Safety profile of intranasal Esketamine

[Lysergaman]

I am considering joining a clinical trial regarding the safety and efficacy of 56-84mg of intranasal ketamine for depression. It seems to be a long term study where you self-administer the dose either weekly, once every two weeks, or once a month. I know ketamine can cause cognitive impairment and serious bladder issues but Im unsure if Id be at risk for those problems. I will obviously discuss this with my doctors, but I dont expect them to be experts on ketamine and I was wondering if anyone here was familiar with the possible risks. Ive heard that issues arise from large doses and frequent use, but Im not sure what exactly qualifies as frequent use. I also am wondering if tolerance will develop from weekly use, resulting in less efficacy over time. Any info on ketamine would be greatly appreciated!

 

[dopamimetic]

You'll be fine if you use it as directed. Much higher (single) doses are considered safe, it's an approved anesthetic at last. The danger comes from over-using, and tolerance, I'd say. So I'd see the biggest danger in that you might like the stuff and continue it after the study ended, without supervision.

I'm through a two-year binge of dissociatives with a good part being deschloro-ketamine and also my fair share of ketamine, yeah it wasn't healthy for sure and ketamine isn't the physically lightest of all of them but it's not that worse. My bladder still works ok, it mewed here an then though so I'm happy about it. Going through much ket feels heavy on it for sure, would love to know what the exact mechanisms are. The antidepressant, anxiolytic effect is unique. The doses appear to be pretty decent for current research so I'd say be lucky to be in

 

[Lysergaman]

Thanks for the input, and I agree its very lucky that there is a study like this in my area! Especially since this is free, unlike the extremely expensive ketamine infusions, and its pure, unlike a lot of the stuff being sold on the street.

 

[dopamimetic]

The last one is a good point also, might have been that everything from a fraction to the most of my side effects / bad experiences (and also what you read about drug users, e.g. the bladder damage has -afaik- only seldomly been observed in purely clinical settings and in such cases the people will have had an underlying diagnosis of what they got ketamine in first line. Sometimes even the best gas chromatography fails, I know this personally when they accused me for smuggling methylphenidate which was ethylphenidate (sampled, so I was pretty sure). Maybe the street lab didn't work really pure, so it might indeed have been partially MPH, but not all what they said initially. They had to drop the case cause they already burned the material and the lab stated it might indeed have been a false positive. (thankful, and learned the hard way, so please don't think "lucky bastard" now..)

Never had a fresh vial of ketamine. Always only powder, crystals, shards. With usually the not-so-pure RCs feeling pretty much more pure than all that "LAB TESTED 98% DIRECT FROM (country)" darknet / dealer shit.

Fuck politics and their ban of drug testing in Germany (not living there anymore so I can say that).

 

[asecin]

how did you find ketamine studies in your area? i want to find some in mine too, im in chicago. any ideas, help?

 

[Lysergaman]

how did you find ketamine studies in your area? i want to find some in mine too, im in chicago. any ideas, help?

Sorry for the late reply, but if anyone is interested they should visit ClinicalTrials.gov to see all FDA approved clinical trials within 50-200 miles of your address. You can add filters to limit the search to specific conditions or specific treatments. Unfortunately you need to meet pre-requisite conditions that vary for each trial. For example, I am excluded from basically everything for using medical marijuana

 

[asecin]

ok i have another question about ketamine. whats the conclusion when it comes to ketamine use and Olney's lesions? from wikipedia, it says it can cause it and ketamine users of 4 years show signs of it, but then reading in depth, it actually says its still unproven. its very confusing. can someone with more knowledge and understanding of the data tell me whats the final conclusion on this??

 

[AlphaMethylPhenyl]

Pretty sure it's all about how chronically one uses (how long and how much). As for ketamine clinics, they use sub-hallucinogenic doses and don't dose until week(s) after another dose. The ketamine there is also pure, administered safely, and with all kinds of medical personnel and functions on hand.

Look for recent peer-reviewed meta-anayses from reputable journals...

The idea is that, if medically warranted and taken in a medical manner, you will end up gaining more than you lose, overall. That's your answer.

 

[asecin]

yes, thanks. i wondered about this. i called few clinics and all of them charge like x dollars per dose and want you to have like at least 6 doses (perhaps its about profit they require that many) but who knows, it might be that much one needs to get help with depression or post traumatic stress disorder *shrugs*
anyway, besides the huge price in doses, they didnt tell me anything else except its IV, and it takes few hours. now, a guy recommended i get pure ketamine online and use that if i really need it in which case it will come out much cheaper of course, but as you mention, the professional medical setting can be a key. they know what they are doing and are trained for this. still, it keeps bugging me that being shot IV for few hours doesnt seem to me at least like a way to safely have ketamine in you and not cause serious problems long term. i mean, few hours directly into your veins and you are telling me its subpar dose below the hallucinogenic value?? how is this possible? besides, the treatment takes several shots during a month. dont you think its pushing it beyond being safe at such point? of course the price is an issue, but i also think because of the high price, this business is being encouraged without control so far.

 

[dopamimetic]

Well with ketamine, the recreative ("hallucinogenic" - I never had any hallucinactions from dissociatives, so I put it into quotes) dose is below the anesthetic one and the antidepressant one is below the recreative one. So, yes that's true although depending on the individual and dosages, intervals used you might and will experience some alternations like feelings of floating, dilation of time, anxiolysis etc. but nothing to be afraid of.

Also, possibly, the speed of onset might be a variable in how it effects you. So going for IV might be a plus, although with infusions one doesn't actually get a fast onset so then again it's just cause it's being supplied in vials for injection and maybe to add to that hospital setting, to keep people from seeing it as a drug they also might get on the black market and things like that.
Thinking over it, it might be the exact opposite of a fast onset - that by diluting the administered dose into a pack of NaCL solution and having that to slowly drip into your vein, they make the ketamine to come on very slowly and then maintaining a given level for some time, then slowly fading out again and thus minimizing possible hallucinogenic side effects.

As maybe four to six antidepressant dosages together make up for one anesthetic one, it's still very within strict safety ranges unless you keep up doing these infusions for months.