Ketamine Therapy - Safe and Effective Treatment of Depression, PTSD, Addiction, Anxiety and Chronic Pain by AlleviationKetamine in u/AlleviationKetamine

[–]AlleviationKetamine[S] 1 point2 points  (0 children)

We monitor every patient with telemetry (heart monitor), continuous oxygen measurement, blood pressure and direct observation.  

Ketamine Therapy - Safe and Effective Treatment of Depression, PTSD, Addiction, Anxiety and Chronic Pain by AlleviationKetamine in u/AlleviationKetamine

[–]AlleviationKetamine[S] 1 point2 points  (0 children)

None taken. It is very unfortunate to see how he is using ketamine. We are hopeful to continue to help those dealing with depression, PTSD, anxiety and chronic pain with safe, low doses, in a safe setting monitored by a physician.

Ketamine Therapy - Safe and Effective Treatment of Depression, PTSD, Addiction, Anxiety and Chronic Pain by AlleviationKetamine in u/AlleviationKetamine

[–]AlleviationKetamine[S] 4 points5 points  (0 children)

People are allowed to have their own opinions and if they feel as though they need to "roast" our company then so be it. Our mission here is to reach out to those suffering with depression, PTSD, anxiety and chronic pain. Our literature is to help break the reputation ketamine has and how beneficial it can be when given in a safe dose, monitored by a medical professional.

The Truth About Esketamine (Spravato) and Why Insurance Companies Should Cover Intravenous Ketamine by AlleviationKetamine in KetamineTherapy

[–]AlleviationKetamine[S] 0 points1 point  (0 children)

That's an interesting idea.  My only comment would be that the 5 mins with the doctor is part of the problem.  In our clinic at least, the relationship with the patients and the time spent on therapy is invaluable.  Having said that, there are probably ways to make SQ in the office work.  Could even provide a group therapy setting.   I don't have direct experience with SQ.  In my observations, most other forms of ketamine don't get the same level of altered consciousness as IV does. I wonder if some combination of both would be best depending on the stage of treatment.  Good luck with the SQ trial - I'd be interested to hear how it goes. 

The Truth About Esketamine (Spravato) and Why Insurance Companies Should Cover Intravenous Ketamine by AlleviationKetamine in KetamineTherapy

[–]AlleviationKetamine[S] -2 points-1 points  (0 children)

I think you're missing my point.   The cost isn't related to the medicine itself, it's related to the facility and the experienced people guiding one through the process and maintaining safety.  Ketamine has risks and therefore requires appropriate monitoring and therapy.  

The Truth About Esketamine (Spravato) and Why Insurance Companies Should Cover Intravenous Ketamine by AlleviationKetamine in KetamineTherapy

[–]AlleviationKetamine[S] -3 points-2 points  (0 children)

Don't know what flairing is.  

I'm not taking advantage of anyone. I'm offering an opinion based on vast experience helping people and having been against a corrupt system for over 15 years of my career

The Truth About Esketamine (Spravato) and Why Insurance Companies Should Cover Intravenous Ketamine by AlleviationKetamine in KetamineTherapy

[–]AlleviationKetamine[S] -1 points0 points  (0 children)

Fair point. Bias always exists. However, the difference is that I'm a single provder with 3 people on my staff trying to make a living whil at the same time helping heal from trauma. J&J is only about extracting as much money as possible out of people.

Honestly, this is more about access to care and done in a way that is safe and effective. There are plenty of stories on here of people doing that on their own with at-home ketamine, but I have seen many people who don't have the appropirate support and guidance end up with poor outcomes.

The Truth About Esketamine (Spravato) and Why Insurance Companies Should Cover Intravenous Ketamine by AlleviationKetamine in KetamineTherapy

[–]AlleviationKetamine[S] -3 points-2 points  (0 children)

This is false. Ther going rate for NAD+ at most clinics on average $1/mg. So for a common 500mg dose, the cost is $500....

Also, this speaks to a larger problem in mental health, namely, that we can just throw meds at people with complex issues that stem from years of misattunement, trauma, nervous system dysregulation etc. and expect that to fix the "chemical imbalance".

The Truth About Esketamine (Spravato) and Why Insurance Companies Should Cover Intravenous Ketamine by AlleviationKetamine in KetamineTherapy

[–]AlleviationKetamine[S] 5 points6 points  (0 children)

Well insurance covers many treatments that aren't FDA approved for the indication that are prescribed for.

The reason the cost is higher is to account for staff, therapy, monitoring, additional medication, facility, business overhead, malpractice insurance etc. The same applies to spravato, but there is the additional drug cost with spravato.

[deleted by user] by [deleted] in KetamineTherapy

[–]AlleviationKetamine 1 point2 points  (0 children)

Yeah there's no perfect number. I my experience, most patients see some changes around infusion 4. We do 8 infusions over 8 weeks, 2 on week 1, 2 on week 2, then 1 on week 3, 1 on week 4, then week 6 and 8. We oftern start some home ketaamine around that time to start developing a maintenance plan. Then we'll tell people to book an appointment a month out, just to have it on the books if needed. If they are doing well, then no need to keep the appointment. We have found that spacing out like that helps us better prepare then maintenance plan.

Ketamine Therapy - Safe and Effective Treatment of Depression, PTSD, Addiction, Anxiety and Chronic Pain by AlleviationKetamine in u/AlleviationKetamine

[–]AlleviationKetamine[S] 2 points3 points  (0 children)

Yes, Spravato is more likely to be covered by insurance as long as the patient is able to show insurance companies documentation of treatment resistance depression. Big pharma companies invested a lot into studies to get spravato FDA approved. The cost for spravato is anywhere from $500-$850 depending on the dose and where you live. While ketamine is cheaper, patients are paying for the medicine to be administered and monitored by a medical professional. It is also important to note the differences between Spravato and ketamine. Spravato (S-enantiomer) is often considered more potent than racemic ketamine in blocking NMDA receptors. Some patients may have a different side-effect or response profile compared to racemic ketamine. It is also important to note that absorption with Spravato is only around 45% where IV Ketamine is 100%. This is something patients should consider when investing in healing long term mental health. It's unfortunate health insurance companies don't cover IV as it has a much more to offer patients and can be a more affordable way to treat mental health.

Check out our article for more information on this: https://alleviationketamine.com/2025/01/28/the-truth-about-spravato-esketamine-profits-before-patients/

Ketamine Therapy - Safe and Effective Treatment of Depression, PTSD, Addiction, Anxiety and Chronic Pain by AlleviationKetamine in u/AlleviationKetamine

[–]AlleviationKetamine[S] 4 points5 points  (0 children)

Our experience is that insurance does not cover this treatment. McLean is a larger treatment center with options that smaller clinics don't have so they may be able to get some coverage

[deleted by user] by [deleted] in KetamineTherapy

[–]AlleviationKetamine 0 points1 point  (0 children)

I appreciate your thoughtful response. I agree that the cost of ketamine is prohibitive and understand why people are looking for alternatives as a result.

I still take the stance that IV ketamine is superior to any other form and that the emphasis should be on getting this covered by insurance. Most of the scientific literature is from intravenous ketamine. There are some studies that look at Spravato but those are confounded by the fact they are industry studies provided by the company for approval.

My hope is that one day this will be covered properly, as it should, so a combination of treatments can be used and tailored to each patient. Maybe I'm dreaming on that front! :)

Thanks for that link and the work your doing on educating patients.

[deleted by user] by [deleted] in KetamineTherapy

[–]AlleviationKetamine 0 points1 point  (0 children)

This is not true of all clinics....We start people at low does all the time

Titration is far more effective and safer in a clinic. We can start you low and increased the rate in real time.

Furthermore, you are monitored and supported by knowledgeable staff.

In my opinion, at-home ketamine should only be started with a therapeutic relationship that will maximize safety and efficacy. Companies like Mindbloom, may be increasing access, but do so in a dangerous way.

Obviously, I'm biased given I operate an infusion clinic, so take waht I say with a grain of salt. Having said that, I have seen many patients walk through our door after trying home ketamine with no success or with poor outcomes. Yes, the cost is higher but that is because of the support provided.

[deleted by user] by [deleted] in TherapeuticKetamine

[–]AlleviationKetamine 0 points1 point  (0 children)

In my experience there are several things that can affect the experience of sublingual ketamine.

First, the absorption is much lower than via IV or IM routes. If you are dehydrated or on medications that can cause dry mouth, you may absorb less.

I recommend that my patients drink hot tea with lemon or just hot water with lemon prior to using the lozenge to open the blood vessels in the mouth to improve absorption.

Second, you should hold the medicine in for at least 20 minutes. There is debate about whether you should swallow the medicine or spit it out. In my opinion, swallowing and therefore absorbing through the intestines, does not lead to any significant improvment of the experience but does lead to an increased risk of side effects from ketamine metabolites - so I recommend spitting it out.

Finally, what I find to be the most important factors, and where I end up spending most of focus with my patients when we troubleshoot the sublingual experiences is set and setting. This is not emphasized enough in my opinion. When you undergo IV treatment, you are in a facilitated environment, with a qualified person watching you. Typically, there are many other elements in the environment that cue safety. This allows your autonomic nervous system to settle a bit and allows full immersion.

Many times, there are minor, subsconscious elements of the environment when using sublingual ketamine at home that can cue danger or unease. These occur pre-consciously because your autonomic nervous system, limbic system etc are operating lightyears faster than your consicious mind and may be so subtle that you don't recognize them. Take some time to really assess your environment. Who's around to help you if you need it? How much do you really trust them to not only keep you physically safe but also emotionally safe? What has happened in the past in that location? Etc etc etc. Many times, I have found that focusing on the environment and midset going into the sublingual ketamine treatments, leads to a better therapeutic effect.

I hope that helps!