r/KetamineTherapy

Hi everyone,

I’ve been dealing with bipolar TRD for the past 2 years and a half.

Last year, during a hospitalization, I was put on Spravato and it was honestly the only treatment that ever helped me. Unfortunately, after only 4 weeks, we reduced the frequency to one a week, and I progressively lost the benefits. I stopped abruptly 3 months later because I wasn’t able to leave my house.

I’m currently hospitalized for a second time. We first tried 30 sessions of TMS, which didn’t work for me.

Now I’m doing IV ketamine because my new hospital can’t afford Spravato. I’m on my 7th session tomorrow and I’m at 0.8 mg/kg.

I’m doing slightly better than before, but it’s really not comparable to Spravato in terms of effectiveness. The sessions themselves are also intense and pretty uncomfortable. My last one was honestly rough. I completely lost the sense of having a body, felt like I was a “spirit” trapped in a box, flying in circles, convinced it would never end.

I’m going to ask my psychiatrist about switching back to Spravato at another hospital or clinic, but he needs to approve the transfer. He’s hesitant because studies suggest IV ketamine is actually more effective than Spravato overall.

So I have two questions for you guys :

- If you’ve tried both IV ketamine and Spravato, did you find Spravato more effective and/or a smoother experience overall ?

- Does anyone understand why Spravato might be more effective and tolerable than IV, despite the trial data on efficacy?
Any personal experiences or scientific insight would help me a lot as I prepare this conversation with my psychiatrist.

Thanks a lot !!!

I know I am so blessed and privileged for this opportunity with K therapy. But I thought Troches were the worst tasting thing EVER and hardest to get through… until I ordered RDT’s… sweet Buddha these make the wax like Troches taste like candy and feel so much better therapeutically during a session… I also feel like the Troches are more powerful and a better therapeutic experience. I’m glad I did try the RDT to know and compare but I have many more sessions to get through and I’m just humbled and disgusted by the taste and lack of strength in them. Sorry just wanted to vent as it is a lot of money, but again so thankful and privileged, and now I know … Troches it is lol 😭🤢😫😆

I am fighting with every ounce of my heart and soul. I love my family so deeply, and I am suffering horribly from suicidal intrusive thoughts- I don’t want to leave this earth I truly don’t - but I am just being plagued by these horrific thoughts and I fear I will never overcome this. Multiple failed meds - therapies - no childhood trauma - only fertility trauma - I truly don’t know why this is happening. Please give me hope.

I began ketamine therapy almost a year ago. Then I was experiencing daily, even multiple times a day, anxiety and panic attacks that often ended in collapse. The world had lost color, everything was flat. Time as a concept was gone. I had withdrawn from life. The calendar may have read July 3, 2026 but I was still reliving January 4, 2023.

Ketamine Therapy has not always been easy. I often spent the next two day in bed and I was unprepared for the somatic releases that felt like demonic exorcism Yet that was better than feeling like a ghost.

It took about 8 months before I understood what Ketamine could do. It restored temporal time: Past, Present and future returned. For nearly four years, every action, memory, event had been processed as if it were still January 2023. Over the next few months, it was like elf night auditors corrected my memories.

This is how I approach my sessions. A friend and therapist told me that ketamine doesn’t respond well to specific instructions but it likes partnering on simple ideas.
• My emotions feel tangled
• I feel stuck
• I know I should have felt happy, but couldn’t

Things eased

If I tried to solve a problem:
• Stop my panic attacks
• Can I dream instead of having nightmares

Things became worse

I go into each session with an intention and music playlist. My intentions emerge from journaling, conversations with my therapist, and even tarot cards or runes. A tarot card like the Tower represents sudden change, chaos and revelation. A rune stone like Isa, represents something frozen or stagnant or a need for inner reflection. I could think about how t applied to my experiences.

I have also used song lyrics , movie quotes anything that resonates with me.

Over time it felt like an inner and outer dialog happened. I’d feel something and then something from the outer world echoed

Some of my best sessions happened when I said “I trust ketamine to know what needs to happen.”

I have found instrumental music amazing. I found a musician who wrote music specifically for psychedelic therapy.

And the right playlist can move you from a bad experience to bopping down the street in 2 songs.

The closest I came to being specific was the day I held a town meeting for the different parts of me. I realized that the part of me that takes high stress situations had not stepped down. I responded to spilling my coffee withe the same intensity as the event that was ground O. With my therapists help, I started out by thanking all the different ME for getting us to shore I acknowledged how hard it was. I asked if any other Me was tired. What I asked of Ketamine was to get other parts to speak.

It took more than 1 session. It made me understand how exhausting it is to constantly scan for danger and difficult it was to trust. But I dropped from red alert to orange alert

While Ketamine is amazing at unknotting and detangling, memories, emotions, even stressors, untangled doesn’t mean resolved. I had all these emotions I couldn’t name. Happy and Sad are simple. There are compound emotions like Hangry, hunger + anger.

Then I realized there were these more complex emotions which I thought of as esoteric esoteric emotions. I was having trouble understanding how my life changed. There was a way I told my life story. I felt like I made a wrong turn , this wasn’t my life.

Then I came across Nodus Tolens: It describes the unsettling realization that your life no longer makes sense to you—when the overarching "plot" of your existence feels incoherent, and the path you’ve been following suddenly stops working.

Knowing that what I felt had a name made me feel relief. I was not imaging this. This was real. It took me down a different path. I wasn’t wondering what’s wrong with me but wondering who about who I was becoming.

I also realized that what I thought started in January 2023 began earlier and the effect on me was gradual. Rain will eventually damage a building’s foundation by taking advantage of cracks. What happened in January 2023 was more like a Tsunami, it was powerful with the force to alter landscape.

I have learned to lean into the discomfort.

I've experienced significant trauma in my life (all the kinds of abuse) but there's a lot of it I've buried - I don't remember most of my childhood. Whenever I've had altered state experiences before, it's been very overwhelming and I sort of blew through my nervous system. The last few years I've just done therapy instead (somatic, EMDR, IFS, etc) and yet there is still SO much more to work through. So I've been feeling called to do a series of 6 IV sessions in tandem with integration therapy. Thoughts on whether ket is a good method for complex childhood trauma (much of which is repressed)? Part of me just wants to get to the core already rather than the slow march through constant therapy, but part of me is afraid of what memories may come up and being overwhelmed, a concern my therapist shares (she recommends smaller doses during therapy sessions... but honestly I'm not sure that will get to what I'm carrying any time in the next decade....). Appreciate thoughts, thank you.

I was with Joyous for a year and felt I needed more than they give. Tried 2 other out of state docs that had licensing issues.

I took a 4 month break and just signed up with Kalm Health. June 3rd was the telehealth appt with the doc. I had already paid the $350ish for 2 months of their higher than micro dosing meds. They dictate to pay 2 months up front. The doc prescribed 200mg/day. Lower than my last but fine to start up again.

Today is June 30th. No meds and hit and miss ONLY online messaging communication. Zero reason for no meds but was told I had to redo telehealth with a different doc. Had that yesterday. He INSISTED I start with two 100mg troches per week!!! At the time, it didn’t occur to me just how low this is.

I’ve been on and off Ketamine for 3 years. He gave no reason for this dosage. It’s only 33% of a maximum Joyous micro dose amount!! The cost for micro dosing with KALM is much lower and you can pay per month.

Not one mention of how they account for that financially. Messaged today saying I need the original dosage from a month ago I’d 200mg/day, or a complete refund. I believe they’ll contest refunding since it doesn’t follow cancellation protocol. Even though it’s been a full month with no meds in addition to the joke dosage!!

Rest assured, I will fight that and I know the entities that will to rattle their cage and spit them out. The fact is, I don’t want, or need that stress on top of all the other stress they’ve caused.

I need an affordable prescriber licensed in MISSOURI for at home troches and nasal spray. Can anyone please help? I have MS, anxiety and depression. This mess is making me feel disrespected, invisible and so frustrated. I’ve been crying most of the past several days. I’m in pain with occipital and trigeminal neuralgia. My mental health is in dire need of immediate help! Especially after dealing with this mess of an operation. To top it off, I was scolded (through messages of course) for calling the pharmacy myself and told to never do that again. What transpired in the pharmacy convo is a whole different conversation!

Please. I can only afford $300 or so per month.

Please, Does anyone know of a doc??

I’ve been doing IV ketamine treatment for depression for a little over a year.

At first, it worked extremely well. The treatment was genuinely life-changing for me. But over the past several months, the infusions seem to have lost almost all of their therapeutic effect.

I tried increasing the dose, but that ended up causing far more negative effects than positive ones. It got bad enough that I had to stop treatment for a few months, and I really do not want to end up in that situation again.

During the infusions, I already try to reduce sensory input as much as possible. I use a well-sealed sleep mask to block out light and headphones to isolate sound. That has helped a lot, and I do think the setting makes a meaningful difference for me.

Now I’m trying to figure out whether there are any supplements, strategies, or other adjustments that might help me get more therapeutic benefit from ketamine again, without simply pushing the dose higher.

I’ve heard some people mention magnesium L-threonate for this purpose. Has anyone here tried it specifically to improve or restore the effects of ketamine treatment? Did it make any noticeable difference?

I’d also be interested in hearing about anything else that helped you after ketamine infusions started becoming less effective over time.

Thanks in advance.

Im getting my first IV infusion tomorrow while inpatient at hospital for treatment resistant MDD, trauma and anxiety. How do I prepare, what can I expect and how will I feel afterwards?

My doctor answered these questions but I would also like to hear real life experiences. He also suggested I listen to music, what sort of music should I listen to? I was thinking probably something meditative or frequency sounds?

I’ve read on here that people set intentions beforehand - how do I do this? Is it just telling myself something like “I want to experience self love” ?

Does anyone journal while having it done?

Has anyone had ketamine treatment after having a horrible relationship breakup and found it helped them heal from it?

Sorry for all the questions, I just want to make sure I’m getting the most out of this. I will be getting around 12 infusions, 3x a week

Thanks!!

Any difference? I’m looking to try ketamine therapy to help with depression and constant rumination, I’ve stopped SSRIs after 10 years and I’m 5 months in so wondering if there a pro/cons to determine what is the best fit for me.

I’m new to this type of therapy so I really don’t know what I’m doing or what any of this means, or what’s normal and what’s not normal and I don’t want to put more meaning into this than there is. But I’ve dealt with depression my whole life, with major depressive episodes every now and then. After my 2nd child was born, I fell into more and more MDD episodes, and they are severe. I just had my 2nd infusion today and after the drug wore off I couldn’t stop sobbing. I was in the infusion office for an hour, uncontrollably crying. Crying for myself, almost like I was trying to comfort my heart, which I felt like my heart had somehow been hurt. But the thought that popped into my head which resulted in the sobbing was “something happened to you.” I don’t know what that means, but I just have this heaviness and feeling like something horrible happened to me, and I don’t know what it is, but it feels extremely traumatic. And as I’m typing this I’m not crying any more but I’m shaking. Again, not sure if it’s just ketamine or what. But I don’t really know what to do with this feeling, or how to move forward.

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Hey!
I’ve been doing MB subq for about 6 months & haven’t had any issues- except for this last time. Im prescribed 100 & pulled two full 100’s out for my two sessions like usual- but on my last week/session, the vial only had 4 units left in it?!???
Meaning I really didn’t get a 3rd session- has anyone ever experienced this before????

Anyone have any ideas?!?! I’m so frustrated. 😩

Tomorrow is my first session. It will either be IM or IV. I am so nervous! I am working hard in therapy to address my issues, and I am so worried that I will mess up the work I have done.

I just started ketamine therapy through Joyous, first time on ketamine. Only on day 3 of 15mg, taking it around 6pm. Is it normal to feel SO drained the next day? It’s like I can never fully wake up and am so sleep hung over even though I slept perfectly well.

Is this a standard side effect to taking it daily via troche or will this effect go away over time of being on it, in your experience?

I mean, after a few weeks, is the effect weaker or does it take several months to build tolerance? Or is everyone unique and it is possible to have less effect after two or three weeks?

Hello! I am in California, currently on Joyous. I love the micro dose; it has done wonders for me. However, I am stuck in a loop of waiting 2+ weeks for my refills. Any recommendations for a different provider?

Hey gang, wanted to check if anyone else has had issues with smells I.e. hyperosmia. I’ve always had migraines and smells have been a big trigger. I’m not sure if Spravata might be making it worse and I’m looking to change to IV ketamine but curious if anyone else has had this issue. Smells are everywhere and it just seems like they smell 1000x stronger to me to the point where I can’t go to many places without a mask on or I’ll end up feeling terrible. I was also recently diagnosed with MCS multiple chemical sensitivity which ties into the hyperosmia.

Hey all, I've been with Innerwell for about a year. I was on 600mg RDTs, as needed. Usually once every week or two. But sometimes I would do 300mg but a little more frequently.

Here they've given me the 200mg troches, with the directions to use half (so 100mg) and if needed do the other half at least 3 hours later. They just say to let it dissolve in the buccal pouch. They don't say whether to hold and swish, or if I should swallow.

I guess I'm a little concerned about doing it daily like they want, I would rather have the higher amount less often. So looking for recommendations here. How do troches compare to RDTs?

I am trying the nasal spray as well, so I am meant to alternate between troches and sprays on a daily basis.

I will say I got an appointment with them quick, and got the medication fast. Much cheaper than continued care with Innerwell.