> Ketamine's antidepressive effects are by far the most potent when ketamine is administered as an IV drip over a long period of time, like 40ish minutes. If you simply inject it all at once, you will definitely go to la la land, but the duration will be too short.
No one understands the exact mechanism of ketamine for depression even though there has been a lot of research and speculation on this topic. Therefore, you can't say which ROA is best for patients or if one works better than another.
Furthermore, all studies have been small and short in duration so there's no statistical significance to the fact that the IV ROA is used more in studies. If IV was the only route that worked it would be the first anti-depressant with that designation. Because of the cost of infusions patients are right to be skeptical about doctors that are running clinics.
> In short, I see the ratio of risk to effectiveness for home use ketamine to be emphatically not worth it. Unless you have a partner / friend who has the necessary training.
My doctor has clinical experience with ketamine and about 2+ years of prescribing patients with TRD with sublingual ketamine that is taken at home. Ketamine is an incredibly safe drug and nothing about his practice has changed. His insurance has even stayed the same. I know that’s a common justification for high prices from docs that run IV clinics.
The reason I’m not going anonymous on this is because I feel passionately that we need to stem the tide of shady ketamine doctors that don’t give a shit about patients. When I asked my doctor why he wouldn’t charge me a lot of money (he could!) for the treatment he asked me, “Would I charge you a lot for Lexapro because it works?” Good point.
See this book for background on Ketamine and the studies completed:
Ketamine for Treatment-Resistant Depression: The First Decade of Progress (2016)
I agree with you that what works best for some may not work the best for others. I disagree that doctors who charge a few hundred bucks for this "don't give a shit" about their patients. I also know that, from personal experience, sublingual ketamine did very little for me (tried that before IV). Doc then suggested IV use, and said most patients end up needing the IV route.
No one understands the exact mechanism of ketamine for depression even though there has been a lot of research and speculation on this topic. Therefore, you can't say which ROA is best for patients or if one works better than another.
Furthermore, all studies have been small and short in duration so there's no statistical significance to the fact that the IV ROA is used more in studies. If IV was the only route that worked it would be the first anti-depressant with that designation. Because of the cost of infusions patients are right to be skeptical about doctors that are running clinics.
> In short, I see the ratio of risk to effectiveness for home use ketamine to be emphatically not worth it. Unless you have a partner / friend who has the necessary training.
My doctor has clinical experience with ketamine and about 2+ years of prescribing patients with TRD with sublingual ketamine that is taken at home. Ketamine is an incredibly safe drug and nothing about his practice has changed. His insurance has even stayed the same. I know that’s a common justification for high prices from docs that run IV clinics.
The reason I’m not going anonymous on this is because I feel passionately that we need to stem the tide of shady ketamine doctors that don’t give a shit about patients. When I asked my doctor why he wouldn’t charge me a lot of money (he could!) for the treatment he asked me, “Would I charge you a lot for Lexapro because it works?” Good point.
See this book for background on Ketamine and the studies completed: Ketamine for Treatment-Resistant Depression: The First Decade of Progress (2016)
https://books.google.com/books/about/Ketamine_for_Treatment_...