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Ketamine for the acute treatment of severe suicidal ideation

bmj.com

61–70 of 120 posts

Re: Ketamine for the acute treatment of severe suicidal ideation

#61

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.

Re: Ketamine for the acute treatment of severe suicidal ideation

#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 long term solution (because honestly its frustrating due to losing a few hours during the work week, inability to drive, etc) so I'm working with Drs to actually resolve things without regularly being stabbed :D

Re: Ketamine for the acute treatment of severe suicidal ideation

#63
post #38

Earlier quoted context omitted.

>1.The nurse administering knew if it was placebo or active (for safety reasons). I read it as the nurse preparing the IV's knew if it was a placebo, it doesn't really say that the same nurse administered the IV's.

The nurse administering it is most certainly liable for what s/he administers. It is a very big no-no to blindly administer a medication of which you cannot reasonably verify what it is. To push a syringe or start a pump of something that "could be ketamine, or could be NS" is walking an uncomfortable line for your license to practice nursing. Right patient, right medication, right dose, right route, right time. If y…

How does it work in other clinical trials where you take a pill instead of getting an injection? Those are double blind all the time. They watch you take the pill, but they don't know whether it is active or placebo.

For that matter, a quick web search shows that at least some of the (injected) coronavirus vaccine trials were double blind. Seems like enough for someone in the next room to know if the maybe-ketamine injection is placebo, so they can unblind immediately in case of a bad reaction.

Re: Ketamine for the acute treatment of severe suicidal ideation

#64

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?

You generally can’t compare recreational and prescribed drug use, even for the same substance, because the doses tend to be widely different.

A lot of people take amphetamines as a medically prescribed treatment for ADHD (and other conditions such as narcolepsy too). A lot of people take amphetamines recreationally. Studies done on the negative heath consequences for recreational users are largely irrelevant to medically prescribed users, because your average recreational dose is an order of magnitude (or more) higher than the average prescribed dose. Increase the dose ten-told, it acts like a different drug altogether.

Plus, the irregular dosing schedule of recreational users probably isn’t helping either. And many recreational users try to get the drug into their bloodstream as fast as possible (injection, snorting, smoking), while most prescription drugs aim to be released more gradually (oral route, sometimes even extended release or an inactive prodrug such as Vyvanse/lisdexamfetamine)

Re: Ketamine for the acute treatment of severe suicidal ideation

#65

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…

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.

Can't reply so sibling but WTF the username "ketamine" was still available... On HN ?

Re: Ketamine for the acute treatment of severe suicidal ideation

#66

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?

You can look at the study yourself to see what dosage was administered, then compare that to user-reported experiences on erowid if you're curious. And the study itself lists out the side effects they experienced.

Re: Ketamine for the acute treatment of severe suicidal ideation

#67
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.

Re: Ketamine for the acute treatment of severe suicidal ideation

#68

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.

There are treatments for that? I've never had anyone suggest anything other than therapy for it.

Re: Ketamine for the acute treatment of severe suicidal ideation

#69
The truly amazing thing here is how powerful the placebo control was, even despite the fact that as someone who's done ketamine IV treatment before, it's pretty obvious when you're on ketamine and when you're not.

"At week 6, remission in the ketamine arm remained high, although non-significantly versus placebo (69.5% v 56.3%; odds ratio 0.8 (95% confidence interval 0.3 to 2.5), P=0.7)."

Re: Ketamine for the acute treatment of severe suicidal ideation

#70

Earlier quoted context omitted.

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?

You generally can’t compare recreational and prescribed drug use, even for the same substance, because the doses tend to be widely different. A lot of people take amphetamines as a medically prescribed treatment for ADHD (and other conditions such as narcolepsy too). A lot of people take amphetamines recreationally. Studies done on the negative heath consequences for recreational users are largely irrelevant to medic…

The person you're replying to, from my interpretation, is saying that their friend had a ketamine infusion at a clinic. Nowhere do they mention recreational use
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