Addressing Questions & Concerns About Ketamine Therapy for Treatment Resistant Depression

Hello. This is Susan from myketaminestory.com. I am once again addressing questions and concerns regarding Ketamine therapies for treating mood disorders and pain. I am writing a four part series answering questions about Ketamine use, based on my experience with Ketamine therapy over the past 2.5 years, for The Injection & Infusion Clinic of ABQ. This is the second post in my Q & A series.

My first blog, Ketamine: Addressing Questions & Concerns focused on my early experience with Ketamine Infusions. It was because of cost and location that I had to search for other options for treatment. Once I realized I was responding positively to Ketamine Infusions, I worried about how I would continue to afford the treatments. I was fortunate enough to discover an interested doctor in my area willing to administer Ketamine with intramuscular shots. I continue to be grateful to Dr. Charles Moseley for providing this medication to me. I fear the idea of drowning in my depression because I can’t afford the cost. I worry compulsively about losing my doctor. What would happen to my recovery if I no longer had a professional willing to administer IM Ketamine shots? What if there isn’t anyone willing to work with me at a price I could manage paying twice a month for this incredible life altering therapy?

Hold that thought.

My husband and I have been considering moving out West for years. I currently live in Virginia. The winter for me is awful. I know those four months may not be horrible to some, but for me it wreaks havoc on me, mentally and physically. This past winter I promised myself that my east coast winter days were numbered. We started researching states like Nevada, New Mexico and Arizona. We looked at the Las Vegas, Nevada area. We examined Albuquerque, New Mexico. We even went back to my birth place of Glendale, Arizona. The problem I constantly reminded my husband about was who would continue to treat me with IM Ketamine shots if we moved? We have to consider tolerating the winter months because I am able to get my Ketamine shots every two weeks at a price that won’t put me into massive debt in six months.  I wish Ketamine therapy was covered by my insurance company. I am aware of several clinics and centers on the West coast now. However, I am realistic. I could never afford switching to a new doctor. We stopped dreaming of moving to a warmer climate. It was while I was updating my Ketamine Provider & Locations list, which is located here and on my personal website, that I found The Injection & Infusion Clinic of ABQ. I was excited to see that this Ketamine clinic had one of the lowest pricing, for Ketamine Infusions. What was even more of an appeal to me was that the owner, Jason Duprat, is a Certified Registered Nurse Anesthetist. I was introduced to yet another profession I could approach and educate. It is because of my Ketamine advocacy that this was valuable information for me. What was even more astounding about this Ketamine clinic was the fact that when I spoke with them, I was informed that they are also willing to administer Intramuscular Ketamine shots. The Injection & Infusion Clinic of ABQ even has IM Ketamine shots mentioned on their website. I love that this Albuquerque center is charging one of the lowest prices nationwide for infusions, but more so, they understand the benefits of Ketamine and are willing to offer another delivery method for Ketamine to those that can not repeatedly cover the charge if routine maintenance or booster treatments are needed. I need them. I know without Ketamine therapy I have no chance at the life I see before me now. It might take a while for me to sink but drown I would. I have no doubt.

When I agreed to write for The injection & Infusion Clinic of ABQ website, I did so knowing that here is one place in the beautiful state of New Mexico I could consider relocating and possibly continue to receive affordable Ketamine treatments. That calms me. I know that I spend hours researching all things related to Ketamine in hope of educating those suffering with mood disorders, as well as professionals, on the hope Ketamine has offered me and could potentially bring others. If more education and awareness is brought to the benefits of Ketamine for depression the chances look great for changes to one day happen. In the meantime, those with treatment resistant depression continue to suffer; waiting.

In this second series of questions I will address the differences between IM Ketamine and Ketamine Infusions. I will answer questions about long term use and my tolerance of Ketamine over the past two plus years. I will tackle difficult questions regarding how Ketamine has improved my life and why I fight to advocate for this unusual form of treatment. I am open to answering a variety of questions so don’t hesitate to contact me or head over to The Injection & Infusion Clinic of ABQ website for assistance.

Now, without anymore ramblings, on to this week’s question and answer format.

Susan, why do you think you are qualified to address the concerns and inquiries people have about Ketamine therapy?

I feel I must add a disclaimer here and say results may vary, but that sounds so tacky.  I feel that many people are still just now discovering Ketamine for Depression. I have been getting Ketamine treatments since March of 2015. I began with 6 Infusions and for the first time in my life I actually responded to a treatment for depression. I have suffered for decades without any relief. I have also had many attempts to end my misery and in hopes of being set free. No medication cocktail or ECT has been able to make a dent in my depression and anxiety symptoms. Nothing. However, with Ketamine I was able to breathe for the first time; a full blissful breath. I am notorious for holding my breath paralyzed by anxiety. I noticed that after my first Infusion of Ketamine I could literally fill my stomach up and release years of pent up emotions in that beautiful breath. That shook me. It was like catching a faint glimpse of hope. I feel that after 2.5 years of continuous improvements with the help of Ketamine I might be able to speak intelligently on the subject and educate. I want to advocate and give hope. I feel I waited over two years before finally coming to my own conclusions about Ketamine. I feel my experience grants me the authority to comment on the research and benefits of this drug called Ketamine.

Why are you getting Intramuscular Ketamine shots instead of Infusions?

I would have to say the main reason is the financial burden ketamine Infusions would cause me and my family. The number of Ketamine Infusion centers in my area is extremely limited too.

How did you hear about Intramuscular Ketamine shots?

I had to travel to New Jersey, in 2015, for my initial six infusions. It was after my second treatment with Dr. Steven Levine that we discussed how I was responding positively to the infusions and what that might mean for me and the future. I was honest with Dr. Levine about my financial struggles and that I lacked the ability to drive 6 or 7 hours for a costly treatment. I cried in fact. I have never experienced relief from my depression and anxiety before being introduced to Ketamine. It amazed and horrified me. I finally found a treatment that could potentially turn my life around and I couldn’t afford to travel and pay for the treatments on a regular basis.

Why would you need Ketamine routinely? I was under the impression that you only need six infusions to get all the benefits Ketamine has to offer?

I can get pretty fired up when discussing all the articles out there making the claims that you only need six infusions to be “cured”. I will try to contain myself and limit my response to this subject. Ketamine lifted the depression temporarily for me. In the beginning, I was only getting a day or two of mild relief from my depression. I was aware more of how it allowed me freedom from the anxiety that had me locked up in my house with agoraphobia. The benefits Ketamine offered for my depression were limited at first. I would need all six infusions to assess how it might help with my depression. I did feel the difference in my mood as each day passed. The farther away the treatments were for me the more intense it felt when the symptoms returned. In the beginning it was extremely difficult to slide back into depression when the Ketamine effect reduced over time. Painful. I was led to believe the depression would not return after the six treatments. I never believed this claim. I didn’t. I figured if Ketamine worked for me then surely I would need to continue to get infusions to have the relief I was striving for. Ketamine was my last option. I had nothing else. There was a part of me that didn’t want the Ketamine to work because how would I cover the cost if it did. I didn’t really expect it to work so I took the risk financially and emotionally; for my family.

It was after my sixth infusion that the depression lifted for several days for me. I had my last infusion on a Friday and felt good until roughly the next Wednesday, I believe. As the week ended and a new week started, the effects from the Ketamine weakened. I wasn’t surprised, but I was discouraged. I knew that I must find a way to have Ketamine administered to me closer to home and at an affordable price. This was my first introduction into advocating Ketamine for depression.

I have spoken to numerous people that want to try Ketamine but can not swing the steep price tag. When I received my six infusions, it cost me over $3,900 for the Ketamine treatments, travel and lodging. That is a fortune to me. I knew this drug was not a realistic long term treatment for me. I wanted to cry out in frustration. I finally found the answer to my incessant search for something to rid me of my symptoms and there was no way I could continue to pay out of pocket for the therapy. Insurance companies, in 2015, did not cover any cost related to Ketamine treatments. It is heartbreaking.

Dr. Levine agreed with me that Ketamine was my answer. I was responding. It was during my stress about finding this drug helpful, and my fear of returning to that horrendous darkness, that I pressed Dr. Levine for another way I could get the assistance I desperately needed. He mentioned that there was a doctor in Virginia willing to administer Ketamine into the muscle by way of a shot instead or an IV. He did inform me that this doctor, Dr. Charles Moseley, contacted him with a lot of interest in learning more about Ketamine for Depression, but didn’t want to invest in an infusion center. Dr. Levine suggested I call Dr. Moseley when I returned home and investigate whether he was still interested in administering Intramuscular Ketamine shots. Dr. Moseley lives one hour away from me, so I was pretty motivated to plead my case to him. And that is exactly what I did.

Do you think Intramuscular Ketamine shots work as well as infusions?

Well, that is a tough question. I do feel IM Ketamine works! Do I think they are better than infusions? I am not sure. I had six infusions total. I have had well over 35 or 40 shots in the past two year or so. I continue to improve and get stronger. IM Ketamine works. Would I be further along in my recovery had I been able to afford the cost of Infusions? Maybe. I have no idea. I do know that I am healing now with the help of IM Ketamine. I never could have continued getting infusions at 450.00 dollars per infusion. This cost is all out of pocket. I am grateful to Dr. Moseley for hearing me out in April 2015. There needs to be more professionals willing to consider administering IM Ketamine for others, like me, struggling with Treatment Resistant Depression.

Do you recommend Intramuscular Ketamine shots?

I do. I highly recommend IM Ketamine for Treatment Resistant Depression. I especially feel it is an option for those that can’t afford Ketamine Infusions. I would recommend getting six Infusions first, if you have the funds for that. I know many people want to try Ketamine but can not because of the price tag. The need for education is immensely important. As far as I know, there are currently over a hundred Ketamine Clinics now and only a handful, like The Injection & Infusion Clinic of ABQ, are offering IM Ketamine shots as an alternative to Infusions.

Could you explain how these two Ketamine delivery methods differ?

I will attempt to explain. Ketamine Infusions use an IV line that allow the Ketamine to slowly, in a timed manner, enter your system. The Intramuscular Ketamine is given in one or two shots and once it is given can not be adjusted or stopped. This seems to be a major concern in the administering of Ketamine for Depression. Often times, I have learned, some providers will take precautions and begin Ketamine therapy at a lower dose than in a clinic giving IV Ketamine. You may then need to build up to the most effective dosage. This was not my experience. I was given the same dose as I was given by IV. I was also given my Ketamine in one shot. I have been able to tolerate this approach but I know several people that prefer to start at a lower dose and often administered in two shots.

Does it feel different during the two treatments?

Yes and no. I feel with the Ketamine Infusions I was much more disconnected from my body. It was more dreamy. I experienced that “out of body” sensation during almost every Ketamine infusion. During an infusion, the thought of getting up and walking around is impossible to me. Whereas, with IM Ketamine, I have been able to get up and walk over to a trash can, let’s say, without incident. I never experienced nausea with my Ketamine Infusions but have been known to vomit during my earlier treatments with Intramuscular Ketamine shots.

You mentioned vomiting during your earlier session of Intramuscular Ketamine treatments and I am curious what you mean. Have the treatments changed over time for you?

Yes. My Ketamine therapy is mild compared to two years ago. I went in last night to get my Ketamine shot and felt only slightly intoxicated. It was mellow. I have built up a tolerance I believe. I am able report that I get the benefits of Ketamine now with very little dissociative effect. I never dislike my treatments, in fact, I would say 97% of the time I enjoy my Ketamine treatments. They can be very insightful and introspective.

I use my Ketamine session with Dr. Moseley for therapy now. I love getting the benefits of Ketamine, such as an uplifted mood, and the mental clarity is a bonus. My thoughts slow down and I process them with determination and focus. I can verbally express to my doctor my feelings. I can make connections between my behaviors and thoughts. I can reflect. I can feel the depression lift. I can openly communication to Dr. Moseley when this takes place. My thoughts are typically more negative and self loathing before treatments. My thoughts race. My anxiety is typically uncomfortable, bordering on unbearable. The inner noise is pure chaos. I will be summarizing the last two weeks, the time in between my appointments, and will literally stop and look Dr. Moseley in the eyes and say out loud, “Hello I am back. I just felt the “shift.”” It feels like I have changed lanes on a highway. I moved out of my own way, and with that awareness, I am excited to begin psychoanalyzing and sorting through the garbage to be tossed. It is pretty incredible really.

What does that “shift” feel like during your Ketamine treatments?

My doctor asked me the same question a couple months back. I found it easy to reply. I smiled at him and said it was like getting a hug from a kind mother welcoming you home after being away too long. It does. It feels like arms squeezing me tight and reassuring me that once again the Ketamine is working its magic and I will be all right. The IM Ketamine shot welcomes Susan home. It calms me. It is like warm water washing over your body and taking the negativity, depression and anxiety downstream. I can once again breathe with an ease I don’t have prior to my shot.

Why are there not more IM Ketamine Providers?

I think the main reason is because there are no clinical studies using Intramuscular Ketamine as the delivery method. They have only researched and evaluated the IV delivery of Ketamine. Education is needed. I know that more professionals are willing to listen and learn. It is a slow process.

What would you suggest to a person suffering with Treatment Resistant Depression who can not afford Ketamine Infusions?

I highly recommend approaching a trusted family doctor, Nurse Practitioner, Psychiatrist, a Physician’s Assistant or a Registered Nurse and educate them on the success of Ketamine for Depression. I would imagine that if you can try Ketamine Infusions (1-6 treatments) first it could be an advantage because you can take your results to a local provider. You would have documentation of its ability to combat depression. That is how I went about it. That will not be a reality for everyone. I realize and understand that. I also know that many professionals will be closed off to the idea of administering Intramuscular Ketamine. That saddens me. However, I strongly encourage approaching as many as it takes until one individual is willing to work and learn with you.

What if you are suffering so deeply that you can not confront doctors and nurses about the benefits of Ketamine for depression? 

I was in no way capable of advocating for myself during my darkest times. I understand the frustration of trying to get your needs met. I was fortunate enough to have a loving husband willing to do the work I was unable to do. If you have a significant other in your life, or a concerned friend, ask them to accompany you to the office visits.

Oh, and another option is to ask for a prescription for nasal Ketamine. It will need to be filled at a compounding pharmacy and not your standard CVS or Walgreen. I just googled my area for a list of the closest compounding pharmacy and called them. I just asked if they make nasal Ketamine. When you locate a facility that will fill the prescription, make a note of the name and number and take it with you to your office visit.

Do you use nasal Ketamine?

I do; on occasion. I have a bottle I use if I am struggling between my Ketamine shots. I consistently make it 8 or 9 days feeling symptom free. However, I am aware of how the depression filters my world and when the “noise” returns I am reassured that I won’t have to remain in this nightmare until my next appointment. I think of nasal Ketamine as my band-aid. It gives me that added shield against my depression, so to speak. I am extremely blessed to be able to get IM Ketamine shots but if I couldn’t, I appreciate knowing I could get some relief from a prescription nasal spray.

How expensive is the nasal ketamine spray?

It is more affordable than Ketamine Infusions and Intramuscular shots. I get mine for 65.00 a bottle but know of several people shelling out close to 125.00. Do your research is all I can say.

You are right, 65.00 dollars seems pretty reasonable. Why do you continue to get Ketamine shots when you can spend $65-125 a month instead?

In all honesty I don’t care for the delivery method. It is a personal preference. I have suffered with extreme allergies all my life and my nose is continuously affected by my sinus issues. It makes using a nasal spray frustrating and inconsistent because of the swelling I experience routinely in my nasal cavity. I do know of a couple people using the nasal Ketamine spray exclusively, and they are doing fairly well. Two of the people I have been in touch with have never had an infusion or injection and are speaking positively about their experience with nasal Ketamine. I think that is very exciting news.

In closing today I would like to ask one more question. How much do your Intramuscular Ketamine shots cost you?

I would love to answer that question but part of my agreement with my doctor was to not discuss the term of our relationship. What I mean is, Dr. Moseley wanted to keep his options open. I was his first Ketamine patient and he has learned quite a bit working with me. We are mutually benefiting. I pleaded with him and he was kind enough to accept my proposal. Having said that, I would aim for roughly 150-250 per session. This unfortunately is still a completely out of pocket cost to you and can put a massive strain on your finances. However, I have great success with Ketamine and I am capable of working outside the home once again. I am more productive. I am living. Priceless. Ketamine therapy has been worth the sacrifices my family and I have made to our monthly budget.

In conclusion, If you know of anyone suffering with treatment resistant depression, like I do, let them know that Ketamine therapy may be an option worth looking into. It has been and continues to offer me relief from my symptoms. If you or someone you know are considering Ketamine infusion therapy, please visit www.infusionclinicabq.com for low cost ketamine infusion and injection options. If you are not in the Albuquerque, New Mexico area I also suggest approaching a local professional. It doesn’t hurt to ask for what you need.

Join me again later in the month, when I address even more questions about Ketamine Infusions and Intramuscular Ketamine. I will share my thoughts and experiences about the different delivery methods, the effects of Ketamine, Ketamine Advocacy, and concerns over what I have been reading during my research and studies on the drug. I will also be answering more questions about Ketamine that many of you have asked me through email or phone calls. Thank you for reaching out. I continue to advocate… Ketamine for Treatment Resistant Depression and Anxiety Disorders.

Originally posted on The Injection & Infusion Clinic of ABQ website.

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