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  • New hope for TRD

    Treatment Resistant Depression

    Depression I expect, is not rare among musicians. Ambient music seems a comfortable place to hang it's hat.
    I have been a sufferer for 35 yrs. As some of you may know, the FDA just approved a new drug to treat TRD and another one is on it's way to approval.
    The drug generic names are esketamine (Spravato) and soon, rapastinel (Allergan). For those unaware, these drugs alleviate depression as soon as 4 hrs after treatment.
    In the US there have been clinics dispensing generic ketamine intravenously for yrs, for a high price. Now with esketamine, your med. insurance will pick up the cost.
    So far I don't have a clue where to go for this esketamine treatment. I could really use it now.
    I have only responded to one antidepressant (MAOI phenelzine) although I have tried many. I managed to stretch the phenelzine responsiveness out over about 16 yrs. But that ended about 10 yrs ago.

    Has anyone had any antidepressant experience with ketamine? or know anything concerning where to go for esketamine treatment?
    How bout you in the UK?
    Last edited by annode; 03-12-2019, 03:39 PM.
    "The dumbest of people are the first to tell you."annodeMy Music
    Check out my ambient radio show list @ recommended listening

  • #2
    Hi Barry,

    I am fortunate not to have felt the need to visit the docs over the years about my bouts of depression so I cannot really help much with your question I'm afraid.

    Anyway, I did a search for "esketamine NHS" and it pulled up a few articles.

    Sounds like good stuff, but does have its drawbacks, much the same as many medications...Nothing is ever perfect.

    https://www.theweek.co.uk/100091/ket...-by-us-doctors

    I sounds like it is expensive, too, so, in the US I suppose it would depend on your insurance policy, although I am only guessing about that.


    cheers

    andy
    I may not post anything useful, but at least I do it often

    Bandcamp // SoundCloud // YouTube

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    • #3
      Have you tried to find some more natural way of curing depression and what do you think about that? I had some, I could say, depression/anxiety related problems in the past, mood changing problems etc. and since I start practicing Tai Chi I had some very impressive experiences. I had been smoker for 10 years, had been drinking almost regularly and about 1 year after I started practicing Tai Chi all of that has changed. I don't smoke anymore, can't even think about drinking and I feel happy and fulfilled like never before. I know it may sound like some commercial but my experience is really that good. I practicing Tai Chi for two and a half years now. Key thing is to find a good teacher, since Tai Chi is internal martial art with purpose to develop inner energy and heal and harmonize mind and body through movement and breathing techniques. Problem is that most people who say they can teach Tai Chi practice it on a physical level and that way Tai Chi can't provide you all it can if you practice it correctly.

      Hope this helps
      Vladimir

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      • #4
        If anyone has knowledge / experience / acquisition logistics with ketamine / esketamine reply in this thread.
        If not, no need to write anything.
        Not to be mean, but this can get out of hand quickly, and I want to stay on topic.

        Thanks.

        synkrotron Going by that article it appears the NHS doesn't have esketamine on a fast track approval in the near horizon.
        I would have thought the US would be behind on that drug.
        (The European Medicines Agency is also considering a licence application that, if approved, would pave the way for the medication to be offered on the NHS.)
        Last edited by annode; 03-13-2019, 07:57 AM.
        "The dumbest of people are the first to tell you."annodeMy Music
        Check out my ambient radio show list @ recommended listening

        Comment


        • #5
          I get the impression that the US is some way ahead with licensing esketamine, in the form of a nasal spray by Spravato and that some US doctors have been administered without FDA approval, which surprised me.

          Over here we are at the mercy of NICE. If they decide that something is too expensive then the only way after getting it is by going private.

          It will probably only be a matter of time that it will become available. Soon, in fact.

          Here is another article, only a day old:-

          https://www.rollingstone.com/culture...proved-806363/
          I may not post anything useful, but at least I do it often

          Bandcamp // SoundCloud // YouTube

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          • #6
            To update my investigations, I'd like to share what I now know.

            To find a treatment center in your area who will accept insurance go to Spravato.com then click the 'Find a Center' tab upper right and insert your zip code.(new site enhancement today)
            This is as far as I gotten so far...left a message asking for an appointment. Now waiting for a call back from this local psychiatric doctor. (Philadelphia)
            From what I've read from ppl who have used ketamine for depression, they all say it's like a miracle.
            I have some theories concerning what it is doing to the mind. That's all rather complicated, but I am educated in this field and can talk about it.
            If this subject picks up interest, I'll get into all that. I'll still share my treatment experiences here as I receive it .
            Music appreciation and depression are close bedfellows. This is the reason I'm keeping this topic.
            "The dumbest of people are the first to tell you."annodeMy Music
            Check out my ambient radio show list @ recommended listening

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            • #7
              Originally posted by annode View Post
              edited:

              I have some theories concerning what it is doing to the mind. That's all rather complicated, but I am educated in this field and can talk about it.
              If this subject picks up interest, I'll get into all that.
              I'd be interested in hearing, but don't know enough to give equally back.

              Comment


              • #8
                Originally posted by aoVI View Post

                I'd be interested in hearing, but don't know enough to give equally back.
                I see your interested Bill, but that's not the conversation I was suggesting/hoping for.
                The drug does some very unique things. It separates the sense of one's self from other parts of the mind while the drug is in your system doing it's thing.
                Jung and Freud wrote about structures of the mind which in theory made for good intellectual thought. But in clinical practice had little use aside from old school Neo-psychoanalysis.
                This drug opens new inroads into the formation and treatment of the broken mind unlike the standard anti depressant has.
                The drug somehow disconnects fearful unconscious memories hardwired to stress mediating structures and circuits like the amygdala. PSTD symptoms fall away. New stressors don't get acted on. Volition is restored in those who find themselves blocked from action. Doing simple everyday things can feel impossible to start or finish. The blocks appear to be fear related.
                Those are just a few items. This drug opens up many new conversations. I just read a study where the quality of the side effect of de-personalization was directly related to it's anti depressive effect. So, how does having the experience of mind and body separation leave one with a better sense of one's self and with affective reparation?

                I'm no researcher...obviously...I'm just someone who has studied various subjects that happen to be related to the various actions of this drug.
                I'm reading about it mainly because I am looking to one day try it. So far, in my area, it's too new and providers are just starting to learn how to bring it into their practices.
                Off label providers exist, but are very expensive...too much for my wallet.
                So, have I started a conversation?

                EDIT - I just found a Dr. who provides insurance covered treatments in my state! Now to contact my insurance company to see if they are on board with this.
                Last edited by annode; 04-08-2019, 10:10 AM.
                "The dumbest of people are the first to tell you."annodeMy Music
                Check out my ambient radio show list @ recommended listening

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                • #9
                  Best of luck with your insurance plan Barry! Keeping fingers crossed for you.

                  Comment


                  • #10
                    Sounds like it may broadly share some claims with LSD and other psychedelics, which I may have some experience with back in the day. Beyond the obvious joy and fun of the experience, there were lasting effects that I still feel were highly beneficial to me and my view of life. I often found it useful to take apart the structures/beliefs/assumptions I had built in my head.

                    Didn't make me wise, but certainly more peaceful, compassionate, and contented.

                    What you speak of sounds more controlled than a bunch of 20-somethings bending their heads, please don't think I am mistaking that situation as being the same as yours.


                    general disclaimer to any reader: Your mileage will most likely vary, and in no way take the above as an endorsement of chemical experimentation or a statement of anything other than my own experience. There are plenty of ways to peel your onion.

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                    • #11
                      Originally posted by windspace View Post
                      Best of luck with your insurance plan Barry! Keeping fingers crossed for you.
                      Thanks windspace, I do feel I'm having to depend on luck more then I would naturally.
                      The pharmaceutical company has a service for this treatment who is helping me with all the logistics between the doctors and insurance co. So that's pretty cool!
                      I made an appointment with my primary care doc in order for him to fill out some forms needed by the pharm service. Then they send those forms to be completed by the doc who will be providing the treatments. Then the pharm service connects with my insurance co. The insurance co. will decide whether they want to start an 'Authorization'. If so, one of the doctors will submit whatever information about my medical history they require to be examined and then my request for treatment will be approved or denied. If denied, I can do this Auth process over until I meet the requirements. ( I have all the necessary background and can prove it, so I'm not worried about this if they do an Auth.)
                      They my not ask for an Auth and just give the approval. I have never asked the insur. co.for psychiatric compensation before, so I am expecting they'll want an Auth. Once I submit the data to them it takes a few days for them to decide and return a decision.

                      This Auth process is common in the US. If a doctor asks for radiology imaging , for example, it would go the same route. The doc needs to 'petition' the insurance co..
                      (I wrote all this out for anyone who might benefit)
                      "The dumbest of people are the first to tell you."annodeMy Music
                      Check out my ambient radio show list @ recommended listening

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                      • #12
                        Sounds like it may broadly share some claims with LSD and other psychedelics, which I may have some experience with back in the day. Beyond the obvious joy and fun of the experience, there were lasting effects that I still feel were highly beneficial to me and my view of life. I often found it useful to take apart the structures/beliefs/assumptions I had built in my head.
                        Yeah, haha...I used to trip on acid almost each weekend when I was in my late teens. I tripped at every hockey rink concert. (ELP, Crimson,Humble Pie, on and on...) Ketamine as is with the psychedelics shares a component of dissociation. The separation from ego self. Ketamine takes this and runs away with it. So much so that you (can) leave your own body and not know who you are anymore. Believe me, I am NOT interesting in psychonautics anymore. I am way to old to do shit like that. I was too old for that by my mid 20's haha.
                        I am afraid of having a panic attack, so I will also be using benzos in the mix. No, I am not at all comfortable about this experience. I can handle the 'altered consciousness' part of it, I have plenty of experience with that...it's that your alone into yourself as you let your 'self' dissolve and disappear that frightens me. I was actually thinking of obtaining the drug black market and doing it myself, alone...which is really fucking scary. I'm REAL happy I don't need to do that! I will also (I guess) be taking the lower of two possible doses the first treatment day. The the next day dose is higher.

                        Yeah, I really used to love tripping with all my buddies, whether at someones home or at concerts. Knowing you were going to lose some ego control for a few hrs made me feel apprehensive just before taking the dose.You remember that feeling don't you Bill? I expect a lovely nurse will be sitting with me while I fade away.
                        Here they are(looking at her pix...she looks rather sinister doesn't she?Shit.)

                        Treatment room - I can see a bit of what sorta looks like a comfy chair. (BTW, did I say patients sit in that chair for about two hrs?)

                        d0924899-e26c-4247-9a89-d40fa7bb1f5bzoom.jpg
                        Last edited by annode; 04-05-2019, 10:42 AM.
                        "The dumbest of people are the first to tell you."annodeMy Music
                        Check out my ambient radio show list @ recommended listening

                        Comment


                        • #13
                          annode Are we talking about clinical trials here? I heard they were open in my state. Been hearing a little 'buzz' about ketamine, and wonder how it compares to DMT.. which, I guess, is arrived at in a couple of different ways.

                          Back in the day, before the formation of the DEA, when LSD was not illegal, the universities were doing clinical trials to see how it could benefit patients with mental problems. There have been a few modifications since then, with designer drugs like MDMA, which I tried a couple of times. To me it was like a combination of acid and coke high, and yes, it made you love everyone, at least for a while.

                          I know what it's like to feel like you are going to 'lose' yourself- in my case it was when I was too high on acid- which was pretty much what made me stop doing it years ago- the little 'ego' getting lost in all that immensity, and feeling like it will never 'come back'.. Sort of makes you think, though. Where did we come from in the first place, and if we 'lost' ourselves, how do we know that we wouldn't come back? Were we here for a reason, or was this all just some cosmic 'accident'? As someone who has made use of chemicals a fair bit, even I know that drugs like these are really only 'stop-gaps' that treat symptoms and don't really deal with root causes. They don't 'heal' you- at best, they can only put you face to face with your demons so you can deal with them yourself. Part of the process of healing is acknowledging your pain, accepting what is, and then letting go.. We are all afraid of something, and that tends to make us act out in ways we don't view as acceptable. I used to go through periods of black depression when I was in my 20s, and I suffered from it for years myself. I have realised over the years and with my experiences that there is really no substitute for just taking good care of yourself- including good dietary choices, and generally good choices when it comes to your health. Despite it sounding like a cliche, your body IS your temple, and whatever you put into it not only affects your well-being, but it can affect your overall mood. If you had a hole in the roof of your house and developed a leak, you would either call a carpenter and have them come fix it, or you would do it yourself if you knew how. Why is your body any different? By all means, if the ketamine trials help, go for it- but they will only take you so far. The rest you have to do for yourself.
                          https://metapop.com/sonic-bodhi
                          https://www.youtube.com/user/SonicBodhi1
                          https://sonicbodhi.bandcamp.com/
                          https://hearthis.at/sonic-bodhi-iw/

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                          • #14
                            The trials to gain FDA approval are over. It is a real pharmaceutical medication as of March 5th I think.
                            It has little to do with LSD and similar psychedelics other then it also being a dissociative drug. There is plenty to read on that. My dosing will be considered mild compared to recreational users. The indication for Spravato so far, is just for 'treatment resistant depression' (when antidepressant drugs don't work for you).
                            A bad diet is never good for anyone. Removing stress, as much as one can, from life, is the #1 best secondary treatment for any type of dodgy mental health.
                            Part of the process of healing is acknowledging your pain, accepting what is, and then letting go.. We are all afraid of something, and that tends to make us act out in ways we don't view as acceptable.
                            I don't 'act out'. I can be pretty damn irritable, but no, I don't get the compound stuff some ppl get concomitantly. Some ppl cause collateral damage to ppl around them when they are ill, luckily I have not hurt other ppl. I always had girlfriends but never married because I didn't want to drag those who I loved into my shortcomings. Having children, for me, was not in my cards...and I'm cool with that...I knew ppl who struggled with some form of mental illness and also had kids...and the hurt carries on to them. I have no regrets in those areas.

                            I'm happy to hear all your black depressions in your 20s could not compete with a good diet and taking care of yourself. Everyone has a story or two. Some ppl are more resilient then others.
                            "The dumbest of people are the first to tell you."annodeMy Music
                            Check out my ambient radio show list @ recommended listening

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                            • #15
                              Considering this subject, I thought I'd share this cool article with you.
                              The web site is pretty cool too. Maybe I'll create some super spacey ambient to share as I have treatments?
                              https://prohbtd.com/i-tried-clinical-ketamine-therapy
                              "The dumbest of people are the first to tell you."annodeMy Music
                              Check out my ambient radio show list @ recommended listening

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