The therapy paradigm you describe here (going to a clinic to receive Spravato), is, as you point out, difficult and bureaucratic.
Through a regulatory loophole, there’s another pathway where you can get ketamine sent to your house with less bureaucracy. https://www.mindbloom.com/ is the main provider I know of. They’re very expensive, but in theory this could be done for cheap and maybe other providers are doing it, I don’t know. If you have a cooperative psychiatrist, you can see if they know about this version and are willing to prescribe it.
As you point out, ketamine lasts a few weeks and then some people will crash back to their previous level of depression. If I am able to successfully treat a patient with ketamine, I usually recommend they continue it for six months, just like any other antidepressant. A cooperative doctor can do this by prescribing it to a cooperative compounding pharmacy. I don’t know if Mindbloom or other companies provide this service by default. Obviously this is easier when you’re doing the version in your house than if you have to go to a clinic each time.
Thanks for this perspective.
The therapy paradigm you describe here (going to a clinic to receive Spravato), is, as you point out, difficult and bureaucratic.
Through a regulatory loophole, there’s another pathway where you can get ketamine sent to your house with less bureaucracy. https://www.mindbloom.com/ is the main provider I know of. They’re very expensive, but in theory this could be done for cheap and maybe other providers are doing it, I don’t know. If you have a cooperative psychiatrist, you can see if they know about this version and are willing to prescribe it.
As you point out, ketamine lasts a few weeks and then some people will crash back to their previous level of depression. If I am able to successfully treat a patient with ketamine, I usually recommend they continue it for six months, just like any other antidepressant. A cooperative doctor can do this by prescribing it to a cooperative compounding pharmacy. I don’t know if Mindbloom or other companies provide this service by default. Obviously this is easier when you’re doing the version in your house than if you have to go to a clinic each time.
I’ve written more of my thoughts about ketamine at https://lorienpsych.com/2021/11/02/ketamine/