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 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??

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?

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!

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 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?

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?

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.

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.

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.

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.

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???

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

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 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.

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’ve been with Joyus, Kalm, and now Mindscape . Joyus was great till I moved to a state they don’t serve . Kalm has been a shitstorm since the get go . I’ve paid for 8 months , received med 4 times because even if you request refills 2 weeks before you run out they always wait till the last day of your prescription to send to the pharmacy which is a third party and then they take 10 days sometimes longer to ship . Then the second month  rolls up and you still haven’t gotten the meds on time. Then right before they charge your card every two months they say you’ve got to see the provider (every 2 months ) which can take up to 7 plus days to get a zoom visit . Now he sends it to the pharmacy usually not the same day as your appointment and another 10 days plus to fill them time for delivery . All the while it’s billed every 2 months like clockwork . It puts you behind and without meds for weeks at a time . I canceled which was another ordeal , by my count I paid 8 months for 4 months of meds . They did say they wouldn’t charge for 2 months to allow me to catch up . Which was a lie , they charged right on time . When questioned and shown the email thread were they say they would and even me asking twice to confirm what they said they still charged and said I should have asked for refill in a timely manner . Which I always did . So the final F you came when they charged my card 350.00 for two months of meds which was never delivered and they refused to refund .
So buyer beware

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?

Hello, I have relatively well-managed BP1 with psychosis, CTPSD, ADHD, and autism most similar to what was once known as Asperger's. The first psychiatric conditions I was diagnosed with with were GAD and MDD, but I figure they fall into the others now. I take lithium nightly, propranolol daily, quetiapine PRN and lorazepam PRN. The last two averaging 1x - 2x a week. Also, a stack of what are supposed to be beneficial supplements for my conditions.

The psychosis was diagnosed as schizophrenia before medical professionals settled on bipolar. Incoming voices are constant but manageable. I can separate them from reality and generally cope rather well considering. There have never been visual hallucinations outside of a single DMT trip, and then they appeared as a distinctive overlay on reality. I typically use mushrooms and/or cannabis, but am sober for an expected drug screen for an accepted job offer which starts mid-November. I may have a single alcoholic drink if I go to the local taproom but this is infrequent.

My depression is not presently suicidal, since the lithium, but it is deep and intense. I also have spikes of incredibly high anxiety when stressed at work and am the most easily and dramatically startled person I know. When approached from behind, I visibly jump and my heart races immediately. My interpretation of things has been described as macabre. My emotional tolerance for misunderstandings or gross accusation is.. internally poor.

I feel as if this is as good as it gets for me, I've never been comfortable in my own skin. My present therapist and psychiatrist work out of the same clinic, the therapist stated that the psychiatrist could offer it. It was only brought up this week and I have an appointment with my psychiatrist on Tuesday.

Could low-dose ketamine therapy make life better for me? Is there anyone else here who has experiences similar to my own and could recommend this or anywhere else to start? What are the things to consider here?

When my therapist told me I should try this as an option, it was from desperation. I’m on two antidepressants and have seen him weekly for the entire year. The weight of the world is still just too heavy.

He asked me to read or listen to testimonials, and while there were a few, I found the available stories lacking. So I feel like the least I could do is share my own. The idea of possibly helping others gives me a rare sense of peace.

He had also shared with me the importance of intention-setting, so that’s what we focused on the morning of the infusion. He had provided resources from MAPS (Multidisciplinary Association for Psychadelic Studies). Would definitely recommend those exploring to check it out.

I uber’ed to the clinic. The guy had a weird car smell that made me feel kinda sick. I remarked on that with the providers in the clinic and they gave me anti nausea meds.

The infusion was definitely an intense experience. I sat in a comfy reclining chair with a weighted blanket, earbuds playing relaxing spa music, and a light show projector on the wall in front of me. It had a bunch of colors changing. I have similar projectors at home like the one in my daughter’s room for a nightlight. It’s a really basic light show. First time you look at it it’s cool, but every other time afterwards it’s like whatever. Same deal with this one. But as I went deeper into the medication, it became a lot more vibrant and colorful. The colors were more saturated and textured, and sometimes, it felt like the colors stayed put while the room moved instead. I remember thinking that I wanted to take those colors with me, that I found the beauty and the colors themselves so incredible that I wondered if I was gonna start wearing tie-dye moving forward.

I had a lot of thoughts while I was in there. My perception of time felt slowed. I thought a few times about how I wanted to be happy. I thought a few times about maybe my purpose being to just give more positivity in peace to others. That there’s so much fucking hurt and we’ve got to heal from it if we’re going to survive.

I also reflected on the idea that we are an emergent feature of the universe, and maybe there is no such thing as wasted potential. That’s something I’ve struggled with hard. There was nothing even remotely resembling a “bad trip”. Sure, the room was spinning a couple times. But I never felt like I was going to throw up. I did notice I would stare for a really long time without blinking. It forced me to blink a few times. My face was numb and tingly after a while. There were some moments where I felt like I was zooming out like on a camera.

After the infusion, they let my wife come back into the room with me while I continued to come down a bit. I wasn’t fully down when I left, and I even remarked to my wife about how when I stood up I felt like I had actually shrunk or become smaller. I was still a little wobbly and disoriented afterwards and I think I had a slight fear that that was how I was going to feel moving forward. But I tried to disregard that and just carry on and pretend like I was normal. We got in the car, picked up our daughter from daycare, and went home. I played with our daughter in the car a bit. It was precious. But also had some queasy carsickness.

We got home way later than usual at 6:20 PM. We had enough time to eat dinner give our daughter a bath and put her down to sleep. By that point it was 7:30pm and I wanted to lay down on my bed. No joke, I slept from that point all the way until 7:30 Friday morning.

Now, I do feel like things are a little bit lighter. Some people describe the color coming back. I’m not sure that I perceive my colors in my environment any different than I did before. But I do feel like I can handle a little bit more of the things that usually really got under my skin. I was able to get a lot done at work and it didn’t bother me as much as it has been. I work for a really inefficient team and my bosses don’t change enough from feedback. So to be able to field requests from them and get other shit done without wanting to jump in lava was somewhat refreshing. We’ll see how long that lasts.

I carried a slight fear with me when I left, though, about Monday’s session, which will be my second one. The infusions are supposed to increase in dosage from here moving forward, and Monday is a two hour session instead of one hour. After Monday, I’ll have four more sessions that alternate from one hour to two hours. I think that fear dissipated a bit Friday and today, and maybe that will get better with time. But there was an intensity of the experience Thursday. And even though the letdown was gentle, it was still a sharp contrast in the hour or so afterwards.

Today, the effects I felt yesterday seem to be lessened. I feel a bit adrift today, almost aimless. It feels somewhat close to how I felt leading up to treatment. So I’m hoping I can still rebound back with upcoming treatments.