My wife went through the therapy. Three days a week for two weeks. It was hell, she changed as a person. There was a lot more expression of anger, she described it like having gasoline poured into her veins when they were already on fire. But, a month later, she was able to interact with her family members again. Without PTSD triggering for the first time in years. It really reduced the control PTSD had over her life. I'm not sure if it was worth it though.
I can’t speak for the OP but as someone with mental health issues, I find a great deal of comfort in learning to cope. I honestly don’t know if I’d choose to magic away half of my issues tomorrow: I know myself today, I know how to get through the day… getting better can be exhausting, and scary. Better the pain you know.
It's honestly hard to say if you haven't tried it. You know your pain, but that's all you know. The experiences behind these substances are incredibly varied. Infinitely so. And they can heal you.
You hit it square on. The hell of terrible lows contrasted with after previously unknown highs abated but the gasoline-in-her-veins anger persisted, and the coping skills she had from more than a decade of incredibly bitter therapy stopped being right for the situation.
Sorry to hear about your wife’s experience. I have never heard of such an intense schedule. In my experience it’s either an ivy or a sublingual session once every 7-14 days.
As with any psychoactive medication, taking it too often sounds physically and mentally exhausting. In this specific case it’s even more unusual as all guidance I saw in regards to ketamine therapy mentions that the post-session period of integration is critical to the success of this whole process. So having sessions back to back is pretty unusual.
The first place I did it, years ago, followed the same schedule - IV 3 times a week for 2 weeks, then followups tapering off until an equilibrium is found (either with no followups eventually or periodic "booster" doses). I was told at the time that this was the common practice, and it did seem to be from the other places I looked at.
The second place I did it was willing to try repeating the exercise.
I think the first went out of business in the last year or so, but they were around for years, so they did get plenty of business for some time.
(I also always recall a couple of times I was there - the infusions were done in an office setting, with insulated but not totally soundproof walls, and sometimes one of the other patients was _VIOLENTLY_ loud, screaming repeatedly for long stretches.
...that said, I looked a couple times, and those patients were coming in and leaving unescorted, so they did not appear to be there under duress, and one might conclude they thought it was helpful despite that, which tracks with my own understanding of how it can be violently intense for people with trauma, but often the trauma is less sensitive, for lack of a better word, afterward.)
I'll also point to my comment[1] from a prior thread about ketamine for a summary of my own experience.
I'm not them but it sounds like his wife had a lot of untreated anger issues and ketamine therapy bypassed the coping mechanisms that she had been using to prevent herself form blowing up, i.e. pouring gasoline into the fire in her veins.
It probably didn't make her more angry, just less able to resist expressing her anger.
Part of the healing process for people who’ve suffered through trauma is releasing all of that energy out of the body. It’s very common to go through big up/down swings during this process.
Most definitely. I'm going through some of this with therapeutic MDMA use for my PTSD. It's definitely been a journey, and not always a pleasant one, but, I believe I'm better off now after a few sessions than when I started.
Self administered, unfortunately. I do have a therapist with whom I discuss things related to the sessions, but he's not directly involved.
Also unfortunately, I'm about out of the drug, and will soon need to either try and find a reliable source, or call it quits on this particular treatment avenue.
"Unfortunately" because I suspect my supply of the drug will run out before I'd like it to. I don't care about the high, just the therapeutic effects.
Edit: Also, unfortunately, the site has just dictated that I've used up all my comments for a while and need a timeout. Had I been warned that this would happen in advance, I'd have done something to prevent it. Unfortunately, they just stick me with this uninformative error message saying I'm "posting too fast," and disallow me from posting anymore for some period of time I'm also not privy to.
I think they mean:
Energy; a shorthand reference to myriad qualities of lived experience including perceptions, ideas and emotions. Deliberately vague to encourage intuitive and personal interpretation. There is a leaning towards embodied sensation.
The general the implied dogma is that energy is healthy when moving and undergoing rhythmic change. It's problematic when variance and flow diminishes.
I have taken many drugs, but I still see that when discussing mechanisms we need to be specific to have a deep understanding of the mechanics. Otherwise we get handwavy garbage that isn't actionable.
This is a large problem is psychology and it's made worse by the lack of research behind psychoactive compounds. That void gets filled by people who take the drugs recreationally and come up with this mythology type of explanations. As a scientist who studies drugs, biochemistry, and behavior; I want to move past this. I want people to have a clear understanding of how the brain works, and we don't get there by being vague.
That may be what you want as a scientist, but often these experiences are only communicable via metaphor. The narrative helps with integration, and can also be deeply meaningful. One side doesn't exclude the other by any means. It is what it is, and is part of what makes the experience so intriguing for people -- particularly people who suffer from depression and have lost their inner mythos.
I understand the difficultly in communicating these experiences. This is yet another issue in psychological research, as not only are they difficult to communicate but people may explain things differently when they're talking about similar experiences. This is the reason I would like to see things explained and studied with specificity.
Its likely that we don't have any research done into these psychological phenomena, partially due to the way research into these compounds has been essentially banned (DEA dragging their feet on applications or denying for arbitrary reasons)
I think a good example of terminology that has come from the drug use underground is that of "vibrations"
It seems to me like the discussion of vibration is actually related to the oscillatory behavior of neurons and their networks. I don't know how we'll be able to dive into this idea and connect what people experience as "vibrations" to oscillatory behavior and their associated behavioral and psychological phenomena, but I think its a good place to start investigating as long as we solidify terminology.
I'm more than happy to hear different ideas and perspectives on these phenomena but I'll always ask clarifying questions. These questions help to get people on the same page so we can all deepen our understanding of the complex machinery that is the human brain.
Ketamine therapy is fantastic. It saved the life of a close friend. And greatly helped another. It helps to find a reputable provider and pair it with good therapy. One friend found a provider that paired it with a therapy session part way through which helped him a lot. These were all with depression therapy, though I've heard from the providers that it's amazing with PTSD.
I have been monitoring this research for years as it could be potentially life changing for a family member. I am so happy your blanket was lifted.
I am curious, was your comment about trying Ketamine just a general nod or are you seriously considering it? Much of what I have read indicates psilocybin has a more long term and profound affect vs ketamine, are you still looking for further improvements?
I am seriously considering it. I found can get ketamine therapy here but it's upwards of $400 per dose, needing multiple doses, and not covered by insurance.
With the psilocybin, I confess it was just shrooms eaten with a bottle of water. Not tasty. What I experienced was nothing short of profound. About an hour after swallowing four grams I started feeling giggly, and happy.
I looked at old photos of my cat that died some years back, and she started to pulse slightly and seemed to move almost in the photo, but that was the extent of the hallucinations. It's what happened next that changed everything.
I remember drinking some water and then going to lay in the bed. My brain started thinking about a very depressive episode that happened to me this year. I thought through it, specifically what it meant for my life, friendships, etc. This is something that would have left me crying in a dark bathroom in the middle of the night before, but this time, it didn't. I didn't feel the usual guilt, embarrassment, and humiliation about my past mistakes.
The best way I can describe it is this: I was walking alongside my depression, having a conversation with it, and at some point, my depression stopped and I kept walking. It was a sudden realization of "wow, that ..isn't making me depressed, or feel guilty, humiliated, etc. !"
About three hours after consuming the shrooms I came out of it and looked around my bedroom as if I was a different person; "holy crap this place is a mess!" I went downstairs and finally did the stack of dishes in the sink, put away the laundry, and spent hours just cleaning joyfully.
I was able to process considerable trauma that night, and my therapist said a few days later that I was a total 180 degrees from where I had been the week before. We've been very careful to monitor to make sure it's not just a manic episode. The positive has kept up. I've had a few down days, but that's mostly due to anxiety and relationship issues, which a little marijuana helps considerably.
Overall these past four months have been some of the best of my life. I wake up with a forward outlook. I can sleep easier, thoughts are no longer dwelling on me. I don't feel this weight on top of me, reminding me of my failures, fears, etc. Above all, I just don't feel like a sad sack all the time.
I've taken maybe two dozen medications in my life for anxiety, depression, and PTSD. Nothing can hold a candle to the immediate, calming effects of marijuana, but nothing has also come even close to the sheer relief from the shrooms.
What an amazing story and not the first time I have heard such results with psilocybin. I really hope and pray that my family member could experience even half of this transformation. To literally continue walking forward while your depression and guilt stay behind!
With all of that in mind and research indicating that you will continue to have this net benefit for up to 6 months, why try something new vs just take another trip?
Also… the dozens of meds is so demoralizing and exhausting. I hear you loud and clear on that front. Not to mention the years that go by while tweaking them… ugh.
I'm not itching to try it again. Let me tell you about the SECOND trip.. that one was much more interesting, and why I'm keeping my options open.. Caveats: If 4g was good, why not 6. I'd heard that you should be in a good "head space" for shrooms, well, I wasn't. My spirits were a bit low, so going in I wasn't sure what might happen.
The second trip was 6 grams, ground with orange juice. After ~20 minutes felt nausea but no happiness in this "come up" phase [0]. I tried reading Dune (again) on my phone but the characters would visually "s e p a r a t t e" and stretch out.
The peak [1] was much more sorrowful; I cried a lot. My trip sitter [2] said I vented a lot, almost vindictive in how I stripped away relationships, friendships, and people from my past that, well, I'd never gotten over. To me, it felt like I was shedding these heavy chains I'd been carrying around. I also, at long last, said "bye Felicia" to a an abusive, lontime "best friend" and walked away. Parse your contacts: How many that you never talk to, and have no interaction at all?
Marijuana was exceptional here for giving me a gentle cloud to settle on. In the words of Big Chris: "It's been emotional" [3] Since then mood has been the same as the last trip, all good.
+1 For using a movie quote... with reference no less.
+10 For including the citations on the various terms.
+100 for taking the time to share this second experience.
FWIW, a friend of mine is a fairly frequent 'traveller' (couple times a year). Every body type is different etc, but his recommendation to me has been:
1. Set and Setting are everything, if you have any doubts it isn't a good time
2. 0.25-0.5g is a micro-dose with no real trip but some potential chill effects. ~1.5-2g is a solid recreational dose. Any more and things can get weird.
3. If things do go sideways, milk can help (no idea of the chemical efficacy of this)
Sounds like it got weird for you, glad there weren't any long term side effects.
I would love to read those! Sort of trip sitter reports but the sitter is a psychiatrist or neuropsychologist. That would be absolutely fascinating (of course with patient permission)
I spent quite a bit of my late adolescence consuming mind-altering substances like LSD and mushrooms. It did expand my mind and made me appreciate certain things.
But it did not fix my depression or make me feel less alone. I might feel connected to the universe -- for a time. But it eventually fades, and the old demons come back.
Sooner or later, you need to deal with the issues at hand. The reason you feel this way.
For me, going to therapy allowed me to address some of the root issues -- generational trauma, a lack of affection, perhaps chemicals in my brain -- and allowed me to start rewriting my story of myself.
I enjoyed my experiments with psychedelics, and I would not discourage anyone from using them. But they are not the cure-all many claim, either.
The drugs certainly do not magically fix your problems. But it does allow you to see them, where you can inspect them (read: yourself) without judgement. This is what people refer to when they say "ego death". Your ego is not dying, it's just that your consciousness has been relaxed to a point that you are capable of witnessing it for what it truly is.
"Set and setting" is a frequent quip of the psychonaut that doesn't get enough respect. You must have intention. Psychedelics are like removing the bumpers from the side of a bowling lane - without intention you will just fall into the gutter (figuratively).
Therapy is vitally important, either externally or internally. One can certainly perform self-therapy, which is sometimes only enabled with the help of a mind-altering substance like Psilocybin.
I think you would be surprised to try them again. You have a lot more lived experiences under your belt, new perspectives, new/fewer biases, etc...
Great comment. This "ego death" can also be achieved through practices like Atma Vichara. Taking a shroom is catapulting yourself into that state of witnessing. It will definitely come off and the mind will take over, as it was induced artificially, the question is - what are you going to do with yourself during this state?
Defining or, rather, roughly sketching out, a mission might be one way to approach psychedelics. You don't want to follow it to the letter, to avoid self-limits, but at least define your attitude: are you looking for a master, an answer, a resolution? Do you want to feel what's inside of something, i.e. how your reactions are built, where this or that comes from? Just mildly keeping your goal in mind may set you to achieve the right result.
As a quick example of the outcome, at some point I felt my body telling me "man, what are you doing with this e-cigarette? Just stop putting this in me." In a few months I quit for good. Understand this might not be a demon as big as the one causing depression, but maybe this will help? Where did that guy came from?
> This is what people refer to when they say "ego death". Your ego is not dying, it's just that your consciousness has been relaxed to a point that you are capable of witnessing it for what it truly is.
A challenge in these conversations is that there’s still no real standardized way of speaking of these experiences. What you’re describing sounds like detachment to me which can vary to different degrees of course but what I would call “ego death” is the actual death of your ego, the dissolution of yourself: you stop existing and with it also any consciousness. In my experience there was really nothing left to witness in that situation as I was no more.
I liken doing psychedelics in late adolescence to reading philosophy in late adolescence. Unfortunately late adolescence is the period where the majority of both psychedelic and philosophical experimentation happen, when both of these are much more useful after gaining some life experience.
If you haven't even spent time working on or struggling with your own depression and isolation, and are in fact still quite tangled up in the formation of these issues, psychedelics don't have much to offer you other than "fun". Likewise reading Nietzsche as an adolescent, you miss many of the subtleties that make his work truly revolutionary, for example misreading "god is dead" a proclamation of some sort of victory against religion, when Nietzsche is much more concerned about our loss of meaning. You can't really get at what Nietzsche is worried about until you've had your own, serious struggle with meaning as you get older and the reality of death hits you much harder than any adolescent can imagine.
As an adolescence you're still rapidly formulating your world view, there's not a whole lot to shake up that isn't all ready rapidly changing. An adolescent will learn far more by interacting closely with a group of people they normally wouldn't, or wandering around parts of a city they normally never go to, than doing any psychedelics. It's not to say they shouldn't experiment with psychedelics and read lots of philosophy, but these won't be really impactful until later.
I highly recommend everyone in their thirties and later revisit both psychedelics and philosophy. There's a lot more there than when you where younger.
I definitely relate with this comment since my psychedelic usage was between the ages of 19 to 23. However, I don't really have any interest in trying them again. My "set" as a 33 year old is significantly more complex than when I was 19 and I'm convinced that my day-to-day worries would cause me to have a terrible trip.
What have you gained by trying them again as an adult?
I find that it's precisely when I'm mired in these "day-to-day worries" that I find shrooms most effective at breaking me out and getting a renewed sense of relative priority.
I can understand your concerns about a "terrible trip", especially since these type of worries typically make me paranoid and anxious when I'm on cannabis. However, I've found that when I do shrooms the psychedelic experience always side steps these anxieties completely and reminds me that these concerns are not the core concerns I have.
What's different about doing shrooms as an adult is that I'm not like "whoa, all this stuff isn't real!", I already know that. It's for those times when I feel daily stresses slowly crushing down, am fully intellectually aware that these things are ultimately not important, but can't quite find the emotional release. Shrooms aren't a miracle cure, but typically I'll feel a bit refreshed for quite awhile. As a teenager shrooms are about changing your perspective of big, metaphysical things "whoa man!", as an adult they're about changing perspective on those small things "oh right, performance reviews really don't matter." The insights are the things you, for the most part, already knew, but have been too distracted by daily life to really realize.
I had bad trips when I was younger, but being older and knowing both myself and psychedelics better I find I am much better at keeping myself from spiraling out of control too easily, and much more deeply feel the wisdom of "there are no bad trips". The other nice thing about tripping as an adult is you have much better control over the scene portion of it.
Same experience but while I was in college, and I was not a casual or recreational user. I fully bought into the whole psychedelic mythology, poured of Erowid trip reports, read books by Timothy Leary, kept trip journals, trip-sat for friends, tripped in nature, tripped alone, experienced ego death, etc. At one point I even backpacked a short portion of the Appalachian trail with a friend and ate mushrooms each morning before setting out.
The "insights" I gained certainly felt profound at the time, but they were kind of silly in retrospect. I'm actually cringing a bit right now remembering what I was like back then. I remember going on a first date with a girl the day after a particularly intense mushroom trip and trying to share my "wisdom" with her. She must have thought I was completely insane haha.
Sitting here now almost a decade since my last trip, I can't say it permanently changed my outlook on anything. I still dealt with a lot of depression and confusion in my 20s, just like anyone else. The things that really ended up moving the needle for my depression and anxiety were: quitting alcohol, lifting three times a week, therapy, getting married, and having a kid.
Same experience as you. I still take psychedelics once in a while but at this point it has become really clear to me that after a few initial epiphanies it can becomes purely recreational. I love taking them recreationally but I am no longer idealistic enough to think I'm really opening the doors of perception.
Talk therapy, becoming estranged from abusers in my family, and SSRIs helped me long term conquer my PTSD and depression.
Educating yourself on psychoactive substances is a good advise. Saying that, many people who are dealing with depression and anxiety need active help. Growing and consuming your own mushrooms might be a very counterproductive or even dangerous advise for an inexperienced person with severe anxiety.
Managed ketamine therapy starts as low as $1200 for 6 sessions I believe.
Check out Mindbloom. These sessions are bundled with a psychiatric and medical assessment, integration sessions, clear and easy to follow guidance for every session, music options. They are very focused on “set and setting”. Also the first session requires you to have a guide present (your friend or relative), who has to communicate over video with your Mindbloom guide right before the session.
This system is not perfect but practically as close as it can get to a fully guided affordable session.
I am having an exceptionally positive experience with them. Saying that, I am pretty experienced when it comes to therapy and psychedelics, so didn’t need a lot of handholding from them.
Clearly ketamine infusions are about being legal and all the benefits of doing business out in the open. Anyone could buy illicit ketamine for 1/50th the cost and administer at home, but that is a felony.
Some states allow for small amounts of ketamine to be a misdemeanor, but for many (most?) it’s a felony. In Texas and Florida, the second and third most populous states, possession of any amount of Ketamine is a felony.
Well... almost everybody self medicates, one way or another. I doing think I know anybody that doesn’t reach for caffeine, Tylenol, alcohol, or cannabis, once in a while.
Uh, why so expensive? Some 20 years ago liquid ketamine was available over the counter in veterinaries here on Balkans, it being known anaesthetics for animals like kettle. You could buy like 2l bottle for less than 20 EUR. When it became really popular among partygoers it became harder to get in cities (also some people got reported to the police), but there was still plenty of it in villages and smaller farming towns.
One would just pour the liquid on china plate and put it on smallest temperature on a kitchener. Liquid would soon evaporate, leaving crystals ready for snorting.
Fun times. I'm glad they are over for me. I guess I'm cured :)
Here in the UK, I pay my pharmacy £13 for a 10ml vial containing 50mg/ml ketamine (I take it for chronic neuropathic pain, prescribed privately since the NHS wouldn't do it). It's available much cheaper in bulk - I know these therapies need equipment and supervision, but I still have no idea how they are so expensive.
I've looked. We tried shrooms once on a whim, in Amsterdam, and while it wasn't that interesting a trip, it did have the side effect of eliminating my wife's OCD for almost a full year. I wish they were easily available. I've even considered driving to that "church" in Oakland to get her something. I don't otherwise have the right kind of friends (or they are quite discrete about it despite my having mentioned it).
Have you searched on https://www.shroomery.org/ or the subreddit unclebens? Maybe this goes against hackernews rules, but you may contact someone with prints there. There is a discord called Fungus Amongus as well, you may have luck there.
Correct. Ketamine is making strides due to the fact that it is already a legal drug and pharma can charge big bucks for it. It is very helpful in the acute sense, but long-term results are bleak. Psilocbin on the other hand has decades of research behind it showing how well it can be used for therapeutic purposes, but there is no money in it right now. I hate to sound like a tin hat conspiracy theorist - but I guarantee that once a pharmaceutical company can legally sell psilocybin therapy you'll never hear about ketamine again.
I've tried many antidepressants with mild improvement. The drugs give me the ability to function, but i'm just pretty numb. I've done lots of talk therapy, with little success. The problem is that I emotionally shutdown as a child due to a lot of traumatic events. Would ketamine open me up, to allow me to deal with the trauma I buried ?
Have you tried 5-HTP? I started taking it around a decade ago, maybe more, and it was really helpful for my depression.
Aside from 5-HTP, I started taking oral ketamine for chronic neuropathic pain around 1-2 years back, and it's been absolutely transformational - I've suffered with depression for my entire life, even when I was a kid, and now for the first time ever I feel... like it's maybe not an issue! The dark feelings of sadness and loneliness, the random tears, the pointless futility of existence... those just aren't there anymore.
even better than psilocybin for me has been MDMA - there was a study recently about how it can help with social anxiety in autistic people. It's also helped me a lot in dealing with trauma, opening up to people and deepening my existing friendships and relationships.
I don't know anything about psychedelics or any drugs, but isn't it true that they can burn out your brain? So although they may have some benefits for those suffering from certain ailments, isn't there significant risk involved? If so, it would seem like your post is missing some very important disclaimers.
I asked my psychiatrist about this and he said he tried with a couple patients but didn’t see any long term results so didn’t want to put me on it. I was hopeful for a good fix but he says it’s not it? :/
I've been through my fair deal of psychiatrists, and the best tip I can give you: if you're not happy with what your psychiatrist is doing with you, or with what help they are giving you, find another one. Repeat until you find someone who actually can help you improve. It might take many weeks to find someone you finally click with, but once you do, you'll improve a lot quicker than you thought was even possible.
Considering the comment you are replying to, that amounts to just "shopping" for a psychiatrist that will prescribe you the treatment you want and not the one you need.
I can 100% get behind the idea that you want to find a psychiatrist that understands you or that you "connect" with, but if your gripe with your current one is that he won't prescribe ketamine even though you read online that it might help, I'd say reassess.
It’s strange how we accept the removal of the patient’s agency in preferring or wanting to try a particular treatment.
The internet has put a lot of health and treatment information into the hands of laypeople that did not go into the medical profession. Some of those people are more than capable of making decisions for themselves, but the field of medicine doesn’t seem to account for this yet.
In softer forms of treatment like talk therapy, the patient's agency is emphasized and encouraged by the pschologist. However, the prescription (and assessment of the suitability of) drugs and active substances should remain the domain of a licensed practitioner.
Get real, the patient does not have a degree in medicine or psychiatry. There is a reason these professions are licensed. Not every doctor/health care worker is out there to dupe you and deny you the treatment you think you deserve.
Their psychiatrist could simply have a personal issue with the treatment protocol and not want to use it due to their personal biases, or maybe the results from their last experiment were disheartening and they don't feel like giving it another go.
> he said he tried with a couple patients but didn’t see any long term results so didn’t want to put me on it
To me that's a very reasonable take if it's coming from a real psychiatrist, OP doesn't tell us his life story. The trained professional thinks there are better solutions for his patient because he tried the protocol on other patients and saw no long term results. If you read that statement and think "OP should try other psychiatrists" then to me that just sounds like you think ketamine is some kind of miracle drug.
As with everything else in life YMMV, but if taking drugs to address a specific issue (i.e. non-recreational), then listen to the person that spent +10 years studying to help you.
especially with treatments for depression, where the state of the art is essentially "keep trying different drugs until one seems to work", it can be a fine line. the psychiatrist knows much more about the drugs than you do, but that doesn't give them much advantage in actually predicting which, if any, will work for you.
at the end of the day, you go to psychiatrists to access pharmaceutical treatments for mental health issues. if the one you pick doesn't prescribe something that solves your problem, it's rational to either try another one or stop seeing psychiatrists.
From what I have read so far the studies on clinical ketamine usage have focused on its (seemingly miraculous) properties as a short term antidepressant.
Long term ketamine usage is not so well studied. Recreationally, using much larger doses, some people have issues with UTIs, bladder/kidney failure and addiction.
The one compound I've used (on and off, for maybe a few weeks at a time over the past 18 years) intermittently is Clonazepam. Recently however I don't find the dosage to be very effective, and reading the literature, upping benzo dosage has a high risk of increased dependency. I'd like to avoid that.
I happened to randomly start Googling about Lithium and stumbled upon Lithium Orotate, which is sold as a supplement pretty much everywhere. There's a little bit of literature on Pubmed, but not much.
I take this exact brand and it is really great. just be careful if you stack with SSRIs. if I take a bit too much I started getting headaches/serotonin syndrome-esque effects. I stepped down to 2.5mg since I take some prescription meds but if you're vanilla 5mg is great to start. For me it does help relieve anxiety and boost my mood a bit. If you have a NY Times subscription or free article viewing you might also be interested in the article "Should we all take a bit of lithium?" which inspired me to try it. Here is an article with some info on dosing from a practicing doctor. https://www.chandramd.com/blog/low-dose-lithium-supplements
The problem with self-medicating lithium is that doses low enough to be harmless were not shown to be effective, and doses proven to be effective are too close to dangerous. The only way to get the dosage right is very careful blood testing.
I have a bipolar diagnosis but with medication I've been symptom free for over 5 years now. For the past two years I've been taking 5mg Lithium Orotate nightly as a supplement to my main medication Lamotrigine [1]. I started taking the Lithium as a prophylactic against dementia. Research has shown that a history of bipolar disorder is associated with significantly higher dementia risk [2-3]. Low-dose lithium has shown promise as being preventative against the progression of dementia [4].
After starting the Lithium Orotate I noticed some subjective improvements in mental clarity and mood within a couple weeks. The effect is very small though and not comparable to that of my main medication. Although it's possible that I'm only experiencing the placebo effect, I suspect that the Lithium actually is helping somewhat.
The 5mg dose in most commercially available Lithium Orotate supplements is a couple orders of magnitude less than the doses typically used to treat bipolar, but I think it would still be good idea to bring it up with a doctor. Also, try to manage your expectations. It's probably not going to change your life all at once, but you may notice some small subjective benefits over the longer term, and the research on low doses of lithium being partially preventative against dementia seems pretty solid.
I highly recommend not using lithium without medical supervision. All of the bipolar people I know have significant side-effects from it. You also need to be careful with hydration because lithium toxicity is dangerous. If you get confusion as a side-effect of toxicity, you become less able to recognize what is happening.
From my own experiences with atypical anti-psychotics, getting dehydrated or running low on carbohydrates can affect my motor control severely enough that I can't drive. (I always have water and energy bars on me.) It resolves within an hour after rehydrating.
Interactions with other medication or supplements can also be dangerous.
I can't say anything about low-dose lithium so I'm sorry if this is out of scope.
I did however take 600mg daily of Lithium Carbonate for a long time and it really helped me with my anxiety, and, importantly, it reduced my suicidal thoughts/self harm urges to basically zero from multiple times a day. This isn't as low as the doses people seem to use with Orotate, but it's still "subclinical".
I’ve known people that took lithium for bipolar. It’s not a drug I’d recommend taking without professional supervision. Its side effects can include personality disassociation, weight gain, and memory loss. The people that I knew fought tooth and nail to get off it.
Obviously, the effects will differ between people, but best to go into things with your eyes open and a professional to supervise things.
As you likely know, but some people replying to you seemingly don’t- lithium orotate is not the same as prescription lithium (carbonate? It’s been a while).
Takes more of the latter form to be effective, and lithium toxicity is no joke- it’s landed a family member (who’s been on it for decades) in the ER multiple times.
Lithium orotate is safe at the doses on the label of otc supplements.
In my experience if has a subtle but distinct effect in terms of reducing anxiety. Particularly if taken with water on an empty stomach. Can’t speak to its effect on bipolar type issues.
Things go in cycles. LSD was a potential miracle drug but then it got a bad name due Leary et al. Ketamine will not make any pharmaceutical companies rich, therefore it will be a fad. Money matters, even moreso with mental health.
That’s a very inconsistent logic. LSD failed due to its uncontrolled mass distribution which should have never happened. Early lab experiments were very promising, and LSD is slowly coming back (check out MAPS).
Ketamine has been in production for decades as an anesthetic, so saying that it’s a fad because it won’t make companies rich is nonsense.
Delivering ketamine will make a lot of people rich. It probably already has for a few people. Opening a depression clinic will simply involve having a bunch of rooms (or maybe just a bunch of chairs) for people to trip in, a nurse on duty, and a doctor somewhere on the letterhead. Medicare et al. will be charged hundreds an hour for each occupied room.
The nasal spray? An anesthesiologist told me that it's 1/10th as effective as IV therapy due to some aspect of bioavailability and how it ultimately didn't produce the same sort of norketamine levels required.
edit: For context, he subsequently complained of how big pharma was conspiring to destroy ketamine iv therapy access in order to better control the "legal ketamine" market.
IV is not 10x more effective than intranasal - it's maybe twice as effective.
IV bioavailability is 100%, intramuscular 93%, intranasal around 50%, and oral around 20%.
This is something I just don't understand about IV ketamine therapy - IV protocols vary wildly, and I haven't been able to find any reasons why IV would be more effective than any other route of administration with an increased dose.
Can't wait for regular people that have a few solvable issues in their life but perceive themselves as "depressed" to just take a shortcut where Ketamine, or whatever is the miracle drug at the moment, will fix everything.
Many doctors won't have any problem prescribing them, as they can always say "it was <national drug institution> approved and the patient should stick to the prescribed dosage".
What the vast majority of people need in their lives are discipline and sense of fulfilling, which they won't get from drugs or other material things they can buy.
Ketamine is used to induct children into surgery it’s so safe.
Depressed people cannot maintain the discipline required to undo their learned helplessness - which is burned into their neurons as structured physical loops.
There are neuronal changes that cannot be rapidly modified without drugs that release BDNF, like infusion-levels of ketamine.
In the time you aren’t treating your patient with the most effective systems, of which ketamine is one of them, they may do irreversible damage to themselves or others. All depression treatments should short-circuit to ketamine as a first line - the efficacy is incredible.
The greatest issue with ketamine infusions is that they cost $800 per session.
>Ketamine is used to induct children into surgery it’s so safe.
Which is not the topic of the article, nor am I debating that fact.
>Depressed people cannot maintain the discipline required to undo their learned helplessness
Those deeply depressed people are not the ones I am mentioning in my comment. And as with any other serious disease, sometimes taking experimental treatments are worth the risk if more conventional treatments don't help patients improve.
If I wasn't clear enough, I'm talking about people who think they are depressed but would most accurately be described as "sad", for any given reason that could be happening in their lives.
"Miracle drug" is a sidelining attempt to dismiss infusion therapy, your primary concern in your post is the patient's health - with recommendations to maintain discipline, which is usually done through a focused, repeated and consistent healthy activity - like running, or weightlifting - known positive recreational activities.
Since your concern is for the patients health, and your recommendation is against the use of first line infusion therapy, and your alternative is a known positive recreational activity with the intent to build discipline; it is implied that you believe the infusion is not safe for the patients health in the particular circumstance of short-term sadness.
You are not debating the fact, you are simply dismissing the efficacy of the infusion with regard to assisting patients undergoing "short-term sadness", and working around it when confronted.
The mistake here is somehow believing that all patients can handle "short-term sadness" without undergoing a mental break; it is analytically correct to assault the issue on all available fronts, and if a small infusion dose assists someone in rectifying their issues, it should be done.
The patients perception of their mental state becomes their mental state, which is why psychedelic drugs have such a high efficacy in the first place, the BDNF literally rewires their brain and how they view their issues. So what exactly is implied when you say "Can't wait for regular people that have a few solvable issues in their life but perceive themselves as "depressed" to just take a shortcut where Ketamine, or whatever is the miracle drug at the moment, will fix everything." - these issues are perhaps solvable for you because you would view it how you view their "short-term sadness". This is not the case, each patient is N = 1.
my review of Dr. Vu K therapy: You are lead into a room with a very comfortable chair, amazing head phones, great relaxing music, think first class airline seat but without being in an airplane. A nurse comes in and injects the K into your arm muscle (not a vein) and within seconds you feel the effect. Soon you forget all about how nervous you were coming to this office or worrying about urinary track issues, worrying about anything at all.
For about an hour you are in this wonderful state. The nurse comes in to check on you every so often. I can barely speak but I'm able to give a thumbs up and mumble "yes yes doing great."
The end reminds me of that Guns n' roses song, "when you're high you never, wanna come down..." But even after the hour is over and you can walk again and you are safe to drive, you are very happy the rest of the day.
I will say Dr. Vu sells a lot of other stuff besides K shots so be careful what you agree to. It can get very expensive! But overall I think it's a wonderful service he is offering.
Hmm, I've read a lot about ketamine infusions, and I don't think I've ever come across them delivering it via the intramuscular route before. Was it just a single injection, and do you know how many mg? I thought the whole point was to keep plasma levels high for a long time.
Anyone with access to a vial of ketamine could easily perform a single IM injection at home without paying thousands of dollars for the privilege.
Single injection I don't remember the mg sorry, but I'll go back and ask later this week. Dr. Vu only charges about $100 for each shot. Others do charge WAY more. But I don't think any licensed real USA doctor with legal access to K is letting people self admin it.
When I asked about muscle vs vein he said a lot of K is lost in the process and not absorbed by the body, but enough is that it still works fine.
what's the current state of the enantiomer disparities? IIRC S-ketamine is less good than R-ketamine or racemic mixtures, but this is stuck in regulatory paperwork.
I wonder how they address the urinary tract issues, especially the bladder. It's one thing when they use it for anesthesia, which is quite rare and sporadic to receive, compared to something like therapy, which might happen more frequently and for longer. Does anyone have any data about that?
Too bad the world's first "synthetic" to combat this issue, MXE, was made illegal.
It has no bladder problems, and shines light where ketamine is cold.
MXE is the perfect drug. 5g in a few months, stopped cold turkey, felt fine - due to the long lasting and dissipating metabolites that these drugs degrade into.
I am planning on getting some Ketamine soon for my own Christmas present. Too bad I can't have MXE, which is safer, better, and fuckn awesome.
you can even smoke it! (very small amounts. makes you feel like a golden greek god)
If you know where to look on the dark web, MXE can occasionally still be found. The fine folks over at Lizard Labs in NL have also developed DMXE, which is apparently qualitatively nearly identical, though I have yet to be able to acquire any in the US.
My understanding is that ketamine therapy doesn't involve many doses of ketamine over a long time, but rather a handful of guided sessions over weeks/months.
Urinary tract issues are not that common. They would have to pretty much take higher doses, long-term. It is not a concern as far as this therapy goes.
Last I heard about this in hard reduction groups, people experience this after 1-2 years of chronic daily usage.
It's definitely something to keep an eye on. But people would be able to get through many sessions before being at risk.
I'm more worried about people stop being able to afford it, going to black market and and up having a dependency.
Apparently there's a big difference in the quantities of ketamine consumed by recreational users versus people who are prescribed it, 90 grams per month being common for recreation versus 300 mg for treatment.
I know many heavy and moderate recreational ketamine users and 90g is completely absurd.the really heavy users I know go through a gram per day max. During parties or festivals it can be more. Not to say that there isn't a big difference to therapeutic use.
You tend to get deals on bigger purchases. But it's a pretty typical pattern for people to destroy all their savings, and social capital very quickly during the escalating dose phase of drug addiction. My friend who got hooked liquidated his retirement funds, sold his car, house, borrowed tens of thousands from family & friends & banks, committed insurance fraud, and embezzled from his employer. Probably over $100K and all gone within 18 months to ketamine and meth.
I think it's worth reevaluating the word 'recreational' here. Except for festivals, or longer parties as someone already mentioned 300mg is an enormous amount to consume in one sitting, especially without a good understanding. 90g per month seems quite unsafe.
Does anyone know if Ketamine is more effective for depression than Psilocybin/classical psychedelics? Is it being used in place of psychedelics because it is already schedule 3 or is there a different reason?
I am not a doctor but I did some research on this a couple of months ago. I recommend you carefully do your own research and talk to qualified doctors, but here is what I found:
Psilocybin is for depression, trauma, PTSD, addiction, coping with pain, and generalized anxiety disorder. One dose induced rapid growth of dendritic spine size by 10% and density by 10% in the frontal cortex within 24 hours and lasted at least one month (they didn't monitor beyond that). Depression is associated with synaptic atrophy in the frontal cortex.
Ketamine is for major depressive disorder, bipolar disorder, obsessive compulsive disorder, and social anxiety disorder.
Eventually, the consumption of all recreational drugs will be medicalized. Turns out that taking drugs makes you feel good, and that if you can keep taking them, you'll keep feeling good unless the body physically adopts, like with heroin. I always wondered why people took them.
Medical ketamine for depression could potentially be an even greater windfall than methadone was. There are a lot more people that can be diagnosed as depressed than as heroin-addicted. I supposed this is all working towards massive state subsidy.
A close friend's startup has an oral alternative to Ketamine that hits a subset of the mechanisms in a more controlled fashion for this purpose. They are raising their first round of funding at around ~1,000,000 USD. If interested, please feel free to email me at the email in my profile.
It's been used in emergency care for decades. It's one of the most used drugs and part of the basic kit in an ambulance or ER. It's safer than other anesthetics because it doesn't affect respiration so much.
I meant as in any neurological impairment. Effects on cognitive functionality or memory retention. You know, the types of damage often reported over extended use of psychoactive drugs.
Can make you feel loopy and nauseous depending on amount and how quickly it goes into your body. You should go back to feeling normal again after about 10 minutes after it stops coming in. (This is based on what a friend experienced when given it by a doctor.)
Ketamine is really interesting drug but let's be honest, the reason you're depressed is probably not because you haven't done enough ketamine. Yes it's fun to do drugs... Going to Six Flags with good friends would also probably make you less depressed for a couple of weeks. Why are we excited that now there's a way for rich people to do a fun drug in the most boring context possible? This feels like part 2 of microdosing LSD or psilocybin at your boring office job.
Is ketamine going to make it less depressing that you work in ad-tech? Why not also microdose magic mushrooms as you work in ad-tech? Why not buy from your local farmer's market as you work in ad-tech? Why not volunteer for a local organization in your free time while you work in ad-tech? The problem is that you work in ad-tech. No amount of microdosing or macrodosing LSD or mushrooms or ketamine is going to change the fact that you probably have no social skills and your life work in ad-tech is meaningless, and having slightly more money than the average prole and being able to afford drugs they can't isn't going to make you happy.
I really dislike that phrase. It comes off as arrogant, condescending - dismissing the quite real change that these drugs can foster when used with a productive intention, in a proper setting.
Not everyone uses various substances for "fun". Some people use them to understand their existence better, or do help combat debilitating mental constructs and experiences.
I have not been able to get ketamine, however I did find my cure for anxiety and depression (mostly).
No SSRIs worked, I'm simply immune to that shit. It makes me feel worse, even more suicidal than usual, even if taken long term. And withdrawals ain't pretty.
So, enter gabapentin and pregabalin. Which no doctors would prescribe as they're for those with epilepsy or something and I'm just a fucking idiot in their eyes.
No matter, I can buy it freely right now.
Both of them work on voltage gated calcium channels, something I do not fully understand.
But I do understand they work, and they work well. As long as I take either, I'm chill, content and even creative.
Doesn't help with attention/focus, but at least it works for the anxiety and depression.
Apparently they're prescription only because a small percentage of people reported euphoric feelings. Damn narcs lol.
Yes, when initially taken in high enough dosages, both gabapentin and pregabalin gave me very euphoric feelings, insane waves of energy, somewhat between alcohol and cannabis, really nice.
However that subsided after several months and now it's only the quiet chill feeling.
Withdrawal is fast, if you taper down over a week there are no effects. If you quit cold turkey, it's a few nights of nightmares or insomnia. Overall, really not bad compared to anything else.
So yeah, they work, they work well and I wish doctors actually put their brains to use and made them more readily available.
Just make them OTC because few people can put up with the regular begging they have to do for life changing medication.
If I had a dollar for every HN story about how technically illegal drugs are being used for psychiatric purposes and we're just on the verge of them going mainstream and legal and licit, I could fund a bunch of YC startups.
Hard doubt. Searched for "mushroom", "psilocybin", "cannabis", "marijuana", "cocaine", "lsd", "ecstasy", "heroin", "ketamine" on HN search and in total came up with just ~4450 submissions in total, and I'm over-estimating by including just mentions of some illicit drugs, not just psychiatric purposes. I'd love to see you fund any startup with just ~5000 USD.
There seems to have been a noticeable dropoff in new depression treatments. Sometimes I wonder if resorting to these options is a kind of desperation. I'm not saying these things shouldn't be investigated, but most of these illegal drugs will cure depression in the short term, but not so much in the longer term. Even the SSRIs have become a disappointment for many in the long term.
Regarding development, there hasn’t been much at all outside of SSRIs/SNRIs. The third chapter in the below video on bipolar disorder and ketamine addresses this.
