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 know of at least one telehealth service that reportedly has a pretty low bar for writing a ketamine prescription. My understanding is that everyonesmd.com is fully legit and a month’s supply of ketamine costs less than one dose from Mindbloom. Now, on the other hand, some people probably shouldn’t turn themselves loose with a month’s worth of a mind-altering drug to be used ad lib—but if you have a promising regimen in mind, and the medical system isn’t delivering, this could be a big deal.
(everyonesmd.com looks VERY sketchy but based on online reviews and a report from someone I know personally, they do provide a telehealth appointment that can result in a valid prescription. I don’t know if I would trust their drug suppliers but if you talk to customer service, instead of going through their checkout process, they are required to transfer your prescription to a reputable compounding pharmacy of your choice).
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/
I know of at least one telehealth service that reportedly has a pretty low bar for writing a ketamine prescription. My understanding is that everyonesmd.com is fully legit and a month’s supply of ketamine costs less than one dose from Mindbloom. Now, on the other hand, some people probably shouldn’t turn themselves loose with a month’s worth of a mind-altering drug to be used ad lib—but if you have a promising regimen in mind, and the medical system isn’t delivering, this could be a big deal.
(everyonesmd.com looks VERY sketchy but based on online reviews and a report from someone I know personally, they do provide a telehealth appointment that can result in a valid prescription. I don’t know if I would trust their drug suppliers but if you talk to customer service, instead of going through their checkout process, they are required to transfer your prescription to a reputable compounding pharmacy of your choice).