Ketamine Case Report #1

by Gabriel
Gabriel
depression
ketamine

Context

Name: Gabriel
Trip Date: 5/23/2018
Age: 23
Setting: At home in bed
Gender: Male
Height: 5'10
Weight: 210lbs
Medications: Propranolol ER 120mg

Substances

Name Dosage Route of Administration
Ketamine 50mg Insufflated

Introduction

This report is a case report of the effects of ketamine long term on depression, so unlike most reports on Effect Index which are reports of the subjective experience of the trip itself I will primarily be focused on the offset/after effects instead of my trip experience itself, which I will only cover in minor detail.

As background - I have suffered chronic major depression for approximately 10 years. When I took this dose I had recently accidentally overdosed on 200mg of DMT in an ayahuasca brew, which was a pretty traumatic experience. I am very stressed about many different aspects in my life (my health, financial security, family health, work stuff, etc) and having minor PTSD flashbacks to the ayahuasca experience. I would rate my depression intensity at 8.5/10 prior to dosing.

Onset

Onset
T+0:00:

50mg of racemic ketamine snorted.

T+0:10:

I am feeling pretty dissociated and am beginning to experience low level visual disconnection and acuity suppression.

Peak

Peak
T+0:25:

I have reached the peak. It is very mild and I can walk around without any difficulty. My spatial awareness is not significantly impaired. Music appreciation has increased quite a bit and I am experiencing minor time dilation.

Offset

Offset
T+0:45:

I am still tripping moderately hard but I am beginning to come down. Visual acuity is increasing and I can see with both eyes open.

T+1:00:

I am almost sober and pretty disappointed - I don’t feel any positive change in my depression, in fact it may even be a bit worse (I am prone to dysphoria on dissociative comedowns).

T+3:00:

Although I am completely sober at this point I have begun to notice an odd feeling in my head. I would describe it as a lightheaded sensation with some moderate euphoria attached to it, I am beginning to feel less depressed and start getting excited.

T+6:00:

The euphoria has become pretty intense, I feel as if there has been a great weight lifted from me that is very distinct from changes in felt gravity in that it feels like an emotional weight. I’m super giggly and continuing to get more and more excited.

T+12:00:

Feeling great and pretty refreshed I decide to lay down, watch a movie, and go to sleep.

T+1 day:

I wake up feeling somewhat groggy after poor sleep but even that grogginess cannot stop me from feeling amazing. I would estimate that there has been a 70% reduction in my depression and I am extremely excited and motivated in a way that I have not been in a very long. I try to work on some projects for Effect Index and some coding projects, but the low quality sleep + ketamine after effects have resulted in some cognitive suppressions and persisting dissociation so I don’t perform very well. Eventually I decide to just try to relax and chill out and watch some films.

T+2 days:

I wake up after sleeping quite well and still feel great - I would rate my depression intensity at about 3/10, so a slight uptick from the previous day. However, all of the cognitive suppressions that I experienced at T+1 day are gone and I am able to be incredibly productive and I am excited about life again. I get a lot of work done on various projects.

T+3 days:

Although I still feel the strange cognitive euphoria/lightheadedness of the ketamine afterglow I have begun to become more tired and am sinking back into depression again - I would rate depression intensity at 5/10. I am still much more functional than I was prior to ketamine and the intensity of the PTSD flashbacks has been reduced significantly. I am losing a significant amount of steam, though, and again I feel somewhat disappointed by ketamine, as the research showed more significant and long term relief from depression.

T+4 days:

I am basically back at baseline depression at this point and have lost most of the gains I made post-ketamine, although I am still somewhat more productive than I had been prior.

Conclusion / Aftermath

My first experience with ketamine was underwhelming, which I believe was due to the low dose of 0.5mg/kg insufflated (research suggests 0.5mg/kg IV is a more effective dose, which is equivalent to about 1mg/kg insufflated). However, I am still very interested in testing out some higher dosages to see if long term efficacy and viability of ketamine is possible.