There is a gigantic difference in patient outcome between clinical ketamine use and recreational ketamine use. For a variety of reasons: careful dose control, having an actual doctor involved, etc. But the biggest one is the antidepressant effects of ketamine only really happen when it's administered via IV drip over a course of 45 minutes. The most common use of recreational ketamine is inhaling it, the effects come up too fast and go away too fast for the antidepressive effects to occur.
> What is true about IV is you can control the amount that actually gets taken in much better.
I agree 100% with this. Furthermore, being able to carefully control the dose and duration is paramount in getting the effects to last as long as possible.
You do not build up a tolerance to ketamine if you follow the treatment protocol, which dictates a lower dose (around 100mg, give or take for body weight), and one infusion every 3-6 weeks.
Source: Been having regular infusions every 3-6 months for 3 years, and it still works for me.
I can't say this enough: experience & anecdotes based on recreational ketamine use /do not apply at all/ to clinical use.