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-   -   WHERE to get ketamine for depression or pain?? Norcal (https://www.healthboards.com/boards/pain-management/973053-where-get-ketamine-depression-pain-norcal.html)

artman77 01-27-2014 02:19 PM

WHERE to get ketamine for depression or pain?? Norcal
 
Live in San Jose, CA. Willing to travel. I have pain, it is not CRPS, but ketamine works well for many pains and depression (it works for all pain at high enough doses, even burn pain). Much of what I've read makes me think ketamine would work well in my case (chronic pain and refractory depression). Oh, it cures anxiety too.

ANYONE know a doctor (other than a CRPS doc) who would consider it for appropriate cases of chronic pain and/or refractive depression with mild bi-polar?

There is one place in LA that works with UCLA and does infusions for $1000 each. They focus on CRPS but do other treatments (I think).

My doctors don't have experience with it and don't want to prescribe or learn about it.

Based on the rigorous studies I've read, I genuinely think if it could be patented by a pharma company, then it would be THE blockbuster depression treatment (for example orally as studied at VLD "very low dose" twice a week 10 mg, or as studied at 50mg twice per week oral).

It is so weird that all the write-ups I've seen (and even the published research study articles) always say something like "Well one big problem is that it does not last forever." OK, this comment makes some sense regarding ketamine infusions, but makes no sense when talking about the oral twice per week or the nasal. Excuse me, but what PILL on earth is taken once and cures depression forever?

I am really frustrated that this very low risk substance with truly amazing efficacy is not used more. If you think I am overstating, look at the numbers. Most anti-depressants are studied on people with depression. But for some reason, the dozens of ketamine studies I've seen are ALL on patients with treatment-resistant depression ("refractory" depression). Patients who have already tried either 6 or 8 other meds previously and usually also ECT. Yet the results are much better than the studies of other meds being used on non-refractory patients. Such as 87% of the patients having... wait for it... not just some relief... 100% remission of their depression. ***?

And finally, it is safe with practically every other drug (at depression or chronic pain levels, not operative anethesia levels). Even MAOI's! (actually even MAOI's at anethesia levels if you read the studies). The only downsides are that it can be abused, and that it MIGHT stop working. But it actually has much less abuse potential than many many drugs routinely prescribed. Why has the abuse issue stuck so much harder to ketamine than to ritalin or adderral or morphine or oxycodone? OK, it's a concern. But you don't have to search high and low for doctors that will treat with those other more addictive meds. Finally people will look at long-term side effects of ketamine addicts as reason it shouldn't be used. Side-effects for people who have taken bucket-loads daily for years (like 2000 mg a day for five years). I wouldn't want those side-effects, but even for people who have been swimming in it their whole lives, the side effects are certainly bearable. Affective loss for example. Jeez, ECT can cause that at therapeutic doses. Ketamine has no side effects even at hundreds of mg per day, which I certainly don't need. I just don't get it and as you can tell I am super-frustrated because I am in a low of pain and very depressed and have tried everything, including things with much worse side effects and much much lower efficacy. I happen to have exactly the things (other than CRPS itself) that ketamine is most effictive with: refractory dep with minor bp, chronic pain with neural components (stenosis, tmj), I probably have some fibromyalgia, have alcoholism in family (ketamine is more effective for such people but not more addictive). argh! WHERE CAN I GET THIS MED? First an infusion and then VLD or 50mg oral twice per week could apparently change my whole life for the better for as long as it lasts, which could possibly be decades. (No, that's not an exaggeration.)

LadyBassPlayer 01-28-2014 09:50 AM

Re: WHERE to get ketamine for depression or pain?? Norcal
 
Hi artman and welcome to the board!

I read your post with interest but I'm afraid I can't be of much help to you as far as knowledge of a doctor that will Rx Ketamine. I do understand your frustration as I also have a low-grade/refractory depression with bipolar features (I get recurrent severe depression but not mania; the low grade depression is probably related to the chronic pain and feeling lousy with little to no energy most of the time) as well as several chronic pain issues, mainly severe fibromyalgia (I say severe because of the level of pain meds I need to be on to just function). I have anxiety also...and have tried just about every antidepressant through the years. I'm now on a combo of meds that seems to help somewhat.

So if empathy helps you, you've got that at least :)

The people on this board are experienced and thoughtful, and live in various areas of the country, so I'm hoping someone here will be able to help you.
I've not read much about Ketamine but I plan to ask my psy-doc next month about it...I've almost been sent for ECT a few years back, so severity wise it might be something I would try, at the doses you mentioned, for the recurrent depression.

You mentioned UCLA has some use of it in infusions? I'm sure you've contacted them to see if there are any research programs they are running, or otherwise some way you could get the treatment there?

Keep us posted if you find any providers or research (maybe check the large teaching hospitals around the country?) I'm at least interested in finding out if this might be a helpful treatment. God bless and wish you all the best.

~~~LadyBassPlayer~~~trisha~~

dave490 01-31-2014 10:47 PM

Re: WHERE to get ketamine for depression or pain?? Norcal
 
I think rather than focusing on Ketimine, the best route might be to talk to a PM doctor and see what he/she recommends. Often times, when a patient starts out by asking for a particular drug, especially one that has a high potency, it's a red flag for any doctor. Just a thought.....

PhilliesFan20 02-01-2014 05:37 PM

Re: WHERE to get ketamine for depression or pain?? Norcal
 
First, I am so sorry you are suffering.

I agree with dave490 that you may be better off finding a good pain management doctor and letting him/her review your case and make recommendations. Going in and telling a doctor you want such and such drug, even if it has helped you in the past, is a sure way to be shown the door.

I know ketamine is often used a component of compounded prescription topical pain meds. I use one of these. But everything I've read regarding oral or IV use of it for anything other than anesthesia seems to be experimental, so if you are set on trying it you probably need to find a clinical study.


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