I don’t quite understand why the days go by so quickly, but the weeks and months seem to drag on and on. I keep trying to get everything done on my daily to do lists. I keep trying, even though I’m not always successful. Blogging is one of my daily tasks that I don’t seem able to complete, but at least I’m doing it today.
I feel like I’m doing a lot better since I started the IV Ketamine. I do the treatments every other week at this point. I’m actually interested in doing all sorts of activities and I enjoy myself when doing them. I feel better about myself in general and my negative thoughts have decreased a large amount. I hope it keeps going this way, improving bit by bit.
I started IV Ketamine this past November. I’m doing the treatment every week (for now). I’m hoping to be able to change that to once every three weeks fairly soon. I was resistant to trying IV Ketamine for a while. Then, my depression got extremely bad, and none of my meds or treatments were helping, so I finally decided to give IV Ketamine a try. It works so well, I wish I tried it a while ago.
The IV Ketamine is working very well for me. It’s the reason that I can finally stop the ECT treatments. I’ve actually already started to wean off of ECT, thank goodness.
I’m back… I disappeared from my blog for more than 2 months. My last post was on November 4th. I said that I needed break, and apparently I took one. My depression has been rough for quite some time, but luckily it has gotten a lot better. I’m fortunate to have family and friends that are understanding, supportive, and honest with me. I’m trying to take everything just one day at a time.
I’m a bit out of it right now because of the ECT treatment I had this morning. I will get to stop ECT fairly soon. In December, we decided to slowly stop the ECT treatments because I finally started IV Ketamine (which is working very well!). I will write about that soon, hopefully sometime this week. I’m trying now to wear myself too thin.
I had another session of ECT last week. My doctor, Dr Espinoza, asked me again if I wanted to switch to once a week instead of once every other week. When I turned him down on that option, he asked me I had any interest in IV Ketamine. I turned that option down very quickly. I know IV Ketamine is a lot different from using Ketamine to get high, but it brings back memories. I told him why I’m so against IV Ketamine. The last time I used it to get high, I ended up cheating on my boyfriend (he asked me to marry him; I’m sure we would have gone through with it, but I doubt that it would have lasted; that’s just how it goes with relationships based on drugs). Then, less than 24 hours after I got home, the cops were at my door to question me. My boyfriend/fiance was killed in a drug deal gone bad. I don’t want to remind myself of that horrible event and the many others that I went through while on drugs.
I’m not doing too much better, but there has been improvement since my last two ECT treatments. I explained to Dr Espinoza that I got a new dog and I think he will be helping me get through this rough time. I’ve been thinking about it all day and I’ve decided that if I don’t improve enough within the next four weeks, then I will go back to weekly ECT treatments. Hopefully that doesn’t have to happen.
Today has been unusually rough. I reached out to my psychiatrist because I wanted to change my meds. Specifically, I want to get off of the Clozapine and possibly try IV Ketamine. However, his response was not as I hoped it to be. Basically, it was an ultimatum. Either I go back on ECT or possibly try IV Ketamine, but it would be in addition to Clozapine. If I go off of Clozapine, he will no longer be my psychiatrist; he would only continue to see me for 30 days or until I find a new doctor.
I’m going to come up with a list of questions to ask him at our next appointment on January 11th. My husband will be coming with me. I don’t know what I’m going to do.
I’m off to go see a Coyotes game; hopefully that will make me feel a little better.
I keep trying, over and over again. If it doesn’t work out the first time, I try again. Sometimes it may take me a while, but it’s important not to give up. This can extend to anything in life. Just keep putting one foot in front of the other.
Right now, I’m just trying to get my medications right. In the past 6 months, I went on Clozapine slowly, I went off of Mirapex and then back on Mirapex, I went off of Deplin, and I also stopped doing ECT treatments. I’ve done almost everything my psychiatrist suggested. The only thing I haven’t tried is IV Ketamine; I’m leaving that as an absolute last resort. My emotional state goes up and down, but it hasn’t been healthy or steady for a very long time, probably about 7 or 8 years.
No matter how bad it gets, I never give up. I may not be happy to do certain treatments, but I try. I give each treatment enough time to work before deciding if it’s right for me or not. This time, I’m going to give the Mirapex another couple of weeks before deciding if I need to try something else, which would be IV Ketamine. The most important thing is that I don’t give up before the miracle happens.
The other day I made the decision to stop my ECT treatments and to increase by Clozapine dosage. I’m currently at 200mg and will be increasing my dose by 25mg each week until I reach 400mg. This was one of the options my psychiatrist gave me. Another option was to go back to doing ECT three times a week, but I’m not willing to do that at this point. The third option my psychiatrist gave me was to do IV Ketamine. He has been offering this as an option for many months now, but it’s not something I want to do.
IV Ketamine scares me for a couple of reasons. I used to get high off of Ketamine when I was using. That was a long time ago, and I know that abusing Ketamine and using IV Ketamine are two completely different things; the side effects of IV Ketamine are nothing like the effects of getting high off of it. My biggest fear of trying IV Ketamine is the possibility of dissociation. When I would use Ketamine to get high, I would take so much that I would slip into what’s called a ‘k-hole’, which is pretty much a dissociative state. I couldn’t move or speak, but I could still feel everything that was going on around me. The possibility of dissociating scares me, it triggers my PTSD. I always need to be able to protect myself, and dissociation would take that away from me. Plus, the treatments are especially expensive.
The use of IV Ketamine is highly effective, and it works very quickly. It is known to show improvements by the end of the infusion. Maybe my reasons for not trying it are ridiculous, but they are my reasons. I’m not saying that I’ll never try IV Ketamine; I would just prefer to leave it as an absolute last resort.
I know I need another form of treatment, and my psychiatrist is respectful enough to give me a choice. However, as stated in my last post, making any decision is extremely difficult. This decision feels as if it’s nearly impossible.
At first thought, IV Ketamine terrifies me. I used to get high off of Ketamine, I’m now 11 years sober, but the possibility of dissociation is what scares me the most, it brings back traumatic memories which trigger my PTSD. I’ve already tried Clozaril once and ended up with a fever around 2 weeks. I had no other symptoms and my weekly blood work came back completely normal. Even though Clozaril is a very risky medication, it doesn’t scare me like the IV Ketamine does.
The information I found out about Clozaril after research and talking to my psychiatrist:
- Giving Lithium with Clozaril can help prevent the low white blood cell count with a 94.5% success rate. I am already on Lithium, so this is beneficial to me.
- The risks of this drug are increased for me because I’m Ashkenazi, which is Eastern European Jewish heritage.
- Only 1-2% of patients that take Clozaril develop agranulocytosis, a blood disease that increases the susceptibility to infection. Only 1-5% of patients may have seizures, but that can be avoided by titrating the dose up slowly.
- Clozaril is 60% effective for patients.
- I would have to do weekly blood tests for 6 months, then do blood tests every 2 weeks for 6 months. I could then go to blood tests every 4 weeks if there were no problems. Blood tests are required to get medication.
- From what I understand, my worst case scenario is: I start to get a fever or other symptoms, I call my psychiatrist, he would send me to the hospital where I would get blood work done and they would make sure my fever goes down. Then I stop the medication again and have to try something else. This is what happened last time.
The information I found out about IV Ketamine after research and talking to my psychiatrist:
- The IV Ketamine trial consists of the first 2 treatments, which are done within 1 week. I would generally start to see some type of result within 24 hours. If I don’t see results after the first 2 treatments it would be considered ineffective for me.
- This treatment is very effective, and patients don’t have to wait 6 weeks for medication to start working.
- I would be monitored at all times by a doctor. If I had a panic attack during the infusion, he/she would be able to treat me.
- I can take something for my anxiety before the treatment to help me stay calm.
- Some patients experience dissociation during the infusion. Dissociation can cause a lack of control mentally and/or physically. This is the part that is a trigger for me. Just writing about it now is causing a massive anxiety attack.
- Maintenance treatments are done anywhere from every 3 weeks to every 3 months. Every patient is different.
Now that I have all of this research, I should be able to make a decision, but my indecisiveness is always there. I’m leaning more towards the Clozaril rechallenge. I understand the risks and as long as I immediately tell my psychiatrist about any symptom I have, I should be okay. I know I could get a fever again and it won’t work, but then my options will be narrowed down for me. I also have several reasons not to do the IV Ketamine. First of all, it terrifies me. I’m having an anxiety attack right now just thinking about it, what will happen when it’s time for the actual treatment? It is very expensive and not covered by insurance. The first 2 treatments are $600 each, and every maintenance treatment is $400. The IV Ketamine is also new to me, and new things scare me. I’ve done the Clozaril before so I know what to be on the lookout for.
The only reason I’m considering either is because the psychiatric benefits outweigh the medical risks. Writing this post has helped me realize how scared I am of the IV Ketamine. I don’t think I could handle the treatment. I think my best option is to rechallenge the Clozaril.