4 KAPs done and no improvement

Well all, I’m disappointed to say I’m 4 KAPs in and I honestly feel no better off than I did when I started. I had a call today with the doc and he was surprised to hear I’m only feeling the positive effects for 2-3 days and then it wears off completely. He seemed to expect I’d get at least a week of relief.

He just prescribed troches and I’ll pick them up this week. He said it may take me longer time to heal because my childhood trauma is complex and multi-layered, and basically threaded thru every aspect of my life for 46 years. Ugh. So I’m going to attempt to give it at least 2 at-home sessions before I decide if this is a total bust and waste of my money. That will have given me 6 which seems like the minimum many clinics recommend.

I’m disappointed. I really hoped I would have more positive and profound healing from this work and it is feeling like I just flushed $1800 down the toilet. :sleepy:

I’m also quite nervous about the troches after reading one of the last threads and seeing how many people can’t tolerate them or get sick from them. A bit nervous of a possible bad experience/reaction. Any advice would be appreciated.

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Troches will work better on an empty stomach, but can be hard on your stomach. I would recommend a little bit of food in your stomach. If you have any trouble with nausea you need some Zofran or cannabis. It took me three treatments before I really started to feel better. We are all a little bit different. That’s OK. With this medication you have to do the personal work for it truly to be effective. Do you have a therapist you are working with?

Yep, I’ve been in therapy for 2 years now. I was going every week but unfortunately my insurance changed to crap and now she is 100% out of pocket so I can only afford to go every other week (I can’t really even afford that!). Our Healthcare system is so broken. $100 out of pocket every time and that’s with a sliding scale. My shit insurance has a $6k deductible for out-of-network. It blows. :frowning:

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Some people have reported success with chewing candied ginger prior to use of oral K. FWIW, I have not tried troches, but I had good success the last time I used the fast-dissolving sub-lingual tablets (at 1/2 the dosage of the previous attempt). I suspect that the fast dissolving tablets get more medication into your blood more quickly than the troches.

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I was told that the 6 doses need to be the clinic variety. I have also been told that the troches are not “infusion Jr.”, which is how I started out with them. I am still trying to figure out what works best for me with the troches.

I am coming up on 2 years at the clinic, they do IM, not IV, but I’m not sure how much difference there is (especially only having the IM). Once I did my initial 6 build up, I am good for about 3 months, +/-.

I just started with the troches this summer, only had them for about 5 months now. I have never had any problems with them. The only issue I have ever had with them is finding/making the time for them. Even with a partial, it isn’t anything that I am going to want to be active for. Nothing even close to the injections, but for me it is definitely ‘Sit back and keep your hands and head in the car.’ Not total debilitation, but gravity is back in service after about 1 hour. Physics gets a little wobbly for a little while.

I would encourage you to consider #5 and #6 at the clinic. I have been told the troches are mainly to smooth the ride in between clinic visits, and can help to extend the time between.

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I think the troches are just a stop gap to get you over a rough patch. The infusion or intramuscular is where we get the big relief! I love troches because when you are starting to head back down the road to severe depression, it can mitigate that to manageable! They are like a small booster, booster!

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Fighting the insurance company is the worst of our nightmares that we have to deal with. Humana makes me depressed! I have never been so mad as I was last week at those :face_with_symbols_over_mouth: SOBs! Stupid insurance companies don’t want to pay for anything even when you have 100% special authorization. Never stop fighting for your rights! We are the pioneers in this that will help other people in the future. This is the best medicine for depression by far! Nothing else really worked other than turning me into a zombie emotionally. The only thing that helped prior to ketamine was cannabis.

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In my unprofessional opinion, I would say it’s working if you’re getting relief. Even if it is only a couple of days… my sessions were spaced every two days for the first 6 so I couldn’t say if I had any relief longer than that. After the first 6, I was able to make it about 5 weeks (which was about two weeks too long). The first clinic I went to basically just gave you your IV then sent you on your way. I knew nothing about ketamine therapy and a lot of times just think of it as a waste of $3000 but it did save my life so I guess it was worth it :joy: I was able to find another clinic that is truly amazing. I did another 6 sessions there spaced two days apart and was able to make it about 5 weeks again before I had to go in for a booster. Before that session I talked with my Dr about getting a nasal spray in between to lengthen my time between boosters and it’s about 1/4 of the cost of an infusion without insurance. It’s been two weeks since my booster and I’ll probably go in for the nasal spray in a week or so. It’s is definitely hard talking myself into and coming up with the money/time to do this. I just have to remind myself that it is just money and if I really need it I’m fortunate enough that I can go work my butt off for some more. I wouldn’t say that I’m happy but I am continuing to improve. My average daily mood “score” is probably a 4-5 out of 10 but it definitely beats standing in my bathroom for hours staring into the mirror with a straight razor in my hand. That alone is worth the almost $7000 I’ve spent since August. I don’t know what I’m really trying to get across. I guess it just takes time. If you’re seeing improvement, no matter how small, you’re getting better. Some of us take longer, if you’re able to come up with the $ and continue treatment, keep doing it.🫀:zap:

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I’m honestly starting to come to the conclusion that it’s not helping at all. I’ve now done 5 sessions and I feel no different than I did before I started. And for all that money. I found this article last night which I found really illuminating. See what he says about the success rate really being only 50%. That seems right to me. My friend saw huge improvement. I’ve seen none. It only feels like I go into a drug den each time, and I feel like a druggie, only to have no change whatsoever. I am strongly considering stopping and going back on Prozac. Prozac always worked beautifully for me. The only reason I stopped it is because I believed that there was an underlying wound that needed healing. Now I’m starting to think I really do just have a serotonin production disorder, and Prozac takes care of it. I can’t tell you how disappointed I am. I really was hopeful this would work for me but it’s not even that I’ve felt a small change- the net result after 2 months of this is that I absolutely no improvement at all. I think it may be time to cut my losses.

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It makes me sad that it’s not working for you like it does for most of us.

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I’m not sure I can say it has worked for “most.” Reading thru all of the posts, I have seen many who have said after 10-12 treatments they are still feeling the same. Lots of posts seem to reflect not great outcomes. To me, if you have to keep getting treatments once a week, that isn’t sustainable nor certainly affordable. Prozac treats much better than that in my case. I really didn’t ever want to go back to the SSRI route, but I think all of this may be showing me that is in fact the most effective path for me. But to say I feel disappointed would be an understatement. I had such high hopes for this treatment. Right now I feel like I’ve merely flushed $2k down the toilet, and that was money I didn’t really have to spare so it is discouraging. Given what that psychiatrist said in that article about it really only working for 50% of people, I think it’s important that the industry be transparent about those odds.

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Agreed - as with any drug the effectiveness rate should be realistically presented. Prior to treatment the effectiveness percentage I saw from most medical studies was estimated at 70%. Even if I had been told 50% I would have given it a try. Even a placebo has (I think) a 15% success rate in many trials.

If SSRI’s work for you, that’s really great! Wish they were effective for me. But everyone’s brain is different.

Very interesting article. My referring psych worked with Dr. Levine (she’s based in CO). I’ll be curious about her feedback. She was very frank with me about the pros and cons.

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You would know your mind and body better than anyone on here. Sometimes it just doesn’t work. I feel bad that it doesn’t work for everyone. I’m glad there is something out there that can bring you relief that you can for a lack of a better term, fall back on. I totally get the not being able to afford it. That’s one of the main things that brings me down about the whole ketamine experience is wondering how I’m going to come up with the $ for a booster, and when I’m going to need another one. It seems to work for me for now and I feel the effects are starting to last longer in between treatments. It has definitely given me a break from my physical pain. I hope you find the help and support you need. 🫀🌟

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Pre-apologies. I am not trying to step on anyone’s toes, nor tell them how they should approach their own medical treatment. Granted, I am not a doctor. But I take issue with some of Levine’s article. This is not to say that anyone shouldn’t take his advice, or do their own homework.

He starts out by stating that SSRIs have a 50% success rate (" Selective serotonin reuptake inhibitors, or SSRIs, are widely used antidepressants but are effective only in approximately 50 percent of patients.") He then goes on to criticize ketamine therapy for the same reason (“Academic trials have shown ketamine therapy to produce response (50% reduction in symptoms) in roughly 50% of patients”).

“Because ketamine already exists as an off-label treatment, the trials that exist are small, academically driven, and motivated by interest alone. There is no incentive to fund large-scale clinical trials to generate data that could show for whom the treatment is safe and effective and from which regulatory approval could be sought. This is the path typically required to gain reimbursement by insurers, the gatekeepers of broad patient access.”

Where is the problem with trials that are academically driven? “Motivated by interest”? If there were no interest, no trials for anything would ever happen. What is the difference between academic and clinical trials? Are they not both held to the same criteria for accuracy?

And as Frank Zappa stated, here is the crux of the biscuit: “…the path typically required to gain reimbursement by insurers, the gatekeepers…”. Ding, ding, ding! Follow the money. When the deep wallets aren’t in charge, they are going to howl “Foul!”.

True, the lack of regulation makes it easier for charlatans to sell snake oil. But, that hasn’t prevented pin-headedness in the medical community. I once had an MD tell me (in all seriousness) that a zit/boil in my underarm area was a ganglion cyst. Even a fairly cursory internet search tells me that ganglion cysts are associated with joints and tendons, not soft tissue and skin. I also had an MD refuse to take follow-up x-rays of my wrist because they had determined that it was sprained. 1 1/2 years later I had that wrist fused because of non-union of a fracture and necrosis of my scaphoid.

He goes on to find fault with ketamine therapy because “Even when things do go well and care is given responsibly, access to treatment still remains an issue. The off-label therapy is most often not covered by insurance plans, as there is insufficient clinical trial data for seeking FDA approval.” I read that as circular logic: There isn’t FDA approval, because there is insufficient clinical data, and there is insufficient clinical data because the only people doing any research are small, independent providers starting with research data that has academic origins, as opposed to drug company funding. And because there aren’t drug company funded trials (for their own patented product), there is no FDA approval. With no FDA approval, no insurance coverage. No insurance coverage, less small, independent providers conducting academic trials.

He goes on to further caution against ketamine, “Ketamine is often included in the discussions around psychedelic therapies. However, ketamine is not a psychedelic and the two should not be conflated.”

Again, a quick Wiki search comes up with:

"David E. Nichols wrote the following about the nomenclature used for psychedelic drugs:

Many different names have been proposed over the years for this drug class. The famous German toxicologist Louis Lewin used the name phantastica earlier in this century, and as we shall see later, such a descriptor is not so farfetched. The most popular names—hallucinogen, psychotomimetic, and psychedelic—have often been used interchangeably. Hallucinogen is now, however, the most common designation in the scientific literature, although it is an inaccurate descriptor of the actual effects of these drugs."

And again, (Wiki): " Ketamine is also used as a recreational drug… for its hallucinogenic and dissociative effects."

Quibbling over semantics…tomayto, tomahto. If it walks like a duck and quacks like a duck…Psychedelic isn’t a scientific, pharmacological term. It is a counterculture adjective. I’ve never seen a mushroom that came in a paisley print. Neither have I seen a bottle of vodka with the usual skull and crossbones indicator that alcohol is a toxin. And I have never seen a bag of sugar or coffee that come with the addiction warnings that appear on tobacco, opitates, and opiods, etc.

On that note, I’ll stop ranting and take my troche and try to “mellow out”.

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It’s all good but I would never go back onto antidepressants personally!

Honestly a lot of us are getting very good results. Again if you want to be a zombie it is up to you. I would never put antidepressants into my body again ever! They have a bout a 10% success rate with me. Meaning I get about 10% of the relief that I get out of ketamine. They aren’t even in the same galaxy. Ketamine as a treatment for myself blows the other stuff away; it’s not even close. I happen to be Phi Theta Kappa, and I don’t appreciate being questioned when I’m telling you the truth. Your perspective honestly is a little bit negative. I want to help you, but I feel like you were trying to talk down to me. Thanks @salty! You always got my back!

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@SavetheVWBeetle, I am very glad you are getting good results. These medicines don’t work for everyone, that is simply a fact. Antidepressants never made me a zombie. In fact Prozac always worked really well for me and I lived a happy, vibrant life. The reason I didn’t want to be on them was because I believed that an underlying wound was causing my depression and I wanted to heal it. But I’ve now done 2 full years of all different types of psychedelic therapies: ayahuasca, psilocybin and ketamine and the sad truth is that none of them have brought me healing. I am no better off after 5 ketamine sessions than I was when I started. Most of what I read suggested that people tended to get results between treatments 3-4. I wanted to give it at least 6 to be sure and I can now say with 100% certainty that I’ve had zero improvement after 5, so I’m afraid it’s just not working for me. I think your note was a bit harsh and unfair. Not all treatments work for all people: that article I posted was from a psychiatrist who has treated over 6,000 patients. The outcomes he saw was that it worked in roughly 50% of cases. The same success rate is true of Anti-depressants, the lesson being that we all have different brain chemistry and not all treatments will be effective for all people. I had high hopes for ketamine, but I can only tell you my experience. I am the same level, if not more depressed, than when I started. And when I was on Prozac I was happy and thriving and never numb or a zombie.

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Thanks for the kind and measured response. I’m disappointed that I’m getting attacked for simply sharing my experiences. I truly wish the ketamine were working for me, but it simply hasn’t made a lick of difference, net result, after 5 treatments now. So I have to be realistic. I can’t keep throwing money away for something that isn’t working. As you said, everyone’s brain chemistry is different and this is all trial and error.

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@yoginichica of course - it’s your brain and your body! I wish you - and anyone here - the best and for strength and healing on your path. Whatever that path may be. :heart:

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+1 :pray: :heart:

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