cortex and on the brain's emotional centers, reducing physical pain and emotional pain.The VR headsets Cedars-Sinai uses are manufactured by Pico and Oculus.

An excellent book about virtual reality therapy is VRx by Brennan Spiegel, MD, the Director of Health Services Research for Cedars-Sinai.

 

Re: Started oral ketamine » Hugh

Posted by beckett2 on June 8, 2022, at 15:10:16

In reply to Re: Started oral ketamine, posted by Hugh on June 8, 2022, at 13:41:20

> Using virtual reality while you're in a dissociative state might significantly improve the efficacy of ketamine therapy.
>
> https://www.freethink.com/technology/virtual-reality-ketamine-therapy
>
> Cedars-Sinai Medical Center in Los Angeles is doing pioneering work in using virtual reality to treat pain and anxiety. They've treated over 3,000 patients with virtual reality, which has a quieting effect on both the sensory cortex and on the brain's emotional centers, reducing physical pain and emotional pain.The VR headsets Cedars-Sinai uses are manufactured by Pico and Oculus.
>
> An excellent book about virtual reality therapy is VRx by Brennan Spiegel, MD, the Director of Health Services Research for Cedars-Sinai.

Thank you Hugh, this is a nice source. I just subscribed to their YT channel as well.

During my sessions, I play a video by the Monterrey Bay Aquarium of red jellyfish and soft music. I listen rather than watch. So far, I feel very light and fluid, and find the idea of using VR that allows for space apt. The experience itself is wonderful and warm and puts me in touch with youthful feeling long ossified.

I understand why some people might become addicted. There is an embrace of warmth, something most addicts are sorely lacking. Setting a different stage, say edm or whatever, would be a very different experience, however!

We have an old oculus around here somewhere. But my visuals from molecular to the icecaps are already scenic. I can feel my body at will, and by lifting my eye mask, return to the room. My imagination is not very visual, so the experience is esp fascinating.

Have you tried it, and if so, what would you say about it?

 

Re: Started oral ketamine » beckett2

Posted by Hugh on June 8, 2022, at 18:32:44

In reply to Re: Started oral ketamine » Hugh, posted by beckett2 on June 8, 2022, at 15:10:16

> Have you tried it, and if so, what would you say about it?

I have an old Oculus, which I could never get to work on my old Android and even older PC. I recently got a new Android and a new PC, so I dug out my old Oculus headset, but couldn't find the controller. So I'll either buy a controller separately or splurge on a new Oculus.

 

Re: Started oral ketamine » Hugh

Posted by SLS on June 8, 2022, at 21:38:50

In reply to Re: Started oral ketamine, posted by Hugh on June 8, 2022, at 13:41:20

> Using virtual reality while you're in a dissociative state might significantly improve the efficacy of ketamine therapy.
>
> https://www.freethink.com/technology/virtual-reality-ketamine-therapy
>
> Cedars-Sinai Medical Center in Los Angeles is doing pioneering work in using virtual reality to treat pain and anxiety. They've treated over 3,000 patients with virtual reality, which has a quieting effect on both the sensory cortex and on the brain's emotional centers, reducing physical pain and emotional pain.The VR headsets Cedars-Sinai uses are manufactured by Pico and Oculus.
>
> An excellent book about virtual reality therapy is VRx by Brennan Spiegel, MD, the Director of Health Services Research for Cedars-Sinai.


From what I've read and heard others describe to me, the magnitude of the dissociation attendent to the optimal therapeutic dosage of ketamine used to treat depression is too mild to produce an altered state with hallucinations. Of course, that doesn't mean that a guided trip at a higher dosages wouldn't work. What I found interesting is that the article described ketamine as having an effect on dopaminergic neurotransmission at higher dosages, but not at lower dosages. At lower dosages, the predominent effect of ketamine is glutamatergic neurotransmission.


- Scott

 

Re: Started oral ketamine

Posted by undopaminergic on June 9, 2022, at 5:04:15

In reply to Re: Started oral ketamine » undopaminergic, posted by beckett2 on June 7, 2022, at 21:16:13

>
> That is interesting. It's 'generally' considered BP safe (I think). You sound like BPl.
>

I'm afraid that's true. Whether you measure by intensity or by adverse consequences, I've had mania, and that is enough to diagnose bipolar 1.

> Have you had psychotic symptoms (only if you don't mind sharing!)?
>

I had a serious episode in the end of 2009 that resembled paranoid schizophrenia. Occasionally after that, I've had what may be considered delusions.

>
> One medication that caused an episode for me was Saphris, an antipsychotic. Go figure.
>

Saphris (asenapine) is interesting. I'm interested in trying it myself. Incidentally, it is one of few medications taken sublingually.

-undopaminergic

 

Re: Started oral ketamine

Posted by SLS on June 9, 2022, at 9:36:58

In reply to Re: Started oral ketamine, posted by undopaminergic on June 9, 2022, at 5:04:15

Hi.

For what it might be worth, I like asenapine (Saphris). It possesses both antipsychotic and antidepressant properties. I had no side effects. My ex-girlfriend, who has the bipolar subtype of schizoaffective disorder, has remained free of both psychosis and depression (last I heard). She went from being homebound to getting a job and building a new life for herself. She had more mental and physical energy and enjoyed crystal-clear thinking.

Of course, asenapine won't help everyone. It is bound to make some people worse.


- Scott

 

Re: Started oral ketamine » Hugh

Posted by beckett2 on June 9, 2022, at 13:32:04

In reply to Re: Started oral ketamine » beckett2, posted by Hugh on June 8, 2022, at 18:32:44

> > Have you tried it, and if so, what would you say about it?
>
> I have an old Oculus, which I could never get to work on my old Android and even older PC. I recently got a new Android and a new PC, so I dug out my old Oculus headset, but couldn't find the controller. So I'll either buy a controller separately or splurge on a new Oculus.
>
>

Sorry, I was unclear, I meant have you tried ketamine :)

 

Re: Started oral ketamine » beckett2

Posted by Hugh on June 9, 2022, at 18:18:27

In reply to Re: Started oral ketamine » Hugh, posted by beckett2 on June 9, 2022, at 13:32:04

I haven't tried ketamine.

 

Re: oral ketamine and question for Beckett2 » SLS

Posted by Jay2112 on June 10, 2022, at 18:41:55

In reply to Re: Started oral ketamine, posted by SLS on June 9, 2022, at 9:36:58

> Hi.
>
> For what it might be worth, I like asenapine (Saphris). It possesses both antipsychotic and antidepressant properties. I had no side effects. My ex-girlfriend, who has the bipolar subtype of schizoaffective disorder, has remained free of both psychosis and depression (last I heard). She went from being homebound to getting a job and building a new life for herself. She had more mental and physical energy and enjoyed crystal-clear thinking.
>
> Of course, asenapine won't help everyone. It is bound to make some people worse.
>
>
> - Scott

Hey Scott! Hi Beck!

Hope you are well. I had very dysphoric effects with Saphris, and all's it really made me want to do was EAT...everything/anything, especially complete 24 slice pizzas...2 at a time...you get the picture. I didn't want to do ANYTHING..just sit, watch tv. I got akathesia quite bad on it..unfortunately the day my father died, in my arms.

For over 20 years, the only AP that made me feel much better is risperidone. That blockade of some 5ht2 receptors, which in particular have some adrenergic properties, seems to be the clincher for me. Nefadozone has similar properties, and was the best antidepressant I ever took. (It got pulled completely from the market here in Canada..even generic)

But, getting back to Beckett's post, I was wondering, once you get a prescription, can you just mail order ketamine?

Thanks,

Jay

 

Re: oral ketamine and question for Beckett2 » Jay2112

Posted by beckett2 on June 12, 2022, at 19:47:07

In reply to Re: oral ketamine and question for Beckett2 » SLS, posted by Jay2112 on June 10, 2022, at 18:41:55

> > Hi.
> >
> > For what it might be worth, I like asenapine (Saphris). It possesses both antipsychotic and antidepressant properties. I had no side effects. My ex-girlfriend, who has the bipolar subtype of schizoaffective disorder, has remained free of both psychosis and depression (last I heard). She went from being homebound to getting a job and building a new life for herself. She had more mental and physical energy and enjoyed crystal-clear thinking.
> >
> > Of course, asenapine won't help everyone. It is bound to make some people worse.
> >
> >
> > - Scott
>
> Hey Scott! Hi Beck!
>
> Hope you are well. I had very dysphoric effects with Saphris, and all's it really made me want to do was EAT...everything/anything, especially complete 24 slice pizzas...2 at a time...you get the picture. I didn't want to do ANYTHING..just sit, watch tv. I got akathesia quite bad on it..unfortunately the day my father died, in my arms.
>
> For over 20 years, the only AP that made me feel much better is risperidone. That blockade of some 5ht2 receptors, which in particular have some adrenergic properties, seems to be the clincher for me. Nefadozone has similar properties, and was the best antidepressant I ever took. (It got pulled completely from the market here in Canada..even generic)
>
> But, getting back to Beckett's post, I was wondering, once you get a prescription, can you just mail order ketamine?
>
> Thanks,
>
> Jay

Hi Jay, my entire process is online w telemedicine and mail order. The subreddit for therapeutic ketamine is a great resource. https://www.reddit.com/r/TherapeuticKetamine/

 

Thanks so kindly for that :) (nm) » beckett2

Posted by Jay2112 on June 16, 2022, at 20:16:56

In reply to Re: oral ketamine and question for Beckett2 » Jay2112, posted by beckett2 on June 12, 2022, at 19:47:07


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