Friday, May 24, 2019

Esketamine & Me: An Ongoing Log

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Being the broke-ass mental case I am, I go to a state-funded mental health clinic that doesn't prescribe any controlled substances...even benzos or other Schedule IV's.  So you can imagine my surprise when my psych doctor brought up ketamine nasal spray at our last visit.  She asked if I'd ever heard of it, to which I (maybe too enthusiastically) replied "Yes!  You mean esketamine, right?  I'd be open to trying that."  

I'm considered treatment-resistant when it comes to depression and anxiety.  I've tried every class of drugs except MAOIs & the old school antipsychotics like Thorazine--neither of which I'm interested in due to the health risks.  I've happily accepted every prescription she's written for me, which I feel has contributed to her willingness to let me explore more "experimental" options like ketamine.  Plus, the list of meds I've tried over the years is exceedingly long--in excess of 22 different drugs, many of which were very unpleasant or caused dangerous reactions.  To qualify for esketamine, you only have to have failed TWO depression meds.

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Spray away the blues with Spravato! 
I have Medicaid & don't think Spravato (esketamine brand name) is covered by it yet.  It's administered by a psychiatrist in an office where you must stay for ~2 hours while the effects wear off, and you must be driven home by someone else afterward.  That's as much info as my psych doctor has about it currently.  But I plan to keep up to date on any new info that comes out as it's one of the few substances I haven't tried already...be it prescribed or of my own accord.  Will update this log as I learn more & hopefully get to try it myself!

From my own research, plain racemic ketamine (generic) can also be administered intravenously or prescribed in the form of a nasal spray or lozenge and made by a compounding pharmacy for much cheaper.  That would be ideal since it could be taken home in the latter 2 scenarios & would be much more affordable.  Spravato seems to be a ripoff in that it's no more beneficial than ketamine but far more expensive.  It may be 20 years before I'm able to try it, but it's still something to be hopeful about.

Do you have any personal experience with using ketamine--either prescribed or "off-label"--for depression?  I'd love to hear your thoughts in the comments!

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