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Ketamine for the acute treatment of severe suicidal ideation

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Re: Ketamine for the acute treatment of severe suicidal ideation

#41

I did a full 6 week course of ketamine therapy. It was really good, and I would recommend it if you're open minded. It's not for everyone, and the lasting (a year+) benefits aren't really measurable (maybe I'm different? maybe I'm not, maybe I've just gotten older). I'd like to go again and see if it can help with my obsessive existential dread.

It immediately relieved my existential dread. I fear the next infusion will be intense, however.

Re: Ketamine for the acute treatment of severe suicidal ideation

#42
post #40

This suggests that ketamine is beneficial for people who are suicidal to prevent them from killing themselves. The claim that is generally made about ketamine and depression is that it can have a short-term resetting effect of someone's depressive symptoms (not necessarily at a suicidal level), making it possible to escape the black hole that otherwise can take weeks, months, years to come out of. https://www.nih.gov…

For bipolar or other disorders, not much of a discernible effect for depressives

Re: Ketamine for the acute treatment of severe suicidal ideation

#43

Earlier quoted context omitted.

I’m sorry but you are strongly over exaggerating the (side) effects of i.v. ketamine. It’s not a dose that sends you in a K hole. It’s way less than that. Some get sedation and some do get dissociative symptoms which can unmask the study arm of the patient. Approximately one out of ten got at least one of those side effects. Sedation can be mimicked with midazolam, so if you use that as placebo, you get 90 % of the p…

Have you had it? A friend of mine did it last week and he described it as the most intense experience of his life. He’s 40 and he has experience with other drugs. I think possibly you don’t know what you’re talking about?

Right it varies greatly depending on dose. If you don't know the exact dose your friend took (they don't sound like an anesthesiologist) then you're insulting someone you likely know much less than.

Re: Ketamine for the acute treatment of severe suicidal ideation

#44
post #6

I did a full 6 week course of ketamine therapy. It was really good, and I would recommend it if you're open minded. It's not for everyone, and the lasting (a year+) benefits aren't really measurable (maybe I'm different? maybe I'm not, maybe I've just gotten older). I'd like to go again and see if it can help with my obsessive existential dread.

Absolutely, I have a partner who has had severe PTSD and went through a great month-long program, she's overcome many longstanding fears and triggers and has made huge strides in being able to feel that she is living her life once again.

I have a close acquaintance who uses ketamine to manage depression and Complex PTSD. My experience as a bystander is that the depressive symptoms reoccur periodically regardless of the use of ketamine. The depressive symptoms seem to be caused by the PTSD, and ketamine does not seem to alleviate the PTSD.

I'm saying this as a huge fan of the positive impact of ketamine.

There are some symptoms that seem like they need more rewiring.

Re: Ketamine for the acute treatment of severe suicidal ideation

#45

> Then, patients received a first 40 minute intravenous infusion of ketamine (0.5 mg/kg) or placebo 0.9% (saline solution) in addition to their current treatment. This really shouldn’t be labeled as double blind. 1.The nurse administering knew if it was placebo or active (for safety reasons). 2. It would immediately become obvious to the subject if they were injected with salt water or ketamine. 3. Within minutes it…

I’m sorry but you are strongly over exaggerating the (side) effects of i.v. ketamine. It’s not a dose that sends you in a K hole. It’s way less than that. Some get sedation and some do get dissociative symptoms which can unmask the study arm of the patient. Approximately one out of ten got at least one of those side effects. Sedation can be mimicked with midazolam, so if you use that as placebo, you get 90 % of the p…

Umm…ketamine IV at these doses is most certainly a unique and insane experience, speaking as someone who’s done it about a dozen times for anxiety.

Re: Ketamine for the acute treatment of severe suicidal ideation

#46
post #30

Some vets use Ketamine as part of a multi stage protocol for euthanising animals, other vets just use a single drug protocol but I havent established what that drug is, but it just seems all a bit refined butchery to me! Ketamine is supposed to be a disassociate drug, which I'm guessing is perhaps like an out of body experience or something. But I cant see how that can help with depression when people dont understand…

Isn't morphine overdose the best (friendliest) possible euthanizing method?

Morphine/Heroin is supposed to physically cause respiratory depression so you stop breathing and I guess the CO2 builds up past the 30% blood saturation point by which stage it takes about 2 mins for the body to shut down. As the CO2 levels reach that 30% blood saturation point, the body becomes increasingly stimulated which is why you see people thrashing around when drowning or asphyxiating. Having done sea rescue to stop someone drowning in rough sea's, you can say goodbye to all the training water rescue people get taught and just hope the panicking person isnt as strong as you and hope your lungs are better than theirs, because they will force you under and you will ingest lots of water so you have CO2 build up which spurs you on to shore ironically.

Obviously (going off things like trainspotting and peoples accounts), opiates are supposed to give you a warm fuzzy feeling as you slip into a deep sleep or unconsciousness I guess but not to sure, never done it not even in an operating theatre.

MAOI's the old style anti depressants are quite sudden in that they are like an on off switch for the brain, you dont remember or feel nothing and I think they were popular with people who wanted to end it, but SSRI's have replaced them as the new anti depressant treatment but their problem is you dont sleep properly on them so they introduce their own problems, but I'm not aware of any end of life properties in SSRI's other than they ruin your sleep and send you off the rails slowly.

But all the while, these chemicals still dont address the fundamental problem with depression which is remembering stuff that causes depression. Maybe depression should be treated more like PTSD, because depression seems to be an ego thing, where as talking to other people, PTSD seems to be more like what people associate as depression.

For bloke's I think the bio mechanical properties of testosterone would help many with PTSD, cant comment for women though, but the risk the police and medical lot dont want is some hulk losing it so the idea isnt entertained AFAIK.

Self preservation of institutions comes before everything else!

Edit: I should add, once CO2 blood saturation exceeds 30% it has a noble gas effect on the body, so anyone who remembers the periodic table should remember what noble gasses are and its why compressed gas companies go to great lengths to not enable pure noble gases getting into the hands of the public.

Biology and chemistry is just the mammalian equivalent of computer hacking.

Re: Ketamine for the acute treatment of severe suicidal ideation

#47

> Then, patients received a first 40 minute intravenous infusion of ketamine (0.5 mg/kg) or placebo 0.9% (saline solution) in addition to their current treatment. This really shouldn’t be labeled as double blind. 1.The nurse administering knew if it was placebo or active (for safety reasons). 2. It would immediately become obvious to the subject if they were injected with salt water or ketamine. 3. Within minutes it…

[deleted]

Re: Ketamine for the acute treatment of severe suicidal ideation

#48
> The primary outcome was the rate of patients in full suicidal remission at day 3, according to the scale for suicidal ideation total score ≤3. Analyses were conducted on an intention-to-treat basis.

Question: does reducing suicidal ideation reduce suicide? I mean, it sounds like it obviously should, but we've been wrong about this before. Many heart medications to reduce cholesterol worked great at reducing cholesterol without reducing heart disease!

All that said, reducing suicidal ideation is a worthy goal itself, even if it doesn't reduce suicide. I'm a full supporter of seeing this treatment move more mainstream.

Re: Ketamine for the acute treatment of severe suicidal ideation

#49

I did a full 6 week course of ketamine therapy. It was really good, and I would recommend it if you're open minded. It's not for everyone, and the lasting (a year+) benefits aren't really measurable (maybe I'm different? maybe I'm not, maybe I've just gotten older). I'd like to go again and see if it can help with my obsessive existential dread.

What's the process for this like? Been curious about the current state of psych medicine.

Not OP

I did 2 surveys and a phone consult then a baseline depression survey before my first infusion.

I go to the clinic and go in my room and they give me my IV then the doctor hangs the ketamine mix bag, hooks it up and leaves. The rooms are dark and they have colored lights or a dim light. I wear an eye mask.

I pay extra to receive talk therapy during the infusion so I have a therapist with me the whole time. We do a ceremony to start each infusion and set the intent just before the effects start.

Re: Ketamine for the acute treatment of severe suicidal ideation

#50

> Then, patients received a first 40 minute intravenous infusion of ketamine (0.5 mg/kg) or placebo 0.9% (saline solution) in addition to their current treatment. This really shouldn’t be labeled as double blind. 1.The nurse administering knew if it was placebo or active (for safety reasons). 2. It would immediately become obvious to the subject if they were injected with salt water or ketamine. 3. Within minutes it…

I’m sorry but you are strongly over exaggerating the (side) effects of i.v. ketamine. It’s not a dose that sends you in a K hole. It’s way less than that. Some get sedation and some do get dissociative symptoms which can unmask the study arm of the patient. Approximately one out of ten got at least one of those side effects. Sedation can be mimicked with midazolam, so if you use that as placebo, you get 90 % of the p…

Inter muscular ketamine treatments were the only thing that helped my severe treatment resistant depression that included suicidal thoughts. They definitely had strong side affects. Complete disconnection, loss of the concept of humanism, I've gone inside a rainbow, held hands with my brain, etc..
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