Jump to content
afraidtolive

Esketamine...any news?

Recommended Posts

42 minutes ago, felix_a_cat said:

Oh man I'm sorry the Ketamine isn't working for you. What drag. Keep trying stuff I guess, right? That's all we can do.

I'm trying Effexor now after Lexapro didn't seem to cut it anymore. 2nd AD I've been on. Been 2 weeks now on Effexor, felt better at first but been in the dumps for a few days now hard. Been in the toilet of toilets for 4 relentless months now. Also have a consultation for an rTMS trial tomorrow. Standup have you heard of TMS? It's different from ECT and might work for you?

I am very skeptical of TMS. The success rate is about 30% and it's not covered by insurance. ECT has a success rate of about 75-80% and I think my insurance would cover it. I'm not worried about potential side effects. I think that's way overblown anyways. Modern ECT is done differently.

Try to stick with Effexor for a while. You might need to get up to 150-225 mg (some people go all the way up to 375). It could take 6 weeks or more for it to start working. If I recall correctly, it didn't fully kick in for me until after week 8.

Share this post


Link to post
Share on other sites

Yeah I agree about ECT - a little memory loss, who cares if it works. Same with sexual dysfunction of ADs... if they can make me not want to die I'll take whatever side effects you got.

TMS isn't covered here in Ontario either yet, but I'd be in a clinical trial so it'd be free.

Thanks for the encouragement regarding Effexor. I'm only at 75 now so who knows, with time and or a higher dose I could see some better effects.

If ketamine didn't work for you, I wonder if esketamine or rapastinel would. They're in trials.

Share this post


Link to post
Share on other sites
On 3/13/2017 at 12:49 PM, standup said:

You nailed it! That's the exact same thought I had about Esketamine....Why do we need Esketamine if plain old ketamine works? It all comes back to money. It's always about the money. It's bad enough that standard ketamine costs $600 per infusion at my local clinic (with an average of 6 infusions and the effects might only last for a couple months). I'm fortunate that my dad is willing to pay for it because he says that my mental health is priceless. I've been through a slew of medications and nothing works and now I'm almost out of hope. My next best option is ECT but, without going into detail, that's not practical for me right now. I need something and I need something fast because I've become obsessed with dying. Going into a hospital won't likely be helpful because they'll just change my medications to other medications that won't probably work and then I'll have to wait another 6-12 weeks just to find out they don't work. 

did it work? damn why is it so expensive? I can't afford it.

Share this post


Link to post
Share on other sites
22 hours ago, ladysmurf said:

did it work? damn why is it so expensive? I can't afford it.

Unfortunately, I was in the roughly 30% group who doesn't respond to it. Since then, I've tried other medications and nothing is working. I am desperate and generally don't have the will to live anymore....which is why I made the decision to get ECT. I'm actually going into the hospital later today (so I won't be able to respond to any messages after that).

Share this post


Link to post
Share on other sites
1 hour ago, standup said:

Unfortunately, I was in the roughly 30% group who doesn't respond to it. Since then, I've tried other medications and nothing is working. I am desperate and generally don't have the will to live anymore....which is why I made the decision to get ECT. I'm actually going into the hospital later today (so I won't be able to respond to any messages after that).

the only bad thing with ECT is the short memory loss. of course it varies with each person and what treatment they have bilateral or unilateral . but most insurances cover it. it does not help with anxiety as far as i know. it didn't help with mine.. it did help a bit with my depression, probably more than any medication ever did ..i hope it works for you!

Share this post


Link to post
Share on other sites
1 minute ago, ladysmurf said:

the only bad thing with ECT is the short memory loss. of course it varies with each person and what treatment they have bilateral or unilateral . but most insurances cover it. it does not help with anxiety as far as i know. it didn't help with mine.. it did help a bit with my depression, probably more than any medication ever did ..i hope it works for you!

Thanks ladysmurf. I'm aware of the possibility for some memory loss, but I'm willing to live with that. I really hope this is going to work.

Share this post


Link to post
Share on other sites
Just now, standup said:

Thanks ladysmurf. I'm aware of the possibility for some memory loss, but I'm willing to live with that. I really hope this is going to work.

I hope it does !!:hugs:

Share this post


Link to post
Share on other sites

Febuary 12 2019: The FDA panel overseeing Jannsen's work has endorsed Esketamine intranasal spray as a treatment for depression. According to news sources the FDA is expected to make a decision on approval by March 4.

Share this post


Link to post
Share on other sites

March 5: FDA approves esketamine intranasal spray. The drug will be named Spravato.

What's the differences between Ketamine and Esketamine?

Unlike Ketamine, esketamine is patented and owned by the company Jannsen, a Johnson & Johnson subsidiary. Ketamine has not been approved for use by the FDA for depression treatment but clinics have been using it as an off-label drug to treat MDD that's treatment-resistant for years.

How will patients get treatment?

Esketamine nasal spray will must be administered by a licensed clinic and patients will have to remain there for observation for 2 hrs after treatment. Clinics must be licensed or certified to administer the spray, Jannsen will provide training. It's unclear yet when patients will be able to take the nasal spray at home. Currently, patients who've been prescribed Ketamine intranasal spray can self-administered once proper dosage is determined. 

What will Spravato cost?

Because Spravato is FDA approved, insurance companies will cover at least some of the cost of treatment whereas Ketamine is not covered by most plans. The esketamine treatments are expensive. There is not yet a generic formulation so it's unclear what the bottom line will be for depression patients. Jannsen is betting big on this drug.

Why is this big news?

Ketamine and esketamine work completely differently than the antidepressants currently on the market. It works on glutamate receptors. If effective, it will represent the biggest breakthrough in psychiatric medicine in decades and potentially help the 1/4 to 1/3 of us who do not respond to SSRI, SNRI, NDRI, TCA, and other varieties of conventional antidepressant medications. 

Who can get this treatment?

The guideline says for a patient to be eligible for esketamine they must show resistance to two kinds of standard antidepressants. That's not a very high bar. It could even include patients who stopped taking a medication when it pooped out, we shall see. Also, not every psychiatrist and GP is super excited about this treatment and there are many who aren't ready to prescribe given that it us so different than other antidepressants

Why I'm interested?

I'm an MDD-TRD patient. I've been in an experimental Ketamine infusion program for about 18 months. It is the only drug that's ever been effective at relieving my symptoms and I get treatment once a month. I do not receive intranasal, I get intravenus via injector pump and I'm getting Ketamine not Sprovato. 

I am really excited that there's a chance for more of us to receive a new treatment for depression - but I'm cautiously optimistic, given that the cost of it hasn't been established. We know pharmaceutical companies want to make their money back from what they invested in R&D. On the other hand, I doubt that Jannsen would've invested so much into Sprovato if they weren't convinced of the potential of this treatment. 

Outside the US

Jannsen applied for a license to market Sprovato from the European Medicines Agency last year. I imagine that a thumbs up from the US FDA is going to help their application along. Some doctors in the UK are voicing reluctance given how there isn't a protocol or standard by which patients are determined eligible and the presence of this new drug represents a disruption of accepted norms. 

There is just one clinic in England that's offering Ketamine treatments (in Oxford, the treatment isn't covered by NHS it's private-only) which is relevant because a lot of doctors aren't familiar with the mechanism by which Esketamine or Ketamine are said to work on depression. 

 

We shall see in the weeks to follow how Sprovato will be rolled out. It's certainly exciting news that there's a novel treatment for serious depression, it's been decades since the last.

If you have questions about the treatment and how it's going for me, feel free to PM me. 

Share this post


Link to post
Share on other sites
On 4/4/2017 at 5:09 PM, standup said:

I did 5 treatments. I have a 6th scheduled for tomorrow, but I'm thinking of cancelling because the odds at this point are slim to none.

I think my hope in any substances is close to zero. I feel like I've tried a million different things. I'm not sure what I'm going to do now. I actually think switching from Effexor (worked at one time but not working anymore) to Cymbalta would be the logical next step, but my doctor is too stupid to figure that out. I've suggested it at least 3 times. 

i thought you had to do 8?

Share this post


Link to post
Share on other sites
On 3/23/2019 at 2:10 PM, ladysmurf said:

i thought you had to do 8?

I think I ended up doing 7 ketamine infusions.

edit: and since that time, I had 12 bilateral ECT treatments, and not even that worked. I'm currently trying Latuda and hoping beyond hope that that helps. 

Edited by standup

Share this post


Link to post
Share on other sites

Johnson & Johnson will get even richer with this drug even though it's just an analogue of something that already existed. I doubt they really spent that much money to develop this, but they're certainly not going to pass on their savings to the depressed consumer who's dying inside and looking for any way to escape.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×
×
  • Create New...