Ketamine infusion therapy

[Rainman8772]

Joey I may ask why the doc is doing rapamycin when it counteracts the anti-depressant effects of ketamine and ask for tramadol that enhances them. Here is the nih study on it.

Rapamycin blocks the antidepressant effect of ketamine in task-dependent manner - PubMed

OBX animals significantly differed from sham controls in most of the tests used. Treatment had more profound effect on OBX phenotype than controls. Pretreatment with rapamycin eliminated the anxiolytic and antidepressant effects of ketamine in task-dependent manner. The results indicate that...

pubmed.ncbi.nlm.nih.gov

 

[joeylittle]

Joey I may ask why the doc is doing rapamycin when it counteracts the anti-depressant effects of ketamine

Yep. It does that - in the short term. What has also emerged in more recent ketamine research is that rapamycin has the ability to extend the anti-depressant effect over a longer period of time. You basically sacrifice some immediate benefits in exchange for a longer-lasting lift, overall.

So rapamycin....

We decided to try it because it has shown to make a real difference in terms of the lasting positive effect of the ketamine. People who were responders (like me), but having only a transient benefit (like me), reported that - for over half of those in the study - there was a noticeable extension on the length of time they could take between infusions. So, we tried it on the off chance that it would have the same benefit for me, and somehow make the ketamine work better overall.

Like @Rainman8772 's link shows, the first thing that happens with rapamycin is a perceptible 'dip' in effectiveness. This was also a noticeable mind-f*ck for me, as I had just started to get used to the fact that I'd feel a little better following the infusion...and now, I felt - if anything - worse, for about five days.

Then, there was a pretty steep ramp up, it only took about 18 hours to pull up out of the 'dip'. And, I did find that I wasn't falling off of the positive effects as quickly as I had in the non-rapamycin sequence.

Another interesting effect, and there's nothing really solid on this, though it jives with how the molecules interact - when dosing ketamine with rapamycin, the dissociative experience is far less hallucinogenic. Way less vivid. Still out-of-body, still weird - but less of a feeling of a trip, and more like just floating in space.

And, not gonna lie - it sucks to be taking an immunosuppressant (rapamycin) in the middle of a pandemic. That's not especially pleasant. It's a single dose, but it's the induction dose, so it's fairly high. Takes about 48 hours to clear, so just requires being extra-aware of not exposing myself to shit unnecessarily.

So, I'll be doing one more infusion two weeks from now with rapamycin, and then will give just straight ketamine a try again, and see if I get this same "boost" from having done the rapamycin. that some others in a study got.

 

[lostforgottensoul]

The pastor I see weekly and email pretty much daily mentioned Ketamine yesterday. His childhood friend's wife has PTSD from childhood sexual abuse and she has Ketamine infusions and he reports that its made a huge difference that not only does she report but he can see.

I asked what it really does and he said, from what he was told by her, is it causes a disconnect from the trauma. Like you are seeing it from a 3rd party perspective. But I've been diagnosed with OSDD. My brain already does that. I have alters that move around in my brain and I already experience a 3rd party separation from my trauma. It's sort of a protective thing that my brain does.

I'm going to bring it up to my therapist to see if he thinks it will help. But I'm curious, what does this really do? Like how does it help with PTSD? I've tried to look it up and not had much success with finding out what this actually does. I have experience with hallucinogen from my trauma. They would give me drugs. I think one of them was extacy and the other was some sort of hallucinogen. So, not sure this would be a good idea for me but was curious what others think and if there is anything I can read about how it works for PTSD and what it actually does. I may just be googling wrong. Just can't find much about how it works.

 

[joeylittle]

I'm going to bring it up to my therapist to see if he thinks it will help. But I'm curious, what does this really do? Like how does it help with PTSD?

It helps with PTSD when it's executed fairly low-dose and used during active trauma processing. The dissociation isn't the same as maladaptive dissociation, as with a dissociative disorder; instead, the overall feeling of wellness/safety that comes along with Ketamine serves to help diminish or ward off entirely the negative emotional experience that comes along with any kind of narrative trauma processing.

Or, when it's used in a depression-treatment protocol (which is a sit-down, no-talking 45-60 minute session) it's helping an underlying depressive disorder that the PTSD patient might have.

the other was some sort of hallucinogen. So, not sure this would be a good idea for me

Ketamine is often compared to hallucinogens, but it's not one - it's a type of drug known as a hypnotic.

Infusions aren't cheap, and they aren't covered by insurance. There's a nasal spray that is now covered by some insurances, and that's easier to work with in conjunction with talk therapy, though the nasal spray is still rather highly regulated, and has to be administered by an MD (I believe).

 

[lostforgottensoul]

Thanks for all the info @joeylittle! Definitely helps!

 

[Ziza]

Well....I'm trying ketamine infusion, for depression. Specifically, treatment-resistant (refractory) Major Depressive Disorder with dysthymia.

About...two years ago, now - my psych prescribed me a ketamine intranasal spray, to give it a go and see if it helped with suicidal ideation and overall mood. It did help some with the former, but not the latter. And, at that time it wasn't practical for me to pursue intravenous ketamine. So - I retained an as-needed option for a ketamine spray when my suicidal thinking got particularly difficult, and that was that.

I went back to TMS, which always helps a bit - but it doesn't really make a big enough dent.

With the pandemic still keeping me rooted to one city - normally I'd travel for work - I've got some time where my local job is a little less intense, and I'm just here in one place....so, psych and I decided it was worth a try.

The protocol is for two infusions per week, three to four weeks. I have them done at a clinic where they can check blood pressure, monitor heart rate, and be there in case I have a bad reaction.

Today was my first day. The doctor administering it was pretty clear about what the goal was, in terms of level of dissociated state - and also, that she would start today by underusing me slightly, to see how it hit me and adjust up from there.

The infusion itself lasts 45 minutes; then, this clinic has you stay in the prone position still running saline for another 10 minutes before you can start getting up again. That apparently helps with the re-connecting to reality part of it. They kept me for another 30 minutes after that, just to watch me and make sure all was well.

Something I didn't know - they do want the patient to get to the point where they are lightly hallucinating and feeling out-of-body. It was interesting...I don't have a lot of experience with hallucinogenics in general. Today, I definitely went out-of-body, lost all sense of time and location, and had the strange feeling that there was some brightness just around the corner of my mostly black with some purple field of vision (this is all done with an eye mask on, so we're talking mental field of vision)...so it was slightly trippy, but not as trippy as it needs to be, so says the Dr.

I wasn't sure how PTSD-me would react, but so far, so good. I did a lot of advance prep, just to get into a leveled out, relaxed frame of mind.

I'll report back on the experience overall...if this ends up even doing a little bit of good, I'll benefit a lot. And once we've gotten through the basic mood disorder protocol, there's a good chance I'll carry on with it for a few more sessions of guided psychotherapy, to work on some of the more difficult parts of that. But - one thing at a time....

Happy to answer questions.

Hi,

Thank you for sharing your experience. I was wondering how it all worked out for you? I'm thinking about starting this therapy also.

 

[PlainJane]

Any updates you’re comfortable with sharing? I’m interested to know it’s going.

 

[Agita Kaput]

I did the injections at The Ketemine KarWash (subsidiary of Kwiky Mart Ketemin) meaning... the clinic had no "prep" besides "what Insurance do you have" and "your life is about to change!" (Hearing that, I fixed her with a steely glare and hissed... "don't ever say that again." Really - I ain't buyin' )

Truth be told - ketemine hit me like a 2x4 hits a piñata... in a good way. That's the big picture. Here's the detail...

There are 2 schools of thought;
A. The molecule's the thing.
B. The experience is the thing.

So... I'm going with door B. Covers both bases. Ketamine is interesting. It acts like a completely different drug (experientially) at different doses. At the lower doses (they start u here) it's like ecstasy. I asked the clinician if she would marry me. Really, I did. She didn't say yes. (She didn't say no either. I'm not bad looking and I told her I had a fat 401k and envisioned us on an island in the pacific 🤷‍♂️)

A middle dose is a bit trippy. I think thats why they have the a projector making stars on the drop ceiling and nature type scenes on a big TV (above the plastic plants.) All easily digested distraction / disguise for those not really interested in experiences... "What the hell was THAT?" "Oh. That was just the TV/star projector ambiance thing sir... it happens"

And then there's a dissociative dose. This is where the B. people want you to go. (The A. clinics probably stop at trippy. I wouldn't know... I was with B. people).

And THEN... there is the K-hole. I had done my homework, had two sessions left, and was not convinced I had taken this as far as possible. Depression wise, I cant lose - right? So... I keep telling them to crank it up. Im no stranger to substances and I'm in a (somewhat) supervised setting. I wanted to see where this could go... 😳. but that's another story.

The piñata. There was still some depression. Its not a miracle cure. Its not like getting the perfect SSRI or tranquilizer dialed in. But my cognitions got shaken up. The needle jumped out of the groove. Little bite sized pieces of me... are all over the lawn (parking lot - whatever.)

Now this may all be just coincidental, but in the following few months...

I discovered cPtsd and that I matched EACH criteria. Except social disfunction. I love being with people... I got game. The fact that I haven't been out of my house in 3 years hasn't changed that. I can banter with the trash guy or the mail guy all day.

I've tossed the rest of my diagnosis in the trash. Pete Walker says if cPtsd was completely recognized, the DSM would be a small pamphlet. I agree.

I discovered that Mom wasn't just a borderline... she was a malignant (sadistic) narcissist.

I found Dick Schwartz, IFS and the framework and capability to conceptualize humans (mom, me, the X) In multidimensional ways... ie; accurately, without irreconcilable observations.

Previously resistant to join a club of the traumatized ( Im aware of the kind of things that go on in this world and most of them didn't happen to me) Im now thinking 15 years of being molded by a sadist gets me a membership card. I now see, why I was in a cult, why I married a narcissist, why I was on family sized portions of psychotropics, why tomorrow morning I will be wailing and gnashing my teeth (post bible terms; flashback with a heaping side of NSSI) and why my new best friend is going to be this website.

Ketamine. Worth it? Depends what your looking for I guess.