Anyone tried ketamine?

[Jackb23]

Very weird, my doctor Jen prescribing it for “pain and sleep” and I thought nmda antagonists decrease glutamate

It does. It suppresses the nmda receptor, but in response to that the brain builds a bunch of new synapses. I’d have to look at the studies again, but I believe AMPA is increased as a result. During the time of the infusion I never had trouble sleeping, but the lingering/ after effects did mess with my sleep. This is just n=1, however, so don’t take my word for it.

 

[frozenborderline]

Okay so I asked an ER doc that uses k a lot and he said basically the effects on bp at sub anesthetic doses were negligible, plus I don’t have essential hypertension, just “pre hypertension” /hyperadrenergc pots, so I went for it.

@Hip do you know what Goldstein’s protocol for the infusion was? I remember someone saying he had a specific protocol for gradual infusion so As to not induce rapid tachyphylaxis and issues upon w drawal, also I think he combined w lidocaine and some other stuff.
Anyway it’s marvelous for pain and mood, while it lasts, which is not very long. So I’m tempted to deviate from the protocol and just try dosing small amounts every thirty minutes, plus gabapentin every thirty minutes, so as to emulate being on a continuous drip of it. I had some irritability when it wore off.

Given that ketamine doesn’t produce a much respiratory depression it would probably stack nicely w any gabaergics or opioids to decrease the amount needed.

I am still fairly annoyed that I am not wealthy enough to afford xenon, however , since it seems like the far superior nmda antagonist in every way shape and form. I really think that xenon used regularly could be very helpful for me/cfs patients, but I doubt it will be studied in a clinical trial or anything, because of its cost.

 

[frozenborderline]

I personally, never had super high blood pressure except for when I decided to drink a bunch the night before.

You mean during the infusion? I would imagine hangover plus k could increase bp yeah. I think I was overthinking this though. Perhaps it’s an issue at anesthetic doses but the effect at small doses seems so small in studies it might just be from nervousness or something. Although they did say higher bp spikes were noticed in hypertensive patients but there are many causes of hypertension and I think in my case it’s not essential hypertension more like hypovolemia compensating/hyperadrenergic pots

 

[Hip]

@Hip do you know what Goldstein’s protocol for the infusion was?

I have not looked into that, but it can of course be snorted into the nose.

 

[Jackb23]

@debored13 Yes, I only had one case of an increase in blood pressure and it was only during the infusion. It was due to the alcohol. During the other twenty-something infusions I never had a problem.

 

[AdamSee]

I had a period of taking it for a few months.

Positives

• Mood gradually got much better, so much so that eventually I became constantly euphoric, loved everyone and very social. It sounds amazing, but actually feeling good all the time got really annoying. I never thought would be possible to get annoyed with feeling amazing.
• No chronic fatigue symptoms. My body felt very relaxed (I usually had loads of pain throughout my body) and emotional problems disappeared.

Negatives

• Social intelligence increased (because I wasn't feeling depressed all the time), but intellectual intelligence dropped significantly. I couldn't do highly technical tasks.
• Random bouts of tiredness, which could be extremely hard to work around. All of a sudden getting very tired and need to sleep.

I think it's not useful long term solution, but I would say it can be very helpful if you are going through an especially hard time or in emergencies (feeling suicidal). It gives you a week of feeling good and that week of feeling good can really help give you some space from the negativity.

Looking back it did help me understand (with a lot of other clues) that a lot of the pain in my body was caused by emotions and past traumas.

 

[Jackb23]

I don’t know if I would try ketamine, at least not more than a few times (5 or less). I fear that it has made me much worse in the long run and rendered old medicines ineffective. I feel blunted and withdrawn, I don’t have thoughts anymore and my moods now grow lower and for longer. I understand that cognitive symptoms are part of ME/CFS, but ketamine definitely made my cognitive issues worse. On top of that, my sleep is extremely screwed now for what seems like for good unless I find another intervention. Perturbed sleep also limits what I can do pharmaceutically with some agents making it much worse, ie BCAAs.
Primary insomnia has been associated with fewer connections in the thalamus in both the insomnia population and also those with fatal familial insomnia from prison disease. Sodium benzoate has been shown to increase connections in the thalamus, brainstem and right amygdala in one patient so I am going to give that a try. If that fails then I will try and address what may be dopamine hypersensitivity by supplementing sarcosine. Sodium benzoate may also help with this as well.
TLDR; Exercise extreme caution if thinking about doing ketamine. It has really messed me up.

 

[valentinelynx]

I use ketamine troches for pain. 50 mg per troche. A troche is a lozenge that you dissolve between your cheek and your gums. It is very helpful for pain. At 50 mg, if you dissolve it slowly, you get (or I do) some intoxication symptoms. So I use it when falling asleep. Makes for much better sleep. If I take half a troche (25 mg), then my cognitive functions aren't notably affected, so this dose is useful when doing things while awake. No side effects other than the mild intoxication and increased salivation (which is a good thing because of my dry mouth symptoms). Typically I use 2-3 troches per day. The pain blunting effect lasts a couple of hours. This is in addition to my traditional pain medication (I won't discuss that outside of the members' only part of the forum).

 

[eon]

I'm not familiar with sodium benzoate's uses before other than it's a preservative found in foods and drinks as E211, but here's some of its medical uses:

Sodium Benzoate: Uses, Dangers, and Safety
https://www.healthline.com/nutrition/sodium-benzoate

I haven't tried ketamine yet but I'm mostly familiar with its usage for psychiatric ailments.

I don’t know if I would try ketamine, at least not more than a few times (5 or less). I fear that it has made me much worse in the long run and rendered old medicines ineffective. I feel blunted and withdrawn, I don’t have thoughts anymore and my moods now grow lower and for longer. I understand that cognitive symptoms are part of ME/CFS, but ketamine definitely made my cognitive issues worse. On top of that, my sleep is extremely screwed now for what seems like for good unless I find another intervention. Perturbed sleep also limits what I can do pharmaceutically with some agents making it much worse, ie BCAAs.
Primary insomnia has been associated with fewer connections in the thalamus in both the insomnia population and also those with fatal familial insomnia from prison disease. Sodium benzoate has been shown to increase connections in the thalamus, brainstem and right amygdala in one patient so I am going to give that a try. If that fails then I will try and address what may be dopamine hypersensitivity by supplementing sarcosine. Sodium benzoate may also help with this as well.
TLDR; Exercise extreme caution if thinking about doing ketamine. It has really messed me up.

 

[humanrising]

I use ketamine troches for pain. 50 mg per troche. A troche is a lozenge that you dissolve between your cheek and your gums. It is very helpful for pain. At 50 mg, if you dissolve it slowly, you get (or I do) some intoxication symptoms. So I use it when falling asleep. Makes for much better sleep. If I take half a troche (25 mg), then my cognitive functions aren't notably affected, so this dose is useful when doing things while awake. No side effects other than the mild intoxication and increased salivation (which is a good thing because of my dry mouth symptoms). Typically I use 2-3 troches per day. The pain blunting effect lasts a couple of hours. This is in addition to my traditional pain medication (I won't discuss that outside of the members' only part of the forum).

I looked at ketamine for pain a few years ago but I am really excited by the idea that it could help for sleep. I have such severe insomnia and have tried just about everything. I feel like one day I am just going to drop dead from not sleeping god knows its damaging my poor little brain.

Would you mind sharing a little more about what your sleep was like before you tried the troche's? how much sleep do you get.... do you feel like you have gotten restorative sleep in the morning? Wondering what the troches cost too. thanks so much!

 

[valentinelynx]

Hmm. I'm not certain that ketamine will help your sleep. But it may be worth a try. I have very high sleep drive: it's easy for me to fall asleep. I don't tend to stay asleep, however. I wake when I need more pain meds, typically after 2-3 hours. However, ketamine appears to encourage me to have REM sleep, which is helpful. I do feel better after I fall asleep using ketamine, which is good. Otherwise, I would usually wake up miserable.

The troches are pretty expensive. I pay about $50 for 30. I use about 3 per day. It's cheaper to use injections: my pain doc prescribes ketamine by subcutaneous injection. That uses far less (5-15 mg per dose rather than 50 mg) and a bottle of ketamine is cheaper than specially formulated troches. However, I've been unable to find a local pharmacy to prescribe it at present. I did find one years ago in California, but that was there, then. I'm happy with the troches, and stick myself with enough needles already. If money were more of an issue, I'd pursue the injectable route further.

 

[frozenborderline]

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

There are two main types of medication that I can think of for attenuating the development of opioid tolerance. I believe @Hip has already covered NMDA antagonists, but the other class of medication is opioid antagonists (at low doses).

(interestingly, kratom has all of these: opioid agonists, low doses of opioid antagonists, and nmda antagonists, all in it. If i wasn't so intolerant to the stimulant effects , I'd say its a perfect med for me)

Theres a report from a mod on bluelight about memantine dramatically reducing his opiate tolerance. From 200 mg morphine a day to feeling strong effects from 10 mg. This is an absolutely huge difference, and hes reported many beneficial effects from memantine besifes that. Its been used off label in me/cfs. Its used in alzheimers. Its an nmda antagonist

 

[frozenborderline]

Hmm. I'm not certain that ketamine will help your sleep. But it may be worth a try. I have very high sleep drive: it's easy for me to fall asleep. I don't tend to stay asleep, however. I wake when I need more pain meds, typically after 2-3 hours. However, ketamine appears to encourage me to have REM sleep, which is helpful. I do feel better after I fall asleep using ketamine, which is good. Otherwise, I would usually wake up miserable.

The troches are pretty expensive. I pay about $50 for 30. I use about 3 per day. It's cheaper to use injections: my pain doc prescribes ketamine by subcutaneous injection. That uses far less (5-15 mg per dose rather than 50 mg) and a bottle of ketamine is cheaper than specially formulated troches. However, I've been unable to find a local pharmacy to prescribe it at present. I did find one years ago in California, but that was there, then. I'm happy with the troches, and stick myself with enough needles already. If money were more of an issue, I'd pursue the injectable route further.

I think my doctor needs to up my ketamine dosage. She prescribes intranasal dose of 10 mg a day. This is smaller than even low doses used by most pain docs, and its also way way smaller than doses used in infusions for chronic pain and depression. But i feel awkward asking for a higher dose.

 

[valentinelynx]

I think my doctor needs to up my ketamine dosage. She prescribes intranasal dose of 10 mg a day. This is smaller than even low doses used by most pain docs, and its also way way smaller than doses used in infusions for chronic pain and depression. But i feel awkward asking for a higher dose.

She should be aware that people develop tolerance to ketamine, so even if your dose was adequate at start, after awhile it may not be.

 

[xena]

I have tried the intranasal a few times. Seems to help a little with depression but I don't know if I've taken it consistently enough to see lasting results. I sometimes feel a kind of euphoria the next day. Once I felt like it made me more brain fogged for several days and I was very worried but it doesn't seem to be a lasting problem in my case and hasn't recurred.
Used to cause extreme insomnia and nausea until I started taking it with charcoal. Don't see an effect on fatigue.

 

[frozenborderline]

okay so the difference btwn xenon and ketamine is that xenon obliterates fear , feels deeper and no side effects. really obliterates it. in the milder, smaller doses, it merely dampens it a lot. in the higher doses it is like high doses of ketamine with none of the nausea, fear or confusion. just blissful dissociation. it is very expensive for something that doesnt last that long and almost feel guilty about it but it really does that thing that I want/need of obliterating the glutamatergic and anxiogenic effects that remain even with ketamine. just pure bliss and fearlessness. and painlessness. id forgotten what the combo felt like. would love access to this post surgery.

ketamine is not a panacea. but xenon might be. sorta kidding . even with its neuroprotective effects it wont make up for constant mechanical stress. but damn, its the best palliative med invented.

 

[frozenborderline]

if theres any downside to xenon its just that when it wears off i feel my bodies pain, and since its the most effective painkiller ive found, the contrast when the pain comes back can just be intense.

 

[frozenborderline]

oh and expense obv. i would LOVE to be able to afford xenon post surgery tho. maybe with another stimulus check. bc of the thing where it obliterates both pain AND fear

 

[frozenborderline]

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

What dose of progesterone do you need? Also Have you tried memantine ?

Ketamine was helpful for me for years but is now, even at a therapeutic dose , harming my bladder, extremely unfortunately. Nitrous oxide has fairly beneficial 3effects but without being monitored for b12 depletion seems far too risky. Only one clinic in the United states seems to do it under clinical supervision, which I assume means testing b12. Xenon is superior to everything on this list, but is extremely expensive. Dxm causes bladder issues like ketamine and is more risky all round. Epsom salt baths have helped me some but nowhere dramatic as ketamine.

I'm hoping progesterone can help.

Iv lidocaine isnt an nmda antagonist but it does lower glutamate. Also I'm not sure that all anesthetics with nmda antagonist mediate their effects solely through that receptor. Xenon has some direct effects on various ion channels, which may make it different from ketamine. Maybe finding drugs that aren't just nmda antagonists but hit same targets as xenon but are cheaper (almost guaranteed to be if they aren't a trace element like xenon) would be. a good bet.

Just desperate now that I cant take ketamine. I do wonder about iv magnesium though.

 

[frozenborderline]

Ibogaine

Ibogaine can significantly reduce opioid tolerance which makes it of much interest for chronic pain patients, however the doses needed to do that often cause deaths from heart failure I believe. Unless you think small doses can be helpful