Following this regimen I should take 285 mg the first session because of how much I weigh. Does that sound right? (Article from Reddit)
Ketamine as a powerful antidepressant: if you have to try it, this is how
**tl/dr:** It works. It seems quite safe and comfortable if you use very little in a controlled setting.
**The drug:** An increasing number of studies are finding that [ketamine has antidepressant effects](http://www.ketamine.com/antidepressant-potential.html). It is powerful, quick-acting and the antidepressant effect can last for days or weeks while the side-effects pass within minutes. Those willing to buy illegal drugs find it fairly readily available and quite cheap. So naturally, some depressed people and their friends are wondering whether it might be worth a try. [This thread](http://www.reddit.com/r/Drugs/comments/au1wv/ketamine_and_depression/) is an example. Offline and off the record, I find a lot of people are very interested but completely uninformed.
**Me:** I work in Ketamine research and know the science of it better than most people outside the field. In my spare time, I have for years aided drug users i.e. I teach safer use, help people quit, guide trippers etc. I have a little training and experience with cognitive-behavioral therapy but am not a licensed therapist.
**What I did:** I have helped two depressed people (one with chronic major depression, one with seasonal affective disorder) who had no Ketamine experience use an experimental treatment protocol I designed based on the existing literature. Both experienced definite improvement. Neither experienced the addiction issues that others have reported. I outline the method here and hope to help others reduce the great risks that are always present in psychiatric intervention, more so with experimental drugs and even more so when it is done non-professionally.
**Legal issues:** Obviously, this is illegal. In most jurisdictions, everyone involved can go to jail for this. I wouldn't advise on it if I wasn't convinced that for depressed people, Ketamine is even more of a godsend than marijuana is for MS patients.
**Very important:** The antidepressive properties of Ketamine take effect at doses that are below even the lowest of recreational doses. "Club doses" are around 0.5mg/kg, i.e. 40 mg for a 80 kilo person, or higher with habituation. "K-hole doses" are around 1mg/kg, anaesthetic doses can be around 5mg/kg. The following method keeps drug levels below 0.2mg/kg. This avoids almost all of the effects Ketamine is normally known for, especially addiction, and according to both the clinical trials and my own experience is enough for the antidepressant effect.
**How to:**
* *Schedule:* Do the following once a day over five days. It is preferable to space the sessions two days apart, to allow more time for integration of the experience. If you do it every day for five days, the depressed person needs be in a fairly stress-free environment for this period, i.e. on a relaxed holiday (not Burning Man).
* *The "patient" (henceforth referred to as the sad person):* Ketamine is being researched chiefly as a medication for very severe, treatment-resistant cases of major depression and the depressive episodes of bipolar disorder. It seems to work at least as well for less severe mood disorders. I wouldn't recommend it for a sad person who had any history of psychotic or schizophreniform symptoms because Ketamine at much higher doses can very occasionally trigger psychotic episodes. Existing medications should be continued. No recreational drug use during this period - a sad person who can't agree to that shouldn't try this. Yes that means not even pot or alcohol. I do not know how previous experience with Ketamine would affect the results.
* *Required amount:* Each of the five session uses five doses of 0.1mg/kg, so overall, a 100 kilo person would need quarter of a gram. Adjust for the sad person's body weight and do not buy more than you need. Depending on your location, it might be so cheap you could get it in exchange for a beer. S-Ketamine (a chemical variant) is two to three times more potent for some of the higher-dose effects, I don't know whether this is true for the antidepressant ones.
* *The company:* A sitter needs to be present. This must be a highly trusted person. A trained therapist would be great, if you can find one who'll risk his license for this, but do not attempt therapy if you don't have the training for it. As a sitter, your job is to ensure safety and comfort, remain calm and sober at all times, be available as a conversation partner, help manage whatever comes up and stay the fuck out of the way when your assistance is not being requested. Experience with handling drug experiences is certainly a plus, but not a requirement: this job is much more similar to the designated driver on a bar night than to tripsitting someone on mushrooms or LSD.
* *The environment:* Be in a completely safe place where you can lie down comfortably, quite warm, with a bathroom and fresh water available. Turn off your cellphones. The sad person would enjoy having showered and being in fresh clothes. You need to be sure you will remain undisturbed for two hours. Hear soothing music if it feels right. If possible, the sad person may want to do it in the evening, in his or her bed, and go to sleep afterwards.
* *The procedure:* Go to the bathroom immediately before you start, and blow your nose properly. (Ketamine can make you want to pee. You may need to go again in between.) Lie down comfortably and under a blanket. In ten minute intervals, sniff five 0.1mg/kg doses of Ketamine. Never mind if it is 12 minutes instead of 10 or if the total amount is off by a few milligrams. Be hygienic about it, do not use rolled banknotes. Do not consume it orally. Relax, be very comfortable, maybe talk, about whether you're feeling anything for example.
* *Immediate effects:* This very mild dose will not produce any hallucinations and none of the out-of-body experiences and dramatic circulation effects Wikipedia tells you about. (If if does, you have a highly unlikely genetic anomaly or something that affects your metabolization of Ketamine. Abort immediately and go to sleep.) In my experience you will feel, if anything, like you're mildly stoned or on half a Xanax. Expect a relaxed buzz or serene high, slowed movements, mildly changed perception of the body, a subjective feeling of cold and maybe a slight change of perception of time. The "inner alarm" (feelings of fear, rage, guilt or shame) is shut off - this can be too subtle for the sad person to notice at this time, but may be very apparent to the sitter. If this is your first time sniffing anything, you might produce more mucus than usual - sniff it right back up. It tastes bad when it drips down in your throat, so drink water. If it feels right (to the sad person), this is an excellent time to think or talk about whatever seems important. You might have a comfortable chat. You might go deeper, and understand more clearly, than ever before. You might have a breathtaking epiphany that illuminates your heart forever.
* *Conclusion:* Immediate effects are gone half an hour after the last dose, at the latest. Take your time finishing up, keep relaxing and enjoying yourself until the session feels done.
* *Expected results:* Since every sad person is different, this is guesswork. I *guess* results might be similar to what happened in my two cases. The person with chronic major depression had markedly reduced symptoms for around two months. Six months later, part of the improvement seems permanent but it is impossible to tell how much of it is due to the Ketamine. The other person's seasonal affective disorder simply vanished and may or may not return next winter. The clinical trials report a wide spectrum of effects, from nothing at all to seemingly permanent alleviation of severe treatment-resistant major depression. None of the studies done so far have included numbers of sad people great enough to paint a clear picture, but very roughly, it seems that around 75% of those with very severe problems benefit from Ketamine at least temporarily. There is a minority of recreational users for who Ketamine does nothing or nearly nothing. I suppose the method outlined will not work for everyone either. Those unfamiliar with sniffing chemicals may experience slight irritation of the mucous membranes that can last for a few days.
**Final words:** This is my first version of the writeup. I'll watch this thread for a while, answer questions as well as I can and perhaps edit the above accordingly.
