I have had ketamine infusions (approximately 15) under medical supervision, where a general practice MD, in his office, but in consultation with my psychiatrist

I have had ketamine infusions (approximately 15) under medical supervision, where a general practice MD, in his office, but in consultation with my psychiatrist, administers a specific dosage (usually starting at 0.50mg/kg, going up to 0.80mg/kg) calibrated by your weight and previous responses using an infusion pump, set to deliver the dose under an exact 40 minutes. Each session in (my case) costs $600 cash, out of pocket, with no insurance reimbursement, other than (in some people's' experience) potentially a small portion refunded (the "office visit" portion). The infusion is conducted in a quiet, darkened room, and I'm checked in on periodically over the 40 minutes. The session makes you feel somewhat "out of it", but not "trippy" or "dissociative" or "psychedelic" in any way. It seems to give you an ability to put things that are causing depression or anxiety "in their place" so they cause less ongoing turmoil. There is conflicting evidence as to whether any of the perceived effects of the infusion have any of the antidepressant benefits or whether the benefits are solely chemical (and not in any way a function of any of this "enlightenment" that may be provided by the infusion). It's a somewhat enjoyable experience but not "fantastic" or one that makes you feel like you want another infusion right away. The poster who insufflated the ketamine likely had a much higher dose over a much shorter period of time than the dosage used for an infusion, and reputable doctors generally give the infusion over 40-60 minutes, not all at once, and not via insufflation. Some doctors will prescribe a ketamine nasal spray or lozenges for use between intravenous sessions, but they are few and the evidence isn't really there for any potential benefit to this practice. I have noticed a positive effect on my mood and depressive symptoms generally recently, but I have also had a full course of TMS during the same period of time, so it's difficult to attribute the benefits to one modality over the other. TMS, unlike ECT, does not involve anesthesia or shock therapy, and unlike ketamine, TMS is usually covered by insurance. However, it generally requires 30-36 visits to see improvement, so the timing is distinctly different from ketamine when ketamine works. I would think I'm a medium responder to ketamine and a medium responder to TMS.