It is an amazing tool that I think is going to help power the next generation of antidepressant treatments. Hopefully the more "traditional" racemic Ketamine does not get covered up as much by more expensive and less effective (but insurance-profitable treatments) like esketamine (which is simply one half of the racemic mix, just patented).

I don't believe that co-Ketamine therapy modalities have been developed well enough either, I think for certain traditionally treatment-resistant clusters of symptoms (like cPTSD, for example), it could be significantly helpful due to some of the properties it has compared to other treatments. Just that not all of those properties are going to be best utilized by a general population on a disorder taking a prescription alone.

It truly is an exciting frontier. (Among other reasons for commenting, I'm very excited about psycopharmacotherapeutics in general as an autism spectrum disorder special interest <3 :)))) )

I'm very thankful we have more options. And there was even a study in recent years by John Krystal on combining another drug with ketamine to increase remission time.

But we aren't learning anything from these trials about the nature of depression. They can't tell us anything about the non-responders.

That's because depression is (as best as I believe) a low dimensional projection of a high dimensional issue.

It's like saying "we aren't learning more about fever from acetaminophen" (or ibuprofen, for example). Of course we aren't! It's a symptom of something else. Depression (I personally believe) is never a standalone syndrome. Ever. Not unless something is wacked out crazy physiologically, in which case for those cases at least you should see a near 0% success rate for talk therapy, I believe (barring a few minor exceptions, perhaps).

Depression can often come from a variety of confounding factors, but the nigh-monotropic tendencies of the field to focus on a singular cause is how we end up with a series of medications where four rounds of different adaptive, extremely well funded and supported antidepressant therapies ended up in an extended remission rate of only ~25% or so. 25%.

I do, oddly enough, disagree that they can't tell us about non responders as the overtly psychedelic nature of the compound does leak information about the underlying system (s) at play. But I think with this reductive approach that many of us (almost necessarily have due to resource constraints) use when trying to tackle the issue, we're going to miss the bigger side of the issue.

On the plus side, in some trials, Ketamine is showing an efficacy of ~%69 or so, or so I've heard, which is quite good. One provider that I've heard about seems to note good long-term results in patients who are initially resistant, which could be for a variety of factors, some of those including simply extremely hardened belief systems that are less game-theoretically compatible with a smooth(er/ish) transition to a less tense-with-the-world strategy set.

That's awesome.

Is it a nasal spray?

Have you ever K-holed yourself?

K-holing can be a horrid idea on a home-dose of Ketamine due to the death spiral of tolerance that ensues. That's what causes the feedback loop of psychological addiction that brings some of the opioid addiction-like horror to the table for this particular treatment, and one of the things I think that could be used to (wrongly, and unethically by some potentially unscrupulous lawmakers of any political dimension) shut it down in the future if too many people began abusing that.

They are lozenges. 250mg and I get 30 at a time for around $40/shipped.

I have closed eye visuals rarely now. I did accidentally go too deep once.

I have kholed at a clinic multiple times . It has been a profound experience

With nasal spray would be difficult. Even sub-lingual would take quite a bit. IM and IV treatments can definitely cause a k-hole.

Have you ever tried pot or mushrooms? They both could help for depression like Ketamine does but any of the effects will be long done by the morning for you.

In my personal experience marijuana only makes depression worse. It can make it more bearable in the moment and treat minor anhedonia, but at least for me it only bolsters my unhealthy habits which in turn makes the depression worse. I don't think there's any evidence that it can lead to long term remission. It's the neuroplasticity provided by psilocybin and ketamine that really helps.

I think psilocybin is promising, but doing it when you're depressed can put you in terrifyingly bad places. I think in the long term psilocybin and ketamine will both end up being valuable tools in combating treatment resistant depression. My guess would be that psilocybin will be used more in clinical settings with a guide and ketamine will be something you can do at home and talk about with a therapist later.

Ketamine was like a flip was switched immediately after my initial session. Nothing at all like cannabis or mushrooms in my experience.

Doctor prescribed Ketamine is legal, whereas marijuana/hemp and psilocybin do not enjoy the same legal status. Though hopefully strong at-home 5HT2A agonists will see more at-home encouragement and legalization along with good spiritual guidelines for spiritual journeywork in the future. It's a promising avenue.

Additionally, Ketamine works along different modalities so it can cover avenues that the previous two cannot. I find the pain relief avenue of action in contrast to the two mentioned above to personally be quite fascinating and I believe underutilized within the current field of research.

I tried truffles. It didn't do anything for me in terms of antidepressant effect. I also tried one of the marijuana variants. Delta 8 or whatever. Gave me a huge amount of paranoia.

Honestly, ketamine is really smooth in lozenge form. The come up and down are pretty nice. If more marijuana users knew about this I have a feeling they would switch. But there is an effect on sleep and you feel a little lethargic the next day.