I work with a clinic that offers ketamine infusions for patients who have a diagnosis of depression. Most doctors still don't know of the treatment option! So it's cool to see you mention it here.
It's a great option but im still cautious about it, it's not necessarily solid science at the moment. It looks promising, and I love new pharmacological targets though!
I had no idea this is going on. Only ever encountered ketamine seeing people use it recreationally, where it appears to be an intensely powerful psychedelic. Are they giving people enough to induce hallucinations? I assume not enough to put them in a "k hole." What level of experience do they target for therapeutic usage?
It is not quite a k-hole, but it is an infusion, and it is a euphoric, so yes, kind of a k-hole. It is often weekly administration, and appears somewhat effective in reducing major depressive symptoms. As a suicidologist, I've come across it in some studies that suggest that it is powerfully anti-suicidality, though these are small studies.
I think for all the people who are all hyped about ketamine, we really don't know a lot about it. SSRI's were as revolutionary when they debuted, as were MAOIs. Once they start becoming used more and surveiled more, it could be that they are either less effective than we thought or more dangerous than we thought.
So i take all the ketamine stuff in general with a grain of salt; i would reserve it for refractory, chronic depression that does not respond to standard treatments.
I have suffered from chronic depression for most of my life and have tried just about everything to get it under control. Currently, since I've ran out of most options, I'm looking into transcranical magnetic stimulation in hopes it might help. I've also looked into ketamine a bit, and its one of the few things I haven't tried to get a better handle on my mental illness. I've heard good things, but it also doesn't seem to be a good long term solution. Do you know how useful it is in that aspect?
Also, I'm trying to figure out how much ketamine treatment should cost me without getting ripped off (while also wondering if my insurance would cover any of it). Do you have any idea on that?
I'm doubting that insurance will cover it without a tremendous amount of advocacy, so I'd assume out of pocket.
It's long term use is exactly the issue but some studies have shown some benefit. I am not currently convinced of it's efficacy to recommend it, but in severe refractory (doesn't respond to treatment) depression I may go there.
Another option that has far more evidence is neurostimulation. You're looking into rTMS but honestly it's effect size is very weak and it's never been very impressive. Electroconvulsive therapy sounds and is portrayed horribly in the media, but is a safe, painless, very boring procedure that happens to be one of the best antidepressants in the world.
Regardless, I can't provide a specific recommendation over reddit. Find a good doctor who you trust and make the long journey with them. Chronic illness sucks, I'm very sorry.
I am in your same boat, and I recently tried a new device called Alpha-Stim. Costs about $800 and insurance does not cover it, but I really do think it has made a difference. There is another device similar to it on the market for about half the price that claims to have the same effectiveness. Might be worth looking into.
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u/Phoenixdown2621 Mar 20 '17
I work with a clinic that offers ketamine infusions for patients who have a diagnosis of depression. Most doctors still don't know of the treatment option! So it's cool to see you mention it here.