Independent home administration of ketamine

Hi, new to the group, thanks for the add. I have been dealing with clinical depression off and on for over 30 years, and have been through many medications and psychotherapy sessions. Last year, after a particularly hard relapse, and after doing considerable research on the subject, and out of desperation, I decided to try ketamine infusion treatment … 6 treatments over a 3 week period, at a local psychiatrist’s practice … started feeling better after the 3rd session, and was back to ‘normal’ after the 6th … in fact felt much better than ‘normal’ . Have been in remission for over a year now, in fact I consider myself ‘cured’ . However, always being 'skeptical’about relapse, I have the following question … since my and most health insurance insurance plans still consider ketamine infusion for depression ‘off label’ and / or experimental, it is not covered, and my out of pocket expense was over $3000., a major expense. Has anyone else here succeeded in convincing their therapists (psychiatrists or other medication providers) that they would be safe in self administering ketamine at home, either by injection or pill ? For a person that is considered by their therapist to be otherwise competent, professional and stable, shouldn’t it be considered safe for a person to self administer ketamine, thus avoiding the exorbitant financial burden of clinic treatment ? I know infusion clinics would probably oppose this, for obvious financial considerations, but I’m reaching out to the non-clinic psychiatric community, the private therapists that could write prescriptions for generic ketamine, liquid or pills. Personally, for the patient vetted as competent and stable, I see this as a low risk, affordable alternative solution to the high costs of uncovered clinic infusion. I see no short term health insurance coverage for clinic infusion anytime soon. Comments, thoughts, opinions on this issue would be appreciated … thank you …

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I’m in the same boat.
20+ years of major depression. Tried everything. Nothing worked.
Six treatments of IV ketamine reminded me what it felt like to have a “normal” mental landscape and I really don’t want to go back to how I was before. I’ve had one “booster” and I suspect I’ll need them at somewhat regular intervals - maybe once a month? But the cost is prohibitive - it’s basically a car payment for a pretty nice car.

My doctor’s only answer has been that I should fight with my insurance company for them to cover IV infusions but I’m highly skeptical that is going to get me anywhere and will doubtlessly require a significant investment of time and frustration. I can’t help but think that my clinic wants to keep me dependent on them and paying them $550 every month or so.

I agree there’s potential for abuse but there has to be a way to screen and monitor patients in a way that make self treatment a viable option.

I’ve been having pretty could success with the lozenge’s. My cost for them was around $30 and they’ll last me a few months. I couldn’t afford to keep getting the boosters at $500 a time after I spent the $3000 like you for the initial 6 infusions. I told my doctor exactly that, I can’t afford it, and she prescribed lozenges. I have a feeling she’ll require another booster before I’m allowed to refill my prescription when the time comes though. They taste so awful and I kinda get a hung over feeling from them the next day, so I really limit it to once a week. At least for me, I can’t see abuse being an issue.

What state are you in? I got through 4 infusions but had to drive 3 hours there and back to Louisiana and covid put an end to that… I am in Florida and there is a place about 12 hours from me that does at home dosing called ketamine road but it’s only Florida so you’d have to look in your state - also you can contact compounding pharmacies in your town or state and ask which psychiatrists or doctors prescribe at home ketamine and see them or maybe you’ll find a place like ketamine road. Good luck

Funny, I’ve been on the 30 year depression circuit as well. I have tried every anti-depressant and also had an extended period of regular ECT treatments (about 12 years ago). I have never had the infusions, but have used lozenges for a few months, both in the therapist’s office and at home with overall good results. Ketamine has been the most effective treatment so far, with most of the results coming from the integration work done in between sessions with the therapist.

My doctor recently gave me the option of trying the quick-dissolve tablets, rather than the lozenges. I have found them to be more potent and effective than the lozenges. They still don’t taste great, but they work. My doctor also said they are a more stable form of Ketamine, will stay potent for longer and don’t need to be kept refrigerated. I have no plans on returning to the lozenges.

I am planning on an IM injection in the office, with the therapist present, once the virus restrictions are loosened.

Best of luck to all.

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Too have struggled with depression off and on for 25 years. Tried everything with little help and then found remission after a series of ketamine infusions. Have been able to stay in relative remission for the past year with infusions every six weeks and sublingual ketamine twice a week. This has really made the difference for me. Without the lozenges I was struggling to make it between infusions. Perhaps you can find a provider who would be willing to proscribe ketamine lozenges.

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I will just repeat my opinion that ketamine infusions at home, or perhaps ketamine intramuscular injections, in a stable, intelligence demonstrated patient should be an acceptable practice. I will also add, that it is my scientific belief, based on years of self research, that ketamine, in ways not yet completely understood, has the ability to ‘cure’ neurologic deficiencies in synaptic connections in the brain, biologically breaking ‘logjams’ in neural circuits and opening up clear pathways … this effect will, like most other treatments, vary from individual to individual, but for me, for now, it appears to be a long term ‘cure’ … after almost 2 years I still feel ‘normal’ … but am always wary of potential relapse … thus my desire to have a home based alternative for ketamine infusion / injection … my research has shown that the lozenges and nasal sprays have much less efficacy … as I suspect a pill would, if pills even exist … I wish a psychiatric professional would provide an opinion …

I think someone else mentioned this, but have you tried lozenges or nasal spray? A compounding pharmacy can create them and you can do them at home. I use both as a booster in between infusions.

I use troche/lozenges twice a week at home. I started scheduling it because I would go too long and it’s hard to come back once you get depressed. I did my 6 infusions and I thought I was cured too for about a month and a half, then COVID came, my dog got hit by a car and died, and my mother in law who lived with us in hospice died in our home about a month later. Then protesters, riots, statues coming down (I am in Richmond, VA), and the news made it pretty rough. I’m just starting TMS as well. It wouldn’t be a bad idea to try to get troches. If you feel cured it’s good to have it if you need it. With the troches you need to leave it in your mouth even after If dissolves to get the best results.

I find the infusions to be more effective. I use oral ketamine at home. It helps for meditation! I am Currently trying to get Medicare and Medicaid to help with the cost of my medication. It’s expensive but it’s the only thing that has ever worked.

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What is available in NC? I believe we have more stringent regulations. I am a nurse and feel capable of administering myself but can’t find help. Is anyone else in NC and able to do treatments at home?

I’ve refrained from responding to this up until now because I’m somewhat puzzled by the question, but there have been enough opportunities to address it now that I feel okay stepping in at this point.

When I am in the midst of an infusion, I am just barely aware of the world around me if at all, and would be completely incapable of getting out of that recliner to deal with any kind of a situation whatsoever. I am monitored for EKG, blood pressure, pulse, and blood oxygen level, I imagine for good reason. Blood pressure medication to address an increase in BP may be added to my infusion. It would be very nice to reduce the expense of these infusions, but they take place in a closely monitored clinical environment, and I see zero likelihood that will change, probably with good reason.

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Not infusions, but you can ask your doctor for troches. They are lozenges that dissolve. You should let it dissolve under your tongue and keep it In your mouth as long as you can. You will absorb more of the medication. If will be stronger and last longer.

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When used in conjunction together; infusions in a controlled environment and troches at home really add to the benefit of the medicine. A good Dr is so important. This is a fantastic medication. To truly get the benefit of this medication you need the help of a ketamine doctor or anesthesiologist. There are some interesting videos on YouTube. I am happy to talk with anyone. I do both. Infusions must be supervised. You must be responsible to do troches at home. It is not as immobilizing as an infusion is. You need to do the infusion first. The troche supplements the infusion. Gives you extra help.

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Do you know if this is available in all states? I live in NC.
Also, does this take the place of an antidepressant?
Thanks

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Anti- depressants did not work for me. Yes ketamine helps with depression. You will have to check on the availability of doctors in your state. Just do a search.

I chose Ketamine as an alternative to anti depressants although my dog got hit by a car and died and my mother in law died within a month. I went on Pristiq which helped at first but messed with my sleep and made me super anxious so I got off of it. No anti depressants now. I can’t stand the side effects.

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I’m interested to know if u r successful getting those insurances to help. I have the same insurances and would love to have them cover my K.

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Supposedly they’re going to reimburse me but I have yet to see any reimbursement. It has been a little over a month. You submit the claims right here at osmind.

Hi all - thank you! If you’re using Osmind with your provider you can definitely submit private insurance out-of-network insurance claims through the app (look at the toolbar at the bottom of the screen and click the money button).
Unfortunately, Medicare and Medicaid aren’t reimbursing for ketamine as we know because they don’t cover anything out-of-network :frowning: so if you’ve tried to submit claims for those plans we unfortunately aren’t able to help. I’m so sorry we couldn’t do more, but I am glad you are getting the help you need :slight_smile: