I would really like to give it a shot -- but for a couple thousand bucks for the initial series of treatments, I would hope that the change is more lasting.
Obviously everyone is different and YMMV, but for me- ketamine has been the only thing that made a real impact, bonus was the lack of nasty antidepressant side effects (I'm still taking an SSRI, SNRI, and a mood stabilizer and I hate them).
I'm hopeful that some of the new ketamine+___ compounds being created to extend the duration of the 'depression slightly lifted' feeling are successful and come to trial soon.
Combination of Wellbutrin & Dextromethorphan -- which is a dissociative with some side-effects similar to Ketamine. It's in trial for severe depression treatment. 15mg of DXM (which you can buy at any drug store) combined with 150mg Wellbutrin (which you can get your dr. to prescribe to you.) Could be worth a try...
It's funny though, if I were to compare recreational DXM to Ketamine I would describe them exactly opposite as you did.
Out of curiosity, where did you get these dosage numbers from?
The linked wiki page doesn't mention dosage and the source on wikipedia is paywalled.
EDIT: looks like it's 60mg of DM, which seems rather high.
The intersection between internal and external is not so clear.
What the ultimate cause is, who knows.
Is the idea of a ultimate cause is even a valid idea?
Personally I don't think so.
Probably not only split on this one variate (externally or internally triggered), but it means that certain types of depression are usually triggered externally and certain types not externally.
It's like saying that "in some cases, a broken leg is not triggered by some external influence". Sure, you could develop some bone density issue and break a leg when walking normally, so we tend to distinguish treatment of these cases--we may recommend a more permanent solution for someone who is prone to breaking their leg.
How can we even falsify your statement? To do so would require self-reports or some sort of real-time 24/7 measurement of the brain, the first doesn't really falsify anything, and the second is not very viable at the present.
Self-reports can easily lie. They also may simply not remember, or be in denial.
- It doesn't necessarily hold for a few months. For some people, it's not too much longer than an infusion session; for others, they might not even need the "booster" infusions some get.
- There's some patients for whom the "tolerance" for the antidepressant effect doesn't go away even after O(years) without taking it when it initially worked and then stopped, so you can't necessarily just do it again. (Source for this one is that it happened to me, and did not return while going as high a dose as the doctor was comfortable with.)
For example, on Nov 27th, they wrote '[this year] I successfully treated depression with Ketamine'.
It's possible that they're not talking candidly on the shorter-form of an instagram post, but it's at least a sign that maybe it stuck, otherwise that phrasing would probably be a bit less positive.