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Ketamine for the acute treatment of severe suicidal ideation

bmj.com

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Re: Ketamine for the acute treatment of severe suicidal ideation

#101

Post by olliej »

standardUser wrote: post #67
olliej wrote: post #62

I've been getting intramuscular ketamine weekly for my severe & treatment resistant depression while working on making progress towards actual recovery. As with participants in this study I wasn't one of the lucky "I did ketamine a few times and my depression was cured" folk, but it has a huge reduction in frequency and intensity of ideation, as well as pretty much completely removing self harm. That said it's not a…

I wish the gap between clinical treatment and recreational use was bridged, and you could use a nasal spray on your own time a couple evenings a week instead of a daytime injection.

The nasal spray is less effective according to the clinical trials, and is patented minor variation on ketamine so is super expensive (though "hilariously" because ketamine is technically being used off label for treating depression insurance may decline coverage of the cheaper, more effective original)

There's also lozenge form which I believe some clinics allow you to take at home, but not sure of the effectiveness

Re: Ketamine for the acute treatment of severe suicidal ideation

#102

Post by Perenti »

bragr wrote: post #78
dataisfun wrote: post #45

Earlier quoted context omitted.

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.

Are you getting it all at once or as an infusion? Considering this is given as an infusion over 40 minutes, this seems to be a pretty mild dose consistent with mild analgesia and well bellow the recreation and dissociative doses based on all the charts I just pulled up, but I'm not personally experienced with K ;)

I've had K infusions for neuropathic pain, in comparable dosage rates, for up to 7 days at a time.

You certainly notice the effects of IV K. So do other people when you start to talk to a hairbrush. It's a bit draining after a few days though, and not terribly fun.

Re: Ketamine for the acute treatment of severe suicidal ideation

#103

Post by ketamine »

glerk wrote: post #61
ketamine wrote: post #32

Hello! Throwaway account for obvious reasons. I just started IV ketamine infusions at .5 mg/kg for depressions. I am not finished with my treatment yet. Ask me anything if you would like.

Any issues with your bladder? Have doctors mentioned anything about the potential damage to the urinary system? This seems to be the scariest side effect.

No issues (yet).

I am a man and it did immediately reduce my libido. Not in the same way SSRIs did. Will be curious to see if that is a lasting effect or not.

Re: Ketamine for the acute treatment of severe suicidal ideation

#104

Post by Perenti »

hadmatter wrote: post #31
chimeracoder wrote: post #24

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. 0.5 mg/kg intravenous. For frame of reference, a small recreational dose is between 5-25 mg (insufflated[0]), and a larger recreational dose (for people targeting a "k-hole") is more like 50-100mg. For clinical depression (ie, not this study, but for a similar pu…

I agree about you second point. I was too quick to make my comment and I was conflating stuff I've read about nasal esketamine, which didn't have as robust evidence behind it as i.v. ketamine. I should not write comments while holding a baby that is trying to sleep and failing at it. About the first point, I still disagree with the parent comment. The standard 0,5mg/kg ketamine is given under 40 minutes. I've seen tw…

It sounds like those patients were in a very nice calm place. During my K infusions (30-50mg/hr for 7 days) for chronic neuropathic pain I was in a single room in a hospital. There was enough to see and hear that the mind took them and ran with them. I had a fight with a shower curtain because it said I wasn't clean yet. I had conversations with my toothbrush and hairbrush. It took 24 hours for my daughter's reporting that a puppy had died to make sense.

And I'm not drug naive by a very long shot. On my 2nd infusion there was an older gentleman across the hall from me who had never had anything stronger than scotch whiskey. He was not having a good time at all.

7 days falling in and out of the K-hole while hallucinating is not as much fun as it sounds.

Re: Ketamine for the acute treatment of severe suicidal ideation

#105

Post by btach »

azalemeth wrote: post #97
sonicggg wrote: post #94

Earlier quoted context omitted.

Not sure what you're talking about. They're are double-blind placebo clinical trials with injectible drugs all the time.

Exactly. The label says something along the lines of "IMP-#####" where "IMP" stands for 'investigational medicinal product' and the number is unique and tracked. Below that will be a dosage statement, a label with the patient's name and patient ID on it, and (in the UK at least) the legally-mandated words "keep out of sight and reach of children". For orally dosed RCTs, often the pill making process is the way the bl…

That's interesting. I am only speaking from experience working in the ED as an RN and do not have any experience with studies like this that give medications that are not positively known (by myself). What you (and others say) actually does make sense. Thanks.

Re: Ketamine for the acute treatment of severe suicidal ideation

#106

Post by ketamine »

VyperCard wrote: post #79
ketamine wrote: post #32

Hello! Throwaway account for obvious reasons. I just started IV ketamine infusions at .5 mg/kg for depressions. I am not finished with my treatment yet. Ask me anything if you would like.

Good luck to you. It helped me a lot. I refresh it every three to four month with a single session and a 2 day of vacation away from everything in another town.

Did you have any particularly bad sessions? I am waiting on the other shoe to drop

Re: Ketamine for the acute treatment of severe suicidal ideation

#107

Post by tayo42 »

ketamine wrote: post #32

Hello! Throwaway account for obvious reasons. I just started IV ketamine infusions at .5 mg/kg for depressions. I am not finished with my treatment yet. Ask me anything if you would like.

do they do anything for motion sickness? the one time i tried i spent the hour trying not to throw up

Re: Ketamine for the acute treatment of severe suicidal ideation

#108

Post by eutectic »

Perenti wrote: post #102
bragr wrote: post #78

Earlier quoted context omitted.

Are you getting it all at once or as an infusion? Considering this is given as an infusion over 40 minutes, this seems to be a pretty mild dose consistent with mild analgesia and well bellow the recreation and dissociative doses based on all the charts I just pulled up, but I'm not personally experienced with K ;)

I've had K infusions for neuropathic pain, in comparable dosage rates, for up to 7 days at a time. You certainly notice the effects of IV K. So do other people when you start to talk to a hairbrush. It's a bit draining after a few days though, and not terribly fun.

How effective was it for you?

Re: Ketamine for the acute treatment of severe suicidal ideation

#109

Post by swores »

sandworm101 wrote: post #17
aaaaaaaaata wrote: post #16

Earlier quoted context omitted.

I read it as their doctor receiving the treatment, not them.

"she uses" is an odd phrase for a patient. Patients normally "receive" or "are given". Drug addicts and doctors "use" a drug.

Mmh, not sure. I received a prescription for a drug from my doctor, now I use (or 'take') that drug/medicine once a day.

It's common for those wordings to be used because often it literally is a handing over of drugs you're talking about - with sickness you're more likely to talk about the moment a medical person said to start using a drug than to tell people about the actual use because it's usually more interesting.

Re: Ketamine for the acute treatment of severe suicidal ideation

#110

Post by ketamine »

tayo42 wrote: post #107
ketamine wrote: post #32

Hello! Throwaway account for obvious reasons. I just started IV ketamine infusions at .5 mg/kg for depressions. I am not finished with my treatment yet. Ask me anything if you would like.

do they do anything for motion sickness? the one time i tried i spent the hour trying not to throw up

Yes. Zofran on request.

I was only nauseous for maybe 1 minute but I can see it being terrible for folks with motion sickness.

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