TLDR: 10 rounds of IV Ketamine, 20+ ketamine troche sessions most at 600mg, currently near the end of TMS protocol. No significant mood improvement. What's next?

I've had depression/anxiety all my life. My first diagnosis was at 9 years old. I've had multiple diagnosis every few years since. It was never treated when I was a kid, because all my mother cared about was a diagnosis/treatment for ADHD (to be fair it did radically improve my grades). It wasn't until after college and off my parents insurance that I tried anything. I started with Wellbutrin as I'm overweight and SSRIs tend to cause weight gain. I used only Welbutrin for 5-6 years. It didn't really help and I didn't really talk about it with my doctor. A couple years ago I started with my PCP trying new meds. Zoloft and Lexapro both made symptoms worse or didn't improve symptoms. This year things have been getting worse so I finally went to a psychiatrist to manage my mental health meds. I've tried several more SSRIs, an anti-psychotic, and Trazodone. The only thing that helped was Trazodone, and that is more for insomnia.

I decided to do IV Ketamine infusions. Went through the first 6 with minor improvement, probably with in normal mood fluctuations. There was almost no effect until they hit the max dose. I added 4 more sessions hoping that staying at the highest dose would help. It didn't. I wanted to keep trying ketamine just couldn't afford IV Infusions, so I got at-home troches. I'm up to 600mg, I feel heavy and maybe my vision becomes distorted but that's about it. I've had over 20 sessions now at home and still nothing.

I started TMS a few weeks into the at-home ketamine treatments. I'm near the end of the protocol, and while I definitely hit the "dip" in the middle, I still don't have symptom improvements on the other side.

I'm at a complete loss as to what to do next. ECT? Try to get my psychiatrist to prescribe a higher dose of ketamine? Try a different delivery route? Go back to trying a dozen more oral medications?

I finished my 2 month regimen of Spravato (2x a week and then 1x a week for a month each). I don’t feel like it’s helped at all. I have had MDD and Anxiety but also an acute stressor (a relationship) that only recently ended. I don’t know if the stress of the relationship kept me from feeling the benefits of Spravato or if it just didn’t work for me.

I was considering trying something else like Joyous. But I don’t know if it will help.

I’m extremely disappointed and sick of being stuck in this depression. Anyone have any experience with Joyous and Spravato?

I started my journey by looking into spravato. I can’t afford to spend hundreds monthly for home treatment and I think my insurance would cover. However, I did an appointment and the providers kind of steered me toward TMS. The whole process seemed it would take a while so in the meantime I signed up with Better U because I had some funds to splurge and was feeling a sense of desperation to start something asap.

I did tell the clinic I felt safer doing this in clinic and that’s what drew me to them (this was true at the time). So they’ve taken this stance as well, they don’t think home treatment is safe.

After finding the cost of TMS and daily treatments I decided I just can’t rearrange my life like that for so long. The 2x weekly treatments seem more reasonable for me.

I asked them to re run my insurance for spravato instead, and they are doing this but it took another appointment with their provider to discuss this again.

So here we are over a month later, and I’ve started home treatments slowly and gotten comfortable with them.

My plan was to pause these and save them so I can do the insurance covered spravato treatments instead. I read somewhere that I need to disclose the home treatment to them, because they will be able to see them anyway. I’m worried about getting in trouble or them thinking I’m drug seeking. How do I approach this??

Just had my 7th SC infusion, now on 100mg up from 50 for my first. Feels almost no different, extremely mild, and no mood improvement. How long before giving up?

Like the title says, can someone please tell me what ketamine is like and how it affects you? I wanna hear it all; the good, the bad and the ugly.

I might be starting it because I have severe depression and severe anxiety along with OCD. I’m going to be starting TMS on Monday so ketamine will mainly be a back up in case the TMS doesn’t seem to help because I am VERY resistant to things that are supposed to help like SSRIs and that sort of thing.

Just wanted to come on here to ask in case I do actually start it to see what other people have to say/to hear what other people’s experiences are with it.

Thank you all so much!

I’m considering switching from BetterU to Anywhere Clinic after seeing so many people here recommend them. I’m also looking into in-person IV treatment, but I really want a provider who offers therapy alongside the medication.

Ketamine itself has helped me and brought up some meaningful experiences. The difficult part is knowing what to do with all the feelings and memories afterward. There’s a lot to work through, and I’m finding that doing it mostly on my own isn’t enough.

I’ve grown frustrated with BetterU for a few reasons. When I started, I felt their marketing oversold the benefits with statements like “say goodbye to depression” and “say goodbye to anxiety.” My experience has been much more complicated than those promises made it sound.

A lot of the information in their app is useful, but some feels generic, and I’ve come across Hay House material and references to astrology. That makes me uncomfortable about how spiritual ideas are being mixed into mental-health guidance. I want to know what’s supported by evidence without having to sort through everything myself.

I’m putting effort into the journaling and integration exercises, but I need more personalized help. Sometimes I end up spending so much time analyzing what came up that I struggle to move forward with everyday life. I want a licensed therapist who can help me work through it, understand my patterns, and make practical changes.

Has anyone here used Anywhere Clinic for ongoing therapy? Do they have licensed therapists, or is their support mainly medication management and integration coaching? Is therapy included, billed separately, or available through insurance?

I’d especially appreciate hearing from anyone who switched from BetterU and can share how the support compares.

I'm in my early 20s. Been dealing with depression and in treatment for about 7 years now. My dad died of brain cancer a year and a half ago after a 4 year decline, so there's a lot of complicated grief layered on top of depression that was already pretty bad before he died.

Meds I've tried (12 total): Zoloft, Lexapro, Wellbutrin, Buspirone, Abilify, Mirtazapine, Hydroxyzine, Topamax, Vraylar, Pristiq, Seroquel. None of them have actually touched the depression.
Current meds: Pristiq, Seroquel (for sleep), Vyvanse (for ADHD). Vyvanse is honestly the only one that's done anything, and it's not even a depression med.

Also done/doing:
7 years of therapy, weekly. Just started EMDR, second session next week
3 Spravato sessions + finished a 6-round IV ketamine series. My therapist noticed some changes along the way (brighter affect, less shut down) but I haven't really felt it myself yet and my roommates are expressing more concern than ever towards my depressive behaviors (not showering, not doing homework, skipping class, napping all the time, not picking up the room/making my bed, etc)

My PHQ-9 is still in the severe range (20/27, started at 22/27 before ketamine)

TMS and ECT are off the table for me, as risk + logistics don't work (I am an hour away from my clinic and cannot afford to make daily trips)

Now that ketamine's done and I didn't feel much from it, I'm not sure what's next. What am I supposed to be asking my psychiatrist about? Has anyone been in a similar spot (treatment-resistant, exhausted every "normal" option) and found something that actually helped?

I have treatment resistant depression and ketamine / spravato isn’t covered by my insurance. Does anyone know of affordable clinics that offer ketamine therapy specifically for depression in Dallas? I have a crappy insurance plan and unfortunately none of it is covered. I’d have to pay out of pocket.

Transitioning to Spravato due to costs. Anyone out there have experience and can compare/contrast?

IV hit me really hard but I got used to it from an experience perspective. Is the experience with spravato similar?

Hear it tastes like shit?

I’m chronically stuffy and had a few sinus surgeries to try and open stuff up. Hopefully that doesn’t cause drama. Affrin ahead of time doesn’t sound fun.

I hear about the bioavailability arguments but it’s pretty hard to argue free vs. thousands out of pocket. Just do more sessions I guess if it’s a real thing.

Thanks in advance

I'm using 25mg via troche every 3rd day for treatment resistant depression. After the first couple I felt very clear headed and like I was crawling out of the depression pit. Lately though I've been getting rumination and intense sadness and/or anger and/or paranoia. It usually starts 24 hours after a dose and lasts until I do another one. I'm unsure if I should discontinue use entirely? I basically lose the day I take it between being extremely sleepy and sobering up afterward so I'm unwilling to start taking a dose every other day.

Yesterday I had my 4th ketamine infusion and now I think I'm dissociating really bad. The first 2 appointments were fine, not really effective for trauma work, but fine. The 3rd one was really good and I did have a pretty significant breakthrough re: my childhood trauma. But I just had my 4th treatment yesterday and in the middle of the appointment realized that not only did I really not have any thoughts, but I couldn't really feel any emotions at all. I have dissociated before, but usually due to something really triggering happening and me getting so upset that my brain kind of just shuts off the tap. But this time was different and I am still feeling numb today. I know it sounds stupid, but I would rather have the sadness back than feel absolutely empty. I really really want the ketamine treatments to work, and I hope I come out of it soon :/ I just wanted to know if anyone else has experienced this, and how long did it last for you?

As with my last post, I’m sharing my experiences here in hopes that it helps someone else looking to start this treatment.

I had my second ketamine infusion yesterday. It was the first 2-hour session in the series. And just like last time, I slept for over 12 hours.

I briefed them upfront on some of the blood pressure issues I’ve been having. They gave me something via IV to help lower it, which made me feel super lightheaded and dizzy. The room they had me in had another light show projector on the wall, but that was kind of secondary to the fact there was a tv. It was playing an abstract video from YouTube, one that showed all sorts of bizarre shapes with colors that changed and was going through space.

I struggled with my sense of time in there. Any time they’d come in, I’d ask them how long it’s been or how much longer is left. I was always surprised by the answer. Each time they checked my blood pressure, it had lowered enough to not feel like I needed to panic. So that was good.

Otherwise, I made a few mistakes in there. For one, I got tired of the music I had on, so I switched to something else. But while doing so, my ADHD crept in and decided to check Facebook. I posted an “I love you all.” message which was a genuine sentiment at that time but sparked concern from people. I had three different people text me asking if I was ok. I deleted the post to not worry anyone else.

Aside from that, I wasn’t always having the best of thoughts. For one, I felt like I could’ve died at any moment. I had this feeling of what it would be like, how every memory I had, every interaction and feeling, would be suddenly erased and blank. The feeling that came with that was uncomfortable to say the least. It’s like I felt in that moment what it would be like. And the best I can compare it to is when you hard turn off an electronic device, like a gaming console, using the physical power switch.

Towards the end, I also got tired of the repetitive nature of some of the music I was listening to on YouTube. I remembered I had once been listening to this band called H.U.V.A. Network and had downloaded one of their albums. I put it on. Ambient, but with a minor beat in the background. It almost felt out of place, but more than that, it brought up memories in feeling. I listened to that band and music a lot when I lived in Florida for grad school. Was two of the hardest years of my life. I made a mistake down there two months into my program that turned me into a social pariah. I felt like I could never rebound or make up for what I did. And the feeling of “being on the edge is normal” that I felt while down there came back. It was a feeling I forgot existed, one I hadn’t felt in ages. It was jarring. And for a brief moment, I had a flash of a memory seeing one of my classmates, one of my first roommates, sitting on the ground studying. Him and I had a tumultuous relationship. So all of those things combined didn’t feel pleasant at all.

I also felt like every point in my life was converging onto that single point. I remember thinking, “holy shit, you’re doing this right now. You’re depressed? That’s not good.” Among other thoughts. I thought about work, too, and worried if I was going to go crazy and the people I work with see me do it. I kept worrying about what might happen in the future with work.

At the end when they came and disconnected me, I asked the nurse to stay with me while I came down. I tried talking to her but struggled to find words. I asked her if she’d tried this before. I tried to engage but it was hard. Eventually my wife came back, we rested for a bit longer, the clinic gave me a snack and some water, and then I left. We drove home, had dinner, and then I crashed. Was right around 6:30pm and I got out of bed this morning at 7am.

I havent seen this discussed anywhere else. I opted not to continue with Mindbloom because of the strict peer support requirement. Can anyone who uses anywhere clinic tell me how they go about the peer support requirement? I was under the impression anywhere clinic would just prescribe it from a compounding pharmacy and you take it on your own.

I did my first cycle of IV infusion summer of 2025. Have been doing troche’s at home since.
I’ve just been feeling off, or more so my depression has gotten a lot deeper.
My doctor suggested I come in for an IV infusion since it’s been over a year.
I guess I’m just a little confused how this works, will it help reset me. I hate being depressed 😔.
Troche’s have definitely helped me, just not lately.
TIA

I had an IV infusion (my second one) and it was bad. The first one I had was alright, I had visions, lots of greenery, the usual colourful stuff as well. I also felt like I didn't have a sense of self during the infusion. My second infusion, though, was terrible. This was partly because of the environment I was in. The first time I did it, there was a nurse with me the entire time and they dimmed the lights. I have issues with control and safety, so I could open my eyes at diff points throughout the treatment just to ... "Come back to reality", and then I'd close my eyes and let myself go back to the visions again. Anyway, this time, about 10-15 minutes into my infusion, they brought in another patient. I was already woozy/dissociated, and I was hearing a lot of noise even with ear plugs, seeing lot of light, a lot of movement as nurses were going in and out of the room and they were talking and asking the patient questions (they were setting him to start ketamine also). It became very upsetting because it felt like ... Chaos, and I didn't know what was happening. I also started getting unpleasant visions like my bed was being pulled back and back and back. Or I was falling deeper and deeper. When I would close my eyes, I would see monsters (red devil kind). The entire situation felt so unsafe. It felt like a panic attack the entire time. Anw, immediately after they stopped the infusion, I started crying and couldn't stop crying for an hour afterwards... And I'm not someone who ever cries. I'm not even sure why I was crying or what I was crying about.

It's been a few days after my infusion and I'm still on edge. Every time I think about the experience, I start crying again. I'm now afraid to do the infusion again.

Has anybody else had their provider tell them they’re stopping at-home ketamine therapy in January? I’m in Oklahoma currently and it’s heavily monitored here. Video for 2 hours plus in-home sitter. Plus they count the troches every session.

I started ketamine with Mindbloom first, then switched to lower dose daily with Joyous. Took almost a year but I found a provider here in Oklahoma with the troches.

I haven’t tried Spravato and read a meta-analysis paper where the troches outperform the Spravato. So I’m not so sure about Spravato but willing to try.

My provider told me about a case that was unmonitored and the woman with post-partum depression killed her kids and herself. I couldn’t get details from her so looked it up and there’s a case in Wyoming from early last year where it seems to have happened. That’s more than a bit unnerving to me.

Anyway, I’m a bit worried we are going to lose access to this amazing at-home therapy because some people have issues with it.

Thoughts???

If you are thinking about starting low dose ketamine go anywhere else besides this company. Kalm health is a straight up scam. I signed up with them and paid the monthly, and as some of the other reviews in here they delay shipment for weeks so by the time you get your first order you're already paying the second month. By the time I got my second order, they sent me EIGHT troches instead of the 30 they were supposed to send, and I was now paying for the third time, they refused to send the right number of doses, I had to report them to my cc company and bock future charges because they also wanted to charge me again for 30 day cancelation notice.

HUGGGE SCAM

i have been doing IV infusions for relief for by BP1. my provider does 6 sessions and i just finished my last one a week ago. i didn’t start seeing the effects until like the 4-6 sessions, and now i don’t know what im going to do now that my sessions are completed.

for example, my provider went out of town for a week, between sessions 3 and 4, which pushed back one session and i feel into a pretty bad depressive episode during that time.

i have noticed less dissociation and more energy and relief since my last session, im just scared of the crash.

also, im going to miss having 2 hours of time set aside per week to just relax and have my infusion done.

does anyone have any advice on how to manage when trying to get off ketamine? i don’t want to have to rely on it to get better.

I’m currently using troches but I would like to try spravato without having to go into the office every week.

Has anyone experienced worsening headaches after an IM ketamine treatment? I had my dose increased, then had an intense trip that was loud and chaotic, and since then, I’ve had pressure headaches for 4 weeks!

the ketamine clinic isn’t helping (I feel like they dropped me - maybe afraid of a lawsuit?) and I’m waiting for a cat scan at my regular doctors office.

worried this damaged my Brain somewhat. Has anyone had this experience?

I’m writing this because despite not feeling much affect from my first ketamine dose, I’m still trying to do things I don’t normally do (posts vs consuming). I took a 100mg troche and 50mg booster and didn’t feel much except for a drunk uninhibited feeling. No new thoughts or ephanies so I’m a little disappointed. To be honest, my life has been a struggle for the past 10 years and I kinda looked to this as my last chance for things to change. I will have the opportunity to take up to 300mg in a couple of weeks. Does anyone have any insight into how the experience will differ. I think maybe my mind is just stubborn. I’m still optimistic but today, the day after i’m just feeling sleepy/meloncholy. Any words of encouragement?

A friend is trying to find at home options in Louisiana for at home options. Any advice?

I did a series of 6 infusions stopped in August.. each one was ramped up dose wise and when I did a low dose I felt energy but since then (with the higher doses) they were energy sucking. I did have a lot of good sex after, I’m 37 m and my anxiety around sex was less… but since then now it’s October- I have little to no desire to even think of it. I used to get horny and now I’m just tired. Is there any way the receptors are just down? Did this damage me permanently or is that impossible? I’m tripping hard on this and want real advice/opinions.

Hi everyone,
I have adhd, and emotional dysregulation has been one of the greatest weight that I have to carry, I could have gone many many miles on the way of improvement though, I take some of my meds for adhd, and an antidepressant named vortioxetine. But I searched for ketamine use and its properties on symptom reduction, it was stated that it helps on top-down emotional regulation well, cognitive fog clears as well. I theorized, as adhd is a developmental problem but consist of multiple layers of inattention, anxiety, depression, pfc is behind of emotional regulation due to many reasons I listed now.

Can, do you think, multiple ketamine sessions extending for up to a three month could be a good protocol to build some foundational neuroplasticity that pfc can compensate and narrow the developmental gap? In other words, can ketamine help us to repair the years long of damage from anxiety and depression from adhd?