Ketamine is Complicated

Here’s an update about Ketamine.

The good news is that the Ketamine works brilliantly to pull me out of depression – it happens within about an hour if I take the Ketamine in injectable form. The bad news is that my doctor (general practitioner / GP, not psychiatrist) believes that the Ketamine dose I took is causing high blood pressure.

Actually, it’s worse than even that. We both are worried that the Ketamine didn’t just raise my blood pressure, but it is keeping it in a possibly long term elevated state – even after the drug should have flushed from my body. There is a fear that each time I take the Ketamine again, my blood pressure will ratchet up to an even higher value. Obviously not a good thing.

(My blood pressure figures were 125/89 on 25 Sep 12. I took 20 mg Ketamine injected at 3.50 pm on 15 Oct 12. Blood pressure was 165/112 at 10.30 am on 16 Oct 12, about 20 hours after taking Ketamine. At about 3 pm on 16 Oct 12, my blood pressure was 137/102 and has remained around 137/95  since then to date. Basically it’s up and it’s not coming down.)

And it’s not just the blood pressure that my doctor is worried about. Ketamine potentially causes tachycardia (fast heart rate), so when I take it, I may be putting myself at risk for heart related damage. Between the spiking high blood pressure and the tachycardia, there is some possibility I may give myself a stroke or a heart attack when I take Ketamine.

This is also the additional small detail that men in my family have a well established history of dying from heart attacks. Some in their forties. You know, around my age.

As you can imagine, my doctor has understandably not been keen on me ever taking the Ketamine again.

I, on the other hand, think that Ketamine is the most promising drug I have ever tried for depression. In fact, it’s the only drug I have ever tried that has been able to pull me out of depression. So I’m understandably not keen on abandoning Ketamine.

I leave you to imagine the discussion that then ensued between me and my doctor.

We finally hammered out a compromise. My doctor (GP) has said that I have to get an okay from my psychiatrist that I should be allowed to try the Ketamine. And that the next time I take Ketamine, I have to do it under monitored conditions – in a hospital with a doctor supervising. We also agreed that I should get a heart Stress Test check done and to also get our plan of action greenlighted by my cardiologist as well. I also had to agree not to take any more Ketamine until the test was done (grumble).

Setting up meeting with my psychiatrist and my cardiologist is going to take some time. And of course we have to schedule the monitored test as well. I’m not expecting this to be all organised until mid-November.

It might sound as if I am jumping through lots of hoops that my doctor has demanded. But it’s not so straightforward. For all my fascination with Ketamine’s action on my depression, I’m not at all keen on the increase in my blood pressure. And I think it would be thoroughly ironic if I managed to finally sort out my depression only to have a stroke or something. Checking to see what happens in detail when I take the Ketamine sounds really good to me too.

So both my doctor and myself agree that being safe is the best next step.

Right.

My story so far are the facts, not the thinking behind the facts. My experience with the Ketamine has reminded me how complicated dealing with depression and drugs are, and how difficult it can be to make the best choice on what to do next. In my next post I’ll talk more about the dilemma and complications that Ketamine is posing for me, or for anyone taking medications for depression.

Meanwhile, we’ll see what happens in mid-November.

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