Compounded Ketamine for use at home

I’m in Houston TX and I’m looking for a provider or telehealth doctor that prescribes compounded racemic ketamine nasal spray (not Spravato), troches, lozenges, RDT’s or capsules. That doesn’t charge a lot. I’ve found places that want $280 or more for monthly consults to provide the prescription, this doesn’t include the cost of the medicine.

I currently get Ketamine IV infusions but would like the at home compounded Ket so I can space the infusions further apart because they are very expensive. Any help with this would be greatly appreciated.

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I’m in the same boat as you, Tree. Also located in TX. I’ve had tremendous benefit from a course of IV ketamine treatment, but stopped half a year ago due to the exorbitant cost. Fell back into the depression hole. There really needs to be reform of our profits before people medical system. Looking forward to any useful replies on providers.

FWIW, I have a telehealth provider in TX that charges $150 per session and provided fast dissolving sub-lingual tablets - 30 of a fairly strong dose - for under $80 shipped to my home. Unfortunately, this provider isn’t accepting any new ket patients, but I expect to have a session with him soon, so I will ask him if he knows of anyone. Clearly, there’s a need to be met, and he seemed to be a very compassionate guy, so I’m sure that if he can help he will. I’ll post back or message if I learn anything.

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I get my troches prescribed by the NP who does my infusions. Did you ask them? The idea right now is not to use them as a replacement for infusions, but to help between sessions and to eventually stretch appointments out to 2-3 months vs every month. I get 30 troches for $75 from a compound pharmacy in Columbus , OH. They have been very helpful for me so far.

@Sojourner - if he does have any suggestions that would be great. Neither my clinic nor my referring psych will prescribe these, as they feel they are strictly for in-clinic use (KAP), for safety reasons. While I do respect that, at the same time many here have been using them safely and effectively, and in my case I would be careful to only use them when I have another responsible adult at home. I do not have extreme reactions to receiving infusions so I feel it would be a reasonable option for me.

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That’s unfortunate that you can’t get them through your clinic. I have never heard of an issue with at home therapy, as long as you take it as prescribed.

FWIW, at home therapy has been great for me - I started about a month ago. For background, my first 6 infusions were in Aug ‘21, then I had 2 in Sept, then once a month since. I was having good results for the first week or two after infusions, but then I would go downhill and couldn’t wait for my next infusion.

With the at-home troches, I have never felt one iota of fear or negativity during the 45 mins- 1 hr that I’m “under the influence”. I just feel very relaxed, peaceful, and loving. Nobody else in the house with me (except for 1st time because I had no idea what to expect.) I only take 30-45 mg at a time though, as my NP only prescribed that much. My normal infusion dosage is 40 mg and I am normal build/weight for a woman my age. But I am very sensitive to K - have been since the beginning - I always disassociate during infusions and usually with troches as well, although not as intense of course. I am going to ask her to up the dosage a bit for the troches next time - to 50-60 mg.

I wish you the best of luck getting the at- home therapy. If you go with troches, ask for peppermint flavored. I don’t mind the taste at all.

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I appreciate your sharing your experience. As I said, while I do very much respect my providers’ opinions, at the same time I have been following the feedback on this topic very closely since July (and reading previous postings as well) and I think it would be a good option. I really think it could make boosters a very rare event for me.

@Shepherdess I was monitored at the clinic before having my home program prescribed. Some of the details that gave me the go ahead to do the home program were: my blood pressure and heart rate were stable through the IM session and the nausea was manageable. It has distinctly made a difference in how often I go back for a booster. My first booster was 2 1/2 months after my initial session. My 2nd booster is scheduled for the middle of February which will be 3 months (the way I feel right now that might be a little too long, may need to reschedule). With that said the home program for me has been extremely beneficial. I hope you are able to find someone that can help you to begin a home program. Praying that happens for you! :heart:

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I don’t have local recommendations for you but want to echo what others have said - my provider for IM injections was willing to prescribe me at-home troches after I showed that I didn’t react negatively to the injection experience. All of my ketamine experiences have been neutral to thoroughly positive, and I haven’t had nausea or other physical reactions that are problematic. I think their strong preference is probably the in-clinic service because they can charge so much for it ($650 out of pocket) but after getting the at-home prescription I am paying about 98% less.

In my experience the provider didn’t realize how cheap the at-home medication was or how easy it would be to get, despite the clinic having prescribed it to others before. I was able to find ketamine troches in my insurer’s drug finder portal online, but I wasn’t able to get them filled at the pharmacies listed (Walgreens). I had to have them sent to a compounding pharmacy who then charged me about $60 for 4-5 doses at my at-home dosage.

So my advice would be to keep asking clinics/providers until you find one who can prescribe for at-home use, and then to try it and see if you like it. I understand most will want to charge even to consult on that, which sucks. I hope you’re able to find an affordable option close to home.

I’m in Atlanta, Ga and can’t find anyone to prescribe troches or nasal spray. Anyone in Ga know of a provider?