New era for ME/CFS research as top cytokine study attracts media headlines
The immune systems of patients who have recently developed ME/CFS look markedly different from those who have been ill for much longer, according to a major new study from Drs. Ian Lipkin and Mady Hornig at Columbia University. This shift in immune function hadn’t been seen before.
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Anyone tried ketamine?

Discussion in 'General Treatment' started by Jenny, May 18, 2010.

  1. lawson415

    lawson415

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    I am just learning about NMDA antagonists and I want to try some. Memantine seems to easily and cheaply available. What dose of memantine were you using? Opps- it is Agmatine that is cheaply available. Has anyone tried it?
     
  2. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    australia (brisbane)
    a cheaper nmda antagonist is dextromethorphan or DMX and is a common ingredient in alot of cough medicines and has been a study showing it was helpful for fibro pain and there is talk that it can help lower benzo tolerance. I have used this and went by the dosage on the bottle which was 45 mg and it has helped with fibro type pain and seem to improve my sleep with benzo's. Its cheap and easy to get at any local pharmacy, robitusson is a common brand that carry this.
     
  3. lawson415

    lawson415

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    Thanks- I see cvs sells lozenges that are pure dmx- will have to check them out. thank you.
     
  4. Rand56

    Rand56 Senior Member

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    I think some words of caution are warranted here if anyone is going to try DXM. Never tried it myself, but I know there are drug interactions people need to be aware of..even some regular supplements too. Maybe these interactions come with only higher doses but just in case someone decides to haphazardly take more than is needed, better to be safe than sorry. I know this info from this site is mainly for people taking it recreationally, but warnings are warnings and people need to be aware of them....

    http://www.hipforums.com/newforums/showthread.php?t=309520

    Drug Interactions
    • Antidepressants of any kind. MAOIs (monoamine oxidase inhibitors) are the worst; DXM + a MAOI will kill you. DXM with other antidepressants can cause serotonin syndrome, an unpleasant and occasionally fatal condition.

    • Diet drugs like phentermine, fenfluramine (Redux), or phen-fen. Again, a risk of serotonin syndrome.

    • Non-drowsy antihistamines (allergy medicines) like Allegra, Seldane, or Hisminal.

    Here is a list of drugs that mixed with DXM can cause Serotonin Syndrome


    Monoamine oxidase inhibitors (MAOIs)
    Tricyclic antidepressants (TCAs)
    Selective serotonin reuptake inhibitors (Zoloft, Prozac, Paxil,
    serotonin-norepinephrine reuptake inhibitor
    Lexapro, Celexa)
    Venlafaxine (Effexor)
    Trazodone (Desyrel)
    Nefazodone (Serzone)
    Meperidine (Demerol)
    Chlorpheniramine
    Sumatriptan (Imitrex)
    Atypical antipsychotic (Zyprexa, Risperdal, Seroquel)
    L-dopa
    Meridia
    Lithium
    Valproic acid (Depakene)
    Linezolid (Zyvox)
    St John's Wort
    Ginkgo Biloba
    buspirone
    tryptophan
    montelukast(Singulair)
    kanna
    Risperidone
    Aripiprazole(Abilify)
    5-HTP
    Diphenhydramine(Benadryl)
    MDMA(Ecstasy, XTC)

    Also, do not mix DXM and amphetamines. This can put alot of stress on the heart due to the combined effects of increased heart rate and blood pressure. Not to mention risk of serotonin syndrome.

    DXM and LSA is also ill-advised as LSA can cause vasoconstriction, in conjunction with DXM's high blood pressure this could be unhealthy for the heart and circulatory system (Thanks BillyX).
     
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  5. lawson415

    lawson415

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    Well I am using some of the things on that list so maybe another nmda antagonist might be a good Idea. I just ordered some agmatine- 500 mg caps. Based on what I see on the weight lifter forums I was thinking of 500 mg 3x daily. Any feedback on agmatine?
     
  6. redaxe

    redaxe Senior Member

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    Bumping this thread to see if anyone here has had any recent experience with Ketamine.

    Apparently there was a clinic chain treating people with severe depression using Ketamine injections in Australia but it was forced to close for reasons that aren't really clearly explained.
    http://www.smh.com.au/nsw/medical-c...treatment-for-depression-20150217-13h51o.html

    http://www.abc.net.au/news/2015-03-...ion-aura-medical-graham-barrett-quits/6345146

    http://www.abc.net.au/news/2015-07-...n-offering-ketamine-injections-closes/6616594


    Now I don't want to associate depression with CFS/ME but it apparently it acts as a NMDA receptor antagonist and also is found to reset pain receptors so apparently some people with fibro have found relief from it

    Dr Jay Goldstein was using it to recover very sick patients. Also to point out he administered the drug by slow IV infusion to reduce negative reactions or tolerance to the drug.
    http://www.cfstreatmentguide.com/dr-jay-goldstein-a-z-treatments.html

    That said the claims for it successfully treating 75% of people with depression are interesting. If those results are consistent that is an amazing development and hopefully it improves our understanding of the biological cause of depression and reduces the influence of psychiatry. I can also imagine in the long run it might help doctors better distinguish between treatment resistant forms of depression that might include some forms of PEM and extreme fatigue and CFS/ME.
     
    Last edited: Jul 14, 2015
    merylg likes this.
  7. redaxe

    redaxe Senior Member

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    Just in reply to my last post there is a US clinic that advertises Ketamine Injections from Manhattan

    http://usketamine.com/

    This is an excerpt

    Ketamine, a glutamate NMDA receptor antagonist, has been shown to provide rapid antidepressant benefits when given as a subanesthetic dose. In addition, ketamine has been shown to increase synaptic connections and reverse neuronal damage caused by exposure to stress. Intravenous ketamine has been most commonly studied and positive findings for symptom improvement have been reported for people with OCD and posttraumatic stress disorder (PTSD) in addition to depression. More recently, a more simple and patient-friendly route of administration has been developed. Dr. Lapidus was lead-author on a report published in 2014 that demonstrated the safety and rapid efficacy of intranasal ketamine for depression. In addition to quickly relieving symptoms in those suffering from depression, this method of administration appeared to be better tolerated and result in less side effects when compared to intravenous treatment for depression.

    The part about increasing synaptic connections and repairing neuron damage I find very intriguing. Since 'brainfog', poor memory and cognitive dysfunction are almost universal symptoms for CFS/ME patients and Montoya's work at Stanford University demonstrating we have diminished white matter.

    If I lived in NewYork I would be very interested in trying that therapy out. Maybe others here can comment if they have any experience on this.
     
  8. Hip

    Hip Senior Member

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    One thing of interest with ketamine is that oral or intranasal administration of ketamine hydrochloride (ketamine HCl) has been shown to work just as well for depression as IV ketamine (although a study found that with oral or intranasal administration, it took a little longer for the antidepressant effects to kick in, compared to IV).

    Oral or intranasal ketamine HCl would be a far more convenient method of administration, compared to having to go to a hospital or clinic to get an IV. Ketamine HCl can be absorbed orally and nasally because it is water soluble, whereas ketamine is not water soluble.

    When sold as a street drug (known as "Special K"), it is the ketamine HCl form that is used. This is usually either snorted or injected, and according to this article, the doses required for a full psychonaut trip on ketamine are around 80 mg if injected, and around 250 mg is snorted intranasally. Obviously for antidepressant or ME/CFS use, you would not want to go on such a trip, so much smaller doses than these are employed. For antidepressant purposes, 50 mg was taken intranasally (see below).

    Here are some studies and articles on oral and intranasal ketamine HCl for depression:
    Daily oral ketamine for the treatment of depression and anxiety in patients receiving hospice care: a 28-day open-label proof-of-concept trial — this study used around a 40 mg ketamine HCl oral daily dose on patients.
    A randomized controlled trial of intranasal ketamine in major depressive disorder — this study used 50 mg ketamine HCl intranasally daily on patients
    Ketamine Nasal Spray For Fast-Acting Depression Relief
    How to Use Ketamine for Depression and Anxiety



    Also useful is this list of US doctors that can administer ketamine for depression:
    Ketamine Advocacy Network



    As well as the ketamine vs ketamine HCl difference, there is also the issue of whether you use ketamine or S-ketamine.

    Ketamine is normally a 50/50 racemic mixture of R-ketamine and S-ketamine. But this study found pure S-ketamine may be better than the racemic ketamine just because S-ketamine seems to have a lower incidence of side effects such as derealisation and hallucinations.

    So ideally, for oral or intranasal used, I think you would want to try to get hold of S-ketamine HCl.

    S-ketamine is also called Esketamine.



    Ketamine has a number of pharmacodynamic effects, and its benefits for depression and/or ME/CFS may derive from more than just the NMDA receptor antagonism:
     
    Last edited: Jul 18, 2015
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  9. redaxe

    redaxe Senior Member

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    Thankyou for that Hip - Makes me think we should have a specific section in the Treatment section of the forum here specifically for neurological approaches.

    But good one too for bringing up the point about oral or intranasal administration - that certainly overcomes some difficulties with accessing the drug due to cost.

    Sadly though I think it is something that will be out of reach of many of us because its narcotic classification which ends up with restricted access that Xyrem has. While I think I'm having some improvement on Valcyte I would like to go further and try out other approaches. Makes me really envious of you Americans that your medical community is much more proactive with doctors willing to try new therapies as they emerge. :)
    In Australia trying to get any treatment that's a bit off-label is a major hassle. It seems like we had a clinic doing Ketamine injections but pressure from the psych lobby forced them to close <sigh> the same shrinks that are happy to give out SSRIs despite the risks.....
     
  10. redrachel76

    redrachel76 Senior Member

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    Israel
    I tried Ketamine at Dr Goldsteins in 1999. It worked briliantly then stopped. I was unable to up the dose or change delivery method because I then discovered that it was near impossible to obtain in Israel.


    If you can get it prescibed in your country I would recommend trying it.
     
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  11. Hip

    Hip Senior Member

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    I am actually in the UK. Yes, I saw that about the Australian ketamine clinics closing down, although reading about them, they did seem a bit cheap, shabby and profit-oriented, which perhaps is not the best motivation and set-up if you are going to explore a novel antidepressant treatment. You would ideally want academics running such clinics.
     
  12. Hip

    Hip Senior Member

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    Can I ask, how long would you say ketamine worked for before it stopped working for you? And what sort of ME/CFS symptoms did it improve?

    For me, I am most interested in ketamine's ability to treat anhedonia, which is a comorbid condition I suffer from alongside ME/CFS.
     
    Last edited: Jul 18, 2015
  13. redrachel76

    redrachel76 Senior Member

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    Israel
    1st day was great , then it worked a lot less for pain, ever day and by 2 weeks it was useless.

    I got tolerance quickly. I wrote to Dr Goldstein and he said to stop taking it as a nasal spray and take it by mouth instead. I then discovered that it was impossible to get in Israel. If it were available here I would be trying it now. I am v.surprised by all the warnings posters give here.

    I used the nasal spray in the exact dosage Dr Goldstein says in his book. I can try to look it up when I feel better, if you like.
     
    AaroninOregon likes this.
  14. Hip

    Hip Senior Member

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    Yes please, it would be interesting to know what dose he used. I have Dr Goldstein's "Betrayal by the Brain" book, but I cannot find ketamine mentioned in the index.
     
  15. redrachel76

    redrachel76 Senior Member

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    I looked up in " Tuning the Brain" p349.
    It says he used Ketamine nasal spray 1:10 or 1:1 and oral swirl 1:1
    Whatever that means. It is a shame I don't have the original bottle it came in.

    I took it for pain and exhaustion, not anhedonia.
     
  16. Hip

    Hip Senior Member

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    Thanks for those details. I notice the page you got them from appears to be available to read here on Google books. Dr Goldstein does not seem to give the actual mg ketamine doses used on that page, but just the concentration of the liquid ketamine solution (concentrations of 1:10 or 1:1).

    Although nasal sprays are typically metered around 0.1 ml for each spray, so it should be possible to work out the mg dosage of ketamine in each 0.1 ml spray.


    Looking that page, Goldstein appears to be using ketamine there as an agent that acts locally on the trigeminal nerve (a nerve which is found in the eyes, nose and mouth), rather than an agent that has a systemic effect. So he may be using lower doses of ketamine for this local purpose.
     
    Last edited: Jul 18, 2015
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