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by strofcon 1536 days ago
Fortunately there are compounded racemic ketamine options in a lot of places, whether troches (lozenges) or nasal spray (that's the one I use).

I pay out of pocket fully, and it's $60/month.

Clearly YMMV, but worth looking into if the infusions are prohibitively expensive.
2 comments
tbalsam 1535 days ago
A hybrid approach is occasional infusions plus at home. I was infusion exclusive for a while and am at home exclusive now (extremely disciplined about it). But my Ket admin doctor and I both I think have the opinion that the occasional IV treatments.... It's hard to beat.

It just does something different. But then at home can help maintain in a more muted way. I think it's because a mainline infusion has no top end limit for drip speed, whereas buccal/nasal membranes can only transport so much at a time. There's a few dose charts that basically flatline at the beginning as transport/transporter stuff saturates vs the line which goes sky-high. Also the bioavailability is phenomenal, and it's easier with IV to avoid the dose creep/tolerance/psychological addiction aspects.

That said, IV Ketamine is hella expensive. :'( An $80 Ketamine nasal spray (not even with insurance, just that), can last me for 6 months with weekly lower dose solid session topup treatments. So, ~$12 a month. Less than HBO Max w/o ads. Hell yeah. That's a good price for an effective treatment haha. Both seem to have unique benefits too that I haven't easily gotten wjfb the other.

Just a few thoughts but am sure you're on a similar wavelength too so mostly just sharing! Curious to hear what your thoughts experiences were/are/have been.

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Natsu 1536 days ago
Yes, Esketamine (what they're calling S-ketamine) can be a good one. Just be careful if there's any history of psychosis.

It nearly got me stabbed and had to be discontinued. It really can work on depression, though, in a way the other drugs just don't.

Makes me wonder how much the others are doing, honestly, though missing a dose causes misery. I truly wonder sometimes what just slowly getting off them all would do to her.

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