Taking Antidepressant Drugs at Least 9 Months Prevents Depression Relapse

It's a big problem: Too many people don't take antidepressants long enough to get the full benefit.

"A few weeks into it, people think 'OK, I feel better, I don't need to keep taking it anymore," says study researcher Scott A. Bull, PharmD, a pharmacy research analyst at Kaiser Permanente in Oakland, Calif.

However, depression has a high rate of relapse -- which very often occurs in the first year, Bull says. "The goal of depression treatment is to prevent these relapses." It can take 9 months of treatment -- may be up to a year -- to help prevent depression relapse.

Why People Stop Taking Their Antidepressant Medications

But why do patients quit taking antidepressants? Bull sheds some light on the problem in the Sept. 18, 2002 issue of The Journal of the American Medical Association.

In their study, Bull and colleagues interviewed 99 doctors and 137 people with depression. People who had seen their doctors less than three times after starting their antidepressant were more likely to stop depression medication treatment because of antidepressant side effects and because they did not clearly understand their treatment.

More patient-doctor visits are the answer, says Bull. "They provide an opportunity for these discussions to occur."

It's all very true, says Harold Koenig, MD, associate professor of psychiatry at Duke University School of Medicine.

"People who are depressed are not very motivated anyway," he says. "They need to be encouraged, to get past the negative thinking -- that this drug won't work, that it costs too much. Side effects can be upsetting. Plus, there's still a stigma about having to rely on a pill to feel normal."

"These antidepressant medications are very effective for treating depression. However, the body takes time to get used to them. They're changing your brain's biochemistry," says Koenig. Patients need to know that if one medication doesn't work, another one might.

Getting past initial side effects requires "toughing it out," Koenig says. "A lot of times people have to get over a hill -- side effects -- before they get to the valley. It can take a month to six weeks to get past that period. But that doesn't happen until you take the pills religiously -- every day -- because they have to build up in your system."

If this is the first depression -- and it's clearly linked with an event like divorce or job loss -- antidepressants may be necessary for no more than a year or so, Koenig says.

For people who have been depressed before, the drugs may be about the only way to get past depression. "Every episode actually creates permanent changes in the brain," he says. "Antidepressants are very effective in treating severe depression."

If your family member or friend has depression, getting treatment for depression is of upmost importance. Here's why and how you can help.

Depression is a serious illness marked by depressed mood (feelings of sadness or emptiness) and/or the loss of interest in (or pleasure from) nearly all activities. Symptoms of depression may also include changes in eating habits, weight gain or loss, changes in sleep o activity patterns, decreased energy, and difficulty concentrating or making decisions. A depressed person may also have recurrent thoughts of death and may actually attempt suicide. The danger of suicide is a serious consideration in cases of severe depression.

Depression is a very real illness. Generally, the depressed person cannot simply "snap out of it", and attempts to get them to do so may be equally frustrating to the depressed person and the would-be "helper". The depressed person genuinely needs additional love, support, and understanding to help them through their illness. (read: Best Things to Say To Someone Who is Depressed) There are many resources for combatting depression, including psychiatrists and other psychotherapists, peer counseling, group therapy sessions, various forms of depression support and mental health and suicide hotlines. Help is always available, and low-cost assistance is there for those who need it.

The possibility of suicide is a real danger of depression. Many people are surprised to learn that suicide attempts are most common when the depressed person has begun to show signs of recovery. It appears that it is when the severely depressed person begins to recover that they have the energy to act on their suicidal thoughts. It is important for family and friends to recognize that just because the depressed person has begun to show signs of improvement, they are not yet "out of the woods", and are still in need of the additional love and support of their friends and family.

Some severely depressed people may experience psychotic depression symptoms, including auditory hallucinations ("hearing voices"), visual hallucinations, or delusional thoughts. These symptoms often appear real to the affected person, and should not be taken lightly. Consultation with a psychiatrist may be helpful in these cases, and the symptoms should go away with treatment.

Depression has been treated with a variety of therapeutic techniques, including antidepressant medication, vitamins, and a wide range of "talk" therapies. Electroshock was employed extensively in the past but is currently rarely used, and only in severe cases. Recent advances and the introduction of new antidepressant medications (such as Paxil, Lexapro) have led to an increase in the use of medication as a treatment for even mild depression. Extreme cases of depression may require hospitalization (as in the case of suicide attempts). Ongoing episodes of severe depression may respond well to residential (inpatient) therapy leading to the re-establishment of effective coping techniques, a return to independent living, and full restoration of prior levels of functioning.

Effective treatment for depression is available. Contact your local mental health provider for further information.

If your family member is out of control or suicidal (danger of harm to self or others), stay calm and call 911. Do not try to handle it alone.

When helping a depressed person, here's how families and friends can convince their loved ones to get treatment for depression.

Helping people with depression get treatment is so important, but families and friends often are unsure how to convince their loved ones to see a medical professional. In a compassionate way, explain to the person that you are concerned that he or she is showing, a treatable medical condition. Often, people with depression feel very relieved to learn that they are suffering from a medical condition. Ask the person to see a medical professional, offer to make an appointment, and go with the person or call the doctor in advance to state the person's symptoms. (read: Why Getting Depression Treatment for Your Loved One is So Important)

Tips on How to Help A Person with Depression

• Show you care. Depressed people feel isolated in their pain and hopelessness. Tell your depressed family member or friend how much you and others care about the person, want the person to feel well, and are willing to help. Listen and sympathize with the person's pain. (read: Best Things to Say to Someone Who Is Depressed)
• Acknowlege the relationship impact. In a caring way, let the person know that depression affects you and others in the family. Your relationship, including intimacy, household responsibilities, and finances, are all adversely affected when someone is depressed.
• Be informed. Read a brochure or an educational book on depression, or watch a video on depression and share the information with the depressed person. Stress that depression is a treatable, medical condition, like diabetes or heart disease, not a sign of weakness. Assure the person that people with depression do feel better with the appropriate depression treatment.
• Use a symptom list. Go through the depression symptom list with the person who is depressed or have the person take a confidential evaluation that will guide him or her toward medical help. Take the symptom list to the appointment for discussion with the medical professional.
• Reach out. Find other people to help you get your loved one into treatment, especially medical and mental health professionals such as your primary care physician or a psychiatrist, psychologist, or social worker. Think of others to whom the depressed person will listen, such as family members, relatives, teachers, friends, or a member of the clergy, then enlist their help.
• Seek immediate help If at any time your depressed family member or friend talks about death or suicide or may be harmful to you or others, seek immediate help. Contact your doctor, go to your local emergency room, or call 1-800-suicide or 911.

Reading this article on "How to Help and Support Someone with Depression" will provide you with additional information.

What Not To Do

People with depression are suffering from a medical condition, not a weakness of character. It is important to recognize their limitations.

• Do not dismiss their feelings by saying things like "snap out of it" or "pull yourself together." (read: Best and Worst Things to Say to Someone Who Is Depressed)
• Do not force someone who is depressed to socialize or take on too many activities that can result in failure and increased feelings of worthlessness.
• Do not agree with negative views. Negative thoughts are a symptom of depression. You need to continue to present a realistic picture by expressing hope that the situation will get better.

When A Depressed Person Refuses Your Help

Often when you try to help someone who is depressed, your help is declined or nothing you do seems to help. You end up feeling rejected and discouraged that there is nothing more you can do.

Depressed people may reject your help because they feel they should be able to help themselves, and feel worthless when they can't. Instead, they may withdraw or start an argument in an effort to resolve their difficulties. In addition, people with depression have negative thoughts and feel so hopeless that they do not see recovery as a reality.

Fifty percent of people with bipolar disorder have a lack of insight (anosognosia), so they do not realize they are ill. For example, people with bipolar disorder may believe they are a "high-energy person." This makes family involvement in seeking and managing treatment even more critical.

With these difficulties in mind, what can you do if your help is turned away?

• Provide consistent support. Over time, if you consistently show support, the depressed person will see that you are resolute and may accept your help. Continue trying some of the tips discussed in this section.
• Discuss your feelings. When your help is refused, restate how much you care for the person. Let the depressed person know how you feel, gently, by stating an example of the support you have offered and how it makes you feel when it is rejected.
• Focus on behaviors. If the depressed person is reluctant to seek help, then don't try to convince the person that depression is causing the problems. Instead, talk about the depressed person's behaviors and the ways in which treatment can help. For example, after you have listened and sympathized with the depressed person's feelings, try to agree on wellness goals (e.g., consistent sleep and feeling less irritable). Then, try to assign some action steps that you can agree on to reach these goals (e.g., after two weeks, if the person does not improve, you will set up a medical evaluation).
• Agree on professional help. It is important to make sure your loved one gets the professional help he or she needs. Sometimes a primary care physician can seem less threatening, or a psychotherapist, or a couple's therapist.

Helping someone who is depressed and reluctant to seek treatment can be very trying and frustrating. As much as possible, try to enlist the aid of family members, friends, and medical professionals in this process.

Helping Children and Teens with Depression

Each year, 3 to 6 million Americans under the age of 18 suffer from depression. Although the symptoms of depression are the same as those for adults, children and teens with depression may not be able to express their feelings as well or may exhibit different emotions. Look for signs of declining school performance (e.g., poor grades), frequent temper tantrums, outbursts of crying, or unexplained irritability.

Your child must receive treatment for depression. Children need to learn how to continue to develop and find ways to cope. In addition, teens suffering from depression are at risk of committing suicide, the third leading cause of death among 15 to 24-year-olds.

Treatment of depression for children and teens includes psychotherapy and antidepressant medication. Psychotherapy helps children and teens learn how to express their feelings and gain critical communication skills. The use of antidepressant medication is an emerging field in child psychiatry, and medications have been approved for children in certain age groups.

What do you say to someone who is severely depressed? Here are some suggestions for talking with a depressed person.

It is not always easy to know what to say when a person you care about is clinically depressed. Here are some words to say that will show your support, while acknowledging the depressed person's right to feel his or her feelings.

1. "I love you!"

2. "I care."

3. "You're not alone in this."

4. "I'm not going to leave/abandon you."

5. "Do you want a hug?"

6. "When all this is over, I'll still be here and so will you."

7. "Would you like hold my hand and talk about it?"

8. "I can't fully understand what you are feeling, but I can offer my compassion."

9. "I'm sorry you're in so much pain."

10. "I have empathy for what you are going through."

11. "I am not going to leave you. I am going to take care of myself, so you don't need to worry that your pain might hurt me."

12. "I can't imagine what it's like for you. I just can't imagine how hard it must be."

13. "You are important to me."

14. "If you need a friend, I am here."

Also read "Best and Worst Things to Say to Someone Who is Depressed

A cure for depression would be wonderful and, certainly, if ketamine cured depression it would become a best-selling drug. The concept of “curing” depression, though, is a complicated one. So to learn if ketamine cures depression, read on.

What Is a Cure for Depression?

The term “cure” is defined as: “successful remedial treatment; restoration to health.”

Using that definition, some people can be cured of depression in that the depression can be treated to the point where the person is returned to health (devoid of depression).

However, if one considers a “cure” to be a permanent restoration to health without further treatment, then there is no known cure for depression. Typically, people with a mental illness like depression are said to be “in remission” when the depression is not present; indicating that the person may need continuing treatment or that the depression may come back if treatment is ceased or becomes unsuccessful.

Is Ketamine a Depression Cure?

There are two situations to consider if one is to look at ketamine as a cure for depression. In situation one, a person receives ketamine for a given period of time and then is symptom-free thereafter. In the other situation, a person receives long-term ketamine treatment for depression and the person remains symptom-free.

If a person were to receive ketamine for a set period of time and then be symptom-free thereafter, certainly the word “cure” could be applied. Unfortunately, no study that has been done on ketamine for depression has tested this theory sufficiently in the long term. Most studies look at ketamine’s effect on depression only over the course of a month, at a maximum, a year. Additionally, study sample sizes have been very small so it’s hard to draw definitive conclusions. And while most people do respond positively to ketamine treatment, most of those who do also relapse following their positive response. For example, in one study where people were given up to six ketamine infusions, 17 people were followed for 83 days. Of those 17, only four didn’t relapse by the 83rd day. This doesn’t mean that more infusions wouldn’t have helped more people, but science just doesn't know how many infusions it would take to create prolonged remission of depression. Science also doesn’t know the specific risks that more ketamine infusions would create.

Ongoing ketamine infusions also haven’t been substantially studied. There is concern that repeated ketamine infusions over time may result in tolerance, wherein the same amount of drug no longer produces the desired effect. If this is the case, greater amounts of ketamine would have to be given. This carries a greater risk of ketamine side effects. Additionally, as repeated ketamine infusions over a long period of time haven't been adequately studied, the risks of this type of treatment is unknown. For now, only a handful of people have received ketamine over the course of many months-years and while their experiences look promising, the lack of data prevents anyone from claiming that ketamine cured their depression.

Ketamine Cures Depression?

So, no, unfortunately, ketamine doesn’t cure depression that we know of; however, the discovery of its very promising use in the treatment of depression has advanced science’s knowledge of both how depression works and of what type of new treatments should be investigated.

Suddenly stopping antidepressant treatment can produce bad side effects. Read about the withdrawal effects of Prozac, Paxil, and other SSRI drugs.

So you've skipped a couple of doses of your antidepressant ... so what? Or maybe you just decided to stop taking it ... what's the big deal? Researchers asking those very questions have found that suddenly stopping treatment with some antidepressants of the type known as selective serotonin reuptake inhibitors, or SSRIs, can cause serious withdrawal effects, both physically and psychologically.

SSRI drugs include those like Prozac, Paxil, and Zoloft. Patients taking these drugs must carefully follow their doctor's instructions about when and how long to take their medication. Failure to do so can lead to unpleasant problems, according to a study in the April issue of the British Journal of Psychiatry -- although some of the SSRI drugs seem to cause worse problems than others.

For those taking Paxil, especially, following the prescribed dosing instructions is important if you want to keep feeling well.

"Compliance with medication regimens as prescribed is important, and new symptoms can occur after missing doses," says the lead author of the study, David Michelson, MD. Michelson adds that in the case of the drug Paxil, negative symptoms can occur as early as the second missed dose.

Side Effect Symptoms From Stopping Antidepressant Medication

"Symptoms related to antidepressant discontinuation [and missed doses] commonly include physical symptoms such as dizziness and gastrointestinal symptoms," he says

Michelson and his colleagues studied 107 patients who had been successfully treated with Prozac, Zoloft, or Paxil. Over the course of 5 days, all of them received an inactive pill as a substitute for their medication, and this was compared with another 5-day period when all they took their regular medication. Patients reported side effects by filling out a questionnaire.

During the time they were taking the inactive tablet, patients treated with Paxil had more unpleasant -- and sometimes severe -- side effects than those who were treated with Zoloft. The most common symptom reported was dizziness. Unusual dreams, nausea, fatigue, and irritability were also common when after stopping Paxil and, to a lesser extent, .

Researchers found that withdrawal from Prozac caused no negative events. They think this is due to the fact that Prozac stays in the body for a long time in comparison to the other SSRIs. If that is the case, withdrawal effects would not have been experienced after only 5 days of taking the inactive tablet.

The short period of the study -- especially given the long time Prozac stays active in the body -- can be thought of as a weakness in comparing the three drugs, says Raymond L. Woosley, PhD, who reviewed the study. Complicating the issue, he says, is the fact that the company that paid for the study -- Eli Lilly and Company -- is the manufacturer of fluoxetine.

Woosley is professor and chairman of pharmacology at Georgetown University Medical Center in Washington, and a member of WebMD's editorial advisory board.

The bottom line, Michelson says, is that both doctors and patients need to pay more attention to the proper dosing schedules for antidepressants in the SSRI group. Adverse events can occur, but the good news is, they are most likely temporary. If patients experience any of these symptoms, and have not been taking their medicines regularly or as directed by their doctor, they should also know that the symptoms will probably resolve spontaneously once the medication is again taken regularly, he says.

Before getting ketamine infusions for depression, you’ll likely want to know what a ketamine infusion experience is like. While the ketamine infusion experience is different from person to person, the protocol for ketamine infusions for depression is similar for everyone. Read on to learn what it’s really like to receive intravenous ketamine infusions.

What Is a Ketamine Infusion?

A ketamine infusion is a dose of ketamine that is given via the intravenous (IV) route of administration. Ketamine infusions are typically used to treat major depression or depression in bipolar disorder but can be used to treat chronic pain conditions as well.

Before Getting a Ketamine Infusion

Before getting a ketamine infusion, you should expect thorough medical and psychiatric evaluations as well as medical tests to make sure you are healthy enough for the treatment. These assessments and tests are very important as ketamine infusions can be challenging both mentally and physically and only a doctor who is well-acquainted with your health can make good decisions for you.

Ketamine Infusion Procedure

You will likely be shown to a room with a comfortable reclining chair or bed. You will not need to disrobe or wear a hospital gown for treatment. The Ketamine Advocacy Network suggests that you always request a single-person room as a ketamine infusion is a very personal experience. A loved one is usually allowed to stay with you during the ketamine infusion treatment if you want. You’ll then be connected to vital sign monitors such as pulse and oxygen saturation monitors.

It is at this point that you’ll have an IV inserted. A tiny needle is used to insert a tube into a vein in your hand or arm and many find this to be painless. The tube will be connected to a bag held a couple of feet above you. The bag contains the specific dose of ketamine you will require and it will be delivered directly into your bloodstream at a controlled rate. The rate may be adjusted during your treatment to maximize its benefit. It takes approximately 45 minutes for a ketamine infusion and you may need to be under observation after that for an hour or occasionally more. You cannot drive yourself home after an infusion.

People, typically, initially receive six infusions over the course of two-three weeks.

What Does Getting an IV Ketamine Infusion for Depression Feel Like?

Once the ketamine enters your system, it will reach your brain within seconds and you will quickly be able to feel its effects. You won’t be able to stand or converse normally and you’ll feel extremely relaxed but you will still be awake. While others may view a person that seems almost asleep, your brain will still fully be engaged. While this sensation is often found to be “weird”, most people do find it pleasant.

Experience of Side Effects of the Ketamine Infusion

During the infusion, you may experience dissociation, where the mind and body seem to separate. This side effect of the ketamine infusion can often be minimized simply by opening your eyes.

As stated, your mind will be very active during the IV infusion so it may wander to thoughts of trauma or anxiety, but unlike your usual feelings around those thoughts, you will view it matter-of-factly. One patient described his ketamine infusion experience like this:

“. . . you start disassociating with everything, like you're observing, not participating in anything. It's really weird . . . As far as the mind goes, you start going through these weird levels, kind of like in the movies Inception or The Matrix, where you don't know what's real.

"You start thinking about all kinds of stuff. Whatever races through your mind—and usually when you're depressed it's negative sh*t—when you're on ketamine, it's just like: ‘Well, nothing I can do about that.’ You feel like, ‘I'm not in control, and that's fine; you're going to die someday and that's just life.’ You kind of learn to just accept it, I guess."

Although most patients do experience relaxation during a ketamine infusion, there can be moments of fright, particularly if you go into the experience with very high anxiety. Listening to calming music or watching a calming image may help with this, however. 

Feeling Better After the Ketamine Infusion Procedure

It varies as to how long it will take for the ketamine to kick in. Some find relief within only an hour or two while others need multiple infusions to feel the benefit. Unfortunately, 20-40% of people do not experience a positive response to ketamine treatment (Reviews on Ketamine for Depression).

What’s important to remember is that no matter what you experience during a ketamine infusion, it’s the changes that the ketamine makes to your brain that relieve depression and not the infusion experience itself.

When abruptly stopping antidepressants, some experience side effects from antidepressant withdrawl. Antidepressant discontinuation symptoms and what to do.

Antidepressant Discontinuation Syndrome

As bad as her panic attacks were, 27-year-old Melissa Hall says that going off the antidepressant medication she originally took as treatment was also a nightmare.

Although she followed a doctor's advice and tapered off the Paxil, she says she experienced severe dizziness, nausea and electric shock sensations, which left her virtually incapacitated.

"I didn't work for two months," she says. "I just laid on my couch waiting for the dizziness and nausea and everything to go away."

When doctors didn't have answers for her, Melissa turned to the Internet, where she found hundreds of postings by people experiencing similar symptoms as they discontinued Paxil, reassuring her that she was not alone.

Millions of people, perhaps as many as 10 percent of the American population, have taken serotonin boosters, which are often used to treat depression, panic disorder, and compulsive behavior. Many of them have no problem discontinuing use, but others experience side effects of varying degrees. And as patients like Melissa attempt to discontinue use of various antidepressants, some experts worry they are not getting enough information about how to deal with potential withdrawal side effects.

Despite anecdotal reports, there have been very few studies on the subject, and experts can't say how many people may experience some form of withdrawal.

"We see antidepressant withdrawal symptoms that can be so severe," says Dr. Joseph Glenmullen, a clinical instructor in psychiatry at Harvard Medical School and author of Prozac Backlash, "that patients feel held hostage to the antidepressant."

Antidepressant Withdrawal, Antidepressant Discontinuation Symptoms Frightening

Shari Loback was prescribed Paxil for chronic headaches by her neurologist, who she says never warned her about problems associated with getting off the antidepressant medication.

"I was so dizzy and sick, and sometimes I would get out of bed and I would just collapse because I couldn't get up," Loback says.

Other patients report experiencing balance problems, flu-like symptoms, hallucinations, blurred vision, irritability, tingling sensations, vivid dreams, nervousness and melancholy.

While different SSRIs work similarly, by adjusting the amount of serotonin in the brain, they each have a varying half-life, which is the amount of time the drug stays in the body. The SSRIs with shorter half-lives, such as Paxil, wash out of the body most quickly, which can cause a jolt to the nervous system. In contrast, antidepressant withdrawal effects may be less disruptive with Prozac, which has a longer half-life and remains in the system longer.

"Prozac is less likely to cause acute withdrawal," says Dr. Robert Hedaya, psychopharmacologist and author of The Antidepressant Survival Guide. "Withdrawal symptoms take longer to hit, but that doesn't mean you won't experience them in four or five weeks."

Compounding the problem, some experts say, is that many patients who go off the drug mistake antidepressant withdrawal symptoms for a return of the original depression symptoms they were using the drug to treat. It is then very common for patients to restart the depression medication.

"This is chasing one's tail by medicating withdrawal side effects," says Dr. Glenmullen, which often results in needlessly prolonging exposure to the drug.

The product insert for Paxil warns that "abrupt discontinuation of antidepressant medication may lead to symptoms such as dizziness, sensory disturbances, agitation or anxiety, nausea and sweating," and also mentions "withdrawal syndrome" as a rare adverse event.

Dr. David Wheadon, vice president of regulatory affairs at SmithKline Beecham, the maker of Paxil, says anecdotal reports show that withdrawal side effects "happen very rarely."

After growing concern about these withdrawal symptoms, drug companies renamed these phenomena "antidepressant discontinuation syndrome. Wheadon says these symptoms only occur in about two out of every 1,000 patients who discontinue the medication in what he calls an "appropriate" way. Even then, he says, the symptoms are mild and short-lived.

But Melissa Hall - who was ultimately able to get off the antidepressant - says her symptoms were far from mild or short-lived. "Even though I had found people on the Internet that were going through the same thing," she says, "no one knew how long it was going to take."

How to Go Off an Antidepressant:

Work closely with a doctor. Think of your doctor as your partner in healing, suggests Hedaya. Don't go off medication without medical supervision.

Taper the medication. Experts agree that the best way to avoid withdrawal side effects is to wean off the medication. By reducing the dosage in small increments, the brain can gradually adjust to the change in chemical balance and slowly adapt to living without the drug. For some people, experts say, this process may take up to a year.

Get psychotherapy. While drugs can often cover up problems, therapy can help uncover and address the underlying causes. Cognitive-behavioral treatment, for example, can work to change maladaptive behavior, bring out stifled emotions and provide you with the tools for dealing with future issues. In fact, extensive clinical research has shown that for some conditions, psychotherapy is superior to medication in the long run.

Time it right. It is best to go off medication, Hedaya suggests, when any external factors that may have led to depression or a panic attack are resolved or at least under your control. It may be beneficial to go off medication when not undergoing a major life change or enduring stress.

Exercise. Study after study provides strong evidence that exercise plays a major role in lifting mood, boosting energy, improving immune function, reducing stress, anxiety and insomnia, increasing sex drive and elevating self-esteem.

Eat a healthy, balanced diet. Consider consulting a nutritionist who can suggest foods that will positively impact mood, energy level or help treat (or at least not worsen) any other conditions.

Find a "centering practice." Dr. Richard Mackenzie of Childrens Hospital Los Angeles recommends exercises such as yoga or meditation to get in touch with your inner compass, find equilibrium, reduce stress, stabilize mood swings and relax.

Get your hormone systems tested. "Everybody should make sure they have a very thorough evaluation of their nutritional status, hormones, minerals, vitamins and immune system," says Hedaya, "to enhance possibilities of reducing dosage or going off medicine." Treatable hormone imbalances like an underactive thyroid or deficiencies of amino acids and minerals can rob you of energy, sexual vitality and feelings of well-being.

Consider vitamin supplements. Hedaya reports success in patients coming off Efexor, for example, by taking 25-50 mg. of Vitamin B6 daily. He notes, however, that excessive doses on a prolonged basis can be toxic.

Turn to friends and family. "These are people who have been in a patient's life far longer than a therapist," says Glenmullen, "and will continue to be there long after therapy is complete." Glenmullen also suggests making use of community resources such as church or support groups.

SOURCE: ABC News article, Aug. 25, 2002

Ketamine is a relatively new treatment for depression so people are often looking for ketamine treatment for depression reviews to help guide their choices. This is understandable as ketamine treatment cost falls between $400-800 per intravenous (IV) infusion and more than six infusions may be needed. Read on for real patients’ ketamine for depression reviews.

Ketamine Treatment for Depression Reviews

It’s important to note that reviews for any type of treatment are personal and individual. This means that any one person may or may not have the same experience as you. This is why it’s important to work with your doctor to decide if ketamine is a good treatment option for your depression.

That being said, there are ketamine treatment for depression reviews available.

A site like PatientsLikeMe can be valuable as individual patients can report their experiences with a treatment. As of August 2017, four patients who took ketamine for major depressive disorder and two patients who took ketamine for bipolar depression have left reviews. Of the six, three indicated that ketamine had “major effectiveness” on their condition. Two patients noted moderate effectiveness and one noted no effectiveness. Side effects to ketamine included: dissociation, dizziness, nausea, memory problems, cognition problems and drowsiness. Two of the patients noted no side effects although one of those also reported no useful effect either.

When looking at these ketamine infusion reviews, most people were happy with the treatment, with one patient saying, “Very effective. I would do it again in a heartbeat.”

However, most patients noted the cost of ketamine infusions as being burdensome.

When looking at the reviews that all patients left, regardless as to the reason the ketamine was prescribed, two out of 24 noted severe side effects and nine out of 24 noted no side effects.

Ketamine Review Article

In 2015, Vice.com published a ketamine review article called, I Used Ketamine to Treat My Depression. In it, one person with bipolar depression discusses his experience with receiving ketamine infusion for depression. Brent Miles, a 41-year-old songwriter and journalist from Phoenix, Arizona, regularly got ketamine infusion treatments at a clinic in North Scottsdale in 2013 and shares his story.

Miles’ experiences are quite positive although he notes that he could not continue the ketamine depression treatment due to cost.

You can read Miles’ experience here.

Ketamine Treatment for Depression Reviews by Doctors

As with many treatments, some doctors are wary of this new depression treatment while others forge ahead with cautious optimism.

"A really important part of these recommendations is to make sure people fully understand what the risks and benefits are to treatment so that they are able to make an informed decision based on knowing what the risk-benefit ratio is," said Gerard Sanacora, MD, PhD, professor of psychiatry and director of the Yale Depression Research Program.

Dr. Sanacora also added:

“The reality is that this is a unique situation where we have a tremendously promising treatment. We use it a lot, and I believe this really is a transformative change in the field, but we do have to appreciate the limits of the knowledge that we are working with right now.”

Ketamine isn’t just a drug used to treat depression, chronic pain or as an anesthesia, ketamine is also a street drug of abuse. Often called “special k,” ketamine is used in large doses by some in the party scene. It’s important to remember, however, that recreationally, people take much larger doses of ketamine than are used in depression treatment (How Does Ketamine Work for Depression?). This means that recreational users are more likely to experience increasing tolerance to the drug’s effects, seek greater doses and become addicted.

Ketamine Addiction

Ketamine is the number one drug of abuse in Asia, particularly Hong Kong. Some of the ketamine found on the street is diverted from pharmaceutical supplies but there is also increasing evidence of ketamine production specifically for street use, particularly in India and China. Ketamine may also be found in ecstasy in Asia.

Ketamine is also a drug of abuse in the United States. The reason why people abuse ketamine is its desirable acute effects on the person. If a person takes a street dose of ketamine, he or she may experience:

• Reduced sensations in the body / a lack of pain
• A floating or detached feeling
• A feeling of being incapable of moving
• A change in how the person sees and hears things, possibly causing hallucinations

Some people find these effects desirable. However, ketamine can also cause:

• Confusion
• Agitation
• Panic attacks
• Impairment in short- and long-term memory impairment
• Attention problems
• Difficulty in cognition
• Impaired reaction time

Death from acute ketamine use is rare but does occur.

If a person continues to abuse ketamine, over time even worse effects can be felt. Someone who is addicted to ketamine or who consistently abuses ketamine may experience:

• Depression
• Very serious bladder problems possibly leading to the bladder needing removal
• Serious damage to the urinary tract
• Liver dysfunction
• Impaired gallbladder activity
• Kidney failure
• Extreme pain, particularly during urination

You may not experience physical addiction to ketamine but you can become addicted to ketamine psychologically. Being addicted to ketamine is no joke and anyone who abuses ketamine or who is addicted to ketamine needs to seek help immediately.

How to Get Off Ketamine

Getting off ketamine involves the same thing as getting off of other drugs: going through withdrawal. Withdrawal effects make it difficult for someone trying to get off ketamine to stay sober, but withdrawal effects can be managed.
If you’re trying to get off of ketamine, symptoms of withdrawal that you might experience include:

• Double vision
• Hearing loss
• Increased heartbeat
• Rapid breathing
• Loss of motor skills
• Loss of coordination
• Depression

These effects are not typically medically dangerous although if they get out of hand, medical intervention may be needed in the short-term. While these withdrawal effects may sound awful, it’s important to remember that these effects are short-lived and day-by-day, you will start to feel better.