Despite having access through acquaintances to recreational ketamine for quite some time, I refused to try it until a couple months ago when a major life event left me spiraling and borderline suicidal. Upon taking it (nasally), I was amazed at how effectively and immediately it stopped my runaway panic and allowed me to feel peace. I fully believe that having access to ketamine at that moment allowed me to stay grounded and made it tangibly easier to bounce back and recover in the weeks following.
I have depression and anxiety, so it wasn't long before something else, less severe this time, set me on another spiral and I decided to address it with ketamine again. I found that the same dose was now less effective at quieting the anxiety. As I continued to experiment with ketamine as a potential anti-depressant and anti-anxiety drug, I found that I was building up a tolerance alarmingly quickly. Doses that would put others in a k-hole would leave me still very much able to feel my panic and anxiety. Realizing that, I decided to stop using it before the ratchet of tolerance turned too far. I still keep some ketamine in the house, but with the personal rule of "only reach for this if you'd otherwise be reaching for a gun."
My personal hypothesis is that whatever chemical difference makes my brain more depressed and anxious than a typical person is also making me more resistant to ketamine, though of course I have no science to back this up. (If you do, please link me!) I'm grateful that I don't have a very addictive personality - I know many people who have made a regular habit of it.
There isn't much point to this post other than to share my personal experiences with ketamine. I'd love to hear the experiences of others with it. I think it has an incredible potential as an acute anti-depressant/anti-anxiety medication, but would love to see more studies on it, particularly on how it affects the neurodivergent.
How often were you taking it? I use ketamine for depression and I don't think I've experienced tolerance before. While I usually feel less depressed during the high, I don't feel the long term anti-depressant effects for 2-7 days after treatment. Once it comes, it lasts for 3-6 weeks. It makes me a completely different person. I can go from borderline suicidal to living in the moment and relishing the simplest parts of life in an unbelievably short time. I fully realize that depression is more than just neurochemistry and that its just as important to use these windows of joy to create healthy physical, mental, and social habits to prolong wellness. I'm still figuring out how I can create a long term regiment using ketamine, but for the time being it seems like using it once every month-ish is making me feel well enough and is not leading to tolerance or addiction. This is after over a decade of constant crippling depression. If I were you I would definitely not think about it as a "feel better in the moment drug", that will only lead to overuse and potential psychological addiction. I was briefly prescribed anti-anxiety medication I can tell you that having a pill that instantly stops chronic symptoms is unbelievably addictive. Ketamine is different in that the effects can last longer than the high itself when used correctly. It takes time, research, experimentation, and understanding of contemporary ketamine assisted therapy methods to really figure out what works for you. I wholly believe that this is going to replace the majority of antidepressant use in the next twenty years.
The ramp-up to "I need to save this for extreme circumstances only" happened over about a couple months, during which I'd use it maybe once or twice a week. I didn't feel any particular longer-term boost attributable to it; it felt very much like just an acute treatment. Maybe I'm due for more experimentation, I'll keep your comment in mind the next time I'm anxious and feel like giving it a another try. Regardless, thanks for your comment.
It's different for everyone, it may be that it works better for my neurochemistry that it does for yours. And for what its worth its never really helped my anxiety, only the depression. You can also try doing it in a more clinical setting with a therapist, that makes a big difference for some people. It can allow you to work on deep-seated emotional issues in a very profound way.
Similar experience. I suffer from PTSD. A friend recommended ketamine therapy.
Ketamine hole is wild. The first time was the most intense and almost impossible to describe. I now understand what an "altered state" is really all about. It's like all of my senses were turned off, but my consciousness was fully present and I could think clearly. Even though I lost my senses, I could hear music more clearly than I ever could, it's like it permeated my whole being.
Later times are less intense, and a bit predictable, since my brain is more used to the altered state. I've gone probably 8 times in 2 years (6 in the first year, twice last year). It's pretty expensive, so unless you're getting real life-changing results I say it's fun to try but not necessary. It's a small reset of sorts. A nice pick me up.
The biggest upside is that it opens up a part of your mind you didn't know was there. Kinda gets the junk out of the way. I found it is a good place to contemplate things and think about bigger picture. The perspective I gained in my inner space I get to carry with me outside.
Every time I go the clinician asks me what is it that has brought me here. I tell them it's like deciding it's time to get a massage. You don't really need it, and will do just fine without it, but it's a nice thing to do for yourself from time to time.
Please do your own research before messing around with your head.
I only did it because it was in a controlled clinical environment, and my vitals were monitored the entire time. Early in the experience as my senses faded and I lost touch with my body I thought I might be dying. It's a ride, and it's not for everyone.
The tolerance runaway with Ketamine is legendary, and how people get addicted.
At some point, people have to give up "that first dose" effect and take what Ketamine does offer in the long term.
That's why doctors tend to lock the dose at one single point. This is what happens with nearly any drug like this, but Ketamine is certainly severely strong in this aspect.
> At some point, people have to give up "that first dose" effect and take what Ketamine does offer in the long term.
Yeah, I was quite sad that I could never quite achieve the bliss of that first dose again. If I didn't have things going on in my external life right now to keep me busy, I definitely would have chased that bliss to a dangerous degree.
> That's why doctors tend to lock the dose at one single point. This is what happens with nearly any drug like this, but Ketamine is certainly severely strong in this aspect.
Do you happen to know what that dose is (or could point me at a paper/some other reputable source that states it)? Would love more information on being able to dose myself responsibly.
> Let's not have another opioid crisis please.
For sure - hence why I stopped using it once I became uncomfortable with how my body was responding to it (or rather - not responding to it).
Ketamine builds up a tolerance in a way that feels not like other drugs. The tolerance is sticky. The tolerance does fade overtime. What it's really good for is catching yourself and setting up better habits so hopefully your next. Ketamine shouldn't be used regularly as it does cause bladder damage.
Personally I'm interested in them exploring analogs of Ketamine in depression treatment. Ketamine is not particularly manic especially when compared to some of the others in its family. That may be helpful in some cases, but not others. There is at least one that doesn't seem to have the holing/disconnected effects but does seem to have some of the antidepressant ones at least from what I've seen. The smaller doses of a lot of them (ketamine is much less potent than DCK, or 3meopce).
This is a very suspicious statement for anyone unfamiliar with ketamine and it is exactly the type of text one would expect from a pharmaceutical company.
It is also coming from a throwaway account, so please take "the same dose was less effective" with a grain of salt.
I know many people with depression and anxiety that used ketamine and never experienced this type of response: extremely limited use and immediate reduction in effectiveness.
I don't buy it.
Edit:
Initial studies show even microdoses of ketamine can cause immediate and lasting (+2 weeks) reduction in depression and anxiety. One should not be going into a "k hole" which is regarded as somewhat of an overdose even to partiers
I disagree. The above is actually a (perhaps unwitting) story of what to avoid in ketamine treatment.
My experience is that I dislike the feeling of ketamine high, and I use a small dose fortnightly. If I go longer than that, the depression and suicidal ideation return. I use a small enough dose that I do not feel the immediate effect. It takes a day or three before I experience a reduction in depression and suicidal ideation, but after that, the part of my brain that says "kill yourself" every few minutes goes completely silent.
I also know people who seek out the k-hole and have built up ridiculous (and very expensive) tolerance to the drug. Their stories are very similar to GP. To be avoided.
I dunno what to tell you. I will say that I have also been prescribed multiple antidepressants (Sertraline, Lexapro, fluoxetine, wellbutrin) and I stopped them all because I hated the side effects, so pharmaceutical companies haven't been any help to me either. That's why I was so initially interested in the potential in ketamine as a treatment. If it works for you, more power to ya. I have a friend who goes in for regular infusions and says it's better than any antidepressant she's ever been prescribed.
Ketamine not only saved my life, it saved my marriage, and my job. I had a mental breakdown. Went catatonic while at work from life/work stress and 13 years of 80 hour weeks. I was able to take a six month leave from work, and had been on all different anti-depressants/anti-anxiety meds for 10 years. A mix of ketamine, time away from work, and therapy quite literally saved me. It's crucial to understand that everyone's mileage may vary, as with every medication/treatment.
You’re making unsupported assertions. It is unclear how dose-dependent the therapeutic effects are. I definitely haven’t seen anything to suggest that microdoses can work as well as larger doses.
Timmy Davis is not an alcoholic. But like many twenty-something students, he's worried he may be drinking too much.
And cutting down isn't easy. The feel-good memory associations that our minds create – between the sight of a cold pint of beer and pleasure, for instance – lead to the cravings that sustain addictive behaviour, and cause us to relapse.
Dr. Ravi Das is a neuropsychopharmacologist at University College London whose research explores whether we can intervene in addiction by weakening those memories. His latest experiment theorises that ketamine – a controlled drug notorious for its recreational use (to attain a state of intense dissociation and incapacitation described as a 'K-hole') – may have the makings of the elusive 'forgetting pill' – a drug that, administered under correct clinical conditions, can weaken specific memories safely.
Timmy has volunteered for Dr. Das' latest experiment, in which 90 volunteers will receive a ketamine infusion in a controlled setting. Timmy is no stranger to psychedelics. But could a drug he has previously encountered recreationally really help him cut down his drinking?
High Society is a VICE documentary series about drugs in the UK.
I've been taking doctor prescribed ketamine at home for several years now for depression. It has worked reasonably well. One downside is that I need to take it at night so it doesn't effect work performance. And often there is a bit of a hangover the next day.
It is an amazing tool that I think is going to help power the next generation of antidepressant treatments. Hopefully the more "traditional" racemic Ketamine does not get covered up as much by more expensive and less effective (but insurance-profitable treatments) like esketamine (which is simply one half of the racemic mix, just patented).
I don't believe that co-Ketamine therapy modalities have been developed well enough either, I think for certain traditionally treatment-resistant clusters of symptoms (like cPTSD, for example), it could be significantly helpful due to some of the properties it has compared to other treatments. Just that not all of those properties are going to be best utilized by a general population on a disorder taking a prescription alone.
It truly is an exciting frontier. (Among other reasons for commenting, I'm very excited about psycopharmacotherapeutics in general as an autism spectrum disorder special interest <3 :)))) )
I'm very thankful we have more options. And there was even a study in recent years by John Krystal on combining another drug with ketamine to increase remission time.
But we aren't learning anything from these trials about the nature of depression. They can't tell us anything about the non-responders.
That's because depression is (as best as I believe) a low dimensional projection of a high dimensional issue.
It's like saying "we aren't learning more about fever from acetaminophen" (or ibuprofen, for example). Of course we aren't! It's a symptom of something else. Depression (I personally believe) is never a standalone syndrome. Ever. Not unless something is wacked out crazy physiologically, in which case for those cases at least you should see a near 0% success rate for talk therapy, I believe (barring a few minor exceptions, perhaps).
Depression can often come from a variety of confounding factors, but the nigh-monotropic tendencies of the field to focus on a singular cause is how we end up with a series of medications where four rounds of different adaptive, extremely well funded and supported antidepressant therapies ended up in an extended remission rate of only ~25% or so. 25%.
I do, oddly enough, disagree that they can't tell us about non responders as the overtly psychedelic nature of the compound does leak information about the underlying system (s) at play. But I think with this reductive approach that many of us (almost necessarily have due to resource constraints) use when trying to tackle the issue, we're going to miss the bigger side of the issue.
On the plus side, in some trials, Ketamine is showing an efficacy of ~%69 or so, or so I've heard, which is quite good. One provider that I've heard about seems to note good long-term results in patients who are initially resistant, which could be for a variety of factors, some of those including simply extremely hardened belief systems that are less game-theoretically compatible with a smooth(er/ish) transition to a less tense-with-the-world strategy set.
K-holing can be a horrid idea on a home-dose of Ketamine due to the death spiral of tolerance that ensues. That's what causes the feedback loop of psychological addiction that brings some of the opioid addiction-like horror to the table for this particular treatment, and one of the things I think that could be used to (wrongly, and unethically by some potentially unscrupulous lawmakers of any political dimension) shut it down in the future if too many people began abusing that.
Have you ever tried pot or mushrooms? They both could help for depression like Ketamine does but any of the effects will be long done by the morning for you.
In my personal experience marijuana only makes depression worse. It can make it more bearable in the moment and treat minor anhedonia, but at least for me it only bolsters my unhealthy habits which in turn makes the depression worse. I don't think there's any evidence that it can lead to long term remission. It's the neuroplasticity provided by psilocybin and ketamine that really helps.
I think psilocybin is promising, but doing it when you're depressed can put you in terrifyingly bad places. I think in the long term psilocybin and ketamine will both end up being valuable tools in combating treatment resistant depression. My guess would be that psilocybin will be used more in clinical settings with a guide and ketamine will be something you can do at home and talk about with a therapist later.
Doctor prescribed Ketamine is legal, whereas marijuana/hemp and psilocybin do not enjoy the same legal status. Though hopefully strong at-home 5HT2A agonists will see more at-home encouragement and legalization along with good spiritual guidelines for spiritual journeywork in the future. It's a promising avenue.
Additionally, Ketamine works along different modalities so it can cover avenues that the previous two cannot. I find the pain relief avenue of action in contrast to the two mentioned above to personally be quite fascinating and I believe underutilized within the current field of research.
I tried truffles. It didn't do anything for me in terms of antidepressant effect. I also tried one of the marijuana variants. Delta 8 or whatever. Gave me a huge amount of paranoia.
Honestly, ketamine is really smooth in lozenge form. The come up and down are pretty nice. If more marijuana users knew about this I have a feeling they would switch. But there is an effect on sleep and you feel a little lethargic the next day.
A 2.5mg/kg dose would be (extrapolating linearly) like a ~200mg dose for a 65-70kg adult. That's wayyy more that most casual users take, probably enough to induce a "k-hole" in the majority of people. Would be a curious to see results for a more realistic dose. Maybe extrapolating linearly is not appropriate however, not a pharmacology expert...
(And good point on the K-hole, in completely naive users my understanding is that this would likely induce a K-hole under IV conditions, but also we have to remember there are dose curve spike flattenings that happen depending upon dosing delivery methods due to transporter saturation, for example, etc as well....)
My wife takes ketamine troches as an adjunct to another antidepressant she is on. She needs to ramp down off that older antidepressant before she starts a new one and the ketamine helps keep depression at bay while she ramps down her dose.
My wife is 5'7" (170cm) and weighs 125 lbs (57kg), and takes 150mg five nights a week. That is about 2.6mg/kg. When she first started taking it the only side effect was on occasion she'd get double vision. Twice in a year she has had a night where it hits hard and she needs me to set with her because the disassociative aspect is unsettling to her. 99% of the time, though, she said it is like being mildly drunk, like after a glass of wine or two, nowhere near k-hole territory.
She has no other experience (recreational or therapeutically) with psychedelics/disassociatives. Perhaps the antidepressant she is taking dampens the effect of the ketamine.
All in all, she is glad to have the antidepressants, but there has been no silver bullet. It is always lurking just below the surface and she is constantly aware/afraid that it will resurface in full force.
Five nights a week is quite a lot, she may have some strong tolerance as well. It's a semi-low to moderate dose for pain patients I believe IIRC just a higher dosing rate compared to the median rates that I commonly see.
There is some promise with NAC and the bladder nightmare that can happen, but yes agreed, those bladder problems can be heinous, and accepting a mildly reduced efficacy in the short term for the trade of being able to maintain this longer term is the risk argument that I think I'd be making here. <3 :))))
It is a doctor's prescription. You might say that the frequent use has increased her tolerance, but she had no other effects even at the start (other than occasional double vision).
I wouldn't really honestly recommend it like that, there are too many asterisks to say 'PSA ket should probably not be taken orally '
Oral has the least bioavailability, but unless one is taking dangerous doses what I've heard is it doesn't likely matter. People will lose so much more in the dosing runaway spiral than from administration method -- you're going to reach a stable point either way if you're holding a certain dose, I believe. I've heard oral is less than ideal for trying to maximize dose response time and efficiency for amount-taken, but IM for example even far outstrips oral or nasal (once again, as implied earlier, I only recommend and advocate for appropriately medically prescribed and dosed Ketamine.
Edit: also a bit of a wtf after the fact but who the heck is taking Ketamine subcutaneously? On first blush, that sounds certainly nightmarish compared to any of the other injection methods.
> Also PSA ket should probably not be taken orally as it will damage your bladder (it always does but I think oral ingestion is worse for this)
I'd like some data to support this.
My understanding is you're going to pee it out (or pee out the waste products from it) one way or another. Oral dosage lasts longer, so theoretically the time it spends entering your bladder is longer, but I don't see why it would be that much of a difference.
The main issue with oral usage is that it's much weaker, you need to take much more for similar effects.
But insufflation damages your nose and sense of smell, so oral is my preferred method.
I've never heard of taking it subcutaneously. I'd plug it long before I'd try that
"Ketamine transiently increased the power of baseline beta/gamma oscillations and decreased sensory-induced beta/gamma oscillations."
"In addition, it disrupted information transferability in both the somatosensory thalamus and the related cortex and decreased the sensory-induced thalamocortical connectivity in the broadband gamma range"
Too dumb to understand, but I'm interested in therapeutic effects of ketamine. Is this good or bad?
From the conclusion:
*Because of their spatio-temporal structure and stereotyped pattern, sensory-evoked and induced gamma oscillations represent potential reliable and suitable variables for the development of innovative therapies preventing the psychotic transition.*
Ketamine is often used as what's called a psychotomimetic to mimic the effects of schizophrenia in drug models of the disorder, so while technically maybe, the answer is "probably not". You generally don't want to add the drug used to model a disorder in the normal population to someone already having that disorder (unless we're wanting to do something like Xtreme Homeopathy: Lab Edition™ or something like that lol.)
That's why it's shocking and exciting to see it be used to successfully treat depression, a chemical where very much the dose makes the poison I suppose
It's more of a purely mechanistic paper I believe, analogous to something like "transfer case wear patterns over 200k miles of normal passenger traffic shows shearing force of XYZ according to this nonlinear graph (which might imply ABC breakages, etc.)".
Which therapeutic effects are you interested in? I'm not a doctor but could point out some potentially helpful information, depending.
Thanks for offering, more looking for a dumbed down version of this paper. I can't understand what the figures in the article represent our communicate.
Just pointing to my previous comment in the chain, specifically: I don't think one could reasonably simplify the content of this paper in a way that you'd find interesting for what you're looking for.
I have depression and anxiety, so it wasn't long before something else, less severe this time, set me on another spiral and I decided to address it with ketamine again. I found that the same dose was now less effective at quieting the anxiety. As I continued to experiment with ketamine as a potential anti-depressant and anti-anxiety drug, I found that I was building up a tolerance alarmingly quickly. Doses that would put others in a k-hole would leave me still very much able to feel my panic and anxiety. Realizing that, I decided to stop using it before the ratchet of tolerance turned too far. I still keep some ketamine in the house, but with the personal rule of "only reach for this if you'd otherwise be reaching for a gun."
My personal hypothesis is that whatever chemical difference makes my brain more depressed and anxious than a typical person is also making me more resistant to ketamine, though of course I have no science to back this up. (If you do, please link me!) I'm grateful that I don't have a very addictive personality - I know many people who have made a regular habit of it.
There isn't much point to this post other than to share my personal experiences with ketamine. I'd love to hear the experiences of others with it. I think it has an incredible potential as an acute anti-depressant/anti-anxiety medication, but would love to see more studies on it, particularly on how it affects the neurodivergent.