5 ms·

Zarate is quoted in the article and is one of the authors of Ketamine for Treatment Resistant Depression. A great book that will give you quite a bit of backgro

Zarate is quoted in the article and is one of the authors of Ketamine for Treatment Resistant Depression. A great book that will give you quite a bit of background. I take ketamine with a prescription at home. If anyone here knows someone who is going to an IV clinic I can give out my doctor's information. He's taking new patients and is okay with me giving out his e-mail. When you're depressed it's easy to overlook the financial implications of spending $500 for an IV. And then you end up in financial trouble. I tried to contact Brooke, but I think I may have been too late... https://www.ketamineadvocacynetwork.org/forums/topic/desperately-need-intranasal-doc/ https://www.ketamineadvocacynetwork.org/forums/topic/despera...

lilsoso 7y ago
What form do you take the drug? IV? Powder? Could you please describe the process and the dosage?
- atomical 7y ago
  I take 250mg sublingual. I put it under my tongue at night while listening to music.
  - MetalGuru 7y ago
    Can you describe your experience with it (how resistant your depression was, how effective ket is, what the short and long term effects you’re noticing are)?
    - atomical 7y ago
      I had tried several anti-depressants before ketamine. I feel a lot better and have much more energy. A side effect while taking the drug in the short term is dissociation. As tolerance builds that eventually goes away. I'm having some issues with sleep and productivity at night.
  - temp2903d 7y ago
    Is that a standard dose? Why do you take it sublingually instead of snorting it? I have taken ketamine recreationally...that is quite a high dose at least from my experience, though I've never though to take it sublingually.
    - atomical 7y ago
      There isn't a standard dose. Far too early for that. I take it sublingually because that's what my doctor prescribes.
    - car 7y ago
      Doc here. Sublingual application bypasses the liver, which removes drugs from the bloodstream. Same reason why nitro is applied here.
      - behindmyscreen 7y ago
        That’s interesting. What’s the mechanism for that? Uninformed intuition would lead one to think there would not be a difference.
        car 7y ago
        It's a function of anatomy. The sublingual veins drain into the jugular and then vena cava. For drugs this avoids the first-pass effect, which is exploited when giving nitroglycerin for angina pectoris. Other ways to achieve this are suppositories (rectal veins) and intravenous (i.v.) or intramuscular (i.m.) injection. https://en.wikipedia.org/wiki/Lingual_veins https://en.wikipedia.org/wiki/Lingual_veins https://en.wikipedia.org/wiki/First_pass_effect https://en.wikipedia.org/wiki/First_pass_effect
      - atomical 7y ago
        Some of the drug will always be absorbed orally and travel to the liver through the the portal vein. The liver will eventually remove ketamine from the bloodstream regardless of which route is used. That's my understanding at least.
- throwaway0x69AF 7y ago
  I take 50mg weekly, insnuflation, but suddenly considering sublingual. It's rid me of a lifetime of persistent ideation that had become a daily burden. It seems like I need way less than clinics give people
  - temp2903d 7y ago
    250mg seems exceptionally high (in reference to the OP's response below). The esketamine nasal spray that was just approved contains only 28mg per dose (1-2x/week). I don't know if that's because you need more if you take it sublingually. Snorting/nasal is almost certainly the most efficient/most effective way to take it.
    - atomical 7y ago
      1) The different ROAs have different bioavailability. 2) Ketamine is cheap. Convenience should be prioritized over efficiency.
      - throwaway0x69AF 7y ago
        It's not just about the expense, ketamine can damage liver and kidneys, and reduce iron uptake. Efficiency, in this case, is more about harm reduction than expense
        atomical 7y ago
        I've read some of the most important papers and books and have never come across this. Please post a source. Depression is a very serious illness and ketamine is a very safe drug. We need to give people more options.
  - lilsoso 7y ago
    Are you concerned about potential long term side effects of the drug? Like MDMA, which has also garnered attention from researchers for potential medical benefits, I was under the impression K had nontrivial neurotoxic potential if abused.
tacotime 7y ago
That is amazing, I've read quite a bit about this and did not know that anyone was prescribing for home use. Roughly how much does it cost? Did you receive initial treatment in a clinic and then transition to home use?
- atomical 7y ago
  The prescription costs $80-$100 a month but since I'm out of state and there are other costs like flights, shipping, etc it's more expensive. If you live near Maryland you have an advantage here. I am paying under $3000 a year. Before I found my doctor I was being mercilessly ripped off by IV clinics. I've been to 3 different clinics around the country. My doctor agrees that IV clinics are spreading pseudoscience. Any doctor can prescribe ketamine off label. It's one of the safest drugs out there and has a lower addiction potential than Adderall (according to DEA scheduling).

lilsoso 7y ago

What form do you take the drug? IV? Powder? Could you please describe the process and the dosage?

atomical 7y ago
I take 250mg sublingual. I put it under my tongue at night while listening to music.
- MetalGuru 7y ago
  Can you describe your experience with it (how resistant your depression was, how effective ket is, what the short and long term effects you’re noticing are)?
  - atomical 7y ago
    I had tried several anti-depressants before ketamine. I feel a lot better and have much more energy. A side effect while taking the drug in the short term is dissociation. As tolerance builds that eventually goes away. I'm having some issues with sleep and productivity at night.
- temp2903d 7y ago
  Is that a standard dose? Why do you take it sublingually instead of snorting it? I have taken ketamine recreationally...that is quite a high dose at least from my experience, though I've never though to take it sublingually.
  - atomical 7y ago
    There isn't a standard dose. Far too early for that. I take it sublingually because that's what my doctor prescribes.
  - car 7y ago
    Doc here. Sublingual application bypasses the liver, which removes drugs from the bloodstream. Same reason why nitro is applied here.
    - behindmyscreen 7y ago
      That’s interesting. What’s the mechanism for that? Uninformed intuition would lead one to think there would not be a difference.
      - car 7y ago
        It's a function of anatomy. The sublingual veins drain into the jugular and then vena cava. For drugs this avoids the first-pass effect, which is exploited when giving nitroglycerin for angina pectoris. Other ways to achieve this are suppositories (rectal veins) and intravenous (i.v.) or intramuscular (i.m.) injection. https://en.wikipedia.org/wiki/Lingual_veins https://en.wikipedia.org/wiki/Lingual_veins https://en.wikipedia.org/wiki/First_pass_effect https://en.wikipedia.org/wiki/First_pass_effect
    - atomical 7y ago
      Some of the drug will always be absorbed orally and travel to the liver through the the portal vein. The liver will eventually remove ketamine from the bloodstream regardless of which route is used. That's my understanding at least.
throwaway0x69AF 7y ago
I take 50mg weekly, insnuflation, but suddenly considering sublingual. It's rid me of a lifetime of persistent ideation that had become a daily burden. It seems like I need way less than clinics give people
- temp2903d 7y ago
  250mg seems exceptionally high (in reference to the OP's response below). The esketamine nasal spray that was just approved contains only 28mg per dose (1-2x/week). I don't know if that's because you need more if you take it sublingually. Snorting/nasal is almost certainly the most efficient/most effective way to take it.
  - atomical 7y ago
    1) The different ROAs have different bioavailability. 2) Ketamine is cheap. Convenience should be prioritized over efficiency.
    - throwaway0x69AF 7y ago
      It's not just about the expense, ketamine can damage liver and kidneys, and reduce iron uptake. Efficiency, in this case, is more about harm reduction than expense
      - atomical 7y ago
        I've read some of the most important papers and books and have never come across this. Please post a source. Depression is a very serious illness and ketamine is a very safe drug. We need to give people more options.
- lilsoso 7y ago
  Are you concerned about potential long term side effects of the drug? Like MDMA, which has also garnered attention from researchers for potential medical benefits, I was under the impression K had nontrivial neurotoxic potential if abused.

tacotime 7y ago

That is amazing, I've read quite a bit about this and did not know that anyone was prescribing for home use. Roughly how much does it cost? Did you receive initial treatment in a clinic and then transition to home use?

atomical 7y ago
The prescription costs $80-$100 a month but since I'm out of state and there are other costs like flights, shipping, etc it's more expensive. If you live near Maryland you have an advantage here. I am paying under $3000 a year. Before I found my doctor I was being mercilessly ripped off by IV clinics. I've been to 3 different clinics around the country. My doctor agrees that IV clinics are spreading pseudoscience. Any doctor can prescribe ketamine off label. It's one of the safest drugs out there and has a lower addiction potential than Adderall (according to DEA scheduling).