Health Consequences of Ketamine Capitalism

[Mycophile]

Well, I haven't read most of this thread, and I've never done Ketamine before (always wanted to find it but couldn't) but now I'm seeing a therapist for my depression and anxiety, and I'm most likely going to have the option of getting Ketamine therapy, and I think it will be promising. According to my therapist, many are finding it helpful, and the give very low doses so I don't think there's many dangers there.

I also don't know how expensive it will be, but I think not nearly as much as some might be assuming. The therapy I think is what really brings out the potential for the substance to have therapeutic effects rather than just recreational ones. My therapist says that it increases brain plasticity and would likely help people stuck in rigid mindsets like myself. I don't think I'll end up addicted to it because I don't think I can at the doses they will provide, and at this particular time, I have no idea how to find it on the street, so I'm hoping that that one poster's comment about Ketamine being like "psychedelic heroin" doesn't ring true for me, but right now I'm looking for anything that might be helpful. They also usually combine it with Oxytocin for some reason.

 

[Chris Timothy]

Your bladder might not be inflamed, but surely..

Bladder damage is a myth [...]

..is about the most inflammatory remark you can start out a post with on here!


(Ketamine damage is complicated btw, it's not directly caustic or anything, but can set off damage cascades under unfortunate circumstances.)

 

[tryptakid]

Well, I haven't read most of this thread, and I've never done Ketamine before (always wanted to find it but couldn't) but now I'm seeing a therapist for my depression and anxiety, and I'm most likely going to have the option of getting Ketamine therapy, and I think it will be promising. According to my therapist, many are finding it helpful, and the give very low doses so I don't think there's many dangers there.

I also don't know how expensive it will be, but I think not nearly as much as some might be assuming. The therapy I think is what really brings out the potential for the substance to have therapeutic effects rather than just recreational ones. My therapist says that it increases brain plasticity and would likely help people stuck in rigid mindsets like myself. I don't think I'll end up addicted to it because I don't think I can at the doses they will provide, and at this particular time, I have no idea how to find it on the street, so I'm hoping that that one poster's comment about Ketamine being like "psychedelic heroin" doesn't ring true for me, but right now I'm looking for anything thathrought might be helpful. They also usually combine it with Oxytocin for some reason.

Just an FYI - I'm a therapist in my day-to-day life. My read on the sudden interest in ketamine is as follows:

1) - SSRIs are pretty hit or miss as far as efficacy goes. They carry unpleasant side effects (no sex drive), are often difficult to pin down as far as whether they are helping, and have dependence liability/withdrawal syndrome upon discontinuation - (I always found it obnoxious how the withdrawals from SSRIs are billed as 'discontinuation syndrome' to make it sound less scary than 'SSRI withdrawals". Ask anyone who has taken them, the brain zaps and anxiety are pretty rough.

2) - Ketamine - unlike SSRIs - provides mood improvement within the day (SSRIs take weeks to demonstrate efficacy). I've read journal articles advocating for the use of ketamine in the Emergency Department for patients presenting with suicidal ideation. There is plenty of data to show a rapid elevation in mood.

3) - We haven't had a blockbuster/breakthrough treatment for depression (which is currently an enormous issue in the West, particularly in the US) since prozac. Ketamine is the first profitable pharmaceutical for the most common mental health problems adults face, in the past 3 decades. It's the same reason that psilocybin is of interest - there haven't really been any major breakthroughs, and ketamine does have some very significant benefits with drawbacks that are not as pervasive in the medical literature*. This is very appealing, and given it's utilization in a clinic setting as well as by prescription, it allows a cottage industry to form utilizing ketamine off-label for treatment resistant depression.

*The drawbacks are well known to communities like bluelight - dissociatives are very effective at improving mood, so much so that people begin to chase that elevation (hypomania). Owing to its relatively short duration of action, ketamine doesn't tend to push people into persistent hypomanic or manic states unlike PCP which is much more likely to result in this type of effect. The mood elevation is so short lived, in fact, that some psychiatric providers question how useful it is as the improvements to mood fade within a few days/weeks. You have to continue to use it but begin to get diminishing returns due to tolerance. Due to it's intoxicating profile, it's not well suited for daily use in many circumstances (Imagine if your bus driver was taking ketamine for depression? how about your doctor? would you trust a hypomanic financial advisor to double down on your investment?) - it's efficacy becomes murky because the improvement to mood is quite ephemeral. If the person using it isn't paying attention to their use (something I'd argue drug users are more predisposed to doing than patients) and the effects that said use is having, one can be blind to the disinhibiting, ego-enhancing, delusional, and dissociating effects of drugs like ketamine. Your own happiness improves and the risk is that you are more detached from those around you, a part of you isn't quite there, but its negative effects can be quite ephemeral and difficult to pin down.

I often use the analogy of psychosis to demonstrate my point - Psychosis has both positive and negative symptoms. Positive symptoms are things like hallucinations, delusions, altered thought patterns - things that are often easily observed in someone's behavior. Negative symptoms are like *the void*; emotional flatness and withdrawal. Ketamine (as do SSRIs, in my opinion) carries a great risk of negative symptomatic side-effects. The cost to gain happiness can be pieces of you detaching. I've noticed this impact most within the context of intimate relationships.

We are in a time where our unhappiness is rooted in a number of factors: loneliness, economic uncertainty, crisis of faith, and technological transition. More and more we supplant artificial relationships via social media for in-person activity and socializing. We are disconnected from a sense of 'why?' and even further from belief in an answer - religion has become politicized at best, and heinously abusive at worst. Our future is uncertain as we begin to test the impact of AI on our psyches already reeling from the innovation of the internet.

^^ All of this comes from a therapist who has an intimate and extensive relationship with ketamine use. Most people who are providing it have almost no personal connection to the drug itself.

My advice to you is this: If you do start using ketamine, remember that it's dark magic. It will improve your mood, but you have to do your own work with the freedom it bestows. If you can do that, you may benefit from it. If you rely on it, it will drain you.

Sunlight
Exercise
Social interactions
Breathing exercises
Sense of purpose
Sense of wonder
Creative expression

These are the very real and very attainable things that will help you deal with depression.

 

[Mycophile]

Just an FYI - I'm a therapist in my day-to-day life. My read on the sudden interest in ketamine is as follows:

1) - SSRIs are pretty hit or miss as far as efficacy goes. They carry unpleasant side effects (no sex drive), are often difficult to pin down as far as whether they are helping, and have dependence liability/withdrawal syndrome upon discontinuation - (I always found it obnoxious how the withdrawals from SSRIs are billed as 'discontinuation syndrome' to make it sound less scary than 'SSRI withdrawals". Ask anyone who has taken them, the brain zaps and anxiety are pretty rough.

2) - Ketamine - unlike SSRIs - provides mood improvement within the day (SSRIs take weeks to demonstrate efficacy). I've read journal articles advocating for the use of ketamine in the Emergency Department for patients presenting with suicidal ideation. There is plenty of data to show a rapid elevation in mood.

3) - We haven't had a blockbuster/breakthrough treatment for depression (which is currently an enormous issue in the West, particularly in the US) since prozac. Ketamine is the first profitable pharmaceutical for the most common mental health problems adults face, in the past 3 decades. It's the same reason that psilocybin is of interest - there haven't really been any major breakthroughs, and ketamine does have some very significant benefits with drawbacks that are not as pervasive in the medical literature*. This is very appealing, and given it's utilization in a clinic setting as well as by prescription, it allows a cottage industry to form utilizing ketamine off-label for treatment resistant depression.

*The drawbacks are well known to communities like bluelight - dissociatives are very effective at improving mood, so much so that people begin to chase that elevation (hypomania). Owing to its relatively short duration of action, ketamine doesn't tend to push people into persistent hypomanic or manic states unlike PCP which is much more likely to result in this type of effect. The mood elevation is so short lived, in fact, that some psychiatric providers question how useful it is as the improvements to mood fade within a few days/weeks. You have to continue to use it but begin to get diminishing returns due to tolerance. Due to it's intoxicating profile, it's not well suited for daily use in many circumstances (Imagine if your bus driver was taking ketamine for depression? how about your doctor? would you trust a hypomanic financial advisor to double down on your investment?) - it's efficacy becomes murky because the improvement to mood is quite ephemeral. If the person using it isn't paying attention to their use (something I'd argue drug users are more predisposed to doing than patients) and the effects that said use is having, one can be blind to the disinhibiting, ego-enhancing, delusional, and dissociating effects of drugs like ketamine. Your own happiness improves and the risk is that you are more detached from those around you, a part of you isn't quite there, but its negative effects can be quite ephemeral and difficult to pin down.

I often use the analogy of psychosis to demonstrate my point - Psychosis has both positive and negative symptoms. Positive symptoms are things like hallucinations, delusions, altered thought patterns - things that are often easily observed in someone's behavior. Negative symptoms are like *the void*; emotional flatness and withdrawal. Ketamine (as do SSRIs, in my opinion) carries a great risk of negative symptomatic side-effects. The cost to gain happiness can be pieces of you detaching. I've noticed this impact most within the context of intimate relationships.

We are in a time where our unhappiness is rooted in a number of factors: loneliness, economic uncertainty, crisis of faith, and technological transition. More and more we supplant artificial relationships via social media for in-person activity and socializing. We are disconnected from a sense of 'why?' and even further from belief in an answer - religion has become politicized at best, and heinously abusive at worst. Our future is uncertain as we begin to test the impact of AI on our psyches already reeling from the innovation of the internet.

^^ All of this comes from a therapist who has an intimate and extensive relationship with ketamine use. Most people who are providing it have almost no personal connection to the drug itself.

My advice to you is this: If you do start using ketamine, remember that it's dark magic. It will improve your mood, but you have to do your own work with the freedom it bestows. If you can do that, you may benefit from it. If you rely on it, it will drain you.

Sunlight
Exercise
Social interactions
Breathing exercises
Sense of purpose
Sense of wonder
Creative expression

These are the very real and very attainable things that will help you deal with depression.

Thanks for the info.

Since you mentioned being a therapist, just out of curiosity, do you administer Ketamine therapy? Because I'm about to get it, but it's far too expensive for me to be able to afford a session or 2 here and there. That's what sucks, but, according to my therapist, sometimes even one single session can have profound effects.

The negative effects you mentioned are almost certainly with chronic usage, and I'd imagine probably chronic high dose usage, as opposed to what I'd be getting, which I've told will be in the 100-300mg range, and they will be Ketamine lozenges as opposed to injections, which, I'm told, makes them far safer.

But also, if you are a therapist, you'd know that combining therapy with certain drugs can make them much more likely to have profound and lasting effects than simply doing the drug by itself. The way they will work is that I will get a 2 hour session where I talk to my therapist while on Ketamine, and then 3 days later we have another "integration session" where we work on helping me understand and maintain any positive benefits or insights. I'm very optimistic about it. It's really only how few sessions I'll probably be able to afford and how expensive it is that are the huge draw backs. That being said, that also makes negative side effects less likely, and I honestly don't know where to find Ketamine on the street, so unless I ever do figure out how, I won't have to worry about the dangers of chronic and/or high dose ketamine.

I do wish I'd never gotten on prozac, but I've been on it 30 years, and I don't know if i can ever get off. It has helped me greatly with my OCD related anxiety symptoms, but not my depression. However, despite all the mentions of negative sexual side effects, I have never gotten any. Just because a drug CAN cause side effects doesn't mean that it will.

I honestly find Kratom to be a great antidepressant also, but the problem is that 1) it doesn't cause great insights, more just masks symptoms, but that can allow you to take on certain risks you might not otherwise 2) it is too addictive for me to want to take it regularly, and I don't really feel comfortable being dependent (it also obviously causes constipation, and I can't sleep unless it's worn off like 6 hours or more prior, so those are other negative side effects.)

I want to see if I can get a doctor to prescribe Ultra Low Dose Naltrexone because that can supposedly eliminate withdrawal completely and also potentiate it. Many people don't realize that high dose, low dose and ultra lose dose naltrexone all have ENTIRELY different effects. I have a prescription for regular/high dose naltrexone so that I can stop myself from drinking if I want and take will power out of the equation. Many people think that ULDN can't help potentiate and eliminate the WD of opioids because regular dose completely blocks it, but they are wrong.

I could try to make ULDN myself, but I'd be worried I'd mess up and dose too high and end up in precipitated WD, which is a huge risk. But if I can get a doctor to prescribe ULDN then the dosage is much more likely to be correct so that shouldn't happen. I have also heard that ULDN has mental and physical health benefits of its own even without opioids and can be used off-label as an antidepressant.

Do you know anything about the combination of ULDN and Kratom used as an antidepressant or have any opinions on that?

 

[tryptakid]

Since you mentioned being a therapist, just out of curiosity, do you administer Ketamine therapy? Because I'm about to get it, but it's far too expensive for me to be able to afford a session or 2 here and there. That's what sucks, but, according to my therapist, sometimes even one single session can have profound effects.

The negative effects you mentioned are almost certainly with chronic usage, and I'd imagine probably chronic high dose usage, as opposed to what I'd be getting, which I've told will be in the 100-300mg range, and they will be Ketamine lozenges as opposed to injections, which, I'm told, makes them far safer.

Thanks for the response! I do not administer ketamine therapy and have never worked in any places that offer it. The vast majority of folks I work for are on public assistance for insurance, either as public welfare benefit or due to disability. Ketamine, generally speaking, too much of an out of pocket cost for most of my folks to even consider, so I understand how your own limits on access are likely pretty frustrating.

I will say that there is benefit in knowing that you *can* feel better. Even if the tool is not something you can access as often as you'd like, it will remind your soul that you don't always have to feel the way that you do. Perhaps being able to experience that degree of an uplift can create positive momentum. I'm a big believer in the notion that our suffering can be very strongly associated with feeling stuck or inertia. When we feel trapped by depression, for example, the amount of energy required to fix all of the things that occupy our mind, reminding us of why we feel badly, is immense. Even trying to sort out and start working on aspects of our lives can feel like a task onto itself. I'm not sure how depression manifests for you, but I imagine there is some ways in which feeling stuck or held motionless and unable to muster the volition to move forward can be quite difficult.

Ketamine's properties are such that a rapid increase in associative learning in its aftermath is often noted, as well as a temporary increase in willpower as well as impulsivity. Impulsivity can be helpful if used to begin engaging in helpful things that you would normally avoid out of fear or routine. It can be bad if it leads you into unhealthy activities, so something to be mindful about. Generally speaking, having someone talking with you about some of this stuff will be helpful in offering personal guidance as to how to use it. I would just try to have some ideas of how you want to use the days and weeks following your session to begin some growth focused activities. Get some momentum going in a positive direction that matters, perhaps something basic like physical fitness. It would be helpful to bring some of this stuff with you to talk with the clinician you are working with.

But also, if you are a therapist, you'd know that combining therapy with certain drugs can make them much more likely to have profound and lasting effects than simply doing the drug by itself.

This was originally how we were going to use SSRIs but boy have the times changed in that regard.

The way they will work is that I will get a 2 hour session where I talk to my therapist while on Ketamine, and then 3 days later we have another "integration session" where we work on helping me understand and maintain any positive benefits or insights. I'm very optimistic about it. It's really only how few sessions I'll probably be able to afford and how expensive it is that are the huge draw backs. That being said, that also makes negative side effects less likely, and I honestly don't know where to find Ketamine on the street, so unless I ever do figure out how, I won't have to worry about the dangers of chronic and/or high dose ketamine.

I do wish I'd never gotten on prozac, but I've been on it 30 years, and I don't know if i can ever get off. It has helped me greatly with my OCD related anxiety symptoms, but not my depression. However, despite all the mentions of negative sexual side effects, I have never gotten any. Just because a drug CAN cause side effects doesn't mean that it will.

30 years is a long time. Maybe it's a good thing that you're limited in how often you can access this treatment for at this time - I do think that it will give you a nudge in a unique and powerful way. I look forward to hearing about how your session goes.

I honestly find Kratom to be a great antidepressant also, but the problem is that 1) it doesn't cause great insights, more just masks symptoms, but that can allow you to take on certain risks you might not otherwise 2) it is too addictive for me to want to take it regularly, and I don't really feel comfortable being dependent (it also obviously causes constipation, and I can't sleep unless it's worn off like 6 hours or more prior, so those are other negative side effects.)

Kratom is great for certain situations - I think of it as temporary boost to constitution or stamina. It's a little energizing, and can help me get through something frustrating/annoying and also pairs really well with exercise. The combination of endorphins and kratom is quite nice.

I want to see if I can get a doctor to prescribe Ultra Low Dose Naltrexone because that can supposedly eliminate withdrawal completely and also potentiate it. Many people don't realize that high dose, low dose and ultra lose dose naltrexone all have ENTIRELY different effects. I have a prescription for regular/high dose naltrexone so that I can stop myself from drinking if I want and take will power out of the equation. Many people think that ULDN can't help potentiate and eliminate the WD of opioids because regular dose completely blocks it, but they are wrong.

I too am curious about ULDN and have been looking at it off and on over many years since someone mentioned something about it on alt.drugs.hard or something back in the usenet days. It's always seemed to be just outside of anyone's experience to get any solid advice, though I do see it come up on reddit a fair amount. Is your regular naltrexone being used as part of "The Sinclair Method"? If so, I have a lot of respect for that approach and wish more people could see using naltrexone in a targeted rather than daily way is likely far superior in objective and subjective benefit.

It probably wouldn't be difficult to make a volumetric solution with 1 tablet (assuming they're 50mg) If so, you'd just dissolve one tablet in a 2 liter bottle of distilled water. You now have a solution of 50mg/2000ml which equals 25mg/1000ml, 2.5/100ml, .25/10ml, .025/ml, .0025/.1ml. As I understand it, there's a sweet spot for folks so you'd need to adjust based on how it works for you, but that's a dose within the therapeutic range that seems like a starting point. There are plenty of ways to find eyedroppers or syringes that will give you .1ml measuring accuracy.

I could try to make ULDN myself, but I'd be worried I'd mess up and dose too high and end up in precipitated WD, which is a huge risk. But if I can get a doctor to prescribe ULDN then the dosage is much more likely to be correct so that shouldn't happen. I have also heard that ULDN has mental and physical health benefits of its own even without opioids and can be used off-label as an antidepressant.

Do you know anything about the combination of ULDN and Kratom used as an antidepressant or have any opinions on that?

I don't know anything off-hand, certainly strikes me as an interesting avenue for exploration. I will say that Ketamine and Kratom have a nice synergy. I would imagine that the prime benefit to ULDN and kratom would be the potentiation of effect and reduction in tolerance, assuming that kratom tolerance is modulated through similar mechanisms as morphine and other opioids. I know that it interacts with receptors in a different way than traditional opioids sometimes, but similarly in others. I don't know how ULDN and kratom would interact.\

Have you followed this thread on the site that discusses ULDN? I found it while responding to your comment.

Thanks for your questions and thoughts. I hope some of it helps.

 

[Mycophile]

Thanks for the response! I do not administer ketamine therapy and have never worked in any places that offer it. The vast majority of folks I work for are on public assistance for insurance, either as public welfare benefit or due to disability. Ketamine, generally speaking, too much of an out of pocket cost for most of my folks to even consider, so I understand how your own limits on access are likely pretty frustrating.

I will say that there is benefit in knowing that you *can* feel better. Even if the tool is not something you can access as often as you'd like, it will remind your soul that you don't always have to feel the way that you do. Perhaps being able to experience that degree of an uplift can create positive momentum. I'm a big believer in the notion that our suffering can be very strongly associated with feeling stuck or inertia. When we feel trapped by depression, for example, the amount of energy required to fix all of the things that occupy our mind, reminding us of why we feel badly, is immense. Even trying to sort out and start working on aspects of our lives can feel like a task onto itself. I'm not sure how depression manifests for you, but I imagine there is some ways in which feeling stuck or held motionless and unable to muster the volition to move forward can be quite difficult.

Ketamine's properties are such that a rapid increase in associative learning in its aftermath is often noted, as well as a temporary increase in willpower as well as impulsivity. Impulsivity can be helpful if used to begin engaging in helpful things that you would normally avoid out of fear or routine. It can be bad if it leads you into unhealthy activities, so something to be mindful about. Generally speaking, having someone talking with you about some of this stuff will be helpful in offering personal guidance as to how to use it. I would just try to have some ideas of how you want to use the days and weeks following your session to begin some growth focused activities. Get some momentum going in a positive direction that matters, perhaps something basic like physical fitness. It would be helpful to bring some of this stuff with you to talk with the clinician you are working with.

This was originally how we were going to use SSRIs but boy have the times changed in that regard.


30 years is a long time. Maybe it's a good thing that you're limited in how often you can access this treatment for at this time - I do think that it will give you a nudge in a unique and powerful way. I look forward to hearing about how your session goes.


Kratom is great for certain situations - I think of it as temporary boost to constitution or stamina. It's a little energizing, and can help me get through something frustrating/annoying and also pairs really well with exercise. The combination of endorphins and kratom is quite nice.

I too am curious about ULDN and have been looking at it off and on over many years since someone mentioned something about it on alt.drugs.hard or something back in the usenet days. It's always seemed to be just outside of anyone's experience to get any solid advice, though I do see it come up on reddit a fair amount. Is your regular naltrexone being used as part of "The Sinclair Method"? If so, I have a lot of respect for that approach and wish more people could see using naltrexone in a targeted rather than daily way is likely far superior in objective and subjective benefit.

It probably wouldn't be difficult to make a volumetric solution with 1 tablet (assuming they're 50mg) If so, you'd just dissolve one tablet in a 2 liter bottle of distilled water. You now have a solution of 50mg/2000ml which equals 25mg/1000ml, 2.5/100ml, .25/10ml, .025/ml, .0025/.1ml. As I understand it, there's a sweet spot for folks so you'd need to adjust based on how it works for you, but that's a dose within the therapeutic range that seems like a starting point. There are plenty of ways to find eyedroppers or syringes that will give you .1ml measuring accuracy.

I don't know anything off-hand, certainly strikes me as an interesting avenue for exploration. I will say that Ketamine and Kratom have a nice synergy. I would imagine that the prime benefit to ULDN and kratom would be the potentiation of effect and reduction in tolerance, assuming that kratom tolerance is modulated through similar mechanisms as morphine and other opioids. I know that it interacts with receptors in a different way than traditional opioids sometimes, but similarly in others. I don't know how ULDN and kratom would interact.\

Have you followed this thread on the site that discusses ULDN? I found it while responding to your comment.

Thanks for your questions and thoughts. I hope some of it helps.

Yes, I have read parts of that thread before. I'll be looking at it more in the future I'm sure.

No, I don't do the Sinclair Method, though I do find it interesting. I use Naltrexone the way most people in this part of the world do: if I want to take will power out of the equation and make it so I can't drink and/or take Kratom and/or Phenibut, I'll just take my Naltrexone so it's not even an option. Then when I decide I want to drink and/or use Kratom or whatever then I'll get off of it. I'm off of it right now cause I wanted to use Kratom. It takes 5 days to fully leave your system so then you can use Kratom. I've found that only 1 day of skipping it is enough for alcohol to work though.

While The Sinclair Method is very interesting, I personally can't imagine deciding to only take Naltrexone when drinking. First of all, I DON'T want to quit drinking forever, so that in of itself would mean it's not right for me. What I've heard in Sinclair Method forums is that for it to really work you have to have 100% compliance, which means never taking Naltrexone when you don't drink and ALWAYS taking it when you do. Then you just can't enjoy alcohol. So I have no use for that. I don't want to ruin my experience. I still love alcohol, I just like having something that removes will power from the equation. And, of course, if I actually could access ULDN then you can't be on that and full dose at the same time or there would obviously be no point.

Yeah, I wish I could get off my prozac because there's so many psychedelics that I want to try which I think could help me with my mental health issues so much more, but I can't due to risk of serotonin syndrome.

Do you think it's impossible for me to ever get off my prozac considering how long I've been on it? Like, it would be very hard, but it must be POSSIBLE right? I'm on 60mgs right now.

And also, do you know whether or not precipitated WD is always life threatening and what it is that doctors at a hospital would give a person going through it to stop it from continuing?

 

[tryptakid]

Yes, I have read parts of that thread before. I'll be looking at it more in the future I'm sure.

No, I don't do the Sinclair Method, though I do find it interesting. I use Naltrexone the way most people in this part of the world do: if I want to take will power out of the equation and make it so I can't drink and/or take Kratom and/or Phenibut, I'll just take my Naltrexone so it's not even an option. Then when I decide I want to drink and/or use Kratom or whatever then I'll get off of it. I'm off of it right now cause I wanted to use Kratom. It takes 5 days to fully leave your system so then you can use Kratom. I've found that only 1 day of skipping it is enough for alcohol to work though.

While The Sinclair Method is very interesting, I personally can't imagine deciding to only take Naltrexone when drinking. First of all, I DON'T want to quit drinking forever, so that in of itself would mean it's not right for me. What I've heard in Sinclair Method forums is that for it to really work you have to have 100% compliance, which means never taking Naltrexone when you don't drink and ALWAYS taking it when you do. Then you just can't enjoy alcohol. So I have no use for that. I don't want to ruin my experience. I still love alcohol, I just like having something that removes will power from the equation. And, of course, if I actually could access ULDN then you can't be on that and full dose at the same time or there would obviously be no point.

Yeah, I wish I could get off my prozac because there's so many psychedelics that I want to try which I think could help me with my mental health issues so much more, but I can't due to risk of serotonin syndrome.

Do you think it's impossible for me to ever get off my prozac considering how long I've been on it? Like, it would be very hard, but it must be POSSIBLE right? I'm on 60mgs right now.

And also, do you know whether or not precipitated WD is always life threatening and what it is that doctors at a hospital would give a person going through it to stop it from continuing?

Re: psychedelics - I will say that 2cb seems to be far more effective for people I know who are on drugs that bind to serotonin sites - could be something worth exploring. I don't recall if mescaline is as well, as I believe that has more of a specific affinity for 5ht2a receptors which are blocked by SSRIs, but I believe 2cb binds to like 5ht2c receptors or something like that which seems to allow it to have an effect. A friend of mine was able to use it successfully where other psychedelics had been ineffective - for whatever that may be worth.

Re: coming off - Anything's possible. The only thing you can do is try. The biggest issue is the fact that you've been using it for about as long as it's been prescribed, give or take. There isn't going to be much data on what to expect in cases like yours, so whatever you try to do, I'd suggest documenting it as it may be of value to others. I'd start by tapering down, switch to 3 20s a day and then start taking only 2/day. I'd be up front with whoever prescribes it that you'd like to try coming down on your dose, and just be up front that should you encounter any major issues, you'll be in touch as soon as possible. The goal is to get down to a consistent 40mg, then 20mg. The recommendations I've seen from both online forums and published articles target a taper to go from as short as 2 weeks to as long as 4. With the length of time and the dose you're on, I"d aim conservative. The benefit to prozac is that it's pretty long-acting, so the drop in dose should be well tolerated, however, the flip side would be that you may want to stager days at the end (taking a dose, then skipping a day, 2 days, dose, 2 days or 3 days, dose etc.)

I think it's certainly possible, but I'd be sure to have a plan in place and involve your doctor if you're going to do it. That said, this is what I would do if it were me. There is always the risk that having been on it for such a long time could lead to unforeseen effects of cessation.

One thing that might be helpful and seems to have been used by others, is following cessation of an SSRI with microdosing psilocybin. Given that psilocybin will bind to serotonin receptors, I wonder if it can help your brain return to whatever homeostasis would look like. Usually people would take about .1g up to .3g of mushrooms for desired effects. GIven that your brain hasn't had an experience without SSRIs, it might take some tinkering to figure out what works. The goal of microdosing can be thought of as feeling nothing, yet knowing that something happened.

I would also, once you feel stable, reward yourself with a full on experience as you've likely earned it. I hope that some of this is helpful.

 

[Mycophile]

Re: psychedelics - I will say that 2cb seems to be far more effective for people I know who are on drugs that bind to serotonin sites - could be something worth exploring. I don't recall if mescaline is as well, as I believe that has more of a specific affinity for 5ht2a receptors which are blocked by SSRIs, but I believe 2cb binds to like 5ht2c receptors or something like that which seems to allow it to have an effect. A friend of mine was able to use it successfully where other psychedelics had been ineffective - for whatever that may be worth.

Re: coming off - Anything's possible. The only thing you can do is try. The biggest issue is the fact that you've been using it for about as long as it's been prescribed, give or take. There isn't going to be much data on what to expect in cases like yours, so whatever you try to do, I'd suggest documenting it as it may be of value to others. I'd start by tapering down, switch to 3 20s a day and then start taking only 2/day. I'd be up front with whoever prescribes it that you'd like to try coming down on your dose, and just be up front that should you encounter any major issues, you'll be in touch as soon as possible. The goal is to get down to a consistent 40mg, then 20mg. The recommendations I've seen from both online forums and published articles target a taper to go from as short as 2 weeks to as long as 4. With the length of time and the dose you're on, I"d aim conservative. The benefit to prozac is that it's pretty long-acting, so the drop in dose should be well tolerated, however, the flip side would be that you may want to stager days at the end (taking a dose, then skipping a day, 2 days, dose, 2 days or 3 days, dose etc.)

I think it's certainly possible, but I'd be sure to have a plan in place and involve your doctor if you're going to do it. That said, this is what I would do if it were me. There is always the risk that having been on it for such a long time could lead to unforeseen effects of cessation.

One thing that might be helpful and seems to have been used by others, is following cessation of an SSRI with microdosing psilocybin. Given that psilocybin will bind to serotonin receptors, I wonder if it can help your brain return to whatever homeostasis would look like. Usually people would take about .1g up to .3g of mushrooms for desired effects. GIven that your brain hasn't had an experience without SSRIs, it might take some tinkering to figure out what works. The goal of microdosing can be thought of as feeling nothing, yet knowing that something happened.

I would also, once you feel stable, reward yourself with a full on experience as you've likely earned it. I hope that some of this is helpful.

2cb sounds interesting. However, I'd have no idea where to get it. The only psychedelics I have access to now are shrooms and Salvia, both of which work on my prozac and Klonopin (I'm also on 1mg of Klonopin per day), but shrooms don't always give me a great experience, and the my last trip was SUPER depressing, as well as the last time I attempted to take a mini dose (not really a microdose), but the time before that was good.

As far as microdosing mushrooms, yeah, I'd kind of like to try it too, but without growing them (which I would like to try at some point), all I can get are these chocolate covered shroom bars. The bars are 4 grams total, which I THINK are made up of 16 squares, but it might be 20, I don't remember. So I tried just 3 squares, which I guess would probably be a little less than 1 gram. I don't know if that counts as a true microdose. I've actually heard that microdosing is lower than that. But I actually just got really depressed that time. It's not surprising that i did both times, because I've been having a depressing life lately, so the shrooms just kind of showed me what was there. We know psychedelics aren't always fun like certain other drugs, and sometimes they want to teach you a lesson. But I have always felt like they probably have reduced effects due to my prozac and maybe Klonopin too. I haven't yet gotten any life-changing trips, whether on shrooms, LSD or Salvia, which are pretty much the only psychs I've tried.

I'm not sure if you were suggesting to taper COMPLETELY off prozac in 2-4 works or to taper down from 60 to 40 in 2-4 weeks. The latter might be doable MAYBE, but NO WAY is it a good idea to taper completely off 60mgs in 2-4 weeks!!!! That's SUPER fast. I don't know how slowly I'd have to go, but I imagine it could take a year or more, and yes, I would definitely do it under doctor's supervision. Problem is that there are certain problems I take it for that I don't want coming back, and I've reduced my Klonopin to the extent that it would probably not work for those same types of issues (mostly social anxiety) without ANY prozac in play. But we'll see.

 

[snmfmy]

I was denied Ket treatment by my Doctors regarding my depression; apparently I haven’t attempted suicide enough times. Irks me to this day.

You obviously went to the wrong doctors.

 

[Pfafffed]

The negative effects you mentioned are almost certainly with chronic usage, and I'd imagine probably chronic high dose usage, as opposed to what I'd be getting, which I've told will be in the 100-300mg range, and they will be Ketamine lozenges as opposed to injections, which, I'm told, makes them far safer.

So there are some totally understandable assumptions here that I should probably push back on regarding dose.

With regards to treatment efficacy, the evidence we've been seeing so far shows a distinct dose-response relationship between ketamine and depression. That's to say, low doses are much less effective in providing meaningful relief from symptoms.

Additionally, low doses are counterintuitively MORE likely to lead to users becoming addicted to ketamine. I have my own ideas as to why that might be the case, but that's just speculation on my end.

(Bladder issues are another thing altogether. For now, I'm not aware of any published literature connecting the use of ketamine used in a clinical setting to bladder issues, so unless that changes I won't speak to any relationships to dose there.)

I'll dig up citations if you want - I'm double tasking with tech support rn.

 

[Mycophile]

So there are some totally understandable assumptions here that I should probably push back on regarding dose.

With regards to treatment efficacy, the evidence we've been seeing so far shows a distinct dose-response relationship between ketamine and depression. That's to say, low doses are much less effective in providing meaningful relief from symptoms.

Additionally, low doses are counterintuitively MORE likely to lead to users becoming addicted to ketamine. I have my own ideas as to why that might be the case, but that's just speculation on my end.

(Bladder issues are another thing altogether. For now, I'm not aware of any published literature connecting the use of ketamine used in a clinical setting to bladder issues, so unless that changes I won't speak to any relationships to dose there.)

I'll dig up citations if you want - I'm double tasking with tech support rn.

You may have studies to support you (yes, I would like to see them), but regardless, this is the option that is available to me. They don't do high doses for the therapy with the therapists I'm currently working with, and I'm working with them for many reasons/therapies other than just Ketamine therapy. I don't think that means that the therapy will be unsuccessful. According to my therapist, many of her (and her group's) patients have seen MASSIVE success from these sessions. Also, they include Oxytocin which also helps, and the therapy and integration offer a lot that you can't get just by doing Ketamine by yourself.

And I'm not going to become addicted to ketamine because I don't have a source for it outside of the therapy, and I'm probably not going to find one.

Also, this isn't JUST for depression, it's for anxiety, OCD, and generally making my brain more plastic and receptive towards therapy in general. You may know something about drugs, but I bet you have no background in psychology or psychotherapy, so you probably don't know how that aspect of it works.

I mean, do you expect me to decide to NOT get Ketamine therapy because the dosage isn't as high as it could be?

Also, you can post all the studies you want, but unless you are a therapist trained to not only administer Ketamine but to give ketamine therapy, and unless you know how the therapy aspect itself works (and i doubt you do) then your opinion is less valuable here.

When it comes to most "psychedelic therapy" (yes, I know ketamine isn't an actual psychedelic) whether it includes Ketamine, Oxytocin, shrooms, MDMA, etc., most experts say that the integration is what is most important. You can get a super high dose of ketamine without therapy and you won't get the same results as a low dose with therapy. That doesn't mean that high doses without therapy can't give benefits, but they will just be different from the Ketamine + Oxytocin + therapy combo.

Also, something you probably don't know, is that one of the reasons why these people use low dose Ketamine is because you can't really talk or respond to therapy at higher doses. This is according to my therapist and the doctor she works with. At higher doses you won't even be able to really communicate with the therapist, so the therapy become pointless. And, that being said, she told me that if I am later interested in higher dose ketamine treatment WITHOUT therapy, then she knows where I can get that. I may try that form as well, but for now, this is what I'm trying.

 

[Mycophile]

Also, what dosages are considered "low" vs "very low" or "moderate" or "high"?

Because I was told my dosage, in lozenge form, would probably range between 100-300mgs.

From what little I've read so far, this seems to be enough (especially combined with Oxytocin and therapy) to get good results from many patients.

 

[LucidSDreamr]

Amid a sea of ketamine therapy boosterism, I came across this article sounding the alarm. It's quite good, and I learned some wild things in it. Link bypasses paywall.

Welcome to nginx!

I wish that we could do things responsibly in this country. Psychedelic therapy offers tremendous opportunities for both sick and healthy people. It also comes with risks, risks that communities like us know very well. Now that their potential has been recognized, I feel that rather than pull in our expertise, profiteers are running full speed ahead heedless of the harm they are going to do.

Even basic things like recognizing that ketamine is addictive and can cause permanent bladder damage get ignored. It turns out that if you offer someone a lifesaving therapy that lasts for a week or two and costs pennies, but charge US$400 a dose, people will find a way to cut out the middleman. And a percentage of those people get hurt. I'm in favor of people having access to drugs, but when doctors with no training give you ketamine and don't inform you of the risks, that's not just irresponsible, that's malpractice. We saw what happened when pharma reps told doctors that Valium and Xanax were safe and not addictive, and then again with oxycodone. Ketamine is neither, but you would have hoped they'd learned.

On the larger scale, I'm concerned by the overpromising. We love doing that with new drugs. We did it with Prozac, we did it with Xanax, hell we did it with Viagra. Measured expectations don't get funding and they don't sell product.

I'm delighted that people are finally getting help, but I wish we had better community-supported spaces and containers for these tools. A generation plus of suppression has really made it hard to create the community capacity to meet all the need.

They are going to fuck it up like the did with opioids.

Give high addictive methamphetamine analogoues and ketamine to sad ppl and do it unethically like pill mills did.

Watch what the fuck happens.

 

[Mycophile]

They are going to fuck it up like the did with opioids.

Give high addictive methamphetamine analogoues and ketamine to sad ppl and do it unethically like pill mills did.

Watch what the fuck happens.

I think it will undoubtedly benefit certain people, and it already has. Others it won't benefit and others could have really bad things happen to them. I'm sure we'll see results across the board. But the way that I'm going to go about getting it doesn't sound at all unethical to me, other than the fact that you could certainly say it's overpriced, but when in our world isn't something like this going to be overpriced? The therapy I'm going to get is done in a very professional manner, and I don't see what's wrong with that.

Also, to the best of my knowledge, opioids have never been prescribed for therapy, only for pain. They train psychotherapists to follow a specific protocol and there's a doctor over seeing it.

MDMA and Psilocybin therapy have already helped lots of people, so I don't see why anyone would think that Ketamine therapy would be different.

I'm also not sure what Metahamphetamine analog you are talking about. I don't THINK that Oxytocin is one. I read the article, and I can understand how it can go wrong, but it can also go well, and has. If people choose to then find it on the street and go nuts with it, then that's really their fault, and not anyone else's.

 

[LucidSDreamr]

I think it will undoubtedly benefit certain people, and it already has. Others it won't benefit and others could have really bad things happen to them. I'm sure we'll see results across the board. But the way that I'm going to go about getting it doesn't sound at all unethical to me, other than the fact that you could certainly say it's overpriced, but when in our world isn't something like this going to be overpriced? The therapy I'm going to get is done in a very professional manner, and I don't see what's wrong with that.

Also, to the best of my knowledge, opioids have never been prescribed for therapy, only for pain. They train psychotherapists to follow a specific protocol and there's a doctor over seeing it.

MDMA and Psilocybin therapy have already helped lots of people, so I don't see why anyone would think that Ketamine therapy would be different.

I'm also not sure what Metahamphetamine analog you are talking about. I don't THINK that Oxytocin is one. I read the article, and I can understand how it can go wrong, but it can also go well, and has. If people choose to then find it on the street and go nuts with it, then that's really their fault, and not anyone else's.

drugs + capitalism = drug abuse not therapy/medicine …..we’ve already seen that.

MethylenedioxyMETHAMPHETAMINE was the meth analogue I was referring to.

Ketamine is being used for pain. and it will be abused in pill mill fashion I predict . The fact that drug addicts like Matthew Perry and Elon musk are given ketamine to take home shows the start of it. But not mdma is only being used for therapy not pain.

Opioids benefited millions of people with crippling disease the couldn’t otherwise work or would kill themselves…but they were given to perfectly healthy 20 year olds in peak physical shape and nothing at all wrong with them on cancer patient level dosages.

 

[Mycophile]

drugs + capitalism = drug abuse not therapy/medicine …..we’ve already seen that.

MethylenedioxyMETHAMPHETAMINE was the meth analogue I was referring to.

Ketamine is being used for pain. and it will be abused in pill mill fashion I predict . The fact that drug addicts like Matthew Perry and Elon musk are given ketamine to take home shows the start of it. But not mdma is only being used for therapy not pain.

Opioids benefited millions of people with crippling disease the couldn’t otherwise work or would kill themselves…but they were given to perfectly healthy 20 year olds in peak physical shape and nothing at all wrong with them on cancer patient level dosages.

Of course mistakes were made with opioids, but, as you mentioned, they also helped lots of people. I don't know about the meth analogue you are talking about.

But what I specifically am talking about in my posts is my plan to use my current therapy group's ketamine assisted therapy just a few times to help me with my problems, and according to my therapist (you could say she's lying but she's not), she hasn't seen any bad outcomes with the people she's worked with, and many have had great breakthroughs.

Fact is, there HAVE been people who have benefited from ketamine, psilocybin and MDMA therapies, amongst others. I'm not sure that it hasn't more often led to good things than bad, so your simple: "drugs + capitalism = drug abuse idea" isn't so simple after all. That's really an EXTREMELY black and white way of thinking about things.

I mean OF COURSE anytime money becomes involved with ANYTHING there are going to be some bad scenarios because that's just what money often does. However, that does NOT mean that there will not also be GOOD scenarios.

So, are you honestly saying that you do not believe that ketamine assisted psychotherapy has ever or could ever benefit anyone? Because if that is what you are saying, then you are already wrong. It has benefited people and continues to. The fact that it has also led to bad outcomes is just par for the course. Nothing is ever always good or always bad.

Ketamine as used for PAIN...yeah, I can see that going wrong a lot more easily than it being used for therapy. Ideally, kratom is probably the best thing I know of for pain because it doesn't have the downsides of stronger opioids or high dose ketamine.

And the therapeutic aspect itself makes what I'm talking about very different from what happened to Matthew Perry. He wasn't using it in that way, and therapy is different in nature than simple pain relief.

 

[Pfafffed]

You may have studies to support you (yes, I would like to see them), but regardless, this is the option that is available to me. They don't do high doses for the therapy with the therapists I'm currently working with, and I'm working with them for many reasons/therapies other than just Ketamine therapy. I don't think that means that the therapy will be unsuccessful. According to my therapist, many of her (and her group's) patients have seen MASSIVE success from these sessions. Also, they include Oxytocin which also helps, and the therapy and integration offer a lot that you can't get just by doing Ketamine by yourself.

And I'm not going to become addicted to ketamine because I don't have a source for it outside of the therapy, and I'm probably not going to find one.

Also, this isn't JUST for depression, it's for anxiety, OCD, and generally making my brain more plastic and receptive towards therapy in general. You may know something about drugs, but I bet you have no background in psychology or psychotherapy, so you probably don't know how that aspect of it works.

I mean, do you expect me to decide to NOT get Ketamine therapy because the dosage isn't as high as it could be?

Also, you can post all the studies you want, but unless you are a therapist trained to not only administer Ketamine but to give ketamine therapy, and unless you know how the therapy aspect itself works (and i doubt you do) then your opinion is less valuable here.

When it comes to most "psychedelic therapy" (yes, I know ketamine isn't an actual psychedelic) whether it includes Ketamine, Oxytocin, shrooms, MDMA, etc., most experts say that the integration is what is most important. You can get a super high dose of ketamine without therapy and you won't get the same results as a low dose with therapy. That doesn't mean that high doses without therapy can't give benefits, but they will just be different from the Ketamine + Oxytocin + therapy combo.

Also, something you probably don't know, is that one of the reasons why these people use low dose Ketamine is because you can't really talk or respond to therapy at higher doses. This is according to my therapist and the doctor she works with. At higher doses you won't even be able to really communicate with the therapist, so the therapy become pointless. And, that being said, she told me that if I am later interested in higher dose ketamine treatment WITHOUT therapy, then she knows where I can get that. I may try that form as well, but for now, this is what I'm trying.

To be clear, I have no vested interest in the choices that you make. I don't care in the slightest. Not. One. Teensy. Bit.
I of course do genuinely hope whatever you do, your life is the better for it.

This is a public forum, though, so I wanted to both share my understanding of the state of the science so that you and others like you can make informed decisions.

With regards to treatment efficacy, the evidence we've been seeing so far shows a distinct dose-response relationship between ketamine and depression. That's to say, low doses are much less effective in providing meaningful relief from symptoms.

"Our findings suggested that effect sizes for depression severity, as well as response and remission rates, were numerically greater for racemic ketamine than esketamine. Higher doses were more effective than low doses. Differences were evident in initial effects, ongoing treatment, and lasting effects after the final dose." Nikolin, S., Rodgers, A., Schwaab, A., Bahji, A., Zarate, C. A., Vázquez, G., & Loo, C. (2023). Ketamine for the treatment of major depression: a systematic review and meta-analysis. EClinicalMedicine, 62, 102127. https://doi.org/10.1016/j.eclinm.2023.102127. The Lancet is highly-regarded, fwiw.

Additionally, low doses are counterintuitively MORE likely to lead to users becoming addicted to ketamine. I have my own ideas as to why that might be the case, but that's just speculation on my end.

I could not find the article that I remember contending this point. Both internet search engines and journal searches are clogged with chaff on the topic these days. The former are full of SEO-generated articles by rehab facilities, with Google particularly bad about censoring relevant websites. The latter are just full of articles; there's been a real surge in research on the topic, which I'm delighted by. That repeated, low-dose ketamine protocols can result in addiction isn't really debatable. There's ample evidence for that. ["Both preclinical and clinical studies indicate that repeated treatment with low-dose ketamine infusions can have addictive properties and induce cognitive deficits." Strong CE, Kabbaj M. On the safety of repeated ketamine infusions for the treatment of depression: Effects of sex and developmental periods. Neurobiol Stress. 2018 Sep 21;9:166-175. doi: 10.1016/j.ynstr.2018.09.001. PMID: 30450382; PMCID: PMC6236511.] But as for my point about their being evidence that low doses are potentially *more* likely to lead to problematic use, I can't find the citation. If I find it later, I'll repost it here.

 

[Mycophile]

To be clear, I have no vested interest in the choices that you make. I don't care in the slightest. Not. One. Teensy. Bit.
I of course do genuinely hope whatever you do, your life is the better for it.

This is a public forum, though, so I wanted to both share my understanding of the state of the science so that you and others like you can make informed decisions.


"Our findings suggested that effect sizes for depression severity, as well as response and remission rates, were numerically greater for racemic ketamine than esketamine. Higher doses were more effective than low doses. Differences were evident in initial effects, ongoing treatment, and lasting effects after the final dose." Nikolin, S., Rodgers, A., Schwaab, A., Bahji, A., Zarate, C. A., Vázquez, G., & Loo, C. (2023). Ketamine for the treatment of major depression: a systematic review and meta-analysis. EClinicalMedicine, 62, 102127. https://doi.org/10.1016/j.eclinm.2023.102127. The Lancet is highly-regarded, fwiw.

I could not find the article that I remember contending this point. Both internet search engines and journal searches are clogged with chaff on the topic these days. The former are full of SEO-generated articles by rehab facilities, with Google particularly bad about censoring relevant websites. The latter are just full of articles; there's been a real surge in research on the topic, which I'm delighted by. That repeated, low-dose ketamine protocols can result in addiction isn't really debatable. There's ample evidence for that. ["Both preclinical and clinical studies indicate that repeated treatment with low-dose ketamine infusions can have addictive properties and induce cognitive deficits." Strong CE, Kabbaj M. On the safety of repeated ketamine infusions for the treatment of depression: Effects of sex and developmental periods. Neurobiol Stress. 2018 Sep 21;9:166-175. doi: 10.1016/j.ynstr.2018.09.001. PMID: 30450382; PMCID: PMC6236511.] But as for my point about their being evidence that low doses are potentially *more* likely to lead to problematic use, I can't find the citation. If I find it later, I'll repost it here.

I get it, and I was in a bad mood when I posted that earlier. I'll read any studies you post, but I think it would make more sense to post BOTH positive and negative experiences with ketamine therapy, not just negative ones. And as far as PHYSICAL dependency, that's not going to happen with a few spaced out ketamine sessions. I can't probably afford more than 5 max, and while I am far from an expert on ketamine, there's pretty much no drug I can think of that you can get physically dependent on by using it once a week for 5 weeks with 7 days AT LEAST between each session. I also probably won't be doing it 5 weeks in a row, more likely it will be spaced out, but I don't know how much (I can decide to space it out more to be safe), and since I have limited money for it, and no outside source for ketamine, yeah, addiction's not happening.

It just kind of bugs me that this thread seems to be nothing but an attack on ketamine's growing popularity as a therapeutic drug, and I really don't understand that. I know that some posters on here have died from excessive ketamine usage, though I know nothing about that and wasn't here for it, and that is very sad, so maybe that's why. But psilocybin and MDMA therapy don't seem to be meeting the same resistance. I get it if we are talking about Ketamine for pain. That seems unnecessary as there are safer alternatives. But for therapy, we've always known that drugs which can get us out of our heads like psychedelics and dissociatives have the possibility to help people. They also have the possibility of hurting, but the danger really comes here IF someone not only then goes and buys it on the street, but then uses it excessively. Not everyone does that, and I don't really think we can blame ketamine therapists for it either. I would greatly prefer to get DMT therapy, but that's not available, and I don't know where to find DMT either. My avenues for this kind of thing are limited because I've been stuck on prozac for 30 years, which I really wish never happened. It negatively interacts with far too many interesting drugs. It did help me many years ago, but I'm not sure it does now. I'd much rather have had psychedelic therapy.

All drugs have positive and negative uses, and I already know that some people have had positive experiences with ketamine therapy. It's for each person to decide if it's for them, and if I want to try higher doses (and can afford it) there are places for that, but you really can't give a person on a high dose of ketamine therapy because they will be pretty much non-responsive. If you want to actually do ketamine THERAPY, it has to be at a relatively lower dose. I already know that simply from having seen friends who are in K-holes: they often can't even understand what's going on, let alone respond intelligently to therapy. So, I would honestly say if this thread is going to be a little less biased we should include some actual studies of Ketamine Assisted Psychotherapy, and preferably some positive or at least mixed experiences and not just bad ones.