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Veteran Member
Member Since Aug 2015
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#1
I don't expect any responses to my specific question, but my understanding is that this drug has been FDA approved as a nasal spray (indicated by the 'es'). However, I've had trouble finding a pharmacy who can dispense the drug. The drug, ketamine, was used in the 60s as a party drug. Now, the National Institute of Mental Health (NIMH) is testing ketamine as a promising new drug for people who have not responded to other antidepressants.
According to the testing already done, ketamine frequently works within days, not weeks. But there are drawbacks. Of course.The form of ketamine being tested now, can cause some dissociation and only lasts a week. Ketamine acts on the opioid receptors, which complicates use in clinical depression. It is not an SSRI. I'm one who has taken almost every antidepressant manufactured, plus four days of TMS, so I'm interested in finding someone who has experience with esketamine. I'm thinking there might be someone in the larger coastal cities who may have access to the nasal spray. If anyone has intimate knowledge of how this new drug works, I would appreciate what information you can share. For those who want to know about the testing by NIMH, this is the link using TinyUrl: https://tinyurl.com/y37w4gkv Thanks~~Let me know if the link doesn't work. __________________ ~~Ugly Ducky |
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Poohbah
Member Since Mar 2018
Location: CA
Posts: 1,009
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#2
I've used ketamine to treat suicidal ideation. It only lasts a few days at first, but with repeated use the effects last longer. I haven't used it in almost a year.
It really was like a switch was flipped in my brain. There's a large subset of the population for whom it doesn't act as an antidepressant but it does alleviate suicidal ideation. I'm in that group. A recent med change caused some suicidal ideation and I'd forgotten how emotionally exhausting it is after not having experienced it for so long. There are a lot of exciting implications. It is further evidence for what we've seen with SSRIs and other meds causing suicidal ideation, that there's overlap with depression and suicidal ideation, but they are two different phenomena. It's not really published in the literature, but it's "common knowledge" among clinics and stuff that if you're on benzos it won't work. There are also studies testing whether naltrexone, an opioid antagonist, prevents the effect (trying to figure out the mechanism by which it works). I haven't seen the results published, but from what I've heard secondhand through the grapevine they're finding that it does prevent the antidepressant effect from working. So the mechanism is probably at least somewhat opioid mediated. As for access, I went with IM not intranasal because I wasn't convinced of the efficacy of the nasal route based on the research at the time, and I acquired it via alternate means... |
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Metaphysic
Member Since Aug 2016
Location: The Netherlands
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#3
I've used low doses (30mg) of pharmaceutical ketamine every 1-2 weeks for 4 months.
It made me LOOK at my thoughts rather than to BE my thoughts. So all the things that I'd be upset about, I'd just laugh and not think it's a big deal. It's like someone else is depressed but I'm also that person at the same time so I can CHANGE my thoughts to more positive ones. I believe the usage of ketamine has benefited me in the long term because even though it's been maybe 2-3 months since I've used it, I still feel less depressed. I feel better now that I know that something actually works very good for depression and that I'm not hopeless. |
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Member
Member Since Sep 2013
Location: SAD
Posts: 175
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#4
For those who had experience did it help with anxiety? ocd? or just depression?
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Grand Magnate
Member Since Aug 2008
Location: Illinois, USA
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#5
Not esketamine, but I started taking intranasal ketamine about a year ago. I get it by prescription from a compounding pharmacy. I would have tried IV ketamine but I live in the sticks and it wasn't available without a 3 hour drive and the logistics of getting a ride a couple of times a week were beyond me. So my pdoc said he would give the intranasal a try. It is amazing. I had tried 20 different meds in all kinds of classes for MDD, none worked. I was suicidal all of the time. The ket provided immediate relief. It still astonishes me.
I took 50 mg weekly for about a year, and then I found that I need it less often. I went about 5 weeks earlier this spring, and am now at 3 or so weeks without. But it took a year to get there. I take it at home. I know that the FDA approval for esketamine requires that you dose yourself at a place that has approval/training in monitoring you. Which I think is fine-except that there are none of those around here-same issue as the IV ketamine. I have DID-the dissociation (if that is what it is) that the ketamine often causes is nothing like what I experience when I switch do to my mental illness. To me, it just feels like waking up from anesthesia-which I suppose you would expect. More like laughing gas. Not scary, although I definitely do not drive after I have dosed. It takes a couple of hours for me to return to feeling normal, so I just take it at night when I don't have any need to leave the house. It does burn a bit, and it tastes icky if it drips down the back of the throat.The side effects are SO worth it. I take benzos as needed, which for me is a small dose maybe once a week. That has not stopped the ket from working. I also have a history of alcoholism and drug use, but I have not had an issue with addictive thoughts or behavior. There is the issue of the amount that actually enters the bloodstream varying with the intranasal, but again, worth it. Sometimes I "feel" the medication more strongly. Maybe due to sinus congestion? But it has still worked. I pay about $75 for 4 doses-insurance does not pay. But that is way less than IV ketamine, which insurance doesn't pay for, either. I don't know what they are charging for esketamine, but I would not be surprised if the co-pay was rather high. The cynical side of me suspects that the drug company developed esketamine because they can patent it and have exclusive rights for 10 years, while ketamine is available as a generic. |
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Member
Member Since Sep 2013
Location: SAD
Posts: 175
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#6
Quote:
thank you for sharing. did you see any relief from anxiety? i have read many stories like yours that the relief is immediate/fast to the point where people cry from happiness after suffering for so long with suicidal thoughts.. Yes it is very sad that the eksetamine (the nasal spray) is not covered by insurance, it must be done at a clinic, yet you get it at a compound pharmacy for next to nothing for the amount the charges at hospitals/clinics. It is sad so many people suffering, and they can't afford it, or don't know where /how to purchase it from a compound pharmacy.. but they care about profits more than anything. |
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Member
Member Since Sep 2013
Location: SAD
Posts: 175
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#7
Quote:
anything about anxiety helpful with it? |
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Grand Member
Member Since Sep 2014
Location: USA
Posts: 750
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#8
I think the “es” is because it’s not exactly ketamine, but a very related compound, rather than having to do with the administration type. There is one esketamine clinic near where I live. It is administered there intranasally, then they watch you for a bit in case of side effects, then someone else has to take you home. No driving or walking yourself. You have to get it and use it at the specially licensed clinic. It isn’t available at the pharmacy.
Side note: I’ve tried dozens of different medications in all sorts of categories for severe depression with constant suicidal ideation. SSRIs, SNRIs, atypical antipsychotics, atypical antidepressants, etc. Even weeks of TMS. Nothing worked... except a random trial of Adderall. The suicidal thoughts lifted within an hour. It was amazing. It surely doesn’t fix everything, but it’s nice to not want to die 24/7. __________________ "I think I'm a hypochondriac. I sure hope so, otherwise I'm just about to die." PTSD OCD Anxiety Major Depressive Disorder (Severe & Recurrent) |
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Member
Member Since Sep 2013
Location: SAD
Posts: 175
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#9
Quote:
have you tried namenda? or looked into spravato the nasal spray form of ketamine ?? my friend did TMS and got no results..im sorry how are you feeling now.. |
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Junior Member
Member Since Sep 2019
Location: Medford, Oregon
Posts: 12
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#10
I want to answer your question about esketamine very badly. However, I don't want to sound like it would work for everyone so I stop myself, even though I want to shout from the rooftops.
I would love to share my experience with you (or anyone who'll listen!!), but it would be best in a private message.... I promise to respond! Everyone is different, no promises- but this former TRD patient is feeling unbelievably normal. And so much at peace... Hope to hear from you! Last edited by CANDC; Sep 22, 2019 at 10:31 AM.. Reason: Clarification |
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Member
Member Since Sep 2013
Location: SAD
Posts: 175
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#11
Quote:
you can prviate message me ..any information will be appreciated ..thanks |
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