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ketamine for depression is widely available, what are the reports??

asecin

Bluelighter
Joined
Apr 13, 2005
Messages
1,725
i was trying to get into ketamine studies for years now and i didnt even know until recently ketamine is actually available legally all over the US. That surprised me as the studies of it for depression are still going on. anyway, since its still investigational but legal drug, insurances wont cover it and the places i called are up to 500 dollars per dose whoa. anyway, they did tell me in the midwest thats how expensive it is because of insurance problems, but in the east side, insurance are likely to cover it. so, how come i havent read of ketamine under controlled circumstances for depression issue reports as of yet? i see a lot of abuse of ketamine as "high" on the forums, but nothing like those therapies popping out everywhere at this point. please collaborate!
 
Search the mental health forum or check my thread history. I started a thread on my experiences at an Arizona clinic where I received slow I.V. ketamine infusions over a two year period. It is prohibitively expensive, but it's the only treatment (besides dexedrine rx) that has ever worked. And by work I mean the depression was not reduced or covered up, just....wiped from my brain, typically for about 3 weeks after the drug was flushed from my body.

I didn't feel artificially happy like on some euphoriant or stimulant. The irrational self hatred was replaced by the person I used to be. The negative default thought patterns about myself or my future or my past were reset, and I was able to really believe "Hey, today might be a good day." for the first time since age 14, instead of automatically writting it off as shit.

Over the past ten years I've had a dozen different psychiatrists and psychologists in 3 states. I've tried nearly two dozen prescription antidepressants in every category including the older ones. Besides ketamine, the only option left was ECT (no thanks, my memories are all I have).

I'm angry that the FDA isn't allowing compasionate use while we wait for a crappy nasal spray to make it through clinical trials. Depression costs the US billions of dollars in economic loss and contributes to over 50,000 suicides per year. That doesnt include deaths due to drug addiction. So now that I've moved back east, sure, there are multiple clinics in Boston. But they have long waiting lists, are impractically expensive and distant and are not covered by any insurance as far as I know.
 
Which begs the question: would 1 microdose of 3-meo-pcp (let´s say .1mg a day) will get the same effect?.

And what 3-meo-pcp quantity?
 
I work with an anesthesiologist who provides infusions to our post ibogaine patients. For those who require it becomes a game changer in there recovery. However after questioning the docs on microdosing it seems unpractical. Some payients will receive ketamine lozeng s post infusion to keep levels of ketamine in the system from breaking down. The magic comes from glutamate saturation, full dissociation. I equate it to having a construction crew working to fix the roads in your brain. When the blood plasma levels are kept at there peak with no fluctuations it’s as if all roads are closed and crews can get everything fixed at once rather than one lane at a time. A little ketamine may help breakthrough pain or acute resurgence of depression but will not give you the full rewards of the medacine
 
I think it's more complicated than that, potential for depression is related to the mTOR pathway which yes involves glutamate / NMDA to stabilize proteins needed to activate mTOR (this promotes synaptogenesis which is thought to be the reason for the anti-depressant effect), but the actual efficacy of norketamine is 100 times greater than of ketamine itself, and a particular hydroxylated norketamine metabolite is even 200 times more powerful at activating mTOR than norketamine, so 20000 times more than ketamine. This makes the fact that it is ketamine which produces this metabolite in the body a bit irrelevant.

Administering pure hydroxynorketamine may not be the way to go because you may also need this NMDA involvement of ketamine (not certain) or another dissociative anaesthetic, but this reflects that it is a pretty particular substance that has this magic and it would be an incredible long shot coincidence for a compound like 3-MeO-PCP to have this same effect on mTOR activation because there is no reason that I know of why the fact that ketamine and 3-MeO-PCP are both NMDA antagonists would be relevant to mTOR. They are just not *that* similar chemically overall.

However, close enough ketamine analogues could produce similar enough metabolites though. It is not unthinkable that some of them may be better as anti-depressant than what ketamine produces even if they are weaker as dissociatives! Because wouldn't it be quite the happy accident if we found the best possible drug to do this for mTOR straight away?? There are countless possibilities so this is unlikely.
Think of this anti-depressant effect and the dissociation as mostly separate things.

The confusing thing is that drugs like ketamine or 3-MeO-PCP can also have other therapeutic effects that may not rely on synaptogenesis at all but just the emergent phenomena of the trip experience or the fact that a dissociative trip could offer a break from negative feedback loops related to depression just by stopping thought patterns temporarily. These are psychological effects rather than pharmacological. Additionally, drugs like 3-MeO-PCP can make you feel really good and even manic or hypomanic, these are different effects still.
Do not confuse these feelings with the anti-depressant potential of ketamine and its application as a therapy. (I tried microdosing 3-MeO-PCP by the way, and I mistook those other effects for an AD benefit until I realized that this was an illusion.)

Sorry I do not know what the official reports are on these therapies, but I'd like to know.
 
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^I think the theory is that there is synergy between HNK upregulating AMPA receptors, NMDA antagonism leading to glutamate release in the cortex, and co-occuring stimulation of Sigma-1 receptors. While other NMDA antagonists are being/have been investigated for MDD, I don't think a pure NMDA antagonist will hold too much promise.

https://www.ncbi.nlm.nih.gov/pubmed/21911285 "Taken together, these data suggest that sigma receptor-mediated neuronal remodeling may contribute to the antidepressant effects of ketamine."

There is also the matter of effects at reuptake transporters, which seems to play a role in abuseability (maybe there is some correlation between abuseability and anti-depressant potential?)
 
The sigma being involved is very interesting, they have been suspected to be important for various psychiatric disorders including depression and to hold promise for years now, though nobody should experiment IMO because you could also be triggering or worsening such disorders if you are predisposed.
Are you talking about the pathway downstream from mTOR activation and further conditions for synaptogenesis?
Are we talking about 'optional' synergy here or about it being necessary for proper effect? Also your link refers to a study of 2012 - was the mTOR involvement elucidated by then or not? Idk. (I mean: this was 2015 https://www.ncbi.nlm.nih.gov/pubmed/26782056 )

It is fascinating though: perhaps norketamine in conjunction with something like a PCP analogue (3-MeO-PCP is selective for sigma-1 at 42 nM - perhaps it is best to be careful with selective agonists though until we know what that does) or some other potent sigma agonist will turn out to be very effective.. but like i suggested already I hope that they will investigate analogues of that HNK isomer for the mTOR part of the puzzle. Maybe that is further ahead though if we still have to get more clarity on what is actually going on with HNK as AD in more detail.
 
very interesting stuff.

i wonder since ketamine is just widely available in veterinary medicine, this way much easier to acquire it than paying 500 dollars per dose???
 
The sigma being involved is very interesting, they have been suspected to be important for various psychiatric disorders including depression and to hold promise for years now, though nobody should experiment IMO because you could also be triggering or worsening such disorders if you are predisposed.
I believe there were some sigma ligands that reversed hippocampal atrophy/induced hippocampal hypertrophy but I don't think were ever deemed safe for human trials. Goes to show that not all growth is good I suppose.

Are you talking about the pathway downstream from mTOR activation and further conditions for synaptogenesis?
Are we talking about 'optional' synergy here or about it being necessary for proper effect? Also your link refers to a study of 2012 - was the mTOR involvement elucidated by then or not? Idk. (I mean: this was 2015 https://www.ncbi.nlm.nih.gov/pubmed/26782056 )
I believe mTOR has been known to play a role in antidepressant response for some time, but it seems as though mTOR is largely increasing proteins constructed by the ribosomes - in that sense mTOR may be a powerful engine, and depending on the antidepressant therapy's mechanism, it could be steered in different directions. So as an example different G-protein coupled receptors can activate mTOR, but depending on what effects are co-occuring, what firing mode the neural networks or individual brain cells are in and what gene transcription is occuring, maybe activation of mTOR can produce various results.

I'd imagine if there is a correlation between abuseability and therapeutic effect here, that it would manifest as some sort of "mTOR activation during patterns of neural activity that correlate to a feeling of well-being" type deal. In that sense, mTOR activation during euphoria could be helpful while maybe mTOR activation during dysphoria could be largely unhelpful. Maybe mTOR activation during neural patterns that correlate to dysphoria might just strengthen the dysphoric neural patterns.

It is fascinating though: perhaps norketamine in conjunction with something like a PCP analogue (3-MeO-PCP is selective for sigma-1 at 42 nM - perhaps it is best to be careful with selective agonists though until we know what that does) or some other potent sigma agonist will turn out to be very effective.. but like i suggested already I hope that they will investigate analogues of that HNK isomer for the mTOR part of the puzzle. Maybe that is further ahead though if we still have to get more clarity on what is actually going on with HNK as AD in more detail.
I think there are two camps here - the "non-psychedelic/psychological" camp that thinks that very low dose ketamine/HNK alone could function as an antidepressant, and then the other camp that thinks the psychoactive experience is important. The practitioners of ketamine AD therapy seem to be either for dosing ketamine low and attempting to avoid psychoactive effects, or dosing higher to produce a more psychoactive experience. I suppose there could a middle ground between the two schools of thought, what a silly idea huh %)
 
Haha yes you are correct on it being more complicated than that, working with ppl who don’t necessarily have an appreciation for receptor binding glutamate, chemistry etc, means I’m always looking for a way to get the very important information you stated to be understood or appreciated. The clinic we work with is very much agrred on the experience playing a roll in the therapeutic value and the medacines ability to work on body and mind all at once similarly to ibogaine is amazing. Thanks for all the amazing info solipsis! I’m such a geek for understanding dissociatives action.
 
ok guys you are discussing more of its mechanism than anything i intended in this thread. its my thread, im just interested how it helped people with reports is all. and since it got way off topic, might as well ask this which is very important for me to ask, what place actually gives ketamine at acceptable price way below 500 for a dose that is!??
 
Low doses of ketamine and DXM helped to keep a ragging opioid tolerance at bay to the point that I was able to taper on my own without even realizing why I did not feel as depressed or anxious. This was long before a lot of the research came out about these substances. Some of the PCE type analogues have also displayed similiar antidepressant qualities and may even last longer in your system.
 
ive never heard of those PCE type analogues. any more information?
 
All I know is I feel better every day on dissociative. Some are better suited, MXE being King Of Kings. Why in Gods the pharmaceutical company isn't legitimately looking at dissociative as legitimate metal health treatment boggles my mind. If I could have the option of Ketamine, MXE, some other chems already on the market and some new designed to treat depression, I would be in heaven.
 
im still angry at how expensive treatment with ketamine can be. even people with money will feel uncomfortable paying so much as if they are being scammed. again, isnt it better just getting a hold of veterinary ketamine and doing it yourself?
 
All I know is I feel better every day on dissociative. Some are better suited, MXE being King Of Kings. Why in Gods the pharmaceutical company isn't legitimately looking at dissociative as legitimate metal health treatment boggles my mind. If I could have the option of Ketamine, MXE, some other chems already on the market and some new designed to treat depression, I would be in heaven.

Define "legitimate mental health treatment". Based on my understanding, current protocols using ketamine for antidepressant purposes involve treating people with either a single moderate dose of K every few weeks, or daily non-recreational doses. That's different from taking recreational doses of K on a daily basis, however.

Not only is ketamine highly addictive, but its piss-poor oral bioavailability means that oral preparations are going to involve fairly high doses, which creates a major incentive for either snorting or injecting the drug to achieve euphoria, or re-selling it on the black market. And speaking of things being "piss-poor", there's the whole bladder toxicity thing.

Just a few days ago we had a thread on this forum from some guy asking how to prepare their antidepressant ketamine lozenges for injecting, and you can expect way more of those once antidepressant ketamine treatment becomes more common.

That's why the pharma companies are indeed heavily looking into novel NMDA-receptor antagonists as potential treatments for depression - they're specifically looking to find ones that preferrably don't have even a fraction of the abuse potential of arylcyclohexamines like K, MXE or PCP.
 
Too true, so to properly use some veterinary / illicit ketamine you would basically need a combination of personal restraint to only use low medicinal doses (preferably being relatively drug-naieve I guess because once you have gotten a taste for recreational use it is probably hard to forget about that as being technically an option), but you would also have to be able to / wanna learn to / know somebody able to administer it parenterally - that is through IM or IV injection as I don't know if insufflation is reliable enough or appropriate in this context.
You might see how this is not necessarily the most obvious premise, especially if people who discover these things and consider this possibility learn from bluelight having some likelihood of being here for originally different reasons related to recreational use of drugs.
This is a way of generalizing but it means IMO that to fit those criteria you may be in the minority of people, and if you don't really fit you should be aware of the risks you are taking. The number of people apparently confusing recreational use/effects with medicinal at least partially on this forum indicate that it is easy to fool yourself just like it is typical for people to overestimate and/or deceive themselves in different matters relating to addiction.

Cotcha, that is really interesting about the principle of 'imprinting', at least that is what I would call it, and this is something I have seen signs of - I think - at various times including with psychedelics like LSD. A therapeutic effect can be achieved by combining a certain state of susceptibility or impressionability with a positive imprint. A positive outlook could be enough, but a high impact experience that shows you a positive lesson of life can probably be much more powerful. Negative things can of course be imprinted too, and I have experienced first-hand how that can lead to anxieties and phobias that are hard to shake and overcome.
It is already a step in the right direction probably, achieving a state that in a sense wipes your previous (negative probably if in need of therapy) thought patterns clear, yet is not impervious to your mindset... but developing this further can probably drastically influence the potential of the therapy. I think these involve therapeutic mechanisms / dynamics even without any pharmacological agent, but it would not be *that* surprising if ketamine or LSD therapies have ways to take these dynamics to extreme. That would be expected to feel subjectively as is often described: months or more of therapy condensed into a brief time.

I agree that we shouldn't overextend our enthousiasm and that we have some questions to answer before impatiently starting with - especially self-experimenting - dissociative therapies, like single high dose vs repeated microdose vs that novel middle ground mentioned earlier of using selective agents to enhance microdoses in ways to utilize the potential of high doses without actually having to regularly trip perhaps.

But hopefully it is found in everyone's interest (too bad that it has to be in the interest of big pharma too) to explore both the necessary mechanisms as well as different analogues and their ability to exploit these mechanisms. There are examples of pharmaceuticals that consist of two complementary compounds but it isn't really that typical and also not considered ideal. Sometimes there isn't really another way though, within our current capabilities.

As for myself, I'd like to know if dissociative abuse in the past and the resultant - kinda unusual - perma-tolerance mean that I could not benefit from these therapies anymore if I wanted to. As far as I can tell, this perma-tolerance involves only parts of the mechanisms involved with K like hyperpolarization channels and I think I can still 'blank out' my mind fine with something like diphenidine analogues even if I am unlikely to get an interesting experience from K and more chance of feeling sick.
 
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I had a daily heavy use dissociatives habit for 5 years mostly mxe but others as well, large tolerance, the doctors were not as worried about that as I was, my dosage was much much higher than most to get full dissociation but that doesn’t influence cost, it’s a pricey option but has been extremely successful in 80% clients that we put through infusions.
 
There is obviously a positive effect of the ketamine experience but from a medical perspective asking our docs they say as per there treatment, they think using the Medacine pump to sustain a blood plasma level without spikes and drops plays an important roll in successfully recreating the beneficial effects we’re seeking w ketamine, I feel like when I abused it only sometimes would I come out the other side feeling like my brain was clearer and depression gone.
 
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