Patient Interview #1: Ketamine Infusion Therapy for PTSD, Depression, and Anxiety (man, 60's, Wisconsin)

Hey all! I’ll be posting a series of anonymous patient interviews, covering topics like the process of discovering the treatment, the treatment itself, how it compares to other treatments, and other content related to the patient experience. We hope these are illuminating or helpful to read! Big thanks to everyone who has given their time to be interviewed—we really appreciate the opportunity to hear about your experiences.


What was your specific ketamine treatment?

I received six infusions and did one follow up. I did six low dose ketamine infusions, starting at 6/10 mg per kg. During my one follow up, the dosage was 9/10 mg per kg.

It was $500 each for the initial series of six sessions—$3000 total. Follow-ups after that were $100 less because I think they want to encourage you to go back.

I was given a set of evaluations to keep track of where I was mentally when I came in, compared to where I was mentally when I left. Sometimes, for people, there is no documentation improvement, and that’s because there are some people that the treatment just doesn’t work for. Still, there are far far fewer cases of it not working compared to SSRIs.

What was your ketamine treatment intended to treat?

I’ve always regarded it as a depression and anxiety issue. However, I have been told—and this is not something that really came up until later—that it’s probably a matter of PTSD. That was not something I ever heard until I was actually talking to a certain mental health professional.

How did you find out about ketamine? What were the factors in consideration when deciding whether or not you should do it?

I was going through a period of hell when I was actively suicidal. Several things were falling apart during that time in terms of my relationships. I went through at least three SSRIs and a lot of other medications, but I eventually flushed them out. That probably wasn’t very smart, but I never regretted it.

When I brought up the idea to my primary care provider, telling him I didn’t want to go back to antidepressants, he made the comparison that diabetics also don’t want to take insulin. But I knew for myself that the antidepressants were not going to get me anywhere I wanted to go.

I can’t remember exactly how I first heard about ketamine for major depression, but I suspect that I probably was just surfing around online and came across it. I started researching it thoroughly, doing a fair amount of research before deciding that I wanted to seek it out. I ended up having to do an interview on video chat—I was not about to drive five hours just to find out that I was not approved for therapy—and when I underwent my first experience, I had no idea what I was in for.

How would you describe the history of your mental health? How would you describe your current mental state?

It’s greatly improved, compared to my past history. I’ve attempted suicide a couple of times, and they definitely were not demonstration attempts. I’m really quite fortunate to be here. All I can really say is that I’m glad I’m still around.

What did your depression feel like? What other treatments did you try before then (or after)?

As I said, I’ve tried several different SSRIs. I tried lithium sometime as well. I made some progress on these medications, but not much. One of the SSRIs killed me—it was genuinely horrible. It was worse when I took it than when I wasn’t on it.

At some point, though, everything kind of fell apart in my life, and it felt like I was basically starting from scratch in terms of my mental health. I hated to see that the depression was rearing its ugly head again. I knew I didn’t want to go back to that again, and I didn’t want to put my wife through that either, so I was a little bit more aggressive about searching for something more effective. I did a lot of research before I decided I was going to pursue ketamine infusion.

Therapy was recommended to me when I went for the first time, and I was able to make a therapy appointment a week after my first infusion. The therapist I was seeing was really excited about the whole thing; from her perspective, ketamine was a whole cutting edge deal.

My psychiatrist was less receptive. The Ketamine Advocacy Network has a good section on why pharmaceuticals and psychiatrists are opposed to ketamine infusions—psychiatrists make a lot of money with maintenance appointments and writing scripts, and the pharmaceutical industry doesn’t make money from ketamine either.

Having been pulled out of my depression as much as I have, I have high hopes that I’ll only have to do a follow up every four months or something like that for a bit.

Did you experience any side effects from the treatment?

After the initial infusion, and later too to a lesser extent, I felt like I had been run through a meat grinder. It’s hard to describe how trashed I really felt after the whole thing. Sleep after the night of an infusion is impossible, unless you have some sort of benzo that you take, which can alleviate a lot of the “aftershock.”

The aftershock is a very physical experience. But the improvement in depressive state is almost immediate. I can see why it’s used for emergency cases—it’s definitely a very positive thing in that regard.

In what way is the ketamine treatment intense? What do you wish you knew about ketamine going into the experience?

I grew up in the 60’s and 70’s and had a little experience with psychedelic drugs during that time. That was so many years ago, though, and I also hadn’t prepared for a psychedelic experience when it came to ketamine. But that’s what it was: a full blown psychedelic experience. Oh boy. I remember my wife was waiting outside in the car for me after my first infusion, and I flopped onto the passenger’s seat and just said, “Holy crap.”

How does the headspace compare to your previous psychedelic experiences? How has the mind-altering aspect of ketamine, a dissociative, has been significant to your experience?

I almost didn’t go back after the first infusion because I’d felt completely blindsided by that. My expectation for the experience was nowhere close to what it actually was, and even if I had expected a full blown psychedelic experience, all the experience with psychedelics I’d had had been forty years prior. The experience was roughly comparable to taking hits of acid.

Keep in mind that I’m reaching back to memories from forty years ago. The other hallucinogens were actually cleaner in experience. When a ketamine infusion really gets going, at least in my experience, you kind of become a point of awareness and forget your body. But if I intentionally directed attention to my body during the infusion, I would become aware of a sense of great weightiness. It would take some focus and great effort to move a body part. No one will ever jump out of a chair and flip out during an infusion. To an outside observer, you would appear to be sleeping. During my second experience, I actually made a point of keeping my eyes open the entire time; it was either during the third or fourth infusion when I didn’t know if my eyes were open or not. It was intense.

I remember speaking with the person that was administering the infusion, and he was talking about how certain benzos work against the ketamine. They recommend that you don’t use it for so many hours before coming in, unless that’s what it takes for you to get in the door.

I think that the route of administration is very important. If you take it nasally or orally, it metabolizes differently, and there’s a massive difference in how it is experienced, compared to the infusions.

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To whomever wrote this: thank you very much for sharing your story. We all really appreciate it. Sending over my best wishes.

When I brought up the idea to my primary care provider, telling him I didn’t want to go back to antidepressants, he made the comparison that diabetics also don’t want to take insulin. But I knew for myself that the antidepressants were not going to get me anywhere I wanted to go.

This is such a problem today - the way doctors push antidepressants and SSRIs on people like they’re nothing. PCPs and many clinicians are simply not trained to really understand mental health care and I think this entire SSRI industry needs to be turned on its head

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I think that one of the biggest gaps in research on treating mood disorders with ketamine is the individual experience and how that impacts outcome. Dosage and frequency are easy to quantify but experience isn’t. There’s more to ketamine than the biochemical effects but it’s not always easy to guide someone so they can find it, and it seems like it’s rarely asked about/ discussed.

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Thank you all for sharing your experience. I just went through my first infusion yesterday and have been trying to process it all. Your insightful words helped me to understand how to approach my therapy. What a game changer! Amazing. Thank you again.

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Thanks for sharing. I have a similar experience with a bunch of anti-depressants. I’m coming off Pristiq now, and it’s horrible.