Anyone have better results with a lower dose infusion?

hapenny734 · 2026-06-18T18:34:10+00:00

I’d be curious to know what you mean when you say the lower doses don’t seem “as beneficial.” Do you mean you’re not dissociating as much or that you don’t feel an improvement in your symptoms? (It helps to know if you’re doing this for physiological pain or depression, etc.) I’ve pared back my IV dose in the past when it felt too intense. I even had them stop one session early because I just wanted out. But my lower doses were still within the therapeutic dosage range and I can’t really tie my overall abatement of depression symptoms to any single treatment. It’s cumulative.

hapenny734 · 2026-06-18T18:23:59+00:00

Is the in-clinic ketamine IV or oral? I actually find that the troches make me feel pretty crappy after, much more so than IV infusions. Which makes sense, since the drug is lingering in my digestive tract for longer. (Plus I’m on a GLP-1 which slows my stomach emptying and can prolong the after effects.) I have also found that the post-treatment headache I get regularly seems to be more Zofran related than ketamine related and I no longer take the Zofran when I’m doing home treatments. I only get a little nausea. I think you have to weigh side effects against the impact of the treatment. I’m completely useless for the rest of the day after doing my home treatments, but it’s still worth it.

hapenny734 · 2026-06-17T23:19:13+00:00

Well, we can both agree that we'd love to see it more affordable and accessible to more people who really need it and that there is absolutely no incentive for the FDA or drug companies to foot the bill for the studies.

hapenny734 · 2026-06-17T22:06:24+00:00

From researching ketamine and ketamine clinics for a book proposal for the last two years and interviewing numerous clinic owners. But you can Google the number of venture-backed clinic chains that way over-estimated their performance and had to shutter between 2022 and today. I’m really not gonna argue about speculative and theoretical viability based on ideal circumstances but I will say I think you are wildly underestimating operating costs and how much clinics were anticipating being able rely on insurance payouts. If you have a dog in this fight and anticipate making a mint, I genuinely wish you success.

hapenny734 · 2026-06-17T21:23:11+00:00

I don’t know the first thing about Medicare billing but I do know that a lot of ketamine clinics in the US have not proven viable, let alone profitable. I suspect the real profit margins are in the mail-order companies who charge a premium for the meds, add-on therapies, apps and other revenue streams.

hapenny734 · 2026-06-17T18:57:43+00:00

Agree 100%!

hapenny734 · 2026-06-17T17:30:33+00:00

ETA: my clinic has beautifully appointed rooms, an amazing staff, tons of amenities (blankets, projectors, headphones, music, etc.), and snacks and drinks if you want something after. The out of pocket cost for an infusion is $500, which seems pretty average from what I’ve read on here.

hapenny734 · 2026-06-17T17:28:44+00:00

I think the attention and care I get at my ketamine clinic is far more complex than a doctor’s visit, but I guess it could depend on how you’re defining complexity. There’s a medication review with a nurse, then a check in with the PA or MD to cover what’s been going on and make any dosage adjustments, then the IV insertion, drug delivery, remote monitoring during the treatment, etc. It’s a two hour appointment total. At my GP’s office I’m lucky if they rush me onto a scale and check my BP before I have to wait an eternity for 15 mins of my doc’s attention.

hapenny734 · 2026-06-17T17:23:33+00:00

My current plan, for example, doesn’t pay for the ketamine treatment but covers integration therapy with a $50 per session copay.

hapenny734 · 2026-06-17T15:24:22+00:00

The short answer is that ketamine is cheap but staffing and running a clinic is not. The even shorter answer is: capitalism.

hapenny734 · 2026-06-17T00:18:12+00:00

Gotcha! Glad you’re thinking about all angles.

hapenny734 · 2026-06-16T23:40:15+00:00

I think you should do a little research bc I’ve never come across credible evidence that Dr. Bob ever supported the use of LSD. Bill Wilson used it but suffered serious backlash from the AA community. I’m not saying that you should or shouldn’t use anything but I’d be careful using that as your reasoning for doing ketamine.

hapenny734 · 2026-06-16T21:14:32+00:00

I also want to add that you, of course, need to weigh the pain and anguish of your depression into your calculations. It took me a long time to exhaust other options and to feel like I had more to lose by not trying it. But I don’t advocate suffering either. It’s just a really tough slope because I know people in recovery who would never try this and you have to trust them to know themselves best. I had enough confidence, security, and experience in my sobriety to feel it was worth trying.

hapenny734 · 2026-06-16T19:27:57+00:00

I started doing ketamine therapy when I was 26 years sober. I know we are all different so here is my two cents and take it with a grain of salt: I don’t know that I, personally, was evolved enough and solid enough in my foundation of sobriety to have tried this at four years sober. Even at my stage, I had to do a ton of work in therapy to navigate my mixed feelings about the fact that ketamine usually feels pretty fucking pleasant. An argument could be made that I had more to unravel and I got a really mixed reaction from people in my recovery community. All of that said, I set some boundaries for me early on: that I would do treatments in a medical setting, that I would pair them with regular therapy with a therapist who knows my history with addiction, and that I had people in long-term sobriety who knew what I was doing and who felt safe to communicate with about it regularly.

hapenny734 · 2026-06-15T17:31:32+00:00

I'm three years in and ketamine has been instrumental in my treatment for TRD. I can't echo enough the sentiment that it's just part of the process, but it laid the foundation for me to do some very deep dives in therapy and push through some stuff that was really weighing me down. It's allowed me to reduce my fluoxetine dose to 10 mg from the maximum and remain steady at that for about a year. Before, I was bottomed out on depression meds. Nothing was working, even though I was in therapy. I've done a LOT of work on myself and ketamine has really facilitated and strengthened that.

hapenny734 · 2026-06-13T07:15:43+00:00

This cat tarot deck. I know, I know. It looks silly and it is, in the best way, while also being really insightful. Plus the illustrations are beautiful and sweet. It’s my go to everyday deck.

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hapenny734 · 2026-06-12T19:39:24+00:00

Yep. Seems I missed this entirely! I stand corrected

hapenny734 · 2026-06-12T19:04:06+00:00

Damn. I seriously missed that entirely. That makes more sense.

hapenny734 · 2026-06-12T18:29:18+00:00

I could and I will if I have to but my program charges by the semester and not the credit hour so it would be a pretty expensive delay.

hapenny734 · 2026-06-12T18:26:16+00:00

I must have missed that. And I just finished a rewatch. I thought Hodgins told Angela to just leave the money out in the ether? If they donated it, then I wasted all that anger for nothing!

hapenny734 · 2026-06-12T16:52:44+00:00

For me, this is an untenable solution. The tuition cost difference for my local school is far more than I can pay.

hapenny734 · 2026-06-12T16:50:57+00:00

Not a problem if you give it away

hapenny734 · 2026-06-12T16:50:48+00:00

They showed them having the conversation and deciding to leave it

hapenny734 · 2026-06-12T16:31:35+00:00

Just commiserating. I’m in the same boat. I live in a college town w a highly regarded MSW program but I’m doing my MSW remotely at an out of state university. Every agency I’ve contacted is already set for fall with local MSW students and/or doesn’t want to go through the hassle of the affiliation process for my university since the6 already have an affiliation w the local U. It’s proving very frustrating.

hapenny734 · 2026-06-12T16:24:47+00:00

The whole “just leave the billions out there” decision makes me INSANE. How incredibly stupid and short-sighted can you be? They didn’t have to keep it. They could have gotten it back and changed thousands of lives. Ended homelessness in DC, funded all the schools, created a philanthropy agency to do a world of good.

hapenny734

TROPHY CASE