5th Infusion Ineffectiveness?

I am going through my initial round of infusions, and have my 6th one tomorrow. I’m ready to stop having IVs in my arms at least - I have tiny veins and lots of bruising. I didn’t notice anything after the first two - the third one was good, and improved my depression a moderate amount. The fourth one did as well, which I thought meant it would just keep on working better. At that point, my depression went from a 10/10 to a 5/10. Great improvement, but still not where I would realistically want to end up as “cured.” After my 5th infusion, I noticed an increase in my depression once again, which is making me a bit afraid that I might not respond well after the 6th and final infusion. I’m better so far, but definitely don’t feel amazing or anything. Has anyone else experienced this increase in depression before treatments are even over? Since ketamine is like a last-resort sort of thing, it would be discouraging if it ends up fading so quickly.

I have tried 6 meds so far, and many years of therapy. I also have Schizoid PD, which may be an interference? I wouldn’t think it would reduce the effectiveness of ketamine on depression, though. I just really don’t want to be disappointed after I finally thought there was some effectiveness going on…

I haven’t had any particular traumatic events to unpack - my depression is the type that almost seems purely biological in its weight. No negative thought patterns or bringing myself down, etc. Just pure depression that ends up feeling physical and unbreakable. There was a moderate reduction after my 3rd and 4th infusions, but not anything extreme.

I’m not sure if I’m looking for reassurance or realism, but I’d take both. Has anyone else experienced a return of depression like this during treatment? Did it go away after the last infusion? Did treatment end up not working? etc. This is my first post here so hopefully this is the right place to ask.

I did two different 6 session treatments at two separate clinics. Just finished my sixth yesterday. At both clinics my fifth session wasn’t necessarily horrible but I was in a bad place a very put off. My hands hurt from the multiple IV’s I was mentally and physically exhausted… then my sixth was amazing. I was starting to think it’s almost protocol to bring you down before they truly set you free. Keep your head up. Even though you’re feeling down. The ketamine is still doing it’s job.

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I’m hoping the sixth one works for me and lasts at least a month (my clinic won’t see you again for at least a month for a booster). I really hope it’s just a minor downfall and that the 6th will look up again. Hopefully a better improvement than what I’ve had so far. Thanks for the advice. : )

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Good question and you are not alone… I’ve been in treatment for many years and there have been times I saw no results and some even felt worse a few times.

After a treatment if I don’t feel better or if I feel worse, I just schedule a booster a little sooner.
Right now I’m every 6 weeks.

It’s a process for sure. But overall, major improvement.

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I won’t be allowed to schedule a booster for a month, as per my clinic’s rules… but I’m wondering if it would even be worth the cost if it ends up not working after my initial 6? I’ve heard that if after the first 3-6 you don’t see improvement that it isn’t going to work for you. : (

It’s weird because it was starting to work a bit and then it’s like it just stopped. Maybe my final infusion today will turn things around. I sure hope so…

Did you feel worse during your first round of infusions? Or only after once it wore off?

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During initial 6 infusion treatment, I was so depressed and the infusions were close together… just a day or so in between…not really a way for me to discern.

I remember after my very 1st as part of a clinical trial, improvement was immediate.

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My clinic does IM, so it might not jibe with your experience.

My initial 6 were spaced out over a little over 2 weeks. Each increased dose worked a little longer than the last. Since my 6th I am able to go 3 months, +/-. I recently added in troches to see how well or if they will smooth the ride between and maybe extend the time between, like they do for some.

I have not had major trauma, just your standard issue slings and arrows of outrageous fortune. My depression is one of those things that is just always there. I have tried several different antidepressant meds. I finally decided that I just wasn’t willing to keep trying a new one every year or so. They would work for a while, then sort of work (more or less). So, now I am doing ketamine. When it starts to taper off, I know I can go in for another treatment that will keep me going.

I just finished my 6th infusion two days ago and feel worse than ever. : ( I’m guessing this means I’m a non-responder. I thought it was working for a few days between my 3rd and 4th infusions, but that seemed to completely stop after my 5th infusion and now I’m back where I started. : (

I’m glad ketamine at least worked for you though!

I’m not sure how much difference it makes, but my clinic is a bit different than what seems to be commonly mentioned here. My guys do IM in a series of 3 for #6 and then the boosters.

I don’t know where you are, but maybe this article that Rafael posted could link you to something that might work for you.

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@nonexistent are u taking any meds that are known to block the effectiveness of Ket? Especially Benzos?

What about your Ket dose…. Maybe it needs to be higher? Have you discussed this with your provider. Everyone is different and some people just require a higher dose for it to work than others do. In my opinion, even though there are guidelines I think the Effective Ket dosage is highly dependent on the individual.

I have a provider that listens to me about dosage. I recently had an extra unscheduled booster because I was feeling terrible due to a bad reaction to trying Viibryd antidepressant. I asked for an increase in dose and length of time for infusion and felt almost immediate relief from SI and very much calmed my anxious thoughts and feelings.

Just giving my opinion based on my experience. I’ve been getting Ket infusions for 2 years and it has been a game changer. I would hate to see someone give up on a potentially helpful treatment although I know it doesn’t work for everyone. But sometimes the reasons it doesn’t work is because of meds people are taking or because they aren’t getting a therapeutic dosage individualized for them.

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I have never taken benzos in my life, and I’m not on any other medications at all. There is no possible interference there.

I wasn’t told the exact dose, but it was upped several times and something was added to make me dissociate faster. We kept the dose so that I would always dissociate - so it was raised several times throughout the initial 6. I’m pretty sure the dosage was good. I was definitely dissociated and experiencing what I was supposed to be. If I wasn’t then we would increase the dose during to make sure I was fully dissociated.

I’m thinking maybe I’m just a non-responder. Or semi-responder? It was starting to help after the 3rd/4th infusion (not to an extreme amount, but it was noticeable), but then after the 5th it just stopped. Then the 6th one didn’t help at all. By the time I was in the car about to leave the clinic I could feel the depressive heaviness returning. I don’t feel like that’s a normal response.

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@nonexistent I’m no doctor but does sound like you were doing everything right. I just wanted to bring those things up because I’m in a group on FB where I see quite of few people not responding and then they figure out it was other meds causing the problem or their providers had them on too low of dose and refused to make any adjustments. There are just so many new things being learned about ketamine treatments everyday it’s hard to keep up.

Also there is some evidence now that in some people Ket can take up to a couple weeks to work. Maybe it will start working for you. I am really sorry to hear how much you are struggling. It can be very disappointing to try something with so much hope it’s going to work and then it doesn’t. Wishing you the Best :pray::sparkling_heart:

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Yeah, I wish it had been something as simple as taking a benzo that I could stop and then see results!

I feel like just giving up at this point. Therapy and meds haven’t worked, and now even ketamine hasn’t done anything? I don’t want to do ECT because my memory is already awful… I think this is the point where you throw in the towel. I guess there’s more meds I could try, but I hate side effects. Withdrawal symptoms are scary as well.

I wish I could keep trying ketamine, but the cost is wayy too much for something I don’t know will ever work. And I live in the south, so there’s not too many choices in clinics near where I live. It’s a bit rural down here.

Thanks for the support. : )

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@nonexistent, please don’t give up! Talk with your Doctor, maybe he will recommend something more affordable for you. Ketamine has help many of us at different levels, I am sure those 6 treatments have you some for of ability to better control some aspects of your depression, focus on that for now and keep looking for answers, like you said they are several antidepressants out there and some of them work pretty well together.
I feel the same way about spending all that money if your results are minimal but at least you tried and I know you will continue to look for something that works for you. This has been a long road for many of us and we will continue on it as long as there is hope. Don’t lose hope.

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