Ketamine for depression – A Powerful but Tricky Solution


69 comments

  1. I have heard of ketamine but didnt know much about it at all. I think it's awesome for those that it helps with treatment resistant depression. Thank you for this very informative video and I totally learned something new today.

  2. I wonder if this is really why ECT works so effectively. Do they use Ketamine to put you to sleep before ECT?

  3. I'd actually completely forgotten that today was Wednesday until I saw the video notification! Great video and very informative as usual, Dr. Marks! I especially liked the newsflash part 😁

  4. As I hear it Dr. Marks. It takes a student two weeks to get an appointment with a mental health counselor on campus. How would you identify the problem and come up with a solution ❓

  5. This is very interesting. I’m really glad they’re trying to find better treatments for people with depression. I wonder if this would work on anxiety as well🤔

  6. i take it recreationally occasionally, so more than the therapeutic dose but i always find the next day that I dont feel at all depressed and at ease

  7. If we had more doctors like you we would be in a better place. Being knowledgeable of what is going on individualy is key. Many diagnosis and we are all different in the response to treatments.

  8. Thank you for putting in so much time for your videos. I have been in a clinical trial of Ketemine for over a year. Still have to work on depression but it has helped with suicidal issues. It is like any other treatment. Works for some but not everyone. Scheduling is difficult do to not being able to drive and fatigue the next day or 2. I have been lucky to have met people who lives may have been saved by Ketemine, mine included. Now the hard part living. 🙂

  9. The disassociation is not worth it for me. I struggle with depersonalization / derealization already from my anxiety.

  10. Does ketamine, or rather esketamine, have any known major interactions? I learned after the fact that one of my medications (though not an MAOI) could interact with the dextromorphan common in many cough syrups with the potential to develop into serotonin syndrome. Since my understanding of dextromorphan is that it is also a dissociative NMDA, could esketamine also have the risk of serotonin syndrome?

  11. Does this drug treat bipolar depression? I've tried a lot of antidepressants in the past with no success. I've been on wellbutrin for a few years now because it has the least amount of side effects but my depression never went away.

  12. Thank you for another great video on depression! It runs in my family and I have had issues with it so I always try to stay in the know. 😊

  13. Great news! I hope it stays well controlled.. Veterinary grade ketamine is already being abused as a street drug, and the narrow therapeutic window makes it somewhat dangerous (although probably not addictive?)

  14. Dr. Marks
    Another interesting video but not a drug for me that’s mainly a medication for maintaining sedation for anesthesia intravenously. However ketamine is effective in treating depression and available in a pill form ! As you know I have a degree in pharmacology and is useless ! How about some more videos new medications for bipolar disorder like the new one Vraylar ?
    General repair

  15. So this would be a "last resort" type of medication, is that correct? It's not one to likely be suggested if other, less tricky options are still feasible?

  16. I see you reference it’s use as a street drug. I assume therefore that it’s addicting? Would an incrementally higher dose be required for each bout of depression? I get the impression that it isn’t really a cure. 😕

  17. Have you studied about other psychedelics like ayahuasca, psilocybin or LSD including micro dosing. What are your thoughts for psychedelics and bipolar? Do you think psychedelics are promising for bipolar or risky? I was researching psychedelics during my most recent depressive episode and was thinking that it may have been helpful. I am 54 years old and was diagnosed bipolar when I was 50. I have since been on seroquel which gives me great sleep but ideally I’d like to get off my meds. Until age 50 I was not on medication. Any thoughts you have would be appreciated.

  18. I have a question my wife just had a manic episode and our family practitioner put her on cymbalta 30 mg and a month later we upped it to 60 mg. She does good for about a week then has a few days of small episodes almost like she’s rapid cycleing. Any suggestions?

  19. Thanks for this very informative video, Dr. Marks! It is very à propos seeing that ketamine is becoming increasingly in-demand. That said, in your opinion, when is it okay to prescribe ketamine to someone with treatment resistant depression? I mean, what if they're only 14, 20, 24 -or even 35? Should psychiatrists keep trying different meds despite, let's say, 3+ failed attempts? Would they more conservative ones value other classes of medication or even TMS and ECT over ketamine? Would you feel comfortable prescribing ketamine to most of your patients with TRD? I hope I am not overstepping with any of my questions, do let me know if I am!

  20. I'm suffering from borderline vs oc..I'm taking lamotrigine 100 mg and escitalopram oxalate 20 and clonazepam 0.5.can I take finasteride 1mg with it.

  21. Ketamine is a dangerous drug illegally used in date rape and child rape, it should be banned completely. Like most pharmaceuticals. Mental issues need to be figured out, not drugged out. Drugging yourself out only protects abusers. Talking from personal experiences.

  22. Seems like one has to take ketamine treatments for the rest of their lives. That sucks. Why cure disease when you can make more money treating symptoms.

  23. Took me a few days to watch, but getting the good news from you was fantastic! Now, i hope the EU won't take forever to approve Esketamine, and Denmark decides it loves me and wants to help me hehehe

  24. Hey Dr Tracey Marks. Peace. How are you? Just wanted to thank you for your informative videos and let you know that I'm trying to raise awareness of mental health in Saudi and I shall definitely use your videos (God-willing). Thank you very much for your efforts.

  25. Hi Dr. Marks my doctor who is a cardiologist gave me a lexapro which I stop drinking because i thinkt has a side effect.Pls. help me need your opinion on this . I have an anxiety for aboout six months now. Thank you hope you' lle reply.

  26. Is borderline comboroid with ocd the worst and painful problem…or is there any more complicated and combined disorders..

  27. Thanks for making this video, I watched a few and subscribed because I like that you speak about mental illnesses and disorders without judgement. I had my first Ketamine infusion today. I've been diagnosed with BPD, major depression and I also have pretty severe chronic pain. My anesthesiologist had me do the infusion for my pain this morning, which has gotten so intrusive and mind numbing that I've had some suicidal episodes in the last 2 months (yes, more than 1), leaving me on sick leave from work.

    I'm definitely not 100 % ; even though I got unplugged from the infusion at around noon, I'm already starting to feel some of the pain relieving, which will greatly help my depression by proxy. But I'm glad to hear/learn it could also help my depression, not just by proxy of helping my pain. I know it's short lived, but the idea of having at least a handful of days with no depression sounds like a blessing right now, so I'll take it.

  28. Dr. Marks I am a 66 yo male who has suffered with anxiety and depression since I was in my late teens. I have also been diagnosed with CPTSD a few years ago. I have been in therapy for years and been on numerous anti depressants. I have thought about suicide and have dicussed it with my psychiatrist and therapist. I am at my wit's end. Things have gotten worse. I am seriously thinking about iv Ketamin. I have recently had an ablation for A Fib and was wondering if this would keep from having the treatment. I have no CAD or CHF. of course I will discuss it with my Cardiologist and EP. I need to do something.

  29. I inquired about ketamine treatments and was contacted by an office in a town about an hour away. I was told each treatment is $400.00 and its not covered by insurance. Also, they said I would be required to take 3-4 treatments at $400 each and then be treated depending on how I reacted to the treatments. Im on disability due to depression/anxiety and I'm told I'm probably treatment resistant due to the countless medications I've taken since 2008. How does anyone afford those ketamine treatments? I live in N.C.

  30. I did a series of 6 infusions a year ago, plus a few occasional boosters. I've had dysthymia with major depressions, for most of my life. Nothing else has ever actually helped me feel better. I wasn't sure if it was working for me until about the 4th infusion. But then I realized the relentless, vicious voice in my head was silent, for the first time I could ever remember. And I just felt calm, balanced, at peace. I felt like everything was going to be OK because I could handle whatever the future held. I was like, holy shit, I think this is was "normal" feels like… Downsides: Obviously the expense! Ack! And the possibility that you might need boosters for a while, or indefinitely. The disassociation is intense. You need to be OK with a very vivid mind trip. I describe my experience like, my body moving in dreamlike ways through psychedelic landscapes and tunnels of color and texture. I thought I had mellow music (with headphones) to listen to, Air, I think, but that was waaay too intense. I found Brian Eno's Music for Airports and the like, fully reclined, with a heated blanket in a dimly lit room, to be best for me. I immediately feel myself coming back to reality when the IV runs out. After about 30 minutes I'm back to normal and don't feel any lingering effects, although everyone's different. It's super important to find a doctor that has a lot of knowledge & experience. My doc started me a lower mg/kg dosage amount and gradually worked up, making sure I was OK with the disassociative effects. I can't imagine starting at a high dose… You'd need therapy just from that! lol Oh, and weird, but I also try not to drink anything for several hours beforehand. The IV fluids, plus side effect of ketamine make me have to go pee so badly! And trying to get up when all woozy with an IV attached to go to the bathroom just sucks. 😉

  31. I’ve done it recreationally and it’s definitely not good at high doses for people with mental illness.

  32. I can't remember if I asked this but what are your thoughts on people starting lithium and having Hashimotos disease along with hypothyrodism? Do they have to fear "hashimoto's encephalopathy" like all the reports say?

  33. CORRECTION – I said Ketamine is an NMDA receptor agonist. It's an antagonist meaning it blocks the receptor.

  34. I took my ketamine in my drs office, placed amount in a small glass of water and held it under my tongue for a minute or so. The treatment lasted an hr and I was able to take the bus home by myself. The dissociative effects only lasted about 20 minutes and my psychiatrist sat with me as I worked through the effects. I even picked up my prescription myself and brought it to my drs office. It was not very expensive this way either, much less than the nasal spray.

  35. Dr Marks, thanks for the informative video. I've been approved for Spravato but want to share my experience in actually trying to get the treatment started. Janssen has a program called CarePath that can assist getting the Spravato for a $10 out-of-pocket co-pay per treatment. The maximum annual cap on that program benefit is $7150. That leads you to believe that, at $10 a treatment, you're most likely not going to exceed the $7150 limit during the calendar year. What they didn't tell me was that, behind the scenes, they charged my insurance provider $2075.33 for the initial Spravato that was delivered from the specialty pharmacy. So, in reality, if each treatment "benefit" is charged at $2075.33, you'll use up that CarePath total after the third treatment. I'm assuming that, after that time, the "real" cost will be applied to your deductible and, depending on your insurance caps, you could be responsible for alot of $$$ out-of-pocket to continue the treatments. The other issue I've found is related to the 2 hour observation period required at the doctor's office. Many psychiatrists never had a need to negotiate the codes related to the observation period with the various insurance providers until now. What I found was that, even though the codes were valid and accepted by my insurance provider, my MD wasn't approved to submit them. Therefore, if they did submit the codes for the 2 hour observation period, my insurance would reject the codes and the provider would have to eat the cost. So what did my MD do? She told me I would have to pay $590 out-of-pocket for each office visit to receive the Spravato. That amount won't come down until such time as my MD negotiates pricing and gets approved to submit those codes. Moral of the story? Just because Janssen and your MD say they offer the Spravato, make sure you understand all the "other" hidden costs that can drain your bank account.

  36. What about people who have psychotic depression or psychotic episodes? Isn't ketamine a pro-psychotic drug?
    And if it can take people out of depression is there a risk of kicking off mania?
    I suppose what I'm asking in a nutshell is do you think ketamine would be suitable for people who have very serious depression or bipolar 1 disorder — or even schizoaffective disorder?

  37. I would definitely recommend Ketamine for treatment resistant depression, if you can find a legitimate clinic in your area and if you have the means to afford it. I did one infusion a few moths ago (would love to do more in the future) and I do feel that it helped me and driving the next day after the infusion, at a red light, I was looking around at the cars passing in the opposing lane and I felt like I could see color again. Depression sucked the “color” out of everything in my life. Ketamine gave some of it back and I am grateful. I can only imagine how well I would feel after having the full course of infusions (6 infusions). It was a positive experience throughout. The only downside is the cost. Where I’m at it’s $480 per infusion. Best of luck to everyone out there that is suffering right now.

  38. It’s saved my life and a total panacea for treatment resistant depression and ptsd and brain or neural … atrophy from opiate abuse damage… fresh snow on a negative synaptic gap circuit or ski slopes from hades… it’s not for everyone. But it was definitely for me and many close friends. And it’s so worth trying. And the best part is there is NO PHYSICAL DEPENDENCE!

  39. Oh great an other drug for potential abuse. I think we can get by without it, ketamine will create more problems then it will solve.

  40. Dr. Marks, first of all, i would like to thank you immensely your absolutely brilliant and insightful videos, as a psychology student myself and a mental health sufferer, i receive double the benefits :).

    Question, is there is any research that shows Ketamine benefits for other mental health disorders such as severe OCD, PTSD etc.?

    Thanks 🙂

  41. I’m tired of living like a dead person. I don’t even want to brush my hair anymore. Everything that could possibly help is too much effort to even try.

  42. Being turned down is depressing itself (no pun intended).
    Still, it's interesting and worth mentioning when trying to help someone else.
    Thanks for being you, Doc 🙂

  43. I have been on infusions and compounded nasal for over a year now . It’s the only thing that’s worked for me . I don’t want spravoto . I’ve heard it’s biodegradability ratio is only about 30% . And compounded nasal is about 60% . I do an infusion every 60 days and am prescribed 2x 100mg (100ml x 10 equivalent) it’s a very low dose , basically micro-dosing to someone who did k illegally . But it works great for me and now since I’m over a year in .. my bill for my nasal script and bi – monthly infusion is about 225$ a month , total . And that’s without any insurance . I won’t give any drug the credit , but I will say ketamine therapy along with some traditional 12 step recovery opened up my mind , body and spirit and gave me the most powerful tool I’ve had in 39 years to change my life ! Thanks for this video , hope to see an update soon. 🙏🏆

  44. I've been getting IV Ketamine Therapy done for about 6 months now. I've found it beneficial. I have to take Gravol (anti-nauseant capsule) beforehand because it makes me nauseous. I also get it infused slower. It has helped me a lot! I have Bipolar 1 and when the seasons change my depression gets bad. Ketamine Therapy isn't very enjoyable but it helps a great deal. I'm also very lucky to get my treatments covered since it's part of a study. I've always wanted to be part of a study!

  45. Don't be foolish and use Spravato ($5,000 ti $7,000 for the first month of treatment!). Go to a compound pharmacy. Take your prescription to a pharmacy and have them fill a 3 month bottle of nose spray for $63. Ketamine is no longer under patent and is cheap. Spravato was created by someone who cut Ketamine in half (literally patented one-half of Ketamine), got it FDA approved with requirement to sit in your doctor's office for 2 hours each visit. The guy will become a billionaire from this…but intelligent people who have done their research will get their initial treatment by infusions, get better, then use the generic nasal spray from their compounding pharmacy as needed to maintain their improvement. The nasal spray is NO substitute for the infusions to treat depression. It is short lasting. Be wise consumers. No need to get ripped off by Spravato.

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