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So I started shopping around for pdocs, as mine is good but very hard to contact, so it's a bit frustrating. New DNP I saw was much more open to creative strategies, most of which are off label... good idea, but too expensive without insurance :( however, she kept bringing up ketamine, which i had heard of, but treatments in Seattle are way out of my budget (something like 5k for the initial series of infusions then 750 every 3-4 weeks for maintainence? No thanks).

anyway, turns out she knows a pdoc who prescribes the nasal spray, made through a local compounding pharmacy. Apparently it's only $75-100/month! Far more than my $12 copay, but if I could cure this shit for $100 I can make that work.

anyone tried this? I've seen a few reports here and there but not much. Part of me is super excited but of course there's the part that's scared it'll be like everything else :-/

itll probably take me 6 weeks to see the guy but tentatively excited!

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I have not heard of this nasal spray and have not tried it.  But it sounds interesting.  I'd be interested is seeing how it compares to the ketamine treatments (not nasal spray).

Do you know how many treatments with the nasal spray do you take to make a difference?  How many sprays do you get a month for $75-$100? 

If you do try it I hope it works for you!

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I have no idea about the dosages, I've heard all kinds of things; sounds like you use a few sprays at a time every 2-3 days, and I think you keep taking it like other meds. I think even the iv treatments use monthly boosters.

they told me $75-100 per month so hopefully that's for whatever strength id need for a month supply.

as far as when it kicks in, most of what I hear is almost instantly but I'm hoping to hear more accounts!

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I also am interested in seeing others accounts who used this form of ketamine.

I was looking into getting the injections at one point (pdoc had to call and fill out papers and register me with the place I was going to me (closer to home), and on the forms it said they wouldn't administer the ketamine if you had SZA or SZA, and a few other MIs. 

So I never got it (long story behind that though).

I know you aren't SZ or SZA ... but I found this article and wanted to share my experience on this:

I found this article on ketamine (not the spray though), and found it helpful:

 

http://ketamine.com/ketamine-effects/understanding-the-effects-of-ketamine-on-the-brain/

^^It talks about how ketamine is used similar to an anesthetic ... anyway, I have had many major surgeries in a small amount of time, and because of those surgeries, the voices became much less ... so in the sense that ketamine works as it does, it is like an anesthetic. 

After all the surgeries, I never knew why anesthesia kept getting rid of the voices more and more ... point being that if ketamine is related to anesthesia, I can say from personal experience it works, especially for the voices etc.  I don't remember about the depression specifically, but it came along with getting the anesthesia, ie, everything was better in general (at least until the anesthesia wore off 2-3 days later). 

-------------

Here is an article about the nasal spray which looks promising:

http://www.medscape.com/viewarticle/823370

Quote

Intranasal ketamine delivers a rapid antidepressant effect in patients with treatment-resistant major depressive disorder (MDD), new research shows.

Investigators report that the N-methyl-D-asparate (NMDA) glutamate receptor, administered via intranasal spray, had a significant antidepressant effect within 24 hours of administration. If confirmed in larger studies, the researchers say these findings may herald a new antidepressant drug class.

"What we have here is a proof-of-concept study, and we consider the results very promising. We hope to see this line of research further developed so that we have more treatments to offer patients with severe, difficult-to-treat major depressive disorder," study investigator Dennis S. Charney, MD, Icahn School of Medicine at Mount Sinai in New York City, said in a release.

 

-----------------

http://www.ketamineadvocacynetwork.org/route-of-administration/

Scroll down to :

Quote

Intranasal administration

^^ This might be helpful for you to read.  TBH I didn't read the whole article, just skimmed it, but from what I read I think you'd find this helpful.

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I was going to recommend the article that melissa linked to. I think it's a good source for understanding ketamine dosing. Most important to remember, if you're going to try a nasal spray, is this:

Quote

We want to make one strong point about the intranasal route.  If you are a brand new ketamine patient, and your first treatment is intranasal, and it doesn’t work, do not declare yourself a non-responder.  There are plenty of patients who respond to IV ketamine but not to intranasal.  You could be one of them.  So you might still get tremendous relief from IV.  Patients like us have tried dozens of meds over many years, and we are justifiably predisposed to declare failure quickly when trying a new one.  Yes, you might truly be a ketamine non-responder.  But a single intranasal failure doesn’t give you enough information to make that call.  IV is the gold standard of ketamine therapy, and until you try it you can’t know for sure whether ketamine can help you or not.

I hope that ketamine is an option, and that it helps you.

My pdoc has told me that sometimes ketamine works the way ECT sometimes works, and seems to kind of rewire the brain so that after treatment with ketamine you may respond differently/better to medications you previously didn't respond to.

My team is hoping to get me into a local clinical trial for ketamine infusions. This will allow me to get IV ketamine treatment without the huge cost. It may be worth looking into if that's an option for you?

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Thanks for the info :) I know intranasal isn't supposed to be quite as effective overall (although I've read some people say it works better) so it's the usual case with any of these meds... it's a craps shoot. But right now there's only one clinic near Seattle that does IV, and I can't even come close to affording it. I checked into clinical studies too, but there's none in my area :(

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  • 2 weeks later...

Update... got appt with ketamine pdoc end of February... I'd previously made an appointment with my regular pdoc for today, and almost didn't go; I didn't see a point to, if I was going to see this other guy. But I went and just told her everything (turns out the two docs were colleagues anyway), and she said, "well I can get you ketamine if you want it." I was a bit shocked, granted I'd never asked, but she'd also never once mentioned it as an option. Anyway, she said she has two other patients using it and they're both responding! Not  a huge sample size, but hey, it's still a good sign :) she thought I'd be a good candidate, so bam... got a prescription for the nasal spray! 

I forget the dose, I think she said 50 mg/ml, five 0.1 ml sprays per day, spaced out every few hours.

now I just need to find a compounding pharmacy who dispenses it! Sadly my pdoc left me twisting in the wind on that one, so I guess I'll start calling around tomorrow. 

So hopefully in the next few days I'll have something to report! :)

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4 hours ago, climber47 said:

Update... got appt with ketamine pdoc end of February... I'd previously made an appointment with my regular pdoc for today, and almost didn't go; I didn't see a point to, if I was going to see this other guy. But I went and just told her everything (turns out the two docs were colleagues anyway), and she said, "well I can get you ketamine if you want it." I was a bit shocked, granted I'd never asked, but she'd also never once mentioned it as an option. Anyway, she said she has two other patients using it and they're both responding! Not  a huge sample size, but hey, it's still a good sign :) she thought I'd be a good candidate, so bam... got a prescription for the nasal spray! 

I forget the dose, I think she said 50 mg/ml, five 0.1 ml sprays per day, spaced out every few hours.

now I just need to find a compounding pharmacy who dispenses it! Sadly my pdoc left me twisting in the wind on that one, so I guess I'll start calling around tomorrow. 

So hopefully in the next few days I'll have something to report! :)

That is great you got the prescription!  I'll be interested in seeing how it helps! 

(bold) I hope you find a compounding pharmacy soon!  You could google 'compounding pharmacies in (your state or town/city)'   Maybe that would help?

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If it's not in a blog no worries as long and you keep us updated .. I think this will be the first post with experiences with ketamine..

I can't wait to see how you progress. What the max duration they will supply you with the nasal spray?

I guess I'm eluding to how long is the max you can be treated using this method?

I also read on treatment lamictal can not be used.. I guess it nullifies the effects of Ketamine 

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Well that was easy! First place I called had it made up and ready to go, so I picked it up this afternoon. 

So its 100mg/ml, each spray is 0.1 ml, 5 sprays spread throughout the day, so it's basically 50mg/day.

im two doses in so far, and I think it's maybe doing something! Kind of hard to tell just yet... I feel slightly buzzed, but totally functional. However, I'm at work and sometimes manage okay... tomorrow when I'm home alone with the kids will be the real test, I will update!

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3 hours ago, climber47 said:

Well that was easy! First place I called had it made up and ready to go, so I picked it up this afternoon. 

So its 100mg/ml, each spray is 0.1 ml, 5 sprays spread throughout the day, so it's basically 50mg/day.

im two doses in so far, and I think it's maybe doing something! Kind of hard to tell just yet... I feel slightly buzzed, but totally functional. However, I'm at work and sometimes manage okay... tomorrow when I'm home alone with the kids will be the real test, I will update!

That is great you found a place so fast to make it, and you were able to pick it up already!  So far it sounds like a positive reaction ... I hope it continues!

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Pretty sure I did the math right, 0.1 ml sprays x 5 sprays = 0.5 ml per day, and 0.5 ml x 100mg/ml = 50mg/day. The concentration varies so I was trying to convert it to straight mg per day like a pill. So if I only use 0.5 ml per day and I have 15 ml, that's a 30 day supply :)

i didn't notice anything like dissociation, just a slightly buzzed feeling, like having a drink or two. I worked with no problems, drove home, etc.

 

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2 hours ago, climber47 said:

Pretty sure I did the math right, 0.1 ml sprays x 5 sprays = 0.5 ml per day, and 0.5 ml x 100mg/ml = 50mg/day. The concentration varies so I was trying to convert it to straight mg per day like a pill. So if I only use 0.5 ml per day and I have 15 ml, that's a 30 day supply :)

i didn't notice anything like dissociation, just a slightly buzzed feeling, like having a drink or two. I worked with no problems, drove home, etc.

 

Oh, ok. Thanks.  I didn't realize you had the 15 ml.

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Thought I'd update... I've used the spray twice this morning, and so far......... not quite sure. Nothing overwhelming for sure, but it may be helping. 

I have atypical depression, which is generally just as horrible as MDD, but one feature is you're able to respond positively to good things that happen, however briefly, before plunging back into darkness. That's generally the case with me; I'd say 60-75% of the time I'm miserable, crying, irritable and sad, can't enjoy anything. But I have some "good" moments, even some "good" days, but in this case good means maybe a 4-5 on a scale of 1-10. So pretty neutral. 

Id give my mood a 5 right now. Not "happy", but certainly not miserable. So as good as one of my better days. So is that an improvement? If every day were like this, I'd be pretty happy with that! I'd rather feel better than that of course, but I'd say even if this is all I get, it's worth the cost. But I can't find a lot of data on how long it takes to take to work; although most seem to say within hours, but a few said it took longer, even with infusions, so I'm gonna hold out hope!

luckily no side effects so far, they said it might be sedating but I thankfully haven't noticed that so far.

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