r/TherapeuticKetamine

Hey everyone,

I'm looking for some advice and provider recommendations for starting Ketamine therapy for depression here in Ohio. I'm located near Cincinnati.

My Current Situation:

I've been on Cymbalta (80mg) for a while, but it feels like it's completely losing its efficacy lately. On top of that, I am really struggling to handle the sexual side effects/drawbacks, which is a major reason I want to look into alternatives.

What I'm Looking For:

* Providers: I’d ideally like to go through an online/telehealth provider that services Ohio to keep things convenient, but I am open to a hybrid model if needed.

* Route of Administration: I was originally hoping to look into IM (Intramuscular), but I'm realizing that might require an in-person clinic. If you use an online provider in OH, what route do they use for you (troches/lozenges, etc.)? Has anyone done the newer at-home injectable options?

A few specific questions for the community:

1. Which online providers have you had the best experience with in Ohio regarding cost, customer service, and clinical support? (Joyous, Mindbloom, Innerwell, etc.?)

2. For anyone who switched from a high-dose SNRI like Cymbalta to Ketamine, what did the transition look like? Did your provider have you taper off first, or did you do it concurrently?

3. If you have to go to a physical clinic in Southwest / Central OH for IM or IV treatments because online didn't offer it, what are the rough out-of-pocket costs you're seeing?

Thanks so much in advance for any insights or experiences you can share. Really appreciate it.

If so, what are your experiences with it? How does it make you feel?
I’m devising a bit of a theory right now, and I would like to hear the accounts of people with primary psychopathic traits or biological psychopathy. I have a friend that we suspect is a psychopath and he reacts quite differently to ketamine than most people I’ve seen.
I have another friend that is diagnosed with ASPD and he has A very introspective experience on it, and his experience seems typical to that of most, but my other friend who is not diagnosed, but displays a lot of behaviours and traits that led to the suspicion that that may be relevant does not have that same introspection or experience on it whatsoever and that’s kind of confused and enjoys the feeling of disconnect, but doesn’t seem to have the same reaction to it whatsoever.

This is not an attempt to diagnose my friend, but it is an interesting thing that I would like to maybe get a little bit more insight on and see if anyone else has a similar experience.
I know that MDMA will often affect people differently who has primary psychopathic traits, but there’s very little documentation of people with it and their experience with ketamine.

my second question is for those with secondary psychopathic traits or just SPD in general is have any of you had any success with either ketamine therapy or any introspective experiences on ketamine that have alleviated symptoms or helped understand yourself better?
I have CPTSD myself and used to be diagnosed BPD, but after ketamine, I actually do not fit the diagnostic criteria for BPD any longer. Secondary psychopathy does share a lot of traits in common with borderline personality disorder, and I would like to know if anyone has had benefit from it

Article from psychiaty online https://psychiatryonline.org/doi/full/10.1176/appi.pn.2022.11.11.13

>>agreed further work with people with treatment-resistant depression is needed, he noted many participants in his clinical studies had taken previous antidepressants, so Auvelity could be a second-line option.

Given its purported effects on the NMDA receptor, Iosifescu thinks one intriguing option for Auvelity is as a take-home medication for people who received ketamine treatment. “In theory, someone who benefits from ketamine would also benefit from this tablet,” he said. “A patient could take it regularly or maybe just as a rescue medication if symptoms relapse,” he said. That is just one of several clinical possibilities that should be tested, he said. Iosifescu also noted that his group is testing Auvelity as a treatment for agitation in adults with Alzheimer’s.

NCBI paper on https://pmc.ncbi.nlm.nih.gov/articles/PMC10591164/

In case any hasn’t been tracking this. I don’t understand all the science, and if you have a better sources, please share.

For those of you who have done both, how different are the experiences?

My previous provider said to spit so I did. My new provider said to swallow so I’ve been doing that mainly since.

I’ve done both and so far spitting seems underwhelming, but swallowing overwhelming lol. When I swallow I’m out of commission for hours (I usually take a few hours before bedtime anyway) but I tend to feel like dead weight until morning. The experiences themselves have felt a bit… darker? Like I tend to feel like I died and have visions like I’m in this black hole as just a spirit. I also notice I tend to see my old sessions as if I’m repeating them as well as the experiences afterwards. It’s so eerie. The interesting thing is I tend to feel more positive 2 days after. I haven’t felt that as much spitting.

Spitting (at a higher dose 600) sessions tend to be more vivid, interestingly enough. The visions are a mix between light and dark. I often explore more topics. I’m able to move around and eat and talk an hour and a half to two hours later. I also notice I tend to be more giggly. I’m able to reflect more on my session as I’m not incapacitated immediately so I can journal. However, sometimes it’s underwhelming and very quick and I end up wishing I swallowed.

I’m hoping to find a balance between the two.
So if you’ve done both, what’s the difference for you? Experience, timing, and benefits?

What dosage are you on (oral or IV)? Does ketamine exacerbate your POTS/dysautonomia?

I have used Joyus and Kalm before . Mindscape seems to offer 200mg daily for 249.00 . Anyone use them , can anyone confirm this as fact and not a bait and switch. Anyone can speak about any issues
Thanks in advance

Hello everyone! I have done 3 rounds of ketamine, all positive experiences. The first two sessions were 400 mg (lozenges), the third was 500 mg (lozenges). The first session was one at a time, the second I started at 200 and then added 200. The last session was 400 out of the gates and a 100 mg booster.

My question is just “is this normal?” On a few things-

1. In the first session I saw really profound visuals that were intense. Nothing was scary, it was like my brain made a perfect allegory for several key things and those made so much sense.
2. In the second I had visuals but it was maybe 2-3 key ones, it was not ongoing.
3. Last time it was just a couple, but they were quick. I could physically feel it for sure and I felt hazy and out of it, but it was less visual and more thought based.

My therapist says that for her every session was different, and that that’s true for everyone. If you have anything you can share from your experiences, I would appreciate it. I feel pretty raw/exposed/vulnerable at times. I generally notice that I am much more hopeful, but crowds are something I typically don’t like, and I do find myself avoiding busy places as I continue to adjust. It overwhelms me.

Just would be curious if anyone has advice for those starting out on what your experience was, any adjustments you made, how you handled it in the earlier days. I will be doing this for a significant amount of time. I’m also quite a type A, so I have this obnoxious voice asking me why I’m not healed yet 😂. I can handle that, but just any heads up advice for someone who is early days in a long series. I am doing EMDR in between on key themes. Thank you in advance!

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 !!!

Hi everyone,
Longtime lurker here..
So I’ve been on low dose somewhat daily therapy for the last couple of years. About 125 mg a day average. Ketamine has helped my depression, OCD, and anxiety a lot. I’m very grateful for it. At the same time, I feel like it’s getting into addiction territory for me. It’s hard to express but it feels like I think about it a lot and it’s hard for me to miss a day. I’ve gone up to two weeks without it but I guess I feel like it dogs my thoughts so much that I’m getting weary of it. I bought a lockbox but that didn’t fix it either. I’m a person of faith and don’t think it’s good to be addicted/dependent on substances but I know the dependence vs addiction argument has a fine line.
Due to chronic health issues I don’t feel like I can go without it indefinitely. Kinda like golden handcuffs, I guess. My life is pretty good as far as circumstances go. Some stress, raising kids, business, etc.. but still very blessed.
Also, I have been on fluoxetine and bupropion since a couple years before ketamine.
Any input is appreciated.. 🙏

TLDR: I feel like I need ketamine to thrive but it’s starting to take an outsized role in my thoughts and habits and I want it to be a tool, not a master.

I recently signed up with Mindbloom because I wanted to do at-home treatments. I didn’t realize you need someone to monitor you while you are taking Ketamine to make sure you don’t completely pass out or run into any other serious issues. I don’t really have anyone I could ask to help me with this. I am recently divorced and only have a few close friends. And I’m not sure if you’d want a close friend nearby as some have suggested it could be triggering. Mindbloom suggested hiring someone on care.com. Has anyone had to go that route and how did you find a safe person willing to sit with you during your treatment? This whole part is overwhelming for me. I have issues asking for personal help. Anyone have advice or hired someone for this?

I’ve done this a few times but have always stopped at one or two in a row. Most of the time I’ve legit basically k-holed or had terrifying experiences with several different providers in my area. This time I was brutally honest with my provider, and she actually listened which was awesome. The trip didn’t feel overwhelming AT ALL. Before it was done I pulled my mask up and was chilling. At first I was like damn, that was expensive to not trip and try to discover my purpose BUT I left and was so happy, felt grateful, all of it. I even thought about bad stuff during the trip - I’m going through it with my job and I handled it. Next day, I woke up
With energy which doesn’t happen. I woke up, played. With my kids, went to the pool, worked out, cleaned the entire house and was just pleasant. For
This first time I had thoughts and they didn’t overrule me and I felt what life could feel like.

Then came night- I was watching project Hail Mary and it was like an adrenaline rush and I couldn’t shake it. Hard to sleep and I woke up. Feel back to earth, very weepy (I’m 37 m), don’t really want to smile. Idk I feel just sad again.

Is this normal? Idk if it was bc I took versed maybe I just actually didn’t have anxiety for a bit? I’m not upset just like depressed and feel icky. Thoughts!? Sorry for long post just have no one else to talk to.

So I have 2mg of Xanax that I almost never take, when I do I break off a 4th of it. I also have 15 mg of Buspar. They look almost identical: both long white bars. Ive have been diligently not taking anything that would affect my ketamine treatments. But I do take Buspar 2x a day. I think I may have taken a 2mg Xanax last night in an accidental mix up and did my ketamine session this a.m. So 12 hours later. I messaged my provider, but she hasn't written back yet. Im using Mindbloom, this was session 3 and am on 90 units of ketamine. Did I completely ruin the ketamine therapy and its lasting effects?

Please let me know if anyone has had a similar experience or has any knowledge about this.

I am reaching out regarding my Son who just had his 3rd infusion for depression, SI, anxiety.. the first 2 seemed ok no big changes but yesterday he had his 3rd and came out looking so terrified and has really shut down.. I don’t pry but as he was crying yesterday and feeling worse than ever.. he said “ you have no idea what I went through, someone was chasing me and I thought I was going to die “ he is extremely traumatized and won’t talk at all.. he has his therapy integration appointment this afternoon but he said he doesn’t want to go back.. if anyone can give me any suggestions or guidance on how to encourage him or do I just leave him alone? He is 21.. suffered from depression and anxiety for years with SI at times.. thank you

Once the medication is administered (sub-Q), I put my mask on and begin meditating, expecting nothing more. When the ketamine kicks in, however subtle, I feel I'm having an exceptional meditative experience. Sometimes expectations and worrying about the session itself get in the way.

My Ketamine Journey

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.

… It’s actually not needles per se, I have a very specific fear of needles in my arm veins (IVs or blood drawn). Makes me very squirmy, clammy, and a little nauseous and when I was younger it would actually cause vasovagel fainting. Every time i have to take a blood test i tell the phlebotomist that id rather they punch me in the face to get a blood sample (none have taken up this offer). Of course it’s my head making it worse than it is and it’s almost never that bad, but knowing this has done nothing to curb this issue.

So my questions:

1. will this put me in a bad headspace and cause a bad experience?
2. Does the anesthetic effect work fast enough that you don’t notice it?
3. Thinking positively: could this possibly be the thing that stops me from having this phobia? - Is that a thing? anyone do ketamine treatment for persistent phobias or just happen to lose their irrational phobia(s) after treatment? If it works for real trauma, surely it could work for that?

I haven’t brought this up yet with the doctor because until i get the tourniquet I am usually pretty good at not worrying about it, but I just read that post from the person who probably had the IV improperly put in 🤢

I have high blood pressure, not extremely high and I’ve been on medication for years and it typically doesn’t impede any other types of treatment treatments.

But it’s still a concern so I wanted from anybody else who may have high blood pressure.

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.

Looking for some advice. I’m only on my third session of IV ketamine (for TRD) and things are going alright so far. I feel a ton of relief during session and luckily I haven’t dealt with a k-hole, but I feel exhausted and more depressed right after session until I sleep it off. Then I go back to baseline depression until the next session. After my last appointment, my doctor asked if I felt like increasing the dose (0.5) and I’m not sure. I would like to feel some increased motivation and less depression but I don’t wanna increase too soon without giving it a chance. Anyone have this experience/advice?