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Comment by mkmk | Hacker News Reader

Not ecstasy and psilocybin, but a few years ago, I met a psychiatrist who had worked in the armed forces and then alongside a crisis SWAT team. After decades of seeing people hit rock bottom, he learned about ketamine therapy as a treatment for treatment-resistant depression. He described it to me, a psychedelic skeptic, as “the closest thing to a miracle drug that I’ve seen in my career.”

I’m not sure why, maybe because he seemed so much like the opposite of a “woo-woo” clinician, but the way he said it stuck with me. It has been fascinating to watch this space and the forward-thinking mental health companies that have been developing in this space.

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Yes, ketamine can shut off depression like a light switch. That's really, really good for the population it works for. Of course, it can also cause psychosis.

As someone who nearly got murdered in their sleep by someone on one such ketamine-caused psychosis, I think that caution is warranted when prescribing it. Waking up to take a knife away from a crying person is not something I would recommend to others.

I've heard that there are studies on a metabolite of ketamine that's supposed to avoid the psycosis. I really hope that works so we get something this powerful without the downside.

Without making light of your experience, the behavior you witnessed is simply not possible to induce with the dosing range used by licensed ketamine treatment clinics. So yes, too much of a good thing is bad.

Ketamine clinics use doses much lower than that which is used for general anesthesia, and ketamine is used for general anesthesia all over the world on a daily basis. It's on the World Health Organization's Essential Medicines List and has a very safe 50+ year track record.

Also don't take powerful drugs off-label, with no monitoring or supervision, and expect them to do the same thing they would at controlled doses in a controlled environment.

I take doctor prescribed ketamine at home. It's incredibly safe and as a bonus it's much more comfortable to be laying in your own bed.

They let people take it at home now? We had to go into a clinic and they would monitor you the entire time. There was a couch to lay on, but not much in the way of amenities.

I've been taking lozenges for over 2 years now.

We didn't! It was a licensed esketamine trial under medical supervision for treatment-resistant depression.

> Without making light of your experience, the behavior you witnessed is simply not possible to induce with the dosing range used by licensed ketamine treatment clinics.

This was a licensed esketamine (s-ketamine) trial under medical supervision which, as you might imagine, left us excluded from the trial afterwards.

So I am going to have to disagree with you regarding whether or not that is possible at theraputic doses. I realize that it's normally safe, and I hope that it helps a lot of people.

> This was a licensed esketamine (s-ketamine) trial under medical supervision which, as you might imagine, left us excluded from the trial afterwards.

Do you feel like the experts are being disingenuous with the safety of this drug? I am not taking sides here - I am genuinely curious of your opinion since you seem to know something others don't.

I feel like this is probably a rare side-effect that people should know about. I hope it doesn't affect many people, and for those it does affect, that the psychosis doesn't turn out like this.

Could you link the trial or any data about it? Genuinely curious.

I don't know specifically which trial it was, but you can google for esketamine trials because that's their brand name for s-ketamine.

Good video on the difference between infusions and nasal, and s vs r isomers. https://www.youtube.com/watch?v=ejjAszofgvA They are essentially different drugs and may explain the reaction.

> the behavior you witnessed is simply not possible to induce with the dosing range used by licensed ketamine treatment clinics

There's a growing trend of clinics prescribing take-home lozenges. Some of them are giving patients 30 or more lozenges at a time, with the expectation that they'll use them once or twice a week.

Of course, some patients take multiple doses at once. Browsing subreddits on the topic shows plenty of stories of people escalating their doses or asking for strategies to convince their doctors to prescribe more.

Unfortunately, I think it's going to get worse before it gets better. Too many unscrupulous doctors are realizing the profit potential for dispensing Ketamine prescriptions in exchange for $300, 20-minute telehealth visits.

That's terrifying. The trial we were in used esketamine dosed via inhalation. You could not take any of it home and the doctors controlled all doses.

I'd be suspicious of those who wanted more and more of the drug. It made her so dizzy and sick there's no way she'd want more.

I almost wonder if you can detect who is abusing it by how much they enjoy it...

Basically the premise of the mini-series The Night Of

Set and setting comes from Mindset and setting. Sounds like that person wasn't using K correctly (they were abusing it). I don't feel as if your anecdote applies to many others in a controlled setting.

You would be wrong about that, it was a licensed esketamine trial under strict medical supervision.

strict medical supervision is sometimes a terrifying experience. Set and setting matter but so does any drugs they are currently on. I would say that your experience is atypical.

As I understand it, the "K hole" was terrifying, the setting for taking this was a doctor's office that let you relax on a couch afterwards.

Worked for me after I had become incredibly depressed while attempting to rescue my daughter from an abuse situation (I succeeded yay!). I went from having tunnel vision, hearing music as just noise, severe dissociation etc. to being just fine and normal two hours later.

Best bio-hack I’ve ever done.

I personally wouldn’t use it as a recreational drug often though as it does have some known side effects from habitual use and regular drug use is always a bad idea, yes folks that includes weed and alcohol.

Thank you for your story.

I just wanted to offer an alternative view on regular drug use. I vape marijuana every day. After college I became an alcoholic after having stayed totally sober until age 21. Binge drinking college parties left me and my friends binge drinking well after college. It was bad, though I never lost a job.

I’d tried marijuana several times and often felt overwhelmed with it. It would take me more than ten years to realize why those incidents happened - group pressure to take huge hits of marijuana left me feeling way too high. A deeply uncomfortable feeling.

But marijuana helped me quit alcohol. I do not consider it the healthiest option nor do I recommend to anyone that they consume marijuana. But I would push back that it is always a bad idea. For my health I only vape marijuana and I keep the doses very small. I know it may still lead to health problems and I hope some day I don’t feel the need to do it. But it seems to help. I’ve stopped for weeks at a time and it’s fine. But I seem to prefer having a bit of marijuana every day. And I really don’t think that’s bad for me personally. I’m a successful robotics engineer. I worked for two years at Google X robotics while consuming marijuana daily and they filed two patents for my work during that time. Since then I’ve gone off to co-found a farming robotics organization that is about to announce our open source farming robot that I designed and built pretty much all myself.

I think we should take a more open minded approach to drug use. Some people may find that certain drugs work for them. Certainly I am achieving my life goals while vaping marijuana daily. I don’t really think it’s best for me long term, but it seems to be what’s working for me now.

It’s not clear to me from your post what the upside was for daily marijuana use is. It sounds like it kept you from reaching for the bottle, which I’m supporting of; but, what does it provide for someone who is not an alcoholic?

Well you'll mostly have to take my word for it. But I think in general it helps with morning body pain, general mood, and some creativity. I'm well aware of other healthy choices I could be making to help with those things, but for whatever reason I find marijuana a convenient supplement. It is not the healthiest option but I don't consider it "bad" either.

I recently went through a similar experience.

It initially helped me to stop drinking. I pretty much swapped out alcohol for marijuana. Alcohol felt really bad for me physical, emotionally, and mentally. And marijuana doesn’t.

I found a lot of other benefits:

- unwind and integrate my brain. As an engineer my brain is constantly is “solve” mode, always thinking about problems at work or side projects. Marijuana stops that, my thoughts and brain feels much more integrated.

- easier to focus and be present with my kids. I wish that I could just sit and enjoy long periods of time with my kids, but my head is always uneasy, checking work, phone, thinking about problems. Marijuana dials that back and lets me be present and focused

- emotional introspection. I had some pretty shitty things happen to me in childhood. I’ve never really reflected on them. I’ve started to repeat some of the abusive behaviors that I experienced growing up. Marijuana has helped me to really introspect my emotions and be open to integrating that trauma

- helps relieve low level anxiety and depression, it’s uplifting. I eat low dosage edibles most nights and positive mood effects linger through the next day

- it’s just fun :$ it feels good and is recreational. Music sounds different, food tastes more intense

I never would have guessed It would be so positive for me. I smoked for a couple months In my late teens until it started making me paranoid. I never would have guessed It would provide me so much benefit. I certainly would never ever have guessed I would become a daily user in my later 30s AND it would significantly improve my quality of life

Wow, nearly the same experience here although my main aim was to alleviate the immense anxiety I faced for years. The various prescription drugs were not helping so I decided to self medicate and bought edibles when they became legal here. It was like a damn miracle. All my tension and irrational scares melted away. I just hope my use won't build up too much tolerance and the effects will last.

Are you saying that you can use one day and have a fresh engineer brain the next? In my experience the “veil” remains for days and takes close to a week to dissipate.

For about my first 3 months :) It’s starting to catch up with me already. I’m scaling back to weekends now to see if I can strike a balance. If not it’s been a huge quality of life improvement and I’d be more than happy with irregular recreational use :)

Would you consume edibles or smoke?? I just take edibles

You really nailed it as far as the reasons why I do it.

My brain is "on" ALL the time and it's hard for me to relax normally. Marijuana really helps with that.

The answer to that varies from person to person. It may provide nothing. Many people have tried it numerous times and don’t like how it makes them feel. You really just have to be the judge of that for yourself.

For me it helps slow down my brain a bit, quelling distracting thoughts and anxieties running through my head so I can focus a bit better. It’s also useful for unwinding and relaxing at the end of the day, and I find that my thoughts are a bit more creative and inventive, if a bit slower.

Set and setting are very important as well, usually it’s best at home or in other relaxed environments. Being high at work or in public is often a pretty terrible experience, for me at least.

I agree that it can help with focus. I learned to do engineering while consuming marijuana by working on personal projects in the evenings at home. I found that in the right setting and with the right dosage marijuana seems to help me achieve a "flow state" of focus. Of course, too much and you'll dash your short term memory and forget what you're working on. Its no silver bullet but I seem to have learned a lot about how to use it by now.

Are there potential lung issues with vaping that much? I.e. if you're going to do it daily, why not edibles? (If you're in a state that allows that.)

Somewhat related -- I used to drink a ton, and though I don't think I was an alcoholic, drinking was part of my life and was terrible for my mood and my weight. I'd get very drunk 2-3 times a week, and the other days I'd drink 3-4 IPAs after work, or get a six pack of really strong beer on the way home from work. Lots of drinking alone. One day I saw a coworker in the checkout line at a store after work, and all I was buying was a bottle of wine. I felt really ashamed, which is a huge red flag. Gave it up "for a month," which turned into two months, and now 6.5 years without any. I do vape/edibles/mints, but it has nowhere _near_ the allure that alcohol had, and I'll go 6 months without it, then a few days in a row, then another irregular pause, etc.

Still have dreams that I'm in some bar drinking, and in the dream I'll think, "I just drink one or two, then stop." It's so relieving waking up!

I can only imagine there are potential lung issues. I am also worried about hot vapors hitting the back of my throat, so one thing I have adapted is that I never turn up the temp of the vape to get the last few hits out. That helps.

Edibles would be better from a health perspective, but they provide a very different effect to vaping. I do have some edible tincture which I mostly only ever have when I'm very sick and playing video games all day. But I vape a pure sativa for it's feelings of wakefulness, and it is hard to find pure sativa edibles. They do exist though, and I think some day I may switch to them. But they take much longer to take effect and they last much longer. I think they also have different psychoactive effects, but that may be down to the different strains used in the edibles I have found.

I've been there with the drinking. Good on you for going 6.5 years! In my original story I left out some details. Marijuana helped me break my nightly binge drinking habit but I continued to drink recreationally for some years. However currently it has been 10 months since I have had any alcohol and I feel great. No interest in starting back up. The plan was to go at least a year but even when the pandemic ends and parties start up again (end of this year maybe) I might just continue to abstain. Alcohol has not been good for me. I am very happy to be away from it.

You can make your own sativa edibles if you can get sativa flower or hash. Honestly, its not that complicated and using full spectrum hash makes dosing simple.

Your narrative describes alcohol and cannabis usage, on the one hand, and work achievements on the other hand. I understand that you are using that latter as a way to establish the benefits of the former, or at least to show an absence of detrimental effect.

But can you can identify why you might be reaching for psychoactive substances in the first place? Did you experience depression, anxiety, or trauma that you have been troubled by and need to blank out?

You mentioned "group pressure", but that on its own doesn't seem pervasive enough to warrant a lifestyle. Do you have any ideas about why you want to consume psychoactive substances chronically? I'm not saying you have to have a reason, or that you have to be aware of one, or that you have to share it here. I'm just curious for more information as context for your anecdotal narrative.

Does anyone else in your family use psychoactive drugs as a lifestyle choice?

My family has a history of alcohol use. The group pressure was only in college though.

I think I experience a lot of stress. I always wanted to change the world growing up, and in the last ten years (I am 36 now) I really learned a lot about how awful some aspects of the world are. I am a deep empath so I have a hard time feeling okay when I know others are suffering. And with the US economy putting the poor at such a disadvantage, I feel pretty unhappy about that stuff all the time. I am in therapy and have been for 8 years, but I still just think a lot of stuff sucks and I can't really ignore that. Just think of the 2 million people in prison in the US. That system needs to change, and it's very easy to learn about that and struggle to not feel okay on the day to day because of that knowledge.

However, marijuana helps, and is part of my coping strategy. Along with time outdoors and a lot of creative endeavors.

I also really hate working for other people, so I am always trying to start startups or something. I don't like working a regular job. But this means that even though I have high value skills, I'm always experiencing some financial stress due to my desire for independence.

I am not trying to say my work accomplishments are caused by my marijuana use, but that one can use marijuana daily and still accomplish great things. I do well despite my marijuana use. Possibly because of it, but that would be harder to prove.

To me, marijuana seems fine. I don't want to do it forever. I am finally in a good place in my career where I am doing what I want. We still have to get through the "trough of disillusionment" on our project and I suspect there will be a lot of stress for some time, but hopefully we will get more traction and the stress will die down and the pandemic will end and I can find other ways to feel okay without vaping every day.

But for now, I'm okay with it.

Thanks for responding with that extra background information.

I feel like I have a lot in common with you - high empathy and awareness of systemic economic disadvantage. I have worked from home for decades in sw dev and pub, so I had the choice to smoke pot and I found it insulated me from what I didn't like about how society is organised. Like you, I found pot helped me to concentrate on work, and liberated me with creative endeavours, although managing it isn't so simple as flicking a switch by any means.

I don't have a family history of alcohol use - the opposite. But I ran into endless legal problems 6 years ago when a major customer stiffed us for a lot of money, then 3 lawyers in a row exploited us while I was off caring full time for a relative. All the money we were owed went to lawyers fees. I ended up drinking just to get away from this awful feeling of being subjugated to injustice by the legal system.

Then 2 years ago, we sorted out the legal problems and I no longer had to dwell on it. I stopped drinking for a while, but so much of my old life had disappeared, I was left with a void. I was happier, but I started drinking again, happily.

After another year I just wanted to stop, but that was difficult. It is hard to change habits, but not impossible. I read about this subject, and learned some techniques, but my experiences taught me about the role that underlying stressors can play in the need for habits, which is why I asked you the question which you kindly responded to.

I actually quit everything 7 months ago, and soon noticed how much I love the clarity. The sobriety is like a new drug. I really dig it.

I do wonder how much the ayahuasca I imbibed in South America a few years ago has contributed to my newfound ability to appreciate sobriety, and to move on from my bad feelings about exploitative lawyers and my economic losses. I don't have any bitterness left. It's all reframed, by looking from outside myself. My empathic abilities can be applied to the lawyers who cheated us in a way that enabled me to move on. I can just see them as actors who did what they did in a way that isn't personal to me, and let it go.

I had a longer reply but I was rate limited at the time.

I just wanted to say I am glad you had that ayahuasca. I am sure it contributed. I am not religious per se but I do believe that psychedelics can provide some guidance from beyond the self.

And I am glad you quit everything 7 months ago. I quit alcohol 11 months ago and it has been so good for me.

You may appreciate psilocybin. It isn't something that is addictive IMO. The last time I tried it I had a lot of deep and serious thoughts and while it was helpful, it was also an intense experience and not the kind of thing you'd want to repeat regularly. However from what I hear it is much less intense than ayahuasca.

Check out this podcast for more info: https://psychonauts.co.za/

Thank you very much for your story too. I'm actively locked in a functional alcoholic state and have been on-and-off for almost three decades. I find I can do a month sober but then I just get back on it afterwards. I've tried weed of various types and in nearly every form factor but have been unable to shake the potency of it (makes me super paranoid and that's not a manageable side effect for me).

However, when I do have it, it's impossible for me to drink so it's hard to look past it's effectiveness in trying to treat the root issue, alcoholism.

My question to you is, what's a small dose for you and how are you vaping it?

Thanks again, I am going back on the wagon today so this thread has been particular interesting.

I have two vaporizers. A Pax3 handheld vape and an Arizer desktop tower vape.

I am currently vaping Oakland store-bought "shake" weed which says it is 12.79% THC, so its on the low potency side. I use a pure sativa so it does not make me feel sluggish (an "indica" will provide "couch-lock" which is an all body effect that makes you want to sit down and not move - so I avoid those). Be warned that sativa is the type that can cause high anxiety. It varies by strain, and you can look up reviews of different strains on leafly.com or weedmaps.com

Both vape devices I own have a "bowl" for filling with ground flower. I tend to replace the bowl in each approximately once every three days right now with low potency flower. The dosage of drug falls off exponentially with the freshness of the bowl so the first hit on a newly packed bowl will be MUCH stronger than the last hit of the old bowl - something to be very careful with as you can get yourself trying to take a big draw off an old bowl, then you replace it, and suddenly if you're not careful to re-adjust your dosage it will be too much. So be careful there.

I basically have a small dose when I wake up with my morning coffee, then puff on my handheld vape during the day being careful to regulate so that I can still write software (and puffing a bit more if I have an hour of mechanical robot assembly to work on or something mindless). And then I have a bit more than those lower doses in the evening after I've gotten home and settled in.

I have roommates that vape using weed-concentrate on a torch-heated quartz crystal which is why I say my dose is small. I go through way less product than them. Because potency builds over time, even my conservative hits are probably larger than what you would want.

I highly recommend the vape for long term use. But a pipe or whatever you have on hand is fine to try for now. If you want to experiment with marijuana without having too much, here is what I would recommend:

Get some low potency hybrid (mixed indica sativa) weed. Look up reviews of the strain on leafly.com or weedmaps.com and make sure it is not one that will trigger paranoia.

Then, take the TEENYIEST amount you can imagine (the size of a pea or less), and smoke it. Then have no more the rest of the night. It is not necessary to combust the entire sample. Just take one hit. You will feel it, but I believe one small hit of low potency marijuana will not cause the anxiety effects I have known.

I suspect that would be okay for you. You may want to have a friend or loved one around to monitor you, although marijuana is relatively safe.

It is worth it to quit alcohol. In my original story I did not mention that I continued to drink recreationally for a long time, but marijuana did help me break my binge drinking. However for 2020 I decided to quit drinking for at least one year. That started in March 2020 and it has been 10 months without alcohol. I am VERY happy for it. I feel so much better. I do not want alcohol and I am not planning to try it when one year is up.

You can do this. My email is in my profile if you'd like to follow up with me in a month or two. I am curious if this helps you.

I wish you the best, and I love you.

Wow, thank you so much for that detailed information and kind support, really appreciate it!

I have an Arizer handheld but I think I've just been packing it too much, so I'll dial it way back and start small.

Really, thank you so much again :)

Marijuana may be the solution for you but I highly recommend checking out The Sinclair Method. There is an awesome book [1] about it and also a great Reddit community [2] for support.

Long story short, your brain is addicted to the endorphin rush that results after consuming alcohol. You can abstain for a period of time but due to the alcohol deprivation effect your urges to drink alcohol only increase as you abstain for longer periods of time (hence the AA mantra "Once an alcoholic, always an alcoholic.") The Sinclair Method gets around this by attacking your brains relationship with the alcohol endorphin rush. Long story short, you take an opioid antagonist (endorphin blocker) before you drink, typically Naltrexone or Nalmefene, which slowly trains your brain to no longer associate alcohol with pleasure. Check out the book for more information.

I was a heavy drinker and alcohol was destroying my life and after 4 months of TSM, I was drinking at a safe level and now one year later I am completely sober. I could continue to drink if I wanted to, with Naltrexone, but at this point I am ready to start a new life without alcohol and leave that all in the past. I believe 40% of TSM users choose to abstain completely and the other 60% choose to drink socially in moderation. It is up to you, which highlights the power of this system. Having complete control over my drinking after being out of control for years is nothing short of a miracle.

(You may also run into systems where you take Naltrexone on days that you don't consume alcohol. This is something different, and it may work for you, but my experience is with TSM which requires you only take Naltrexone before drinking)

[1] https://www.dropbox.com/s/60fs7gmvbyzs1kk/Cure%20for%20Alcoh... [2] https://www.reddit.com/r/Alcoholism_Medication/

Thanks for your information! I've tried so many different meds over the years and I honestly can't recall my reaction to Naltrexone but I know I've tried it and think it didn't jive with my SSRI medication.

Thanks so much though, I'm going back to the GP tomorrow so I'll read up on the links you provided and see if the GP can give me another run at it (or at least remind me why I didn't stick to it last time!)

Really appreciate the support, thanks again :)

How long were you in that state before the ketamine? That’s fascinating. Wondering if length of time in a state like that affects odds of permanent reversal.

Ketamine treatment for depression doesn’t require a psychedelic experience. Many clinics prefer to keep doses low enough to avoid full psychedelic experiences. Of course, some clinics blast patients with excessive doses and send them into full-blown psychedelic trips, but it’s definitely not necessary for the anti-depressant effect.

Ketamine’s effects on depression are almost certainly mediated by something other than any psychedelic effects. Ideally we’ll find a safer medication which accomplishes the same thing without disorienting the patient

Unfortunately, the effects of this therapy are rather short lived. There’s a growing industry of ketamine clinics that are happy to continue charging patients for endless ketamine infusions. Some offer outpatient prescriptions of ketamine. However, repeated treatment isn’t quite as effective as tolerance develops.

The best approach appears to be using ketamine as a way to kickstart more sustainable, long-term depression treatments, such as therapy programs.

There's a growing industry of therapy clinics that are happy to continue charging patients for endless sessions. Some offer anti-depressants and anti-psychotics. However, repeated treatment isn't quite as effective as the wrong mix of drugs are prescribed, the therapy re-enforces the trauma, and it is quite costly for patients to afford.

Ketamine is a not uncommon thing in psych today. It is routinely prescribed. The problems are that it does seem for most people the effect is short lived (weeks) and psychosis is a thing (the poster below saying it’s never an issue even in pain setting is simply mistaken). The thing is that neither of these are uncommon problems for psych meds in general so ketamine shouldn’t be singled out for this, but it’s more complicated then some of the armchair docs here make it seem.

There is continuing research into regimens that might minimize the tachyphylaxis, but it’s an ongoing problem.

>psychosis is a thing

Looking through Google scholar + personal experience I don't see evidence that this is an issue for non-schizophrenics.

You need to look harder. Schizophrenia and psychotic features are relative contraindications for use of ketamine per APA guidelines. “It is unclear whether patients with depression that is not treatment- refractory or patients with other psychiatric illnesses are ap- propriate candidates for ketamine treatment, and extreme caution must be exercised in patients with psychotic or substance use disorders.”

Side-effects associated with ketamine use in depression: a systematic review, Short 2018.

To summarize: A review of 60 studies found dissociation and psychotomimetic effects >70 percent of the studies at varying rates. And note that the time courses of observation were variable. Furthermore most of these studies excluded participants with psychotic features or known psychotic disorder.

But for any provider considering ketamine this is literally top of the list in consideration of adverse effects.

This review doesn't say all that much. I just took another look at it and it merely reports what % of the studies mention those effects without effect sizes or anything of the sort.

Also they clump psychotomimetic and dissociation effects together which is really weird as ketamine is a dissociative. It's literally the highest number in their analysis (72%) because dissociation is to be expected from a dissociative.

The point with referring to a review article/meta is that you are free to look at the references themselves. Adverse effects secondary to dissociation can obviously be troublesome for some using in a professional clinical setting, which is what this is about..

Anyway, in medicine statements of the form “x never happens unless y” or it “only” happens in certain circumstance are always wrong. The data is not perfect but your implication that only schizophrenics experience adverse effects is not only an idiotic statement on its face you can easily find case reports refuting it.

I didn't say it never happens. Everything is correlated but if the risk is extremely small, as I believe it is here for non-shizophrenics then I don't consider it a concern. And others definitely experience dissociation for example, that's not something I am questioning.

I've done both back then, those stuff really changed my life perspective in terms of depth.

Recreationally some of them can be misused (ketamine, extasy), but for the medically desperate I'm hella convinced these substances deserves more research.

The Center for Transformational Psychotherapy in SF leverages ketamine as part of their treatment, to good effect. Hopefully continued use and research will continue to mainstream its use (when appropriate).

Gary Gulman talks a bit about the relief he got from it.

Unfortunately for him it was only short term relief, but it really did seem to work.

He’s doing well now, so maybe that short term relief helped in some way as part of everything else.

Are you saying he abandoned the therapy because of the short-term relief? Most people return to their depressed state when they stop taking their anti-depressants.

The doc told him he wouldn’t continue it because it wasn’t helping outside of the therapy session (and each session was quite expensive).

Did 12 sessions, after the first session I had instant relief. Even the urge to drink was completely gone. I should have gone back in for boosters but just let it slide, mostly due to the continued cost. About 3 months later I was back into a depressive state. I was able to get out of that one on my own but I don't think it would have been possible without the ketamine treatments.

It is hands down the most effective medicine to treat depression I have taken. The maintenance is the downside, however the minimal side effects are worth it.

I don't know. Every generalist doctor I have known got a alt phase aound 50. Homeopathiy, bach's flower, essential oils, etc. I chalk it up to "they have seen bad stuff and can't help some of their patients going through rough times and they look up for alternatives and settle for something for a few years".

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