Anyone tried ketamine?

[Jenny]

The attached gives some evidence of its use in fibro and how it might interact with various mechanisms of brain inflammation.

Rather a long and complex read!

Jenny

 

[Sam Carter]

Dr. Jay Golstein wrote that when treating CFS, "The ultimate goal appears to be (for most patients) to reduce the sensitivity of the NMDA receptor"[1] and that ketamine was "the single most useful medication in the neurosomatic pharmacopeia" [2].

Ketamine is an interesting drug. It's useful for refractory depression, chronic pain and inhibiting opioid tolerance. Some UK specialist pain clinics will prescribe it but most docs are frightened to touch it because it can cause psychosis.

Clonazepam is a mild NMDA receptor antagonist which can help manage the symptoms of ME/CFS. Another drug, memantine, may have the same positive effects as ketamine without causing psychosis.

[1],[2] Tuning the Brain p55, p216

 

[glenp]

Be careful - I know of two people who have had bad affects from this drug and one claims to have permanent damage from it

glen

 

[Sam Carter]

Hi Glen,

Were the people harmed by Ketamine receiving it from a specialist physician? It's a powerful drug and I imagine it needs to be administered by someone with experience in this area.

Sam

 

[glenp]

Sorry I don't know of their physicians specialties. I only know of it from when they discussed it in our yahoo chats.

glen

 

[ramakentesh]

http://chronic-fatigue-syndrome.suite101.com/article.cfm/nmda_antagonists_cfsme_and_fm

this may be of interest, as NMDA receptor hyperactivity is implicated in at least some forms of dysautonomia.

 

[kbak]

Hi, I use a compounded cream that has lidocain and ketamine. I have found it more effective than anything else I've used. Now I'm going to have to talk to the pharmacist and see about this psychosis side effect. Hopefully my dose is small enogh I won't have to worry about it.

kbak

 

[Hip]

Dr. Jay Golstein wrote that when treating CFS, "The ultimate goal appears to be (for most patients) to reduce the sensitivity of the NMDA receptor".

A while ago, I had a severe problems with mental tension and anxiety, which I think is caused from NMDA overstimulation. I have compiled a list of safe supplements that reduce the sensitivity of the NMDA receptor. If you take several of these together, they do work. They act as anxiolytics.

Here is the list of NMDA inhibitors:

Transdermal Magnesium - potent
Taurine
Guaifenesin
Cats claw - possibly
L-Huperzine A
Zinc
Progesterone (transdermal)

Ibogaine

Amantadine, Ketamine, Riluzole, Memantine, Dextromethorphan

Nitrous oxide, xenon gas

 

[garcia]

Hi, I use a compounded cream that has lidocain and ketamine. I have found it more effective than anything else I've used. Now I'm going to have to talk to the pharmacist and see about this psychosis side effect. Hopefully my dose is small enogh I won't have to worry about it.

kbak

kbak, that is very interesting. Can I ask who prescribed you the ketamine cream? Was it a CFS specialist?? I'd love to be able to try that out.

Many thanks,
garcia.

 

[garcia]

Hip,
many thanks for your post. I'm also currently looking into NMDA antagonists. Can I ask which ones you currently use?

garcia.

A while ago, I had a severe problems with mental tension and anxiety, which I think is caused from NMDA overstimulation. I have compiled a list of safe supplements that reduce the sensitivity of the NMDA receptor. If you take several of these together, they do work. They act as anxiolytics.

Here is the list of NMDA inhibitors:

Transdermal Magnesium - potent
Taurine
Guaifenesin
Cats claw - possibly
L-Huperzine A
Zinc
Progesterone (transdermal)

Ibogaine

Amantadine, Ketamine, Riluzole, Memantine, Dextromethorphan

Nitrous oxide, xenon gas

 

[Beth Berner]

Jenny,
I am taking ketamine right now. My brother is a psychiatrist--tho not mine--and he started using ketamine several years ago. I am very cautious and I was too scared to take it for a long time. Plus, my other meds were doing the trick. I am twice blessed with having BipolarII Syndrome and Chronic Fatigue Syndrome. The BPII is going on 30 years; the CFS for four. There are major sleep issues with both illnesses. When my current meds weren't up to the CFS, I reconsidered taking ketamine. At that time, my sleep was just a mess. I was waking up 10-12 times a night, maybe more, and not getting deep sleep at all. I was miserable.

I started the ketamine out at 10 mg as a nasal spray. I worked my way up to 40 mg. Then we doubled the dosage. In a CFS moment, I forgot that and jumped straight to 80 mg. In retrospect, that was good, as every time I went up I would get nervous. Now I am at 90 mg and should stay there for awhile. My first sequence of sleep--about 6-7 hours is great, usually with just one awakening. Since I have CFS, I sleep 12 hours, so the second sequence is more problematic, as I still have medicine in my system. I used to take one 10 mg, then 20 mg, spray before going back to bed. The results were sketchy. I think a nasal spray just isn't completely stable. So, now I am doing a 10 mg pill and it is working better.

I will always be careful with ketamine. I alway read the label--for correct dosage--before I take it, but I have read that it is actually a mild drug. My brother is convinced it is the next big drug for depression of the decade. He told me of a woman who had such bad BiPolar II that she had tried everything. After 3 ketamine infusions, she was cured. Obviously, this will not work for everyone, but if I were struggling with BPII the way I used to, I would say, "Sign me up!" I still might.

Bottom line: I used to dread going to bed; with ketamine, I look forward to it.

Betth

 

[ramakentesh]

Otto and another are using Huperzine A and having good success. Not sure if its from NMDA antagonism or central acetylcholine esterase.

 

[Legolas]

Jenny,
I am taking ketamine right now. My brother is a psychiatrist--tho not mine--and he started using ketamine several years ago. I am very cautious and I was too scared to take it for a long time. Plus, my other meds were doing the trick. I am twice blessed with having BipolarII Syndrome and Chronic Fatigue Syndrome. The BPII is going on 30 years; the CFS for four. There are major sleep issues with both illnesses. When my current meds weren't up to the CFS, I reconsidered taking ketamine. At that time, my sleep was just a mess. I was waking up 10-12 times a night, maybe more, and not getting deep sleep at all. I was miserable.

I started the ketamine out at 10 mg as a nasal spray. I worked my way up to 40 mg. Then we doubled the dosage. In a CFS moment, I forgot that and jumped straight to 80 mg. In retrospect, that was good, as every time I went up I would get nervous. Now I am at 90 mg and should stay there for awhile. My first sequence of sleep--about 6-7 hours is great, usually with just one awakening. Since I have CFS, I sleep 12 hours, so the second sequence is more problematic, as I still have medicine in my system. I used to take one 10 mg, then 20 mg, spray before going back to bed. The results were sketchy. I think a nasal spray just isn't completely stable. So, now I am doing a 10 mg pill and it is working better.

I will always be careful with ketamine. I alway read the label--for correct dosage--before I take it, but I have read that it is actually a mild drug. My brother is convinced it is the next big drug for depression of the decade. He told me of a woman who had such bad BiPolar II that she had tried everything. After 3 ketamine infusions, she was cured. Obviously, this will not work for everyone, but if I were struggling with BPII the way I used to, I would say, "Sign me up!" I still might.

Bottom line: I used to dread going to bed; with ketamine, I look forward to it.

Betth

1)Somebody here was qouting Jay Goldstein, he succesfully used ketamine to treat patients but they needed to be pre-medicated to avoid possible damage. He also infused the ketamine over a long period of time (2 hours I think).
On this way he avoided side effects and the patient didn't get tolerant. It is known in the literature that ketamine can "cure" depression in a couple of hours. The problem is that patients seems to become tolerant over a period of time.
What scientists don't seems to know is that the infuse it way to fast, and by doing so induce tolerance. This is something Goldstein explicitly warned for; fast titration will induce unreversible tolerance!

I think it's a pitty so few people are aware of his theory/books and method's of treatment. I think ME is a immunological disorder causing imbalance in brain neurotransmittors. Most symptoms we experience are coming from the CNS.
He considered ME as a pure neurological (or neurosomatic as he used to call it) disorder, which is not completly right i think, but nontheless it think his theory is very valuable and his approach fast acting and can relief so much suffering.

See also Palls' theory on NMDA http://sprident.com/martin-pall/cfs.htm

2) The problem is that pure NMDA antagonists induce hallucinations. That's why they never maded it to the market. But scientists discovered subunits of the receptor that are not expressed in neurons all over the brain.
On this way they can target this receptor more selectively, causing less side effects. The subunit farma companies are now aming for is NR2B. Some NR2B antagonists are currently in the pipeline and worth following!

some med's in the pipeline

http://www.evotec.com/article/en/Alliances-Projects/EVT-101-103-NR2B-selective-NMDA-Antagonists/11/4 (evt 101 study terminated)
http://www.dddmag.com/articles/2010/10/unlocking-therapeutic-potential-nmda-receptor Naurexs GLYX-13 (works on glycine-site)
astra zenecas' AZD6765
traxoprodil


This NMDA receptor is also the target for other diseases such as neuropathic pain, seizures, migraines, etc...

 

[ramakentesh]

I think ME is a immunological disorder causing imbalance in brain neurotransmittors. Most symptoms we experience are coming from the CNS.

I couldnt agree more. The evidence is certainly mounting and pointing firmly in that direction. On thing that got my interest recently was looking at the abnormal brain flow in Alzheimers disease and its similarities to what has been described in some with CFS. Excitation could be the result perhaps of abnormal acetylcholine activity or abnormal choline as is suspected in Alzheimers in relation to the blood flow. Im just thinking out aloud, but I agree with your statement.

Ive often argued with POTS patients about how their symptoms are mainly CNS yet they believe the source of the problem is peripheral. Could be true, but it could also be the opposite just as easily and probably more likely.

 

[heapsreal]

Thought i would bump this as its of interest to another thread

 

[August59]

I second that bump!

 

[xks201]

ACE levels interest me because they dictate neurotransmitter levels to a good extent...immune response...sympathetic nervous activity-etc.

 

[Hip]

Since this thread has come back to life, I may as well post my updated list of NMDA receptor inhibitors. Inhibiting NMDA receptor activation will reduce anxiety symptoms, and protect against excitotoxicity.


NMDA inhibitors /antagonists

Magnesium — a potent NMDA inhibitor. High dose transdermal application, or injection, required for maximum effect.

Zinc

Progesterone (a hormonal supplement usually sold as a transdermal cream)

Huperzine A (a supplement)

Taurine (taurine also activates GABA receptors)

Amantadine (antiviral drug, also used for Parkinson's and Alzheimer's)

Agmatine (a supplement)

Lithium

Dextromethorphan (DXM) — an over-the-counter cough mixture (cough suppressant)

Dextrorphan (DXO) is an active metabolite of DXM. DXO a psychedelic drug and cough suppressant, is a much more potent NMDA antagonist than DXM. DXM is converted to DXO in the body by cytochrome P450 2D6 isoenzyme (aka: CYP2D6). Thus cytochrome P450 2D6 inhibitors such as imipramine, propranolol, quinine and citalopram may decrease the effect of DXM.

Dantrolene (muscle relaxant)

Orphenadrine (muscle relaxant)

Methadone (opiate)

Dextropropoxyphene (weak opiate)

Ketamine — an anesthetic and recreational drug.

Riluzole (ALS drug)

Memantine (Namenda)

Ibogaine — the hallucinogenic active principal from the root bark of Tabernanthe iboga. Microdoses of around 50 mg daily of Tabernanthe iboga root bark will not produce a hallucinogenic effect, but still have therapeutic effects. Tabernanthe iboga root bark is legal to buy in the UK, but not in the US.

Nitrous oxide (N2O) — an anesthetic gas (often used in dentistry) and and recreational drug. Also know as laughing gas. Depletes vitamin B12.

Guaifenesin (possibly?) — an over-the-counter decongestant. The guaifenesin protocol is a fibromyalgia and ME/CFS treatment.

Xenon gas. An anesthetic gas.

Cat's claw (Uncaria tomentosa) — the rhynchophylline constituent of this herb may inhibit the NMDA receptor.

Syrian rue (Peganum harmala) — a MAO-inhibitor herb. MAO-inhibitors should never be taken with nexavir/kutapressin, which contain tyramine.


Dangerous/Toxic NMDA inhibitors/antagonists:

Lead is a potent inhibitor of the NMDA receptor.

Phencyclidine (PCP, angel dust). Some studies found that, like other NMDA receptor antagonists, phencyclidine can cause a certain kind of brain damage called Olney's lesions in rats.

Kynurenic acid (high levels associated with schizophrenia and pychosis).


NMDA agonists:

Glutamate
Glycine
Ammonia

 

[FunkOdyssey]

Don't forget methoxetamine.

 

[August59]

I've tried agmatine and memantine and had some results with both, but can't say it was a lot, but I wasn't on either very long due to finances. Agmatine has gotten much cheaper than since I tried it as I could only find 1 supplier of just plain agmatine, but now there are a few.