This was written a month after the treatment ended. I would love to hear how the author is doing now, because all of my research has conluded that this therapy -- while really powerful -- does not make a lasting and permanent change in your brain.
I would really like to give it a shot -- but for a couple thousand bucks for the initial series of treatments, I would hope that the change is more lasting.
I did six infusions at 1.25mg/kg (because I have a high tolerance to.. Everything it seems?) and it lasted a few weeks~a month and a half. I did another batch of sessions 3 months later and the results were the same. I now take it as an intranasal spray at a much lower dose every other day. It makes me mentally exhausted for a few hours afterwards, but at least it provides me some ease on the mental burden I have. I've been in psychotherapy twice a week for nearly ten years, tried literally every drug aside from classic MAOIs and ECT. I've debated TMS/rTMS, but I'm concerned about the memory loss that I've read about and heard first hand accounts of from friends in similar situations.
Obviously everyone is different and YMMV, but for me- ketamine has been the only thing that made a real impact, bonus was the lack of nasty antidepressant side effects (I'm still taking an SSRI, SNRI, and a mood stabilizer and I hate them).
I'm hopeful that some of the new ketamine+___ compounds being created to extend the duration of the 'depression slightly lifted' feeling are successful and come to trial soon.
Combination of Wellbutrin & Dextromethorphan -- which is a dissociative with some side-effects similar to Ketamine. It's in trial for severe depression treatment. 15mg of DXM (which you can buy at any drug store) combined with 150mg Wellbutrin (which you can get your dr. to prescribe to you.) Could be worth a try...
I'm actually on wellbutrin, double that dose though, and have done dxm a few times. It's... Different. Very similar in dissociation, but ketamine dissociation for me I can actually go in with planned introspection in mind while I lose all sense of self and become one with whatever music I'm listening to, but dxm just makes me 'out of it', if that makes any sense.
Certainly, I'm well aware of DXM's side-effects (at 'recreational' doses). The point of the trial is to use very low doses of it though, on a regular basis.
It's funny though, if I were to compare recreational DXM to Ketamine I would describe them exactly opposite as you did.
15mg of DXM (which you can buy at any drug store) combined with 150mg Wellbutrin (which you can get your dr. to prescribe to you.) Could be worth a try...
Out of curiosity, where did you get these dosage numbers from?
The linked wiki page doesn't mention dosage and the source on wikipedia is paywalled.
Have you tried or considered hallucinogens? I'm not suggesting that you do, just interested in your perspective considering how severe and long-lasting your depression seems to be.
I have, but I don't think I have the right mindset for tripping. Acid is totally out of the question for reasons related to an lsd abusing family member, but shrooms is still on the table
It holds for a few months. During that time you can get your shit together. Try to figure out what is triggering the depression and try to change that thing. If you fail you can just do it again.
To be fair, I would much rather have a ket party once in a while than be on amohetamines (Adderall) for the rest of my life; which is an accepted treatment for certain disabilities.
- It doesn't necessarily hold for a few months. For some people, it's not too much longer than an infusion session; for others, they might not even need the "booster" infusions some get.
- There's some patients for whom the "tolerance" for the antidepressant effect doesn't go away even after O(years) without taking it when it initially worked and then stopped, so you can't necessarily just do it again. (Source for this one is that it happened to me, and did not return while going as high a dose as the doctor was comfortable with.)
The issue with saying this is we should probably have many words for different types of depression.
Probably not only split on this one variate (externally or internally triggered), but it means that certain types of depression are usually triggered externally and certain types not externally.
It's like saying that "in some cases, a broken leg is not triggered by some external influence". Sure, you could develop some bone density issue and break a leg when walking normally, so we tend to distinguish treatment of these cases--we may recommend a more permanent solution for someone who is prone to breaking their leg.
How can we even falsify your statement? To do so would require self-reports or some sort of real-time 24/7 measurement of the brain, the first doesn't really falsify anything, and the second is not very viable at the present.
Self-reports can easily lie. They also may simply not remember, or be in denial.
The author's active on instagram (linked from their medium profile), and has more recent writing there. From that, it sounds like they don't feel as if they've regressed.
For example, on Nov 27th, they wrote '[this year] I successfully treated depression with Ketamine'.
It's possible that they're not talking candidly on the shorter-form of an instagram post, but it's at least a sign that maybe it stuck, otherwise that phrasing would probably be a bit less positive.
The entire first section of the article is about how good the author was at pretending to be happy. Since projecting a happy image is also the main point of Instagram for most people, I'd be hesitant to assume everything is fine based on a few posts.
Comments
This was written a month after the treatment ended. I would love to hear how the author is doing now, because all of my research has conluded that this therapy -- while really powerful -- does not make a lasting and permanent change in your brain.
I would really like to give it a shot -- but for a couple thousand bucks for the initial series of treatments, I would hope that the change is more lasting.
I did six infusions at 1.25mg/kg (because I have a high tolerance to.. Everything it seems?) and it lasted a few weeks~a month and a half. I did another batch of sessions 3 months later and the results were the same. I now take it as an intranasal spray at a much lower dose every other day. It makes me mentally exhausted for a few hours afterwards, but at least it provides me some ease on the mental burden I have. I've been in psychotherapy twice a week for nearly ten years, tried literally every drug aside from classic MAOIs and ECT. I've debated TMS/rTMS, but I'm concerned about the memory loss that I've read about and heard first hand accounts of from friends in similar situations.
Obviously everyone is different and YMMV, but for me- ketamine has been the only thing that made a real impact, bonus was the lack of nasty antidepressant side effects (I'm still taking an SSRI, SNRI, and a mood stabilizer and I hate them).
I'm hopeful that some of the new ketamine+___ compounds being created to extend the duration of the 'depression slightly lifted' feeling are successful and come to trial soon.
Last time this topic came up on HN this came up: https://en.wikipedia.org/wiki/Bupropion/dextromethorphan
Combination of Wellbutrin & Dextromethorphan -- which is a dissociative with some side-effects similar to Ketamine. It's in trial for severe depression treatment. 15mg of DXM (which you can buy at any drug store) combined with 150mg Wellbutrin (which you can get your dr. to prescribe to you.) Could be worth a try...
I'm actually on wellbutrin, double that dose though, and have done dxm a few times. It's... Different. Very similar in dissociation, but ketamine dissociation for me I can actually go in with planned introspection in mind while I lose all sense of self and become one with whatever music I'm listening to, but dxm just makes me 'out of it', if that makes any sense.
Certainly, I'm well aware of DXM's side-effects (at 'recreational' doses). The point of the trial is to use very low doses of it though, on a regular basis.
It's funny though, if I were to compare recreational DXM to Ketamine I would describe them exactly opposite as you did.
Out of curiosity, where did you get these dosage numbers from?
The linked wiki page doesn't mention dosage and the source on wikipedia is paywalled.
I'm trying to find where I read this last time this came up on HN. In the meantime, this presentation goes into more detail on the psychopharmacology: http://media.corporate-ir.net/media_files/IROL/25/254022/Psy...
EDIT: looks like it's 60mg of DM, which seems rather high.
Have you tried or considered hallucinogens? I'm not suggesting that you do, just interested in your perspective considering how severe and long-lasting your depression seems to be.
I have, but I don't think I have the right mindset for tripping. Acid is totally out of the question for reasons related to an lsd abusing family member, but shrooms is still on the table
Why do you say totally out of the question, is it basically a risk calculation?
Look up moclobemide if you are open to trying MAOIs instead of heavy SSRI/SNRI cocktails. IMHO reversible MAOIs are severely underrated.
This article from September suggests he still has depressive episodes: https://psiloveyou.xyz/depression-doesnt-ask-if-now-s-a-good...
It holds for a few months. During that time you can get your shit together. Try to figure out what is triggering the depression and try to change that thing. If you fail you can just do it again.
To be fair, I would much rather have a ket party once in a while than be on amohetamines (Adderall) for the rest of my life; which is an accepted treatment for certain disabilities.
Two remarks:
- It doesn't necessarily hold for a few months. For some people, it's not too much longer than an infusion session; for others, they might not even need the "booster" infusions some get.
- There's some patients for whom the "tolerance" for the antidepressant effect doesn't go away even after O(years) without taking it when it initially worked and then stopped, so you can't necessarily just do it again. (Source for this one is that it happened to me, and did not return while going as high a dose as the doctor was comfortable with.)
In many cases, depression is not triggered by some external influence.
The issue with saying this is we should probably have many words for different types of depression.
Probably not only split on this one variate (externally or internally triggered), but it means that certain types of depression are usually triggered externally and certain types not externally.
It's like saying that "in some cases, a broken leg is not triggered by some external influence". Sure, you could develop some bone density issue and break a leg when walking normally, so we tend to distinguish treatment of these cases--we may recommend a more permanent solution for someone who is prone to breaking their leg.
How can we even falsify your statement? To do so would require self-reports or some sort of real-time 24/7 measurement of the brain, the first doesn't really falsify anything, and the second is not very viable at the present.
Self-reports can easily lie. They also may simply not remember, or be in denial.
There is always an internal trigger.
The intersection between internal and external is not so clear.
What the ultimate cause is, who knows.
Is the idea of a ultimate cause is even a valid idea?
Personally I don't think so.
And the medical insurers and providers get to make hundreds of dollars for every $5 of ketamine dispensed, so it's win-win.
The author's active on instagram (linked from their medium profile), and has more recent writing there. From that, it sounds like they don't feel as if they've regressed.
For example, on Nov 27th, they wrote '[this year] I successfully treated depression with Ketamine'.
It's possible that they're not talking candidly on the shorter-form of an instagram post, but it's at least a sign that maybe it stuck, otherwise that phrasing would probably be a bit less positive.
Possible. However it is also possible that saying that would lead to less clicks on his instagram's donate link.
IMO there's a decent probability that's the reason... The treatments cost an arm, a leg, and one kidney.
Only via the licensed path. The amount of ketamine his blog post talks about him receiving actually costs less than $100.
Assuming he wasn't being dishonest in the discussion of his current financial state, this angle seems off the mark.
The entire first section of the article is about how good the author was at pretending to be happy. Since projecting a happy image is also the main point of Instagram for most people, I'd be hesitant to assume everything is fine based on a few posts.