[tasty_freeze]

My wife takes ketamine troches as an adjunct to another antidepressant she is on. She needs to ramp down off that older antidepressant before she starts a new one and the ketamine helps keep depression at bay while she ramps down her dose.

My wife is 5'7" (170cm) and weighs 125 lbs (57kg), and takes 150mg five nights a week. That is about 2.6mg/kg. When she first started taking it the only side effect was on occasion she'd get double vision. Twice in a year she has had a night where it hits hard and she needs me to set with her because the disassociative aspect is unsettling to her. 99% of the time, though, she said it is like being mildly drunk, like after a glass of wine or two, nowhere near k-hole territory.

She has no other experience (recreational or therapeutically) with psychedelics/disassociatives. Perhaps the antidepressant she is taking dampens the effect of the ketamine.

All in all, she is glad to have the antidepressants, but there has been no silver bullet. It is always lurking just below the surface and she is constantly aware/afraid that it will resurface in full force.

[tbalsam]

Five nights a week is quite a lot, she may have some strong tolerance as well. It's a semi-low to moderate dose for pain patients I believe IIRC just a higher dosing rate compared to the median rates that I commonly see.

[snackwalrus]

Five nights a week is extremely frequent, if she does not tone it down she will likely develop moderate to severe bladder problems in the future.

[tbalsam]

There is some promise with NAC and the bladder nightmare that can happen, but yes agreed, those bladder problems can be heinous, and accepting a mildly reduced efficacy in the short term for the trade of being able to maintain this longer term is the risk argument that I think I'd be making here. <3 :))))

[tasty_freeze]

It is a doctor's prescription. You might say that the frequent use has increased her tolerance, but she had no other effects even at the start (other than occasional double vision).