Best Practice-home treatments

I have been getting injections (IM) at the clinic for around 2 years, just started with troches last summer (around 6 months).

How do others do troches/lozenges/sprays…forms of ‘at home’ ketamine?

I am learning that it isn’t “injection jr.”. I have been told to use them as (my wording) an ‘attitude adjuster’.

I am going to mix metaphors and bend and maim lots of grammar rules, I’m sure.

Do you use them like an asthma inhaler…“I can’t breathe…HUFF…OK, I’ll make it”?

Do you use them like an after work cocktail (“What a horrible day!”…GULP)?

Do you take them on a schedule ("…my levothyroxine every morning, ketamine every 3rd day…")?

I am finding it hard to find any “sweet spot”. What I end up doing is kind of “…seems like a good time for it…” with nothing regular about it. Kind of, sort of, seems to work, sort of.

Any Advice?

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I have no experience with troches, only suppositories (bad idea), and fast-dissolving sub-lingual tablets. Without getting into specifics, the first time I took too much (400 mg), and didn’t try it again for about four months. Second try at half that dosage was manageable. I would go by the baseline-if you’re consistently below where you think you should be, it’s time.

I have been taking troches for 1 1/2 years. I normally take them 1 -2 times a week. I am currently taking them when I feel the depression or super anxiety come on. I feel like Ketamine is weird. If I’m in a really bad spot I normally will wait until the next day and I try to do them in the morning so my head is empty and not full of the stressors of the day. I’m self employed so my schedule is flexible. If you can’t do it in the morning. I recommend taking like 30-60 minutes to unwind. Try to stay off your phone and any stimulation or stress. Do a meditation on a headspace, bloom, fabulous, or calm app. This will help you have a better experience. It can either go sideways (bad trip) or not work as well and potentially cause more anxiety if you can’t let go because you are stressing about something. I let the troche fully dissolve and then I swish it around my mouth and hold it in for 15-30 minutes total before I swallow. It seems to absorb more, but also gradually ease you into it. I take 1 100 mg troche, let it dissolve and swallow and then take another with the same process. I’m 6’2 and 235, so my doctor said I could take 2. One wasn’t enough. I had started a schedule Sunday’s and Thursdays but with my schedule being all over the place it wasn’t always possible. I would schedule days if you can. It helps when it’s scheduled because you’ve set aside time, and if you space them right you should be doing it before things get bad. I think having a good playlist is key. I have one on Spotify called Ketamine Bon Voyage if you want to check it out. I feel like I actually have gotten a lot more insight on the troches than the infusions. I feel like the infusion is like a sprint and the troches are a marathon. When I’m done with my infusion I basically feel semi back to normal pretty quickly. When I take the troches I feel like it’s not as intense. You can contemplate things easier, but it lasts longer. I feel more out of it longer on troches. Since I’m super anxious all the time I try to take the day off. I’m sure I could function and do stuff when I take the troches, , but it feels good to enjoy feeling relaxed for once. That’s kind of the point right? The Best times are when you go in with an intention. For example, I repeat in my mind what my intention is when it starts to kick in. “Take my anxiety away” “Think positive” “Please help me with my relationship with ________”. Whatever your intention is I feel like If i repeat it in my mind I will get some mindfulness out of it. I try not to eat anything before I take them, or if I do I wait like 4 hours. No drinking anything at least 2 hours before. Get noise canceling air pods or headphones and make sure you tell anyone that lives with you not to bother you for at least 3 hours. I recommend putting your phone on do not disturb. I also practice meditative breathing if I feel like I’m not relaxing enough. Follow the music with your mind and it will take you to different levels of consciousness. I also use Siri to change the song by voice command if I feel like it’s going in a bad direction that way I don’t have to open my eyes and can stay in the zone. I play my playlist on shuffle so it’s never exactly the same. I also take off songs that I feel take me to a bad place and continue to add new songs to see how they go. I like Ludovico Einaudi, Cris Derksen, Ratatat, and a bunch of other random stuff I found on other Ketamine playlists. I also pick a “safe” song. One that i know is either upbeat or with a confusing beat so if I’m heading to a bad place I just change it to that song to snap me out of it. I try to always keep my eyes closed. I feel like once you open them it’s hard to get back to where you were. If I’m having a bad time I will open my eyes or use Siri to call my wife. Hopefully this helps.

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Hi there!

Salty, thank you for bringing this topic up! I too have been wondering if there were any “best practices” for the troches. After a couple failed attempts to use them between infusions, I started looking for info and discovered that the dosage was pretty low (50mg & I am a large person) and the Clinic that I had started off with wasn’t overly helpful.

I ended up switching to a far better practice and had started to use 100mg troches for my virtual sessions with my therapist (who was downright giddy with the results lol), I had been struggling, yet again, with maintenance but then noticed things lightening up a bit. Related that to my Dr. Who helped connect the dots and I have moved up to 200mg 3x a week.

Outside of the use with my therapist, I have been trying to figure out the best method for me. So was grateful to fpeot1 for sharing his experience. Appreciated that it was a well detailed response!

Hope that we might see additional insights from others!

Although I have been using Ketamine for a bit over 2 years now, I am new to this site and haven’t had a chance to dig into it yet. Your post caught my eye right off.

Haven’t had the opportunity to interact with others using Ketamine prior to this, so am looking forward to delving in.

Sorry, didn’t mean to hijack your post, so will shut up for now…after reiterating that I hope more people will respond!

All the best, Cin

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I am just starting to think about troches (pending insurance coverage) and posts like this are really helpful. Thanks for sharing your experience! If I figure out how they work for me, I’ll circle back

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@cindynagel I use fast dissolving lozenges once a week with the option of twice a week. I also have the option of not using the lozenges if I feel it is not necessary (or if other life events happen, work, illness…). What I was told is the home lozenges help to keep the Ketamine in your system so you can continue with the integration process. I text my therapist when I start the home lozenges ession and let her know when I am back from the trip. We do a very quick integration lead up through text. Then I either journal or draw about the session (sometimes not until the next day). I also meet with my integration therapist once a week. Having the journal/drawing helps me bring back some of the details of the home session so we can extend the integration into my daily life.
I have been through the initial 6 IM sessions and now go in for boosters. I do not have a set time for the boosters but with the help of the lozenges and my therapist I went almost 2 months before my first booster.
I experienced extensive childhood trauma throughout my entire early years into being a young adult before I was able to make a break. I was disappointed after the first 6 sessions that I wasn’t rid (so to speak) of all the flashbacks, dissociation and night terrors. However, my therapist and my Ketamine doc assured me with what I have experienced I am early on in the Ketamine process. I have made significant improvements however, as you know healing is Not linear, definitely have my ups and downs. The home lozenges help me even out some of those ups and downs and continue progressing with integration.
I wish you the very best with your experience.

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Oh, thank you Deb! Although I can understand your desire to have it all over & done with, it does sound to me like you have made a great start down the right path! I do envy you having someone to work through the integration process! Good on you for finding that support. I do have a wonderful therapist who has managed to keep me going the last 12+ years, but although she enjoys having phone sessions after I have had a troche, benefiting from the resultant lack of internal editor (or ego), it isn’t really her wheelhouse. I can tell that using the toches are clearly helpful between infusions…but outside of the ones during occasional sessions with her…I feel like some sort of structure (???) would be ideal. Just haven’t worked out what that should be.

Again, thank you for responding! It is a comfort & sorrow to know I am not alone in this journey! If you ever need someone to share with, don’t hesitate to call on me. I have way too much time on my hands which is never a good match with depression!

Be well & wishing you a warm holiday season!

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For now, this is working for me and I feel more stable than I have in a while (depression) - one 200mg rapid dissolve tablet weekly at about 5:30 pm. I take 1 2000 magnesium threonate capsule about 30 minutes before. I might do an infusion every few months but this has been working well for me. I usually have several realizations/learnings during each that I am working to integrate into my life. I meet with my therapist about every other week. Good luck.

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@cindynagel You are so welcome. I believe sharing information is so helpful. I wish you the very best in finding an integration therapist. The work with my integration therapist has seriously made the Ketamine treatment invaluable to me. Take care of you! I appreciate your offer to talk, I may take you up on that sometime. My schedule is often very tight but it so nice to have someone to talk with that has similar experiences.

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