If anyone is looking at this during insurance relooking time, with ACA this is fall, check with an insurance person to see which plans cover this on the policy formulary. I just changed my policy to cover this med for my son who is 22 and has been recommended this treatment.
Good point. Good time to look into what treatments will or won’t be covered, especially for difficult to treat depression. Worth checking to see coverage policies on Esketamine, Transcranial Magnetic Stimulation, higher level therapy programs like Partial Hospital or Intensive Outpatient Programs
Plus I don't think if you have medicare and medicaid you can get this. Insurance wil not approve it. I am poor. It has some of the same side effects that my current psych meds have.
A dissociative anesthetic makes perfect sense for treating depression. Of course, this is based partially on my experience abusing dextromethorphan in quadruple doses, where this antitussive drug has a dissociative anesthetic effect. I am curious as to the long term side effects of esketamine, but if it can save 1 persons life who would otherwise have committed suicide it is worth whatever risks. Isn't ketamine a horse tranquilizer?
Side comment on your comment: one of the newer FDA meds for depression is Auvelity; which is basically a combo of Bupropion (an existing antidepressant) and Dextromethorphan. And basically they try to leverage a drug drug interaction where Bupropion slows down the metabolism of Dextromethorphan to keep the level of the Dextromethorphan high, and by doing so, you start affecting Glutamate. Kind of an interesting indirect way to mimic ketamine, similar to what you said. But to your other questions: yes, it has been used as a tranquilizer for horses, but also an anesthetic for children in the past. But the doses used for depression purposes are miniscule compared to anesthetic doses. In terms of long term side effects, still to be determined as most of the clinical trials out there, the longest I am aware of has been 5 years. In clinical research that is considered “long” but 5 years is not long in real life, so we are going to have to collect more long term data from observational real world reports. Thank you for the comment. The Dextromethorphan angle is very intriguing just from a mechanism standpoint, whether it can be as robust or not compared to more potent glutamate modulators is really the question
Kidos Dr Kim for pushing research. Hope this helps people who need it.
As a side note: I’d love to see a video on the dvds behind you. Ta.
just had first spravato yesterday. I definately was high. But this morning I of course am still depressed
Keep going! I really hope you are feeling better now since it has been a few months.
If anyone is looking at this during insurance relooking time, with ACA this is fall, check with an insurance person to see which plans cover this on the policy formulary. I just changed my policy to cover this med for my son who is 22 and has been recommended this treatment.
Good point. Good time to look into what treatments will or won’t be covered, especially for difficult to treat depression. Worth checking to see coverage policies on Esketamine, Transcranial Magnetic Stimulation, higher level therapy programs like Partial Hospital or Intensive Outpatient Programs
Plus I don't think if you have medicare and medicaid you can get this. Insurance wil not approve it. I am poor. It has some of the same side effects that my current psych meds have.
@@danpage79 I get all of my healthcare via the VA. If you have served in the US military you too are eligible. The VA pays for EVERYTHING.
A dissociative anesthetic makes perfect sense for treating depression. Of course, this is based partially on my experience abusing dextromethorphan in quadruple doses, where this antitussive drug has a dissociative anesthetic effect. I am curious as to the long term side effects of esketamine, but if it can save 1 persons life who would otherwise have committed suicide it is worth whatever risks. Isn't ketamine a horse tranquilizer?
Side comment on your comment: one of the newer FDA meds for depression is Auvelity; which is basically a combo of Bupropion (an existing antidepressant) and Dextromethorphan. And basically they try to leverage a drug drug interaction where Bupropion slows down the metabolism of Dextromethorphan to keep the level of the Dextromethorphan high, and by doing so, you start affecting Glutamate. Kind of an interesting indirect way to mimic ketamine, similar to what you said. But to your other questions: yes, it has been used as a tranquilizer for horses, but also an anesthetic for children in the past. But the doses used for depression purposes are miniscule compared to anesthetic doses. In terms of long term side effects, still to be determined as most of the clinical trials out there, the longest I am aware of has been 5 years. In clinical research that is considered “long” but 5 years is not long in real life, so we are going to have to collect more long term data from observational real world reports. Thank you for the comment. The Dextromethorphan angle is very intriguing just from a mechanism standpoint, whether it can be as robust or not compared to more potent glutamate modulators is really the question
Project 2025 will cause hopelessness in the United States. 😮
You convinced me to not try this, even though living in Canada I probably can't get it anyway.