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    Jamshyd's Medicinal Ketamine Regimen! (V 1.5 - UPDATED 11-22-10) 
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    Still in the middle of being re-written, but should be perfectly useful as-is :) - Jam, May 2011

    This is a work in progress, and hopefully it will still be a work in progress after I die. I shall update every time I add something. This is a preliminary and very rough draft, and I expect every word to change by the time I am done editing it. The procedure, however, remains relatively constant, so you can take it from here. Please feel free to ask any questions or leave any comments you have in this thread.


    The following document is the result of several requests from people both on and off BL to write up on the way I use Ketamine medicinally to cure my manic-depression (and yes, I am diagnosed with "Bipolar II with co-morbid Dysthemia and anxiety", in case you were wondering). I have been doing this for 4 years and nothing but good came out of it.

    It is tragic that such a medicine remains illegal and largely stigmatized (even within the drug-using community).



    WARNINGS:

    1. While my and several people's positive experiences with Ketamine are now beginning to be corroborated by science, never forget the fact that Ketamine itself IS addictive if abused. It may not be AS addictive as, say, Cocaine or Television, it nevertheless IS more addictive than, say, Tofu. As such, it is very important to remain true to one's self and, if in doubt at least record all of one's usage. If both discipline in use and discipline in recording use fail, then it could be for the best that this project is abandoned altogether.

    2. I have found that in my case, Ketamine has acted as an anti-depressant in small doses UNTIL an entheogenic dose of it catalyzed my personal working through the root of my depression. I'd say this is a reasonable goal to pursue. As you'll find mentioned throughout the following text, DO NOT use the "antidepressant" excuse to cover hedonistic use. Ketamine can be fun, I will never deny this - I think hope is never lost so long as one remains true to one's self as to why one is using.

    3. When I found myself abusing Ketamine, I was tempted to delete this altogether. But I am constantly reminded of just how much this medicine has helped me, and I cannot bring myself to do so - in short, the I find the benefits to far outweigh the dangers here. After all, I personally contend the Heroin is probably a better immediate "antidepressant" than K, yet I will not for once delude myself into thinking that such immediate effect is worth the disaster of its addiction.

    Read the discussion following this post - all of it. All of the experiences shared, good and bad, have truth in them.
    Never deny the experiences of others - you are not above any of them.[/b]


    DISCLAIMERS:

    a. I am neither a medical doctor nor a pharmacologist. My knowledge in either area is amateur at best. I am simply sharing something that has worked for me and a handful of others. Notice how the procedure is written in the first-person. This is for a reason. Therefore, if this doesn't work for you, or if you have doubts, or if you try it and screw up, then I'm sorry, but I am not responsible for that.

    b. This is for the truly melancholic depressed people. If you're depressed because you haven't had sex in 2 weeks, then this guide is NOT for you. My point is: There are several types of depression, and there are several cures. This is not for someone who is simply feeling down. This guide is for those who truly suffer from an incurable depression that is out of their hands.

    c. That said, over the years that I've been hammering this procedure out, many new people have tried it, and I heard nothing but praise for it. I literally have not received a single complaint yet. And while I am personally convinced of its safety at this point, please do keep in mind that research regarding safety is just starting to surface, and caution is still important.

    NOTE that throughout this procedure it is assumed that one has no other drugs in one's system, including Cannabis. Nicotine seems to be acceptable.[/b]



    PART I: Science
    Full Bibliography available below.

    Recent Findings and Discussion:

    Read this thread for the latest research on the area as well as my notes which complement this procedure.

    When I wrote the first draft of this document, interest in Ketamine's antidepressant action was just starting to break in to the scientific mainstream, even though a Glutamate-based model of depression had been in existence for a while. Dissociative Anaesthetics carry a huge stigma, and one can only be happy that this stigma is only just beginning to be outweighed by the possibilities presented with this theory.

    Since then, especially over the last year, there has been an explosion of interest in Ketamine's antidepressant effects, generating a wholesome body of scientific literature that aims at this specific quality of Ketamine rather than discussing it as a side-topic.

    My current, amateur, and personal opinion reflecting on these studies follows. Feel free to skip.

    Ketamine is an extremely complex drug, pharmacologically-speaking. It has an immensely wide therapeutic window being active with as little as 5mg and as much as 2g while maintaining safety. Unlike most drugs which simply intensify in effect as the dose is raised, Ketamine seems to morph into what looks like several different drugs, depending on dosage. On the very high end, it acts as an anaesthetic, it is considered an essential medicine internationally, and its safety as an anaesthetic is established beyond all doubts by years of use on all kinds of animals, including human children. Just now, the scientific community is awakening to the effects of lower (several magnitudes in order) doses as possessing apparently miraculous antidepressant effects. Somewhere between contentment and anaesthesia is the realm of entheogenic experience - a property of Ketamine exploited by shamans, party-goers, and even recognized, if not used, by a few licensed therapists (e.g. Grof).

    Of course, I will not be talking about anaesthetic use in this document. Nor will I be talking about Entheogenic/Psycholytic use of this medicine here, as this is a vast and wonderful subject to which justice cannot be done in a simple forum post. If interested, I refer you to Karl Jansen's authoritative classic, Ketamine: Dreams and Realities. This can be ordered from the MAPS website where proceeds can go for a good cause.

    It is therefore conceivable that the antiquated neuropharmacological paradigm of trying to tie the effects of a drug or a psychiatric disorder to a single neurotransmitter, particularly in the case of melancholia, has long expired. It is time to look for something else that takes into account both big AND small phenomena, and arrive at an emergent hypothesis that accounts for both itself and its constituents.


    Evidence for Safety in Antidepressant Use:


    RESULTS: Ketamine elicited minimal positive psychotic symptoms. Three patients experienced significant but transient dissociative symptoms. Side effects during and after each ketamine infusion were generally mild. The response criterion was met by nine patients after the first infusion as well as after the sixth infusion. The mean (SD) reduction in MADRS scores after the sixth infusion was 85% (12%). Postketamine, eight of nine patients relapsed, on average, 19 days after the sixth infusion (range 6 days-45 days). One patient remained antidepressant-free with minimal depressive symptoms for >3 months.

    CONCLUSIONS: These pilot findings suggest feasibility of repeated-dose IV ketamine for the acute treatment of TRD.

    aan het Rot M, Collins KA, Murrough JW, et al. Safety and efficacy of repeated-dose intravenous ketamine for treatment-resistant depression. Biol. Psychiatry. 2010;67(2):139-145..


    A nice summary of recent Findings:

    NSFW:
    Antidepressant drugs have traditionally addressed the monoamine triumvirate: serotonin, noradrenaline, and dopamine. There have been predominantly two mechanisms recruited in drug action - inhibition of monoamine reuptake and inhibition of intravesicular monoamine catabolism. Tianeptine, which increases the synaptic reuptake of serotonin, and mirtazapine, which blocks alpha-2 adrenergic autoreceptors and heteroreceptors, are examples of the very few drugs which have other mechanisms of action. Yet, even these two antidepressants target the traditional neurotransmitters in psychiatry. [1]

    Recent evidence suggests that glutamate-mediated neuroplasticity may be the final common pathway of antidepressant action; [2],[3] tianeptine is the best-studied antidepressant in this regard. [4] If glutamate holds the key to recovery from depression, then treatments that directly address glutamatergic neurotransmission may exhibit greater antidepressant efficiency.

    Glutamate acts on metabotropic receptors and ionotropic receptors in the brain. Ionotropic receptors surround ion channels and are of three types: N-methyl-D-aspartate (NMDA) receptors, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors, and kainate receptors. [5] The glutamatergic system and particularly the NMDA receptor play an important role in the neurobiology of major depressive disorder, and different glutamatergic targets have been considered as treatments for depression. [6],[7] For example, antagonists of the NR2B subtype of the NMDA receptor are currently under development as potential antidepressant treatments; and traxoprodil, an NR2B antagonist, has demonstrated antidepressant effects in selective serotonin reuptake inhibitor (SSRI)-resistant patients. [7] Ketamine, the focus of this editorial, is an experimental antidepressant treatment which acts on NMDA receptors. [5]


    Ketamine as an Antidepressant


    Animal studies have shown that ketamine and other NMDA receptor antagonists have antidepressant effects in different animal models of depression. [8] About a decade ago, Berman et al.[9] described the first double-blind, placebo-controlled (crossover) study, which showed that an intravenous ketamine infusion (0.5 mg/kg) resulted in significant and rapid but short-lived antidepressant effects in seven patients with major depression.

    Several years later, Zarate et al.[8] described the first randomized, double-blind, placebo-controlled (crossover) study of ketamine in 18 patients with treatment-refractory major depressive disorder. Ketamine (0.5 mg/kg) was administered as an intravenous infusion in normal saline across a 40-minute period; placebo comprised normal saline alone. There was significant antidepressant benefit within 110 minutes of the ketamine infusion. One day later, the response and remission rates to ketamine were 71% and 29%, respectively, and the antidepressant effect size was 1.5. However, only six (35%) patients maintained response for one week, by which time the effect size had dropped to 0.7. In contrast, the response rate to saline infusion was 0% after both one day and one week. Adverse effects with ketamine included perceptual disturbances, confusion, euphoria, dizziness, increased libido, and elevated blood pressure; these, however, lasted only for 1-2 hours.

    Several case reports were subsequently published illustrating the efficacy of ketamine in medication-refractory patients. For example, Goforth and Holsinger [10] described a patient with severe, recurrent major depressive disorder who markedly improved within eight hours of receiving his first bitemporal electroconvulsive therapy (ECT) treatment under ketamine anesthesia. It is possible; however, that the dramatic response was to ECT and not necessarily to ketamine because such dramatic response to ECT has occasionally been described in literature. In another case report, Liebrenz et al.[11] described a 55-year-old male with treatment-resistant major depression and co morbid alcohol and benzodiazepine dependence, whose depression ratings dropped by >50% from the severely depressed into the mildly depressed range within two days of receiving an intravenous ketamine infusion of 0.5 mg/kg across 50 minutes. In this patient, the benefits of ketamine treatment were maintained for a week.

    Other studies subsequently appeared. Price et al.[12] showed that suicide ratings dropped significantly within a day of treatment with ketamine (n=26); thrice-weekly ketamine infusions across a 12-day period were associated with sustained fall in suicidality scores (n=9). The authors considered that the attenuation of suicidality was likely to be a result of the antidepressant effect of the treatment rather than a specific antisuicidal effect. Aan het Rot [13] administered a single ketamine (0.5 mg/kg) infusion to 10 patients with treatment-refractory depression; a day later, MADRS scores in nine patients showed >50% attenuation. These nine patients received five more ketamine infusions across the next 10 days. At the end of the ketamine course, there was 85% attenuation in MADRS ratings in the sample. The patients were maintained drug-free; eight patients relapsed 6-45 (mean, 19) days after the last infusion. One patient remained antidepressant-free with minimal depressive symptoms for >3 months. In this study, three patients experienced significant but transient dissociative symptoms; other adverse effects during and after each ketamine infusion were generally mild.

    Finally, in an open-label clinical trial of ketamine vs. propofol anesthesia in 31 medication-resistant depressed inpatients referred for ECT, Okamoto et al.[14] found that the speed of response and the magnitude of response were both greater with ketamine anesthesia at the end of a course of eight ECTs administered across four weeks. A limitation of this study is that the choice of anesthesia was based on patient preferences after informed consent; thus, an expectancy effect could have biased the outcomes.

    In summary, intravenous ketamine infusion (0.5 mg/kg in normal saline, delivered across 40 min) is associated with dramatic antidepressant and antisuicidal effects in patients with major depression, including patients who are treatment-refractory. The benefits develop within 1-2 hours of the infusion, peak 1-2 days later, and persist for up to a week. Repeated infusion of ketamine is associated with maintained antidepressant effects for up to nearly two weeks; again, discontinuation of treatment is associated with relapse after an average of nearly three weeks. Adverse effects of ketamine infusion include confusion, dizziness, euphoria, perceptual disturbances, and increased blood pressure; these usually last for not more than 1-2 hours. Infusion of ketamine in sub anesthetic doses may therefore be a useful though temporary antidepressant measure in patients with refractory depression.

    (Continued)


    Rao TS, Andrade C. Innovative approaches to treatment - refractory depression: The ketamine story. Indian J Psychiatry [serial online] 2010 [cited 2010 Nov 23];52:97-9. Available from: http://www.indianjpsychiatry.org/tex.../52/2/97/64573

    [Full Article Available Free]


    A Few Examples of Recent Research:

    RESULTS: Subjects receiving ketamine showed significant improvement in depression compared with subjects receiving placebo within 110 minutes after injection, which remained significant throughout the following week. The effect size for the drug difference was very large (d = 1.46 [95% confidence interval, 0.91-2.01]) after 24 hours and moderate to large (d = 0.68 [95% confidence interval, 0.13-1.23]) after 1 week. Of the 17 subjects treated with ketamine, 71% met response and 29% met remission criteria the day following ketamine infusion. Thirty-five percent of subjects maintained response for at least 1 week.

    CONCLUSIONS: Robust and rapid antidepressant effects resulted from a single intravenous dose of an N-methyl-D-aspartate antagonist; onset occurred within 2 hours postinfusion and continued to remain significant for 1 week.


    Zarate CA, Singh JB, Carlson PJ, et al. A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression. Arch Gen Psychiatry. 2006;63(8):856-864.

    ----

    Depression is prevalent and undertreated in patients receiving hospice care. Standard antidepressants do not work rapidly or often enough to benefit most of these patients. Here, two cases are reported in which a single oral dose of ketamine provided rapid and moderately sustained symptom relief for both depression and anxiety. In addition, no adverse effects were noted. Further investigation with randomized, controlled clinical trials is necessary to firmly establish the effectiveness of oral ketamine for the treatment of depression and anxiety in patients receiving hospice care. Ketamine may be a promising safe, effective, and cost-effective rapid treatment for depression and anxiety in this population.

    Irwin SA, Iglewicz A. Oral ketamine for the rapid treatment of depression and anxiety in patients receiving hospice care. J Palliat Med. 2010;13(7):903-908.

    -----

    RESULTS: Suicidal ideation scores decreased significantly on the SSI as well as on the suicide subscales of other rating instruments within 40 minutes; these decreases remained significant through the first 4 hours postinfusion (P < .001). Ten subjects (30%) had an SSI score ≥ 4 at baseline; all these scores dropped below 4 (9 dropped by 40 minutes and 1 by 80 minutes). For those patients with a starting score below 4 on the SSI, only 1 reached a score of 4. Depression, anxiety, and hopelessness were significantly improved at all time points (P < .001).

    CONCLUSIONS: Suicidal ideation in the context of MDD improved within 40 minutes of a ketamine infusion and remained improved for up to 4 hours postinfusion. Future studies with ketamine in suicidal ideation are warranted due to the potential impact on public health.

    Diazgranados N, Ibrahim LA, Brutsche NE, et al. Rapid resolution of suicidal ideation after a single infusion of an N-methyl-D-aspartate antagonist in patients with treatment-resistant major depressive disorder. J Clin Psychiatry. 2010. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20673547 [Accessed November 23, 2010].

    -----

    There are scores more research, with more being added daily. I will be updating this and adding to it periodically, as with the bibliography.


    PART II: My Procedure
    This is still under construction, but should be useful as-is.

    Preliminaries:

    Below is a list of things that I personally use for this procedure. If you are unable to get one or any of the below things, I suppose you can use your eyeballs and intuition, and hope that your intuition doesn’t want a buzz, but actually wants to heal.

    What is recomended:
    - A limited supply of the purest Ketamine one can get, in powder form.
    - A “bumper” or bullet or any device that will give out a calculated dose.
    - A mg scale.

    EDIT: Actually the IM route seems to be ideal. If at all capable of obtaining sealed medical vials and know proper sterile IM technique, then by all means.

    Even after all this is obtained, the most important part is SELF CONTROL. Setting a strict budget or getting a limited supply is a good way to do that. Precision in dosing does not seem too critical [Edit: Further experimentation revealed to me that the more precise the dosing, the better - and that an ideal dose is 12mg], as long as that saturation is attained and maintained (more on that later). The reason self-control is critical is so that therapeutic relief of the disease itself is attained rather than having its symptoms masked with a "K-hole." I will detail below a series of “checkpoints” that will tell you whether you are still on track or not.

    Some notes: It is unfortunate that Ketamine does not work well rectally, and I am not rich enough to experiment with oral administrtion although I imagine it should work just as well. I don't know if IMing is a good idea, unless you enjoy looking like a pincushion! [EDIT: Further experimentation revealed that IM is perhaps the BEST method as it allows for a calculated dose] IVing is out of question, and I can only call it abuse. IMO, if this eventually turns out to be a legit medical practice, a controlled-release transdermal patch would be ideal. But for now, intranasal seems to be the most convenient method. I have attempted to make nasal sprayers but found them useless as the dose delivered per spray is very low and too much spraying leads to lots of drips and will indubitably form halos of crusty stuff around your nostrils...

    About isomers: I have not worked with pure s-Ketamine or pure r-Ketamine, so I cannot speak for these. I have, however, worked with the racemate (most commonly available, and likely what you’re getting) and another brand reported 8:2 ratio of s:r, respectively. The latter is the Ketamine I’ve been using therapeutically for the past 4 and a bit years, as it is much less tempting to abuse than the racemate, while the latter would be my personal choice for entheogenic or IV experiments.

    EDIT: Recently the above has come to be questioned. I can say with certainty that most of what I used was Racemic. I also had the chance to try s-Ketamine since and found it to be less useful.

    A note on dosing: I used to basically make my own bumps/lines and eyeball a dose. Since this is something that will be done several times daily for several days, measuring each dose individually is simply impractical. What happened is that I decided to just walk into a local headshop and buy a “bumper” – if you don’t know what that is, it is a simple device designed to produce a consistent small dose out of a chamber containing a large amount of powder. I used the scale several times to figure out the average dose that this bumper will produce, and it was perfect: 10 – 20mg for each bump.

    The actual procedure:

    It really doesn’t matter how you decide to start. On some occasions, I’d take a recreational dose, and after that, work from there. Other times, I simply start with the smallest dose possible. The bottom line is that what is done in the first couple of days seems to be of little consequence to the regimen, as long as some amount of Ketamine is constantly supplied. (This is what leads me to believe that the desired effect is a result of some kind of receptor saturation).

    Here is my own thought on this: A recreational dose for a start may allow for some introspection , or even just a bit of fun to take one’s mind off things. The follow up would then be a maintained and controlled intake of small doses to achieve a very specific state (lets call it “a state of balance”), completely different from the usual effects of Ketamine.

    Going back to what was said earlier, I say what happens in the first few days seems of little consequence because it has become apparent to me that this “state of balance” will simply not manifest until after a few days of constant use. So here is what I do:

    After the initial dose, I wait until I feel completely sober, and I take my first dose (from here on, “dose” will mean 2 bumps, one in each nostril). I then wait an hour and take the dose again. If I feel I got too buzzed, I wait two hours until I redose. Don’t worry – eventually one will only need 4 – 5 doses per day, but the beginning is always a tricky calibration between a buzz and “tuning in” to that state of balance. [EDIT: Later experimentation with precise dosing via IM showed that several tiny doses per day are more effective than a few big ones]. This first stage is the most difficult one, and one that admittedly resembles simple abuse and denial thereof, (but bear with me)... in fact it may cause negative side effects such as headache, ataxia, confusion, and even nausea (none of which should be too severe – if they are, you’re abusing it!). All these effects should subside by the end of the second day (Edit: this is definitely consistent, I made two experiments since writing the first draft and reproduced this faithfully).

    EDIT: In the two years following the writing of this document, I underwent this procedure many times, with a number of them using precise dosing via IM. All is still consistent, but I have noted that in some


    STOP!! HAVE YOU READ THE WARNINGS POSTED AT THE TOP OF THIS TEXT? HAVE YOU HEADED THE WARNINGS STREWN THROUGHOUT? IF NOT, PLEASE DO SO NOW!


    cases the nausea CAN be severe enough to cause vomiting, generally intensifying at the end of day 1, yet also consistent is the fact that as soon as it is purged, it goes and never returns, no matter how much you take or how long I take it for. The fact that I experienced this most severely when I was severely depressed suggests that it could very well be psychosomatic and that the purging is a cathartic experience.

    This goes on until that state of balance is attained. It will become apparent after the fact that one feels clear-headed, motivated, content (note: content, not manic or euphoric) and completely sober and NORMAL (a word very rare in the world of bipolar people), and that those effects now seem independent of the exact moment one takes a new dose (you were that way, and you simply continue to be that way after you dose rather than experiencing a shift in consciousness). At that point, it seems like a certain saturation is attained, and this state of balance becomes one’s new “baseline”. It truly feels as though some switches have been switched off and a couple of new ones have been switched on.

    And from here, one can dose less frequently per day. The trick is not to fall into the trap of trying to catch a buzz while maintaining this state – because you can, by simply taking a higher dose than usual. I CANNOT STRESS THIS ENOUGH. What is fascinating is that if I willingly decide to catch a buzz or even an entheogenic experience, when I return to baseline, my baseline will actually be that state of balance, not my bipolar “sobriety”.

    I REPEAT: THE MOST IMPORTANT THING IN THIS WHOLE PROCEDURE IS RESISTING THE URGE TO GET HIGH. Two years after writing this articles, I received nothing but good reports except from two people, and both admitted to having succumbed to abusing the drug by binging on recreational doses.

    Another pointer that that state as been attained is that one can maintain it overnight while one sleeps without the need to wake up for a scheduled dose. One’s sleeping patterns are no longer affected (as use of small doses of K can cause amphetamine-like stimulation), and one wakes up feeling fine, not hung-over, or manic, or depressed - just fine. Of course, a morning dose is definitely recommended to maintain that. How many times a day one must redose seems to be entirely dependent on one’s brain chemistry. Eventually it always balances out.

    Once that week is over (or the limited amount of Ketamine is depleted), this state of balance should remain for at least 2-3 weeks, assuming no other drugs were taken. I have no idea how this would turn out for the chronic cannabis smoker, since I do not partake in cannabis regularly.

    One thing I recently discovered accidentally is that Gabapentin seems to "fortify" and maintain the state of balance for longer (it potentiates Ketamine for me anyway), but I'd have to try this again on my next regimen.

    EDIT: Gabapentin was used in two regimens since the first draft was written, and has proven to be a fantastic tool in this regard. Gabapentin has become second only to Ketamine as a wonder-drug in my world.

    EDIT2: I have absolutely no doubt that Gabapenin works wonders to "Rekindle" the effect. I have also found that using Hydergine concurrently with the procedure tends to enhance the effects.

    Some checkpoints to make sure you're on the right track:

    - By day 4, are you still stumbling when you walk, dizzy, slurring your speech, or getting any other clear symptoms of intoxication? If so, STOP! You've been abusing.

    - By day 5, if you feel "loopy", then you're abusing.

    - Panic Attack? While K is known to be a panic-free drug. Getting a panic attack as a direct result of taking K is, IME, a sign of having binged on very high doses. The best thing to do, IME, is if you've taken a high dose to taper down to a 10mg or so dose.

    - Are you drinking more often, or taking more drugs than you used to? Another bad sign. I have found that the above procedure has an anti-addictive property, and I have actually used it to help myself quit benzos and codeine. I don't yet have enough info to make the claim that it definitely cures addiction, though.

    - A seemingly universal (ie. from everyone that gave me feedback) effect of this procedure is that it makes one a more pleasant person to deal with. If you've been getting complaints about some serious personality changes, then look back and make sure you're doing everything properly.

    - By day 7, do you notice no improvement, despite having followed this procedure faithfully, calibrated your weights, and followed the checkpoints? Then perhaps this is simply not for you.


    In conclusion, I sincerely hope this is helpful to you. If you have any questions, please post them in this thread.



    PART III: Some Idiosyncrasies and Intrigues

    My personal experience w.r.t. the method of action, without getting into biochemical jargon which I am simply not qualified enough to discuss, is as follows:

    It appears that Ketamine interacts with two separate "systems" or "circuits" (nerve-related). One is excitatory, the other inhibitory (let as call them a and b). The body, in turn, reacts as Ketamine wears off, with inhibitory and an excitatory reactions in the respective systems (let's call them x and y). It appears that this can be "harmonically" exploited by re-dosing the ketamine as these reactions start up such that Ketamine's inhibitory action (b) synergizes with excitatory reaction (x), and Ketamine's excitatory action (a) synergizes with the body's inhibitory reaction (y).

    I am sorry if this is confusing, but it is the best I can articulate what my body is telling me.

    Interestingly, while I have never had a particular interest in Chinese medicine, it appears that the Taoist model is more helpful in this particular instance: from my limited understanding, the Chinese posit that the body had active currents (Yin) and Passive ones (Yang), and that good health is obtained by balancing these two currents through a healthy lifestyle (cf. Chia).

    My experience has repeatedly shown me that a successful Ketamine therapy course will, at its best, result not only in a sense of contentment and balance, but also a moment of clarity when the body feels absolutely at peace, as though a gentle wave of frothy, lukewarm (just right) water has washed upon it. Incidentally, much later, I realized that the Chinese use this very metaphor to explain the state of balanced health.

    Does this prove the Chinese model correct? I have no idea. But here is to hoping Ketamine bridges the gap between Modern and Traditional medicines!

    [More to be added]

    PART IV: First-hand Accounts Feedback

    [To Do]

    PART V: Bibliography.

    [To Do]

    Update History:

    • November 22nd, 2008: Finally gave it a proofread (heh, about time), fleshed out some parts, and added several updates (some important) since the first draft.


    • November 20th, 2010: Updated with several edits. To be ironed out and rewritten soon.


    • November 22nd, 2010: 2 Year Anniversary!! Added entire new section (Part I), and edited typos out of Part II.


    [list]May 17th, 2011: 2.5 years! Updated with highlighted warnings, long overdue. Thanks to BD and Ximot for sharing their warnings, their input is just as valuable as all the positive input.
    Last edited by Jamshyd; 17-05-2011 at 08:15. Reason: Updated
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    #2
    you didnt even touch the fact that ketamine is the most wonderful metaphysical->physical manifestor known to man!!! hours of k-holing can bring you wealth from unknown orgins, can solve realationship issues, can get you in touch with long lost pals and so on.
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    #3
    Bluelight Crew B9's Avatar
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    I expect every word to change by the time I am done editing it.

    *smiles*
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    #4
    Bluelight Crew Jamshyd's Avatar
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    Indeed youkai, goes to show just how wonderful that medicine really can be when used responsibly. You are right - in one of my experiments I was able to induce an orgasm simply through channeling the energy that Ketamine allows one to do, without any physical stimulation (unfortunately I have too many blockags and the orgasm ended with a leg cramp). Point is, K is a wonderful entheogen on its own accord, but the above is for the use of K to cure a certain disease by using the least ammount possible.

    I also didn't touch on the fact that Ketamine is one of the safest anaesthetics out there, thus its use on children.
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    #5
    have you felt that the addiction potential for you is stronger than your own willpower at points throughout your self medication?
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    #6
    Bluelight Crew ~*geNeRaTiOn E*~'s Avatar
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    thank you for finally posting this, i've been waiting on it for a while now.

    how long do you expect to maintain this regimen? do you think that one could take ketamine as an anti-depressant for a set period of time and experience no symptoms of bi-polar/depression thereafter or does the regimen need to be maintained?

    when you do take a recreational (k-hole) dose, do you just continue off with your normal dosing patterns the next day?

    i really want to try this but i am quite fond of k-holing and i'm afraid that i'll be tempted to take a full dose every time. k-holes are so soothing for me and i find their effects last a good 2-3 weeks btu thereafter, they subside. ketamine tolerance is not something i want to deal with.
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    #7
    Quote Originally Posted by ~*geNeRaTiOn E*~
    thank you for finally posting this, i've been waiting on it for a while now.

    how long do you expect to maintain this regimen? do you think that one could take ketamine as an anti-depressant for a set period of time and experience no symptoms of bi-polar/depression thereafter or does the regimen need to be maintained?

    when you do take a recreational (k-hole) dose, do you just continue off with your normal dosing patterns the next day?

    i really want to try this but i am quite fond of k-holing and i'm afraid that i'll be tempted to take a full dose every time. k-holes are so soothing for me and i find their effects last a good 2-3 weeks btu thereafter, they subside. ketamine tolerance is not something i want to deal with.
    ketamine tolerance is something that never REALY goes away 100%. sure it goes down, but doesnt ever fully fade away.
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    #8
    From what I understand, it sounds like your standard antidepressants help about 2/3 with major depression. Ketamine OTOH, has been studied only in treatment-resistant depression, where it helps another 2/3 of that final 1/3. I'm not a fan of ketamine unless it is in combination with a tryptamine, but those are pretty impressive numbers.

    Here's what looks like an interesting review. I haven't had a chance to read through it yet (or Jamshyd's full post either), but I can probably email to those interested.

    Maeng S, Zarate CA Jr. The role of glutamate in mood disorders: results from the ketamine in major depression study and the presumed cellular mechanism underlying its antidepressant effects. Curr Psychiatry Rep. 2007 Dec;9(6):467-74.

    "In this article, we first review a study showing that the N-methyl-d-aspartate (NMDA) receptor antagonist ketamine leads to rapid, robust, and relatively sustained antidepressant effects in patients with treatment-resistant major depression. We then discuss our hypothesis that the therapeutic effects of monoaminergic antidepressants and ketamine may be mediated by increased AMPA-to-NMDA glutamate receptor throughput in critical neuronal circuits. We hypothesize that ketamine directly mediates this throughput, whereas monoaminergic antidepressants work indirectly and gradually; this may explain, in part, the lag of onset of several weeks to months that is observed with traditional antidepressants."

    PMID: 18221626 [PubMed - indexed for MEDLINE]
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    #9
    Bluelighter Thou's Avatar
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    Thank you so much for the write up and the research, your a man on a mission, and we'll all benefit from your dilligence and overall unique intellectually based motivation.

    Expect a PM and and some back and forth discussion on this, because I've been trying a similar practice as you in the past month.
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    #10
    Bluelight Crew Jamshyd's Avatar
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    Question
    Thanks for all the kind words . Again, I realize this copy is very rough (heck, I found a few typos already!), so I intend to update it and perhaps give it more structure. At this point it is all verbal-vomit.

    bickoma: Yes, I have. It is very easy to cover yourself in a blanket of dissociation than face the world. This is why I think getting a limited supply and only allowing yourself 1 week/month is instrumental for this to work.

    Dondante: Thanks a lot for the article, I will send you my address if you can email the whole thing . I definitely qualify as "treatment resistant", if not for the fact that nothing worked for me out of a plethora of prescriptions, then because the causes of my problem are known, out of hand, and cannot be worked through (being homosexual in a non-accepting culture/family...etc).

    gen e: how long do you expect to maintain this regimen?
    I honestly don't know. They claim that bipolar is incurable... but I tend not to trust psychology and psychiatry too much.

    do you think that one could take ketamine as an anti-depressant for a set period of time and experience no symptoms of bi-polar/depression thereafter or does the regimen need to be maintained?
    I hope so! Unfortunately nothing has changed in my life with regards to my problems, and therefore I am dependant on these regimens (and benzos), although I managed to dodge any addiction to Ketamine, but benzos managed to catch up with me and now I am again slowly escaping their clutch.

    when you do take a recreational (k-hole) dose, do you just continue off with your normal dosing patterns the next day?
    Yes... as mentioned, I return to my newly-achieved baseline, which, being so positive, allows for the trips to be much more introspective and rewarding.

    i really want to try this but i am quite fond of k-holing and i'm afraid that i'll be tempted to take a full dose every time. k-holes are so soothing for me and i find their effects last a good 2-3 weeks btu thereafter, they subside. ketamine tolerance is not something i want to deal with.
    This "afterglow" that you mention is what I am trying to maintain using the abovementioned method, using the lowest possible doses of ketamine. So far, by the time I come back the next week, I have to do the "calibration" phase again because Ketamine tolerance DOES go back down, but as youkai mentioned, it never resets.

    2c: as usual, thanks for your kind words. I appreciate it .
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    #11
    Thanks for posting this - a very interesting experiment - glad to know it's working for you. I have been following the latest wave of "off-label" Ketamine usage with interest.

    Regarding your dosages - I understand that you've increased from 10 - 20 mgs to 40 mgs each time due to tolerance, and that you dose 4 to 5 times per day for a week. That would suggest 1120 - 1400 mgs for the week, but I believe you've mentioned elsewhere several grams each session. Would you mind clarifying how many grams you use over the 7 day schedule? Do you generally include some recreational doses during the week? And if so, how often and how many mg/kg?

    I once tried similarly small doses for low level depression, but found myself slightly altered and couldn't concentrate on work effectively. I didn't dose regularly, nor did I do this in any systematic way, so it is not a good comparison.

    Interestingly the Zarate study in the US for treatment resistant depression used a single dose of 0.5 mg/kg (IV), which would be only 35 mg for someone of my weight. I would certainly notice that but it's well below a psychedelic dose. Yet they appeared to have considerable success with this modality.

    Krupitsky uses 2mg/kg IM for treatment of alcohol and heroin addiction, so presumably inducing a spiritual experience is central to this technique. Apparently two to three such sessions are more effective than a one off.

    It seems that more studies are being planned with Ketamine - it has the advantage of course of being a legal medicine with a long history of use, whilst many other potentially useful psychedelics were long ago banned and stigmatized.
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    #12
    Quote Originally Posted by Jamshyd
    in one of my experiments I was able to induce an orgasm simply through channeling the energy that Ketamine allows one to do, without any physical stimulation


    I've read your posts about how awesome K is but holy shit! I had no idea it was so powerful for working with psychic energy.
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    #13
    Bluelight Crew willow11's Avatar
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    bump
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    #14
    Bluelighter GreenMachine's Avatar
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    Quote Originally Posted by swilow
    bump
    *snicker*
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    #15
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    Thanks Xorkoth for bringing this thread to my attention...

    ... worth considering, this!

    The one issue I have with it is that it's a LOT of dosing and a lot of 'K-fixation' to have in that one week.....
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    #16
    Bluelighter TRPPNASS_DSCOMONKE's Avatar
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    JAMSHYD- do you find that after a few days you become "loopy" as other members as noted after several days use?
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    #17
    Bluelight Crew Jamshyd's Avatar
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    ^ Very interesting, I shall read this completely when I have the time As I always say, I try not to speak out of my ass. I wouldn't have posted any of this had I not been backed by research that proves that K has antidepressant effects.

    I have not taken any Ketamine for a couple of months now, and the good news is that I seem to be able to remain emotionally-stable with the help of Gabapentin.

    But thanks for keeping this alive, everyone! I should edit and update it.

    To answer your questions and concerns:

    Ximot: It may appear as such, but I personally truly believe that the best method to take K medicinally is through a timed-release patch. The only way to emulate this is by taking many tiny doses throughout the day. It seems that keeping a steady concentration of the drug (or possibly, its metabolite) is key to its medicinal benefits.

    Trippinass disco monkey: Only if I succumb to the temptation of dosing higher in order to get a buzz - then yes, after a few days I become I bit weird and generally paranoid. I wouldn't call it psychosis though - it seems more like some kind of over-excitation, since it is completely curable with a dose of benzo (and of course, stopping the K). That being said, following the above regimen at said doses will not cause any mental disturbances. I have only had problems three times in four years...
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    #18
    better living through chemistry
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    #19
    Quote Originally Posted by Jamshyd
    [color=sienna]
    [size=3][b]DISCLAIMER: I am neither a medical doctor nor a pharmacologist.
    I know you are a fully qualified witch doctor tho jamshyd - don't undersell yourself
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    #20
    Bluelighter stonerfromohio's Avatar
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    Quote Originally Posted by vegan
    better living through chemistry
    word to that
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    #21
    Bluelighter Psych0naut's Avatar
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    I've succesfully come off of a 6 month benzo addiction after having tapered down my dose with Librium, and quitting altogether(Lbrium and Risperidon) in combination with ketamine. I've tried to quit both without ketamine, but after a week the withdral effects where so harsh that I just couldn't handle it anymore, even though I really taperede my dose down very slowly, and was just at 5mg Librium a day at the moment I completely quit alltogether. The wd effects I had were derealisation, depersonalisation, tremor, rebound insomnia, shaking limbs, apathy and depression.

    My second attempt, with ketamine, was indeed succesfull and without nearly any withdrawl effects at all! I read an article about a former opioid addict who used to do 100+mg morphine IV daily, and also had quit altogether using ketamine 5 days, once-daily. Because of a slightly more limited stock of ketamine and a high permanent tolerance to it, I used it by a slightly different scheme, but nearly the same. I used it 3 days on end, skipped a day and took the final big dose on the fifth day. I did not get any wd effects in the week after that, nor any in the periods after that, except for some minor sleeping difficulties, but that was just some of the mental part too. All in all, I really have to vow for ketamine's amazing properties at quitting long-term addiction!
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    #22
    Bluelighter Ximot's Avatar
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    NOTE: the below is an experience with the s-isomer of ketamine, not racemic ketamine.

    I am just back from a 4-day school trip (I am a teacher, not a student) .... on this trip I experimented with S-ketamine... using eyeballed mini-bumps throughout the days... and what I got from it was, after the initial pleasant buzz, pretty much what jamshyd described. I leaned a tad towards manic occasionally, but not so much so that I would be out of control and get carried away with my fancy ideas and thus act inappropriately. What I got was, on the whole, a pleasant state of balance that felt nice rather than dull, and that gave me an aura that seemed to make everyone feel attracted to me -both colleagues and students. A couple of of people found that I seemed to be in an excellent mood and simultaneously very relaxed. But there was no hint of anyone thinking I might be in any way medicated, and I found that people seemed to seek me out and talk to me, ask me what i thought about this and that and tell me things about themselves . . . I was totally a people magnet... I was very nonchalant whilst being totally approachable at the same time... I'd noticed in the past how tiny bumps of K can act as a great "defocuser" when I am tense or socially anxious or overstimulated (for example when I go out to a party of a gig), but these few days in a relaxed yet semi-professional environment REALLY allowed me to explore this side of K. . . Did it almost non-stop for three-and-a-half days (5 to 10 bumps a day) . . . and I feel GREAT today, the day after the trip. And this despite probably having had more beers than hours of sleep during the trip (due to being recruited for night-time drinking by young colleagues and students...who are all 18+, so no worries).

    2 thumbs up for mini-K-bumps-as-an-antidepressant. Works instantly. I cannot yet say whether the effects will indeed last 2-3 weeks because it hasn't been that long yet. But I'd wake up in the morning and still feel chirpy . . . like I am perma-thresholded on K right now.
    Today I haven' had any yet, and I still feel chilled . . .but tonight I shall go to a concert, and I shall partake in a few more bumps of K, no doubt.

    The thing is, the temptation to do just a tad more so one gets a true and proper buzz is always tempting, especially in an environment where it doesn't matter if people can tell... which wasn't the case during the trip, where I really had to keep it low so I'd be properly social... which i was. Hell, it worked almost like a low-dose empathogen . . . like a mini-speedball (I got the calm of a tiny dose of alprazolam or an opiate, the joy of a low dose of amphetamine, and the ability to listen to others and feel for others that I might get on a threshold dose of methylone...)

    But for me it is clear that ketamine has so much more to offer at low doses than at K-Hole levels.

    Maybe I am just growing up and no longer that interested in freaking myself out with poweful mind-boggling experiences so much any more. And if I keep using like this, my little K-stash should last me years . . .

    K is a great tool that has so many dimensions . . . because, as many of us know, it DRASTICALLY changes character at higher doses . . .

    Many thanks, jamshyd, for sharing this!!!
    Last edited by Ximot; 06-07-2008 at 20:09.
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    #23
    Bluelight Crew Jamshyd's Avatar
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    Thanks a lot for the input, guys

    I have updated this thread at last! Mods, please update the thread title to reflect changes (simply c/p the OP's title as I have changed it).

    Btw, feedback is appreciated, especially from people who are regular cannabis users.
    Last edited by Jamshyd; 22-11-2008 at 04:49.
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    #24
    Bluelighter organicshroom's Avatar
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    Jamshyd what are your thoughts on possible neurotoxicity with daily repeated use? Also while I'm on the subject what is your opinion of ketamine neurotoxicity at k hole does too?

    Thankyou for all your inspiring posts.

    Darren
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    #25
    Bluelight Crew Jamshyd's Avatar
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    Hello Darren, thanks for the kind words.

    Re toxicity at daily low-dose use: I have personally experienced no symptoms of such, and neither have any of those who tried it. Same goes to other adverse effects associated with chronic Ketamine abuse, such as Urinary Tract infections, which I am happy to say I never got throughout my whole relationship of (mostly) responsible K use.

    Re toxicity of daily abuse of high-doses: like any other drug, of course ketamine will prove toxic if abused constantly (although still surprisingly benign). I have only experienced adverse neurological effects twice, both of which were directly associated with blatant abuse - once a huge panic attack, and the other a slightly loopy episode, both of which were terminated with benzodiazepines.

    I will note that scientific literature seems to suggest that NMDA-antagonists are neuroprotective, actually. As a matter of fact, it is proven that they are protective in cases of ischemia, if I am not mistaken.
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