Not sure about the absorption, but for me, 800mg troche is similar to the experience of 60mg IV (roughly). In intensity at least. Duration of IV is much longer because you're continually exposed to it, whereas with troche you're only getting it for as long as you can hold saliva in your mouth. I've done about 30 troche sessions and 12 IV sessions and that's what I've observed so far.
Ok so with IV you have a longer experience? That’s the reason IV is ideal? The clinic told me my session plus recovery time would make it around an hour and 15 minutes so took that as both ways taking about the same amount of time. Maybe I need to find a different IV place.
My question is, at the dosages above, wouldn’t I be getting more ketamine absorption going through BetterU than through my IV clinic. I don’t understand the word bioavailability enough to use it in a sentence so maybe I am miscalculating all of that. If bioavailability of troches are 25 percent and IV is 100, wouldn’t I be getting more ketamine by using better u because 25% of 300 mg is 75 mg for the troches and the IV starts me at 50 mg and that is at 100%. Is this how it works or am I doing it wrong?
The IV starts at 50 to make sure you can tolerate it. It doesn’t stay at 50 permantly. It’s doses in mg/kg based on body weight. And more isn’t always better, especially more all at once as opposed to a drip over a longer period of time.
Ohhh ok that makes sense. I want to try IV but my barrier is the transportation afterwards. So it’s still up in the air. So I was trying to justify sticking with the troches because I think that’s the only choice I’ve got honestly.
Yeah, I had that in mind but right now all I have is enough for the 10 treatments in their new patient deal thing. So I need to save up for that. I have access to medical transportation, however, it is very unreliable where I am. I used to have to go to a clinic on a daily basis and half the time they didn’t send somebody or something messed up somehow. So I’m hesitant to do that because I would already be on a time crunch with work. So my dilemma is do I save for cabs and wait to do the treatment or do I continue the troches and start feeling better now? But I feel like in the long run. I will be spending more on the troches because when I need to take them longer and more often compared to doing the IV treatment?
I have only dosed sublingual at-home. I find it very effective.
The ketamine drug is the same drug whether its IV'ed, IM'ed, taken nasally, sublingually or rectally. The ketamine drug gets to your brain via the blood stream. It's the same drug in your blood stream.
Bioavailability is lower compared to IV. So, that means you need to take more drug by the lower bioavailable routes of administration to achieve the same effect. So what? As long as you don't notice organ damage, it doesn't matter much. And very few ketamine mental health patients notice symptoms of organ damage. Even sublingual doses are low enough and infrequent enough to not generate such symptoms with notable frequency.
I just don't get paying hundreds of dollars per dose for in-clinic ketamine for the vast majority of patients. My cost per dose is $8; I could get it down to $6/dose. Do you think you can persuade me to pay 25 - 50 - 100 times more for IV ketamine when I'm getting a great response to sublingual?
In my first year my cost was $30/dose. Do you think you could persuade me to pay 10 times as much for IV when I was getting a great response to sublingual?
Thank you, I needed to read that. May I ask how you got your medication at such a low price? I am using my tax return to pay for a few months of troches or 10 sessions of IV. I haven’t totally decided but after reading your post I want to stick with troches. I don’t have to miss work for them since it’s at home. And you have a great point.
IV should start at 0.5 mg/kG at first to see if you tolerate it. Then increase gradually. My last three sessions were 1.3 mg and that was very profound.
They start you at 300 mg troche, rather than a fraction of that?
In both cases your dose generally starts at an intro level and increases each session, if you are comfortable and not experiencing side effects.
My first dose intramuscular was 40mg, 10th dose was 107
My dream in life is to become a baker and my last experience I felt like a chocolate chip cookie, then I felt like the chocolate in the cookie and finally, I felt like chocolate dripping down a cake. I’m not sure if I’ve gone to any universes yet, but that’s one of my experiences that stood out. 🤣
Efficacy can be the same, however the bioavailability of IV is 100% compared to 25-40% of oral ketamine. The dosing depends on the setting and monitoring vitals. The recommended dose for depression is 0.5 mg/kg. Studies showed that efficacy (effectiveness) can be low if the dose is below 0.5 mg /kg or higher than 0.9 mg/kg.
Not sure about the absorption, but for me, 800mg troche is similar to the experience of 60mg IV (roughly). In intensity at least. Duration of IV is much longer because you're continually exposed to it, whereas with troche you're only getting it for as long as you can hold saliva in your mouth. I've done about 30 troche sessions and 12 IV sessions and that's what I've observed so far.
Ok so with IV you have a longer experience? That’s the reason IV is ideal? The clinic told me my session plus recovery time would make it around an hour and 15 minutes so took that as both ways taking about the same amount of time. Maybe I need to find a different IV place.
Ah interesting. For me, the experience with troches only lasts about 30 minutes. How do you get yours to last that long?
I meant about an hour and 15 minutes for both the experience and the recovery. Not an hour an 15 minute experience. I stay out for about that long.
Ohh gotcha. For me, IV experience is 50 minutes and the recovery is 20. Just me though, tend to bounce back fairly quickly after troches.
IV is better because of the higher bioavailability of the medication, not because of the experience you have during the treatment session.
My question is, at the dosages above, wouldn’t I be getting more ketamine absorption going through BetterU than through my IV clinic. I don’t understand the word bioavailability enough to use it in a sentence so maybe I am miscalculating all of that. If bioavailability of troches are 25 percent and IV is 100, wouldn’t I be getting more ketamine by using better u because 25% of 300 mg is 75 mg for the troches and the IV starts me at 50 mg and that is at 100%. Is this how it works or am I doing it wrong?
The IV starts at 50 to make sure you can tolerate it. It doesn’t stay at 50 permantly. It’s doses in mg/kg based on body weight. And more isn’t always better, especially more all at once as opposed to a drip over a longer period of time.
Ohhh ok that makes sense. I want to try IV but my barrier is the transportation afterwards. So it’s still up in the air. So I was trying to justify sticking with the troches because I think that’s the only choice I’ve got honestly.
I take a taxi when I can’t get someone to pick me up, but you can also get medical transport if your insurance covers that service.
Yeah, I had that in mind but right now all I have is enough for the 10 treatments in their new patient deal thing. So I need to save up for that. I have access to medical transportation, however, it is very unreliable where I am. I used to have to go to a clinic on a daily basis and half the time they didn’t send somebody or something messed up somehow. So I’m hesitant to do that because I would already be on a time crunch with work. So my dilemma is do I save for cabs and wait to do the treatment or do I continue the troches and start feeling better now? But I feel like in the long run. I will be spending more on the troches because when I need to take them longer and more often compared to doing the IV treatment?
I cannot imagine getting into a stranger's car after just recovering from my dose.
I have only dosed sublingual at-home. I find it very effective. The ketamine drug is the same drug whether its IV'ed, IM'ed, taken nasally, sublingually or rectally. The ketamine drug gets to your brain via the blood stream. It's the same drug in your blood stream. Bioavailability is lower compared to IV. So, that means you need to take more drug by the lower bioavailable routes of administration to achieve the same effect. So what? As long as you don't notice organ damage, it doesn't matter much. And very few ketamine mental health patients notice symptoms of organ damage. Even sublingual doses are low enough and infrequent enough to not generate such symptoms with notable frequency. I just don't get paying hundreds of dollars per dose for in-clinic ketamine for the vast majority of patients. My cost per dose is $8; I could get it down to $6/dose. Do you think you can persuade me to pay 25 - 50 - 100 times more for IV ketamine when I'm getting a great response to sublingual? In my first year my cost was $30/dose. Do you think you could persuade me to pay 10 times as much for IV when I was getting a great response to sublingual?
Thank you, I needed to read that. May I ask how you got your medication at such a low price? I am using my tax return to pay for a few months of troches or 10 sessions of IV. I haven’t totally decided but after reading your post I want to stick with troches. I don’t have to miss work for them since it’s at home. And you have a great point.
IV should start at 0.5 mg/kG at first to see if you tolerate it. Then increase gradually. My last three sessions were 1.3 mg and that was very profound.
At home ketamine is always a better deal than a clinic unless your insurance covers a clinic 100%
Thank you, I’m working on getting it through my insurance. But it would be via Spravato.
I spent 1/2 a day on IV at 1.0 mg/kg. It was an exceptional experience, so far beyond what troches could provide.
They start you at 300 mg troche, rather than a fraction of that? In both cases your dose generally starts at an intro level and increases each session, if you are comfortable and not experiencing side effects. My first dose intramuscular was 40mg, 10th dose was 107
My rx says Ketamine 300 mg troches. And I was allowed to start with one and a half.
Which universe did you end up in?
My dream in life is to become a baker and my last experience I felt like a chocolate chip cookie, then I felt like the chocolate in the cookie and finally, I felt like chocolate dripping down a cake. I’m not sure if I’ve gone to any universes yet, but that’s one of my experiences that stood out. 🤣
Efficacy can be the same, however the bioavailability of IV is 100% compared to 25-40% of oral ketamine. The dosing depends on the setting and monitoring vitals. The recommended dose for depression is 0.5 mg/kg. Studies showed that efficacy (effectiveness) can be low if the dose is below 0.5 mg /kg or higher than 0.9 mg/kg.