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Positivenegative

Had my first Ketamine treatment today

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39 minutes ago, standup said:

I totally understand where you're coming from. Ketamine will also be my last resort because my doctor is giving up on me. But what if it doesn't work? I will probably feel hopeless again too. But then, I will just have to try ECT and/or get a new doctor who will actually try. I still have never even tried an MAOI.

Does anyone still use MAOIs?  Successfully? 

I've never tried them either - psychs don't even seem to consider them most of the time.  Or Tricyclics.  And maybe for good reasons.

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1 hour ago, gandolfication said:

Does anyone still use MAOIs?  Successfully? 

I've never tried them either - psychs don't even seem to consider them most of the time.  Or Tricyclics.  And maybe for good reasons.

Yes, people still use things like Emsam/ selegiline, Parnate, etc, successfully. A lot of doctors are hesitant to prescribe them because of dietary restrictions but sometimes they work for treatment-resistant patients better than anything else. Often, this comes after years of failed attempts with the new generation of antidepressants - SSRI's, etc. For example, selegiline partially metabolizes (a very small amount) into an amphetamine, thus it can give people energy where SSRI's make them tired. I think all treatment-resistant types should at least give it a shot. I'm willing to try anything at this point - ketamine is the next thing on my agenda.

Here's an article (by psychiatrists) about MAOI's and treatment.

"In our experience, MAOIs succeed in at least one-half the depressed patients who have failed on other antidepressants, and they are highly useful in treatment-resistant depressions and related disorders. Further, hypertensive crises are rare, and dietary restrictions are often exaggerated."

http://www.mdedge.com/currentpsychiatry/article/66132/depression/mao-inhibitors-option-worth-trying-treatment-resistant

 

Edited by standup

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By the way, people take selegiline (in countries where you don't need a prescription) simply as a nootropic. It's also an anti-Parkinson's drug. It is neuroprotective and can create neurogenesis.

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12 minutes ago, Positivenegative said:

Well, didn't work. I went today and the doctor discontinued the infusions because my body is too sensitive. I'm proud of myself for trying but extremely disappointed. Now what? I can't even think. I'm so sad about this. 

Im sorry to hear about this. I know what its like to put all your hope into something  and then to be let down its so disheartening Ive had it happen to me and its awful. Dont get down on yourself.You are so brave to even be trying. There are many different medications coming out very soon and Im sure there are combination meds that might be helpfull in the meantime. Also at the very least in the next few days youll start feeling better and you ll get back to your baseline pre-ketamine. Also you still may be a responder and could see a noticeable positive shift in mood in the next two weeks or so. Its happened to a few people Ive read on the ketamine advocacy forum. If your someone whos sensitive to meds the treatment might have been alot to handle. Your body may just need a small timeout. Dont give up! 

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On 2/9/2017 at 10:11 AM, gandolfication said:

Does anyone still use MAOIs?  Successfully? 

I've never tried them either - psychs don't even seem to consider them most of the time.  Or Tricyclics.  And maybe for good reasons.

Just an FYI, I started  EMSAM a week ago.... still not sure if it is doing much, but am treatment resistant and doc wanted to give it a try.... the patch apparently helps with absorption, and decreasing food reactions. I will keep y'all posted... Best wishes to all!

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29 minutes ago, lex333 said:

Just an FYI, I started  EMSAM a week ago.... still not sure if it is doing much, but am treatment resistant and doc wanted to give it a try.... the patch apparently helps with absorption, and decreasing food reactions. I will keep y'all posted... Best wishes to all!

Thanks for sharing.  I hope I'll see you post again after it hopefully starts working.

I know almost nothing about MAOIs, but talked about them with the psychiatrist today as an option to try before ECT.  I don't really ever plan to try ECT.  I'd sooner try leaches.  ;(

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Update again....So turns out, ketamine withdrawals suck really bad and eventhough I stopped the infusions, it's still in my system and literally feels like I'm going to die. Also, now I want to die because I feel so disappointed that the ketamine didn't work. I mean, come on! I tried one of the more extreme treatments because nothing else works, and it made me feel even more like dying. As if that was possible. I am so jaded and cynical anyway, but now, why try anything? Really. Why try if trying makes me worse? I don't care that the next cure might be right around the corner. Because now, I probably won't even try anything for fear that it will make things worse. I suppose I'm just very angry and I know I'm allowed to feel that way. When do you just throw in the towel? I say, when nothing else works. And guess what, nothing works. 

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On 2/11/2017 at 11:24 PM, Positivenegative said:

Update again....So turns out, ketamine withdrawals suck really bad and eventhough I stopped the infusions, it's still in my system and literally feels like I'm going to die. Also, now I want to die because I feel so disappointed that the ketamine didn't work. I mean, come on! I tried one of the more extreme treatments because nothing else works, and it made me feel even more like dying. As if that was possible. I am so jaded and cynical anyway, but now, why try anything? Really. Why try if trying makes me worse? I don't care that the next cure might be right around the corner. Because now, I probably won't even try anything for fear that it will make things worse. I suppose I'm just very angry and I know I'm allowed to feel that way. When do you just throw in the towel? I say, when nothing else works. And guess what, nothing works. 

Positiveandnegative,

I'm very sorry to hear that.  I start Ketamine infusions tomorrow morning.  I had thought that short term and lower-dosage shouldn't have led to withdrawal.  However, that clinic certainly should be able to ameloriate the symptoms of withdrawal to at least alleviate them.  That may not help with the disappointment, which I certainly understand.  I've experienced that disappointment with TMS and virtually all other treatments, so most of us can relate there.  I would encourage you if you haven't, to contact that clinic - they should be able to help ease off if you are having withdrawal.  

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Hey gandolf, 

You're correct...Ketamine at such a low dose like this won't cause any problems for most people. I'm just extremely sensitive and everything causes me a problem. The doc said I was probably having an allergic reaction to one of the Ketamine metabolites. You should be fine and I really hope the infusions work for you!!!

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12 minutes ago, Positivenegative said:

Hey gandolf, 

You're correct...Ketamine at such a low dose like this won't cause any problems for most people. I'm just extremely sensitive and everything causes me a problem. The doc said I was probably having an allergic reaction to one of the Ketamine metabolites. You should be fine and I really hope the infusions work for you!!!

Just for the heck of it try some antihistamine. Like you I am sensitive to meds. I failed on Trintellix from what we believe is one of the metabolites or fillers, not the drug itself. I took children's Zyrtec with it and it cut the itching and over reacting way down without making me a zombie. It might work to help you while your body stabilizes again. 

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1 hour ago, Positivenegative said:

Hey gandolf, 

You're correct...Ketamine at such a low dose like this won't cause any problems for most people. I'm just extremely sensitive and everything causes me a problem. The doc said I was probably having an allergic reaction to one of the Ketamine metabolites. You should be fine and I really hope the infusions work for you!!!

Oh, I see.  (Maybe you'd mentioned that).

Well, I got the first infusion this morning.  I should clarify here, that I am getting a phase-3 FDA trial drug called Rapastinel (from Irish pharma, Allergan), which is modeled after Ketamine, but designed to take out the dissociative affect and I think some of the nausea.  Anyway, since this morning, I have felt nothing, which the doctor keeps telling me is normal and expected....that it can take 2-3 weeks at least.

I hope you can find something to to reduce the withdrawal symptoms or that they go away quickly.  Please know that you have done the right things trying all the things you've tried.  There are few things I know for sure about depression, but one I do is that when something doesn't work, it is not your fault.

Best to you

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On 2/10/2017 at 6:05 PM, lex333 said:

Just an FYI, I started  EMSAM a week ago.... still not sure if it is doing much, but am treatment resistant and doc wanted to give it a try.... the patch apparently helps with absorption, and decreasing food reactions. I will keep y'all posted... Best wishes to all!

How are you feeling on it?

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46 minutes ago, ladysmurf said:

How are you feeling on it?

Lex333, I had to look up EMSAM.  Hadn't heard of it.  On-label looks like for Parkinson's.  

Interesting.  I did an Androgen (testosterone) transdermal patch once.  Did nothing, except maybe help me work out a little harder....which adderall does and MJ does better.

Anyhow, I'm curious how this is working for you, if at all, also.  I am between Ketamine trials.  Currently on on something called Brintellix (Trintellix), phasing out Prozac.  Still have adderall and klonopin as needed, and MJ is honestly still the best acute relief agent.  I think I found a nearby dispensary where I can get the right type.

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Ladysmurf and Gandolfication,  Sorry that if has taken me awhile to provide an update on EMSAM. Unfortunately, I did not tolerate it very well--became increasingly anxious, caused night terrors and night sweats, and increased su i cidal thoughts. Had to come off it after about a week and a 1/2.  Now on a cocktail of 60mg of  Mirtazapine. 300 seroquel xr and 100 mg of regular seoquel, zolpidem for sleep, and 1 mg lorazepam twice a day for anxiety as needed. I am calmer and have less self-destructive thoughts. Wishing you both the best! 

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3 hours ago, lex333 said:

Ladysmurf and Gandolfication,  Sorry that if has taken me awhile to provide an update on EMSAM. Unfortunately, I did not tolerate it very well--became increasingly anxious, caused night terrors and night sweats, and increased su i cidal thoughts. Had to come off it after about a week and a 1/2.  Now on a cocktail of 60mg of  Mirtazapine. 300 seroquel xr and 100 mg of regular seoquel, zolpidem for sleep, and 1 mg lorazepam twice a day for anxiety as needed. I am calmer and have less self-destructive thoughts. Wishing you both the best! 

Ah, sorry.  These things are trial and error.  That's quite a cocktail of 'quels, and 'zapines etc., about half which I'm familiar with or have taken.  I guess I have 4-5 things altogether right now and I would take more of them too, but they rarely have done much for me.  My current regime really did undeniably help me go from barely or not being able to get out of bed to dramatically improving and ratcheting up energy and productivity.  I did a lot of quality work in the span of a month.  Which made it all the more perplexing when, I was still let go by a boss I now realize is just kind of a jerk who treats people transactionally in general.

Anyway, the calmness and reduced ideations and destructive thoughts sounds like progress in the right direction.  Hope it continues.

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Just thought I'd let you know that I had 6 ketamine infusions and they did nothing for me. Not sure where I go from here. I was kind of looking at that like it was my last good chance. I feel this depression is just inescapable. This is going to be a long road. 

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On 4/11/2017 at 8:03 PM, standup said:

Just thought I'd let you know that I had 6 ketamine infusions and they did nothing for me. Not sure where I go from here. I was kind of looking at that like it was my last good chance. I feel this depression is just inescapable. This is going to be a long road. 

Standup,

I'm very sorry to hear that.  Ug, that's discouraging.  I want to curse here, but am not supposed to in the open forum so won't.  I've had 5-6 fairly rough days myself, and am pretty far away from starting any next EsKetamine trial...and naturally any anecdotal point like this tends to confirm my own mostly resistant experience.

For me, seeing a Dr. and NP who really gave a care the past few months, and then the new meds regimen the past month or so, seems to have helped me a lot during this time period, although as the Dr. and I knew, the effect of adderall certainly wanes, and pretty quickly.  Nor is it all positive even at its best.

The reality of not working/earning income at all in the past few weeks is rapidly setting in.  For me, in my perhaps-sheltered life, it is one of the scariest things I know.  Anyway, I press on as well.

How goes your day right now when you read this?  It is always somehow affirming for me to get on DF here, which I haven't been much lately, even when I'm discussing with others like you, how sh*tty things seem to be going and feeling.

Cheers,

-g

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On 4/18/2017 at 2:29 PM, gandolfication said:

Standup,

I'm very sorry to hear that.  Ug, that's discouraging.  I want to curse here, but am not supposed to in the open forum so won't.  I've had 5-6 fairly rough days myself, and am pretty far away from starting any next EsKetamine trial...and naturally any anecdotal point like this tends to confirm my own mostly resistant experience.

For me, seeing a Dr. and NP who really gave a care the past few months, and then the new meds regimen the past month or so, seems to have helped me a lot during this time period, although as the Dr. and I knew, the effect of adderall certainly wanes, and pretty quickly.  Nor is it all positive even at its best.

The reality of not working/earning income at all in the past few weeks is rapidly setting in.  For me, in my perhaps-sheltered life, it is one of the scariest things I know.  Anyway, I press on as well.

How goes your day right now when you read this?  It is always somehow affirming for me to get on DF here, which I haven't been much lately, even when I'm discussing with others like you, how sh*tty things seem to be going and feeling.

Cheers,

-g

As I write this, I'm feeling OK-ish but only because I had some kratom left from Easter. Things continue to be bad enough that I need a crutch just to go through a few hours of holiday. The worst thing about it is, if I take something like kratom just to feel good enough to get through a holiday, I'm left with worsened depression and anxiety for 4-7 days. The point being, I can't escape. Now I'll be "punished" just for trying to feel normal. Just the idea of that is infuriating to me.

g, I know you can relate to this, but there are no episodes. It's just varying degrees shi**iness, for lack of a better term. There are no breaks. I try and try and try and nothing changes. This is why I don't feel the least bit bad for saying that I'd gladly trade for bipolar disorder, or anything else for that matter. While chronic, severe, treatment-resistant unipolar depressive disorder with GAD doesn't sound "sexy" or "exotic," I can't imagine anything worse. I don't mean to downplay anybody else's condition. My point is that I'd just like to have 5 ****ing minutes of normalcy in my life.

I've been denied disability several times, and I have a sneaking suspicion that I would be approved if my label was "bipolar" or "schizoaffective." I am as disabled as anyone.

I'm sorry, I'm just literally angry right now. I keep trying, but I feel powerless. I will keep going on for now, but I don't have years of this left in me. I just don't. But in the end, I will know I have tried everything. Nobody will be able to hold that against me. And if anyone I know dares to say that (in my case, specifically) suicide is a "selfish act," then they don't know what they're talking about. I could/ should have been gone five years ago but I'm still here. But one thing I can say with absolute certainty is that I DO NOT have another 10, 20, 30 or 40 years of this left in me.

Hopefully, my doctor can be bothered to prescribe me Cymbalta (long story) without giving me a completely illogical, unscientific excuse. Otherwise, I need to change doctors, which feels like a tall order in and of itself.

The next few days will be even more difficult than normal, and only because I dared to feel like a functioning human being. I'm sick of all of this.

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I'm genuinely amazed at how much suffering we can endure. It's pretty amazing. Completely f****d up but kind of amazing.

I feel for you guys. It sounds like every day is a battle. It is for me too. @gandolfication sounds like you're having at least some success with meds. That's good. What does your Naturopath do for you? Wonder if I should see one. @standup good luck for the next few days. They're going to be crazy rough for me as well. I've been trying Effexor the past few weeks and have realized that now at 150mg it does nothing for me but give me outrageous anxiety and deep dread and depression. I'm gonna drop the dose to a level where all it does for me is nothing at all, so I'll be merely a raw exposed nerve walking around, instead of a raw exposed nerve with a needle P**king it. But I know I still have a bunch of days ahead of me with this crap in my system. I better just strap in. 

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15 minutes ago, felix_a_cat said:

I'm genuinely amazed at how much suffering we can endure. It's pretty amazing. Completely f****d up but kind of amazing.

I feel for you guys. It sounds like every day is a battle. It is for me too. @gandolfication sounds like you're having at least some success with meds. That's good. What does your Naturopath do for you? Wonder if I should see one. @standup good luck for the next few days. They're going to be crazy rough for me as well. I've been trying Effexor the past few weeks and have realized that now at 150mg it does nothing for me but give me outrageous anxiety and deep dread and depression. I'm gonna drop the dose to a level where all it does for me is nothing at all, so I'll be merely a raw exposed nerve walking around, instead of a raw exposed nerve with a needle P**king it. But I know I still have a bunch of days ahead of me with this crap in my system. I better just strap in. 

These drugs are  medieval and not in a good way like MJ.

Yah, they've helped me recently, but even with that I have to reiterate my belief and experience that pharmaceutical antidepressants are primitive blunt tools and modern psychaitrists are the witchdoctors groping around in the dark.  I think the historical value of these dangerous and cost-benefit failing chemicals will be as a bridge, yielding some knowledge for future therapies that are actually effective.

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5 hours ago, standup said:

As I write this, I'm feeling OK-ish but only because I had some kratom left from Easter. Things continue to be bad enough that I need a crutch just to go through a few hours of holiday. The worst thing about it is, if I take something like kratom just to feel good enough to get through a holiday, I'm left with worsened depression and anxiety for 4-7 days. The point being, I can't escape. Now I'll be "punished" just for trying to feel normal. Just the idea of that is infuriating to me.

g, I know you can relate to this, but there are no episodes. It's just varying degrees shi**iness, for lack of a better term. There are no breaks. I try and try and try and nothing changes. This is why I don't feel the least bit bad for saying that I'd gladly trade for bipolar disorder, or anything else for that matter. While chronic, severe, treatment-resistant unipolar depressive disorder with GAD doesn't sound "sexy" or "exotic," I can't imagine anything worse. I don't mean to downplay anybody else's condition. My point is that I'd just like to have 5 ****ing minutes of normalcy in my life.

I've been denied disability several times, and I have a sneaking suspicion that I would be approved if my label was "bipolar" or "schizoaffective." I am as disabled as anyone.

I'm sorry, I'm just literally angry right now. I keep trying, but I feel powerless. I will keep going on for now, but I don't have years of this left in me. I just don't. But in the end, I will know I have tried everything. Nobody will be able to hold that against me. And if anyone I know dares to say that (in my case, specifically) suicide is a "selfish act," then they don't know what they're talking about. I could/ should have been gone five years ago but I'm still here. But one thing I can say with absolute certainty is that I DO NOT have another 10, 20, 30 or 40 years of this left in me.

Hopefully, my doctor can be bothered to prescribe me Cymbalta (long story) without giving me a completely illogical, unscientific excuse. Otherwise, I need to change doctors, which feels like a tall order in and of itself.

The next few days will be even more difficult than normal, and only because I dared to feel like a functioning human being. I'm sick of all of this.

Standup,

Yah, I know what you mean.  MDD (and GAD) are the worst.  I have 'em both.  I have had 2-3 periods of hypomania (mild mania) in the last 5-6 years, and I've probably always had a personality in some ways florid (dramatic and rather passionate I guess).  Does that make me "bi-polar"?  A number of doctors have disagreed or not known.  No question, if one was able to choose a variety of sever depression to have, you'd rather have bi-polar and specifically bi-polar II (mild/hypomania).  Mine have lasted just about a month or so, but holy sh*t, it was the best.  And I've learned mostly how to channel it and not let it become self-sabataging.  And by now, I've read too much and somewhat romanticized it a bit too much (though the rate of suicide is off the charts).

Anyway, you raise a very interesting point - it is the case that we and doctors look at these as a hierarchy of disease with MDD somehow being more benign (which is ridiculous), then bi-polar being next, and schizophrenia being a more severe impairment (which, I must admit I think as well).

I think these are probably base on current misunderstandings.

You won't get any guilt-lecture about suic ide from me.  Just hope that you hang around a while longer here with me.

Best,

-g

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Wow. I have never even heard of this. I just came across this site because I have very low testosterone and also suffer from depresssion and anxiety. I'm on many meds but nothing for the Low T yet. In my younger days (I am also an addict in recovery) we used to snort Ketamine (Special K) and I remember the effects very well. I'm sure this treatment is much different, but I didn't know it was a thing. I guess I will google it. Thanks and good luck

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PN - I know this is an older thread but I just found it.  my heart really goes out to you positivenegative how are you doing now? Your case of ketamine therapy for treatment resistant depression describes mine exactly but I didn't see anywhere on here if you  completed the six treatments? if you did mention it and I missed it I'm sorry -  I too thought I was completely untreatable -  it looked like the ketamine didn't work on me - I felt much worse before I felt better - I had all six treatments and had given up as a "non-responder" which made me feel even worse than when I began.  However after six treatments and a couple days later I started to notice the absence of something - I didn't feel euphoria or anything like that it was just the absence of my heavy heavy depression.   It was very slow and gradual and barely noticeable as this happened but it did happen.  I'm only a week out but I know now that there is hope -  I am ecstatic that there something out there that works on my brain to make the depression go away.   Just knowing that it's possible is wonderful .  I'm looking into ketamine nasal spray since I can no longer afford the IV treatments.     I'd love to hear how you are doing & more than happy to answer any questions you might have  about my own K treatments :) 

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