FYI: Johnson & Johnson patented the S(+) enantiomer of ketamine and sells it as a nasal spray called Spavato. It's been FDA approved for depression since 2019. Although Spravato costs more on paper than regular ketamine, it's often less expensive for patients since it is covered by insurance (regular ketamine treatments are considered an off-label use and are usually not covered).
Ketamine for the acute treatment of severe suicidal ideation
71–80 of 120 posts
Re: Ketamine for the acute treatment of severe suicidal ideation
#72Hello! 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.
I'm not OP, but I have some relevant professional (clinical) experience here.
> 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.
We're lucky because ketamine has been used for decades in inpatient settings at much, much higher doses than what is being used now for psychiatric purposes, so we have a good sense of its safety profile already.
Urinary tract and bladder issues are noted for long-term and frequent recreational users of ketamine, but not really for anesthetic use. The dosing schedule for psychiatric use is closer to anesthetic use than it is for recreational use.
The effects also are reversible if detected early and use is ceased, so periodic but infrequent treatment is unlikely to result in long-term damage, both because it's not frequent enough to accumulate, and because you can stop if it becomes a problem.
Re: Ketamine for the acute treatment of severe suicidal ideation
#73Hello! 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.
This is part of the reason MXE was developed. Love me some MXE.
Re: Ketamine for the acute treatment of severe suicidal ideation
#74Earlier quoted context omitted.
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.
Clinics in the US seem to all use .5 mg/kg as a baseline
I vouched for your comment since it is relevant. I assume it was dead because you're new.
Re: Ketamine for the acute treatment of severe suicidal ideation
#75Earlier quoted context omitted.
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…
Source: patient taking infusions. .5 mg/kg I was numb all over, my lips tongue and throat were numb. I melted in to the chair and felt like I was up down and sideways at the same time. You would not be able to tell immediately but I put on my blindfold within 7 minutes due to effects starting.
I've had to vouch for four of your comments now. Looks like you account was shadow banned. Maybe contact @dang to see if they'll fix it?
Re: Ketamine for the acute treatment of severe suicidal ideation
#76> 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…
I get the used dosage every three month and I can assure you, it is very noticeable.
However, I have no idea how other sedations feel, so who knows if they are a good placebo. Could be.
Re: Ketamine for the acute treatment of severe suicidal ideation
#77Earlier 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…
> 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.
What you're saying applies in other cases, but in the case of ketamine, the recreational dose is one or two orders of magnitude lower than the clinical dose.
Re: Ketamine for the acute treatment of severe suicidal ideation
#78Earlier 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.
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 ;)
Re: Ketamine for the acute treatment of severe suicidal ideation
#79Hello! 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.
Re: Ketamine for the acute treatment of severe suicidal ideation
#80Earlier quoted context omitted.
There is precedent for this; it's called "active placebo." For example, I think some of the psilocybin trials used methylphenidate as an active placebo comparison condition.
Sure, but as a scientist conducting an experiment I will be able to determine who is dosed with psilocybin and who is doses with methylphenidate >90% of the time, thus removing the observer mask. I think the average patient would be able to tell if they were dosed with psilocybin or methylphenidate, even if they were drug naive, thus removing the patient mask. I'm not saying it's impossible to conduct good experiment…
The person assessing the depression response in the psilocybin studies is not in the room with the person while they are under the influence of the substance. The ratings are done on a different day. It's two different people to preserve blinding.