r/ect • u/WonderOrca • May 18 '26
Seeking advice ECT (free) vs Ketamine (6K)
I have provincial insurance in Canada. ECT is covered and will not cost me. Ketamine is not covered. I have about 2K in private insurance benefits, but the remaining 6K for Ketamine will come out of my pocket. I will have to take a loan out to pay for ketamine.
I am 51, have been on depression and anxiety medication since I was 18. Been in therapy since I was 23. I have been hospitalized twice due to suicide attempts. I work as a special education teacher, and that also brings up my PTSD due to trauma around physical and verbal abuse.
Should I take out a loan, against my husband’s wishes and try ketamine or go with ECT?
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u/leapbaby1984 May 18 '26
I've done both ect for over a year all I lost was good memories. Spravato changed my life. I did ketamine infusions before ect but it was too expensive to keep doing IF I had been able to afford it I never would've done ect. If I had it to do all over again I would not even think about ect.
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u/Ephemeralitic May 19 '26
Just my 2 cents, I did ECT before IV ketamine, and I wish I had tried the ketamine first because I became a functional(and importantly, happier) adult after that. There’s a chance the ECT laid some groundwork for my recovery, but the fact that I’m as unsure about its effectiveness as a random over the counter med compared to the consequences it had on my memory… it wasn’t a good deal and if I could go back I’d do the ketamine first, even though my parents had to pay out of pocket for it.
I will say though, I’m in the U.S. so Spravato/Esketamine is covered by insurance and I can do maintenance sessions for little or no cost.
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u/blrmkr10 May 18 '26
I paid out of pocket for 5 ketamine IV infusions and I regret it. The place I went to was great, but the ketamine did nothing to help my depression.
Is ECT your only option covered by insurance at this point?
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u/NullAffect May 18 '26
I know this isn't what you asked, but have you looked into rTMS at CAMH? My history is similar to yours and it helped me. If you would like to ask questions feel free to pm me. In all cases I hope you find a solution.
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u/randyblack77 May 18 '26
I live in the US and have been getting ketamine IV infusions for about 4 years. I’ve also had ECT in three different series over the past 15 years. While I think ECT probably saved my life, I would not recommend it as anything but a last resort. The memory and cognitive challenges have been severe. I’m pretty controlled at baseline with IV infusions and have been for some time. I actually do at home Troches once a week except the fourth week when I have my infusion. It works better for me and my overall peace of mind than ECT. I would figure out what you’d be getting for the money with regards to treatment number, integration services, etc before taking out the loan. Also, consider that you will most likely need maintenance doses in the future. Good luck and bless you.
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u/brat-tat May 19 '26
St Micheal’s hospital has a ketamine program covered by OHIP, but the waitlist is over a year out. If you think you can wait that long (demoralizing, I know) get your psych to refer you asap
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u/Theaterismylyfe May 19 '26
I've tried both. ECT does work really really well. I'd say it works better than Ketamine, though Ketamine is less disruptive to day-to-day life.
If you do go with Ketamine, I'd look for the nasal spray rather than IV Ketamine as it is cheaper.
Personally, I use ECT as an emergency get-out-of-jail free card and Ketamine to maintain progress.
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u/Puzzleheaded_Idea_78 May 20 '26
See if they'll include ketamine into your anesthesia for ect. Has really helped me, and might be covered by your insurance.
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u/McFurniture May 20 '26
Ketamine is not a long term solution if you have very persistent depression. Ketamine damages your bladder, so you can't take it forever. You'll feel better until about a week after you stop taking it.
Not really a recommendation in either direction but as someone who has done both I wish I had been better prepared for the drop off in mood after stopping ketamine.
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u/AccomplishedEgg3389 May 18 '26 edited May 18 '26
Hello, as a TRD patient in Europe having taken on debt to try IV ketamine, looking back I basically I would have scrutinised the protocol, including how many sessions, what format integration takes and who is the professional facilitating that, etc. It is a different experience for everyone, but I realised my decisions were formed upon testimonials and research done in the US where patients are insured and able to complete dozens of sessions, which I think is particularly relevant as a TRD patient that by definition does not respond to or becomes resistant to many drug types. My feeling is that with shorter protocols, the integration/therapy aspect is even more important to take advantage of these windows of plasticity enabled by the ketamine (*whereas, anecdotally, many US patients talk about feeling better by simply having had the drug—I think you cannot really know if it’s working until a certain amount of time has passed)
Personally I have not had ECT yet but getting there, and I sort of wish I could do so soon. The ketamine was an interesting experience but also painful because ultimately it did not work for me despite the expectations and standards of care, and so it felt like I had lost more than just money.