Ketamine works great for depression and other conditions, and costs $10/dose; the new FDA-approved "ketamine" performs badly in trials and costs a fortune


#21

bb4m3, I understand your concern, and I will admit that a small number of people will find a way to misuse it, including driving while “tripping” in a hallucinatory state. I am currently still in the study that got the FDA approval for Esketamine. After DECADES of trying every anti-depressant pill out there, it is only now that I am free of depression, thanks to Esketamine. I travel an hour to get my monthly maintenance dose, and I cannot get it if I don’t have someone with me to drive me home. I love to drive, and don’t like being a passenger, but I will tell you that I would not WANT


#22

to drive after having my dose; I am glad to have my wife or a friend drive me home. [Sorry, I hit the wrong button!] The new approval requires a minimum 2-hour stay at a doctor’s office or clinic in order to receive Esketamine, by which time, the effects have worn off and you are back to normal. Also, having the opportunity to receive treatment with just a copay is a blessing. I know the street drug “Special K” is still out there; it is NOT the same as what you receive medically, having much higher strengths in the street drug. It is a problem that must be addressed. But PLEASE don’t argue to take away an extremely effective medication from those of us who had (HAD) drug-resistant depression. Thanks, and may you never be affected by crazy, irresponsible drivers!


#23

After years of antidepressants not working for depression I was given the opportunity to try ketamine. TMS had minimal success and ECT was not an option for me.
My psychiatrist and I ended up on 70mg Ketamine, sublingual every other day. It has been nothing short of a miracle.
It is compounded and not covered by insurance. Initially when finding the right dose level I would catch a “buzz” for a couple of minutes, but nothing out-of-body.
Too bad more psychiatrists dont pursue this for drug resistant patients.


#24

Phenylephedrine anyone?

This is what happens when the DEA gives orders to the FDA: the whole “effectiveness” standard for approval goes out the window and the next thing you know we’re getting oxycontin.


#25

yup probably better if they order darknet lsd that is actually 2ci and jump off a balcony because threre’s no trip sitter


#26

No, you can use racemic ketamine in a nasal spray. There was a small study a few years ago out of Mount Sinai in NY that in this form, racemic ketamine has a significant anti-depressant effect. I myself have been given by my doctor intranasal ketamine to use conveniently at home. It didn’t work for me and had horrible side effects.


#27

I have been using IV Ketamine through a clinic for ~9 months and it has changed my life. The clinic adheres to strict safety policies and I must be driven home. The doses are FAR lower than the street use (Special K). What’s sad is that, being non-FDA approved, I pay out of pocket. It is expensive. But I cannot put a price on what it has done for me. It has given me a life worth living.


#28

All of these are Elsevier publications. While I have a couple of papers in there (and unfortunately one in press), I really would encourage skepticism of anything published by them. They really don’t care about quality. It is all about profit to them.


#29

Ah. Thanks for the correction.


#30

Completely agree.
Also, when it comes to prescription drugs, whether one likes it or not, it is a government prerogative to go as safe as possible. There are methods by which safety and efficacy are demonstrated. As a new drug which can cause hallucinations and addiction, they are well within their safety standards to lay down the rules of clinic administration. Whether clinics adopt it and whether the pharma company makes money out of it - these are not the FDA’s lookout. And I agree. FDAs across the world operate on the same logic, not just US FDA.
This is the reason there are so many proven safe medications available to us today. Yes, there have been mistakes but there have been enough and more successes. Hurrying out new treatments without any proof of efficacy is just waiting for another thalidomide like disaster waiting to happen.


#31

Throwing my two cents in here as a compounding pharmacist that has dispensed intranasal, intravenous and sublingual racemic ketamine.

As explained above, Esketamine is simply a purified form of racemic ketamine (read: ketamine), which is a 50/50 mix of Esketamine and arketamine.

Ketamine can be obtained as a nasal spray or a sublingual lozenge from just about any compounding pharmacy. It’s a pretty simple compound for the nasal spray: literally ketamine crystals weighed out in the appropriate dose and then mixed with an appropriate amount of water. We typically prepare 100 mg/mL solutions by this method. Dosing is usually 0.1 to 0.5 mL per dose (10-50 mg), given in one nostril once a week, separating each 10 mg spray by about 5-10 minutes. Our collaborating physicians and our patients swear it works incredibly well. Our pricing is usually in the range of $50-100 per month.

As mentioned above, Ketamine is not approved for depression precisely because it’s an old drug that isn’t on patent. Unfortunately, most drugs don’t get new FDA approved indications after they lose their patent. Where’s the incentive for someone to go through the incredible investment to get a new indication added to a drug they don’t have exclusive rights to sell?


#32

Same with albuterol (ventolin). Levobuterol on my kid is fine. The mix? I have to peel him off the walls.


#33

Does it smell like astroturf in here?


#34

Whoa there. It isn’t available for home use and it is taken every other week for depression. The clinic will tell you specifically not to operate any machinery and don’t even let you leave until for two hours - well after the primary effects have worn off.


#35

There have been quite a lot of formal clinical trials run by research hospitals from Stanford to the Mayo clinic. This wasn’t pushed by pharma. Research doctors have been investigating it for some time.

I mean… the NIMH (part of the NIH) first did a ketamine trial for depression 13 years ago.

Thousands of people have undergone ketamine treatment for depression in the US and Canada.


closed #36

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