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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Clearskies on April 25, 2019, at 20:22:34
Hi, I started using the Ketamine nasal spray yesterday. I felt positive effects within 15 minutes of application. Today I am tired but much more functional and productive than Id been previously.
Im keeping a mood journal for this meds trial as its so utterly different from anything else I have been on. My existing drug regimen was not changed. The delivery is five sprays into the nose, alternating nostrils. Repeat every three days.
Is there anyone else using this currently?
Clearskies
Posted by Ruuudy on April 25, 2019, at 23:17:59
In reply to Ketamine nasal spray, posted by Clearskies on April 25, 2019, at 20:22:34
Howdy ClearSkies,
Hope the skies only get clearer & clearer!!!Please do keep us looped into your progress - I, for one, am very interested!
My doctor is listed as a soon-to-be-participating provider of the ketamine sprays.Are you in the United States?
Take care,
Rudy> Hi, I started using the Ketamine nasal spray yesterday. I felt positive effects within 15 minutes of application. Today I am tired but much more functional and productive than Id been previously.
>
> Im keeping a mood journal for this meds trial as its so utterly different from anything else I have been on. My existing drug regimen was not changed. The delivery is five sprays into the nose, alternating nostrils. Repeat every three days.
>
> Is there anyone else using this currently?
> Clearskies
Posted by Clearskies on April 25, 2019, at 23:52:14
In reply to Re: Ketamine nasal spray » Clearskies, posted by Ruuudy on April 25, 2019, at 23:17:59
> Howdy ClearSkies,
> Hope the skies only get clearer & clearer!!!
>
> Please do keep us looped into your progress - I, for one, am very interested!
> My doctor is listed as a soon-to-be-participating provider of the ketamine sprays.
>
> Are you in the United States?
>Yes. Washington state, on the west coast. I was starting to feel particularly crappy, so I asked my doctor about availability. I believe at the price I paid that it will be an affordable med.
Ill post updates periodically.
Nice to meet you!
> Take care,
> Rudy
>
>
>
Posted by SLS on April 26, 2019, at 7:22:09
In reply to Ketamine nasal spray, posted by Clearskies on April 25, 2019, at 20:22:34
> Hi, I started using the Ketamine nasal spray yesterday. I felt positive effects within 15 minutes of application. Today I am tired but much more functional and productive than Id been previously.
>
> Im keeping a mood journal for this meds trial as its so utterly different from anything else I have been on. My existing drug regimen was not changed. The delivery is five sprays into the nose, alternating nostrils. Repeat every three days.
>
> Is there anyone else using this currently?
> ClearskiesI wish you the best of luck.
What is the concentration of the ketamine solution? Did you experience any strange or dissociative feelings immediately after dosing?
- Scott
Posted by Roslynn on April 26, 2019, at 14:05:12
In reply to Ketamine nasal spray, posted by Clearskies on April 25, 2019, at 20:22:34
I'm wondering if it is covered by insurance? Are you using the Spravato?
Can you tell me how you accessed the treatment?
Sorry for so many questions.
Thank you,
Roslynn
Posted by Clearskies on April 26, 2019, at 15:09:13
In reply to Re: Ketamine nasal spray » Clearskies, posted by SLS on April 26, 2019, at 7:22:09
>
> I wish you the best of luck.
>
> What is the concentration of the ketamine solution? Did you experience any strange or dissociative feelings immediately after dosing?
>
>
> - Scott
>
>Hello Scott, I hope you are doing well.
The solution is 100mg/ml (which sounds rather concentrated to me, but then I failed to properly learn the metric system). I didnt feel disassociated, but rather some profound fatigue, not to be confused with sleepiness. I note this because its recommended to take the dose at bedtime. However, since it was the first ever time I had tried it, I took it during the day to ensure that I could get help if I needed it, i.e., my doctors office would be open. From here on in Ill be taking it at night.I felt quite able to concentrate on tasks and it cleared up my depressive brain fog. No effect on my short term memory issues, good nor bad. This is my third day and I continue to feel good...I am so distrustful of trying any new medication that I doubt a placebo effect is possible.
Nancy
Posted by Clearskies on April 26, 2019, at 15:19:22
In reply to Re: Ketamine nasal spray, posted by Roslynn on April 26, 2019, at 14:05:12
> I'm wondering if it is covered by insurance? Are you using the Spravato?
>I dont know what Spravato is.
I had the scrip filled at the compounding pharmacy my doctor recommended. This wasnt covered by insurance, but the cost, at $50, is a bargain compared to my last treatment of TMS, which wore off quickly after the treatment ended. The sticker says its 15 doses of medication, so it should last me about 45 days.I had been feeling particularly bad (incessant crying, some ideation, apathetic about everything, negligible self care) so Id gone to see my pdoc for a consult. I asked her if she had any patients using this treatment and asked what the results were looking like. Mixed, was the answer I got, which is about what any med I have ever been on has been. Im a skeptic.
Seeing that this is the newest thing to come down the pike in 11 years or so, Id never forgive myself if I didnt try it.
Nancy
> Can you tell me how you accessed the treatment?
>
> Sorry for so many questions.
>
> Thank you,
> Roslynn
Posted by PeterMartin on April 26, 2019, at 23:00:07
In reply to Re: Ketamine nasal spray » Roslynn, posted by Clearskies on April 26, 2019, at 15:19:22
Wow sounds like you have a good doctor. I don't think the new FDA approved "Ketamine nasal spray" (called Spavato) is allowed to be used outside of a doctors office. Plus the cost is 500 to 800 per treatment based on a google search.
Sounds like your doctor did something offlabel for you.
Highly doubt my doctor would go that route so I'm very jealous. Good luck!!
Posted by Clearskies on April 27, 2019, at 2:14:03
In reply to Re: Ketamine nasal spray, posted by PeterMartin on April 26, 2019, at 23:00:07
> Wow sounds like you have a good doctor. I don't think the new FDA approved "Ketamine nasal spray" (called Spavato) is allowed to be used outside of a doctors office. Plus the cost is 500 to 800 per treatment based on a google search.
>
> Sounds like your doctor did something offlabel for you.
>
> Highly doubt my doctor would go that route so I'm very jealous. Good luck!!
I had no idea at all. Wow.
Posted by Ruuudy on April 28, 2019, at 14:27:31
In reply to Re: Ketamine nasal spray » PeterMartin, posted by Clearskies on April 27, 2019, at 2:14:03
My awesome psychiatrist here in Central Florida is listed as a Spravto-providing doctor, and I will be visiting with him this week - I'll post what I learn from him.
He doesn't mess with taking insurance, so it will be interesting to see if he has a clever way of gaining some reimbursement from your insurance company.Rudy
> I don't think the new FDA approved "Ketamine nasal spray" (called Spavato) is allowed to be used outside of a doctors office. Plus the cost is 500 to 800 per treatment based on a google search.
> >
Posted by Clearskies on April 28, 2019, at 16:04:56
In reply to Re: Ketamine nasal spray, posted by Ruuudy on April 28, 2019, at 14:27:31
> My awesome psychiatrist here in Central Florida is listed as a Spravto-providing doctor, and I will be visiting with him this week - I'll post what I learn from him.
> He doesn't mess with taking insurance, so it will be interesting to see if he has a clever way of gaining some reimbursement from your insurance company.
>
> Rudy
>
> > I don't think the new FDA approved "Ketamine nasal spray" (called Spavato) is allowed to be used outside of a doctors office. Plus the cost is 500 to 800 per treatment based on a google search.
> > >
>I guess my compounded spray is the generic drug? I was sent to the specific pharmacy to get it made. I dont understand the cost discrepancy, unless the treatment is an initial course of infusions in the doctors office, followed by home treatments with the spray.
Puzzled.
CS
Posted by Roslynn on April 28, 2019, at 16:32:25
In reply to Re: Ketamine nasal spray » Ruuudy, posted by Clearskies on April 28, 2019, at 16:04:56
Does anyone know how the generic compounded version differs from Spravato in efficacy or active ingrediants?
Posted by TH on April 28, 2019, at 17:50:27
In reply to Re: Ketamine nasal spray, posted by Roslynn on April 28, 2019, at 16:32:25
> Does anyone know how the generic compounded version differs from Spravato in efficacy or active ingrediants?
We haven't heard exactly what was in the generic version from above, but as for "Spravato":
"Each device delivers two sprays with a total of 32.3 mg of esketamine hydrochloride (equivalent to 28 mg of esketamine) in 0.2 mL of a clear, colorless aqueous solution with a pH of 4.5. The inactive ingredients are citric acid monohydrate, edetate disodium, sodium hydroxide, and water for injection."
The edetate disodium seems to be added with the aim of preventing sinus infections, but maybe someone else will know better. I suppose the citric acid is added to maintain the low PH, but whether this is as a preservative or helps with absorption, I couldn't say.
Posted by Roslynn on April 29, 2019, at 15:05:06
In reply to Re: Ketamine nasal spray, posted by TH on April 28, 2019, at 17:50:27
Posted by Roslynn on April 29, 2019, at 15:09:13
In reply to Re: Ketamine nasal spray » Ruuudy, posted by Clearskies on April 28, 2019, at 16:04:56
Dear Clearskies,
If you don't mind, if there's any way you could let us know how the treatment goes for you I would greatly appreciate it :)
I cannot afford the infusions nor the Spravato, so getting the generic in a compounded nasal spray version might be the only was I can access it.
Thank you very much!
Roslynn
Posted by Clearskies on April 29, 2019, at 17:33:19
In reply to Re: Ketamine nasal spray, posted by Roslynn on April 29, 2019, at 15:09:13
> Dear Clearskies,
>
> If you don't mind, if there's any way you could let us know how the treatment goes for you I would greatly appreciate it :)
>
> I cannot afford the infusions nor the Spravato, so getting the generic in a compounded nasal spray version might be the only was I can access it.
>
> Thank you very much!
>
> RoslynnI am keeping a mood journal and will share how Im doing at the 4, 6, and 8 week marks. Im in the same boat as far as affordability.
Nancy
Posted by Roslynn on April 29, 2019, at 18:11:39
In reply to Re: Ketamine nasal spray » Roslynn, posted by Clearskies on April 29, 2019, at 17:33:19
> I am keeping a mood journal and will share how Im doing at the 4, 6, and 8 week marks. Im in the same boat as far as affordability.
> Nancy
>
Thank you so much!! Was also wondering if you have a research-oriented doc and is that how they knew how to order the generic compounded? My doc is pretty basic, not sure if he would know about this, but I'm quickly running out of options.Thank you again,
Roslynn
>
Posted by Clearskies on May 2, 2019, at 16:44:40
In reply to Re: Ketamine nasal spray, posted by Roslynn on April 29, 2019, at 18:11:39
>
>
> Thank you so much!! Was also wondering if you have a research-oriented doc and is that how they knew how to order the generic compounded? My doc is pretty basic, not sure if he would know about this, but I'm quickly running out of options.
>
> Thank you again,
> Roslynn
> >
>
I see a nurse practitioner for my psych meds within a psychiatric practice - I dont have to have any consultation with the doctor. I cant say one way or another whether shes research oriented...I was the one who asked about even trying ketamine, she had never brought it up. She always has her reference book at hand to look up meds. TBH I dont have the greatest confidence but I live in an area with a paucity of mental health providers. I took the best I could find. Im just happy that she is amenable to my ideas or suggestions.Mostly I just sit at the appointments and cry, and she pushes tissues at me.
Posted by Roslynn on May 3, 2019, at 13:57:17
In reply to Re: Ketamine nasal spray » Roslynn, posted by Clearskies on May 2, 2019, at 16:44:40
> > >
> >
> I see a nurse practitioner for my psych meds within a psychiatric practice - I dont have to have any consultation with the doctor. I cant say one way or another whether shes research oriented...I was the one who asked about even trying ketamine, she had never brought it up. She always has her reference book at hand to look up meds. TBH I dont have the greatest confidence but I live in an area with a paucity of mental health providers. I took the best I could find. Im just happy that she is amenable to my ideas or suggestions.
>
> Mostly I just sit at the appointments and cry, and she pushes tissues at me.
>Thanks very much for letting me know how you obtained the prescription.
It's hard to find good docs these days.
I can relate to the sitting and crying at the appointments!
Best,
Roslynn
This is the end of the thread.
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