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My doctor prescribes ketamine for take home use. Unfortunately infusion clinics are taking advantages of patients by administering the most expensive ROA. Keep

My doctor prescribes ketamine for take home use. Unfortunately infusion clinics are taking advantages of patients by administering the most expensive ROA. Keep in mind that the IV ROA has not been proven more effective or safe than cheaper ROAs.

ozzyman700 8y ago
Is this in the US?
- atomical 8y ago
  Yes it is.
ketathrowaway 8y ago
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. And if you're talking about starting an IV on yourself... without training, the risks of really bad health issues, including death, are pretty high. Almost no one outside of professional health care has that training. Even if they did, you still need to be monitored by someone else via pulse ox and sometimes blood pressure for safety reasons, and said person monitoring you needs to have the training to know how to help you if something goes wrong. Keep in mind that if ketamine is effective for you, you will end up needing to keep taking it for a long time, typically every 3-6 weeks, or the effects wear off. That frequency multiplies the risks. 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. I know from talking to my doctor that of the $375 I pay, his cost for the ketamine he uses for that one treatment is under 10 bucks. If you've got a medical license, you get access to buy legit pharma drugs very easily. I believe he told me that one vial of Ketamine is something like $20 and there's multiple doses in there.
- atomical 8y ago
  > 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) https://books.google.com/books/about/Ketamine_for_Treatment_Resistant_Depress.html?id=OB_BjwEACAAJ&source=kp_book_description https://books.google.com/books/about/Ketamine_for_Treatment_...
  - ketathrowaway 8y ago
    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.
- 8y ago

ozzyman700 8y ago

Is this in the US?

atomical 8y ago
Yes it is.

ketathrowaway 8y ago

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. And if you're talking about starting an IV on yourself... without training, the risks of really bad health issues, including death, are pretty high. Almost no one outside of professional health care has that training. Even if they did, you still need to be monitored by someone else via pulse ox and sometimes blood pressure for safety reasons, and said person monitoring you needs to have the training to know how to help you if something goes wrong. Keep in mind that if ketamine is effective for you, you will end up needing to keep taking it for a long time, typically every 3-6 weeks, or the effects wear off. That frequency multiplies the risks. 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. I know from talking to my doctor that of the $375 I pay, his cost for the ketamine he uses for that one treatment is under 10 bucks. If you've got a medical license, you get access to buy legit pharma drugs very easily. I believe he told me that one vial of Ketamine is something like $20 and there's multiple doses in there.

atomical 8y ago
> 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) https://books.google.com/books/about/Ketamine_for_Treatment_Resistant_Depress.html?id=OB_BjwEACAAJ&source=kp_book_description https://books.google.com/books/about/Ketamine_for_Treatment_...
- ketathrowaway 8y ago
  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.
8y ago