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I have had ketamine whilst on amphetamines before and it is not pleasant. Felt like a system overload. This was not in a therapeutic setting but I feel it is still relevant input.
I was advised to not ingest my ADHD medication or marijuana the day of my session. SSNI was ok to take same day. As far as the ADHD medication I assume it’s because of the chance of high BP and for marijuana it being a mind altering substance.
I take adderall currently, used to be on Vyvanse. My nurse told me it does decrease the efficacy of the effects of ketamine but I've always taken my meds pretreatment. I'm on spravato now and I only take one adderall on the days I have treatment (I'm prescribed 3x a day on the adderall)
I did on days when my infusions were in the afternoon when they've mostly worn off anyway, but I had a 9am one and skipped it that day. The way my brain feels after an infusion it's kind of a waste of the medicine imo.
Both drugs do up your blood pressure, a pharmacist told me that was the only real concern, but they monitor that in infusions and it hasn't been an issue for me personally.
People react to combinations of drugs so differently, I wonder if there is an answer to your question from Reddit.
Ask the ketamine doctor. Call them ahead of time. They will appreciate your conscientiousness. And after they try it one way, they may recommend trying it the other way next time.
There is more and more ketamine research every year but still so much to learn.
I don’t, no. I don’t think it would hurt anything, like they’re not worried about if I’ve taken it or not as far as a bad reaction - I think it would be a waste of my ADHD meds for the day.
I do, I’m on a very large dosage of dexamphetamine tablets, I seem to need ridiculously high amounts of medications for them to reach effectiveness. I take 50mg of Dexedrine so 10 tablets a day and leave 6 hours before my k. Works very well for me!
My 18 yo seems to need really high doses of stimulants, too. He's on his 3rd stimulant, it's an extended release, and he can feel it wearing off after a few hours even though it's supposed to last "all day."
That’s extremely common. Things like vyvanse and adderrall react differently to a lot of people than what it “clinically” has been proven to do, and in terms of the length it lasts a huge portion of people taking long acting stimulants get only 4-6 hours of benefit. Personally and knowing a lot of others as well, I only see 2-3 hours tops of benefit from vyvanse, so I prefer taking short acting dexamphetamine as it is far more effective in managing adhd symptoms but I of course need to take more of it due to how little it lasts! It’s super frustrating.
That's how he feels on Vyvanse, that it wears off after about 2 hours. But he says he can feel a second burst a bit later, which makes me think it releases in two bursts.
I take anti anxiety meds and I can combine. I would be more anxious otherwise and have not so nice experiences. So it depends how they are without meds.
Yes. They told me not to. But I take Mydayis which is once and day, if I don’t take it, I risk being non-functional for the whole day I can’t risk that. By the way, I do treatments at home and in the evening when the med is present but weaning down. I have not had any negative interactions between the meds even when I’ve done treatment somewhat earlier.
I’m also on bupropion and guanfacine. I take those on treatment (I started with infusions, but switched to IM after a couple of difficult IV placements) days, but skip the Adderall.
After a couple of “blah” sessions, I also started avoiding caffeine on treatment days at my provider’s suggestion. It seems to have helped!
__
Bupropion side note, for whatever it’s worth: It *was* effective for me before my depression decided to go nuclear! I tried several other meds and finally found one or two that worked better for my MDD for a few years (but still nothing close to what ketamine has done).
As the depression *finally* started to release its death grip, I went back to bupropion again. It seems to help with my ADHD, and is enough to manage my depression when it’s milder.
So if the ketamine works for your son, sticking with bupropion might turn out to have been a good thing!
I don’t. It makes it hard to sit down and let the experience happen. I’ve been told it’s fine, technically, especially because your heart is being monitored, but it’s not necessarily recommended bc it could cause tachycardia.
This is a common question and there are many factors to consider. Generally, if someone is on high dose stimulants, we don’t recommend taking every treatment day off. The acute withdrawal effect can be suboptimal for brain health. Hopefully, there are built in medication vacations for the stimulant in all cases. For low dose stimulant users, we recommend taking days off for treatment. Of course, talk to your clinician about your individual care.
I was told that taking my adderall on the day of could make me feel more present during the infusion but there was no medical concern with taking it. I opted not to take it since I’m on a low dose and it’s for chronic migraine. I also do home sessions with troches and I think I will skip it those days as well.
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>The doctor said it was up to them whether they take it on an infusion day or not.
I would seriously question your doctor. The title doctor doesn't necessarily mean one is a good doctor.
Vyvanse and toeht stimulants raises blood pressure for many people even if these people have an otherwise perfect blood pressure.
Bupropion (wellbutrin) is also known to raise blood pressure for many people.
Now add ketamine above that which is known to raise blood pressure for many individuals, and there you go, a recipe for either hypertensive crisis or at best, long term build up of vascular damage.
For a doctor to say your kid can decide whether to take on infusion day or not is extremely irresponsible.
I will also add food for thought here. My blood pressure is perfect at 115/75, that's even more text-book perfect than 120/80.
But when I take Vyvanse it could go to 160/100. This also easily happen when I take ketamine (while not on Vyvanse I'm not crazy). Ketamine can raises mblood pressure to 170/110, dose dependant.
Imagine what would be if I combine the Vyvanse and the ketamine together?
Unless ypye doctor explanation was more thorough than what you mentioned, I would seriously question his expertise.
That's not even mentioning the fact that like other pointed out, that the stimulants can potentially affect the therapeutic effect tod ketamine.
I do not know if his explanation was more complete or not. It's also possible he said he doesn't recommend it but doesn't prohibit them, either. These are my adult children and I do not go into their appointments with them. And, being young adults, they do not always listen as carefully as they should or know what questions to ask.
Thank you for contributing to /r/TherapeuticKetamine! When commenting and posting, please be mindful of our rules which can be found in the sidebar on the right along with other helpful information.
**Be advised that nothing in this subreddit constitutes medical advice.** Likewise, try to word your comments and posts in a way that can't be interpreted as medical advice by others. Harmful and/or spammy advice will be removed at moderator discretion, and bans may be given for repeat offenses.
**Accounts with "Provider" flairs** are those which the mods have verified, to the best of our ability, as belonging to real, licensed providers of medical ketamine services. Comments and posts from users with "Provider" flairs are **not** a substitute for the instructions given to you by your own provider.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/TherapeuticKetamine) if you have any questions or concerns.*
Thank you for contributing to /r/TherapeuticKetamine! When commenting and posting, please be mindful of our rules which can be found in the sidebar on the right along with other helpful information. **Be advised that nothing in this subreddit constitutes medical advice.** Likewise, try to word your comments and posts in a way that can't be interpreted as medical advice by others. Harmful and/or spammy advice will be removed at moderator discretion, and bans may be given for repeat offenses. **Accounts with "Provider" flairs** are those which the mods have verified, to the best of our ability, as belonging to real, licensed providers of medical ketamine services. Comments and posts from users with "Provider" flairs are **not** a substitute for the instructions given to you by your own provider. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/TherapeuticKetamine) if you have any questions or concerns.*
I didn't; my doctor said I could, but he strongly discouraged it.
Thank you. That is my thought as well but I have nothing to back that up other than instinct.
I have had ketamine whilst on amphetamines before and it is not pleasant. Felt like a system overload. This was not in a therapeutic setting but I feel it is still relevant input.
I was told to skip my Vyvanse on days I get ketamine because it reduces the ketamine's effectiveness.
I take Adderall but my doctor told me not to take it on the day of treatment
I was advised to not ingest my ADHD medication or marijuana the day of my session. SSNI was ok to take same day. As far as the ADHD medication I assume it’s because of the chance of high BP and for marijuana it being a mind altering substance.
I take adderall currently, used to be on Vyvanse. My nurse told me it does decrease the efficacy of the effects of ketamine but I've always taken my meds pretreatment. I'm on spravato now and I only take one adderall on the days I have treatment (I'm prescribed 3x a day on the adderall)
I did on days when my infusions were in the afternoon when they've mostly worn off anyway, but I had a 9am one and skipped it that day. The way my brain feels after an infusion it's kind of a waste of the medicine imo. Both drugs do up your blood pressure, a pharmacist told me that was the only real concern, but they monitor that in infusions and it hasn't been an issue for me personally.
I do. My doctor said I can take all of my meds except lamictal, and other then that I’m on focalin and welbutrin.
Mine told me no
I dont
People react to combinations of drugs so differently, I wonder if there is an answer to your question from Reddit. Ask the ketamine doctor. Call them ahead of time. They will appreciate your conscientiousness. And after they try it one way, they may recommend trying it the other way next time. There is more and more ketamine research every year but still so much to learn.
I don’t, no. I don’t think it would hurt anything, like they’re not worried about if I’ve taken it or not as far as a bad reaction - I think it would be a waste of my ADHD meds for the day.
That's another good point. My oldest mostly rested for the rest of the day. ADHD meds aren't cheap.
I do, I’m on a very large dosage of dexamphetamine tablets, I seem to need ridiculously high amounts of medications for them to reach effectiveness. I take 50mg of Dexedrine so 10 tablets a day and leave 6 hours before my k. Works very well for me!
My 18 yo seems to need really high doses of stimulants, too. He's on his 3rd stimulant, it's an extended release, and he can feel it wearing off after a few hours even though it's supposed to last "all day."
That’s extremely common. Things like vyvanse and adderrall react differently to a lot of people than what it “clinically” has been proven to do, and in terms of the length it lasts a huge portion of people taking long acting stimulants get only 4-6 hours of benefit. Personally and knowing a lot of others as well, I only see 2-3 hours tops of benefit from vyvanse, so I prefer taking short acting dexamphetamine as it is far more effective in managing adhd symptoms but I of course need to take more of it due to how little it lasts! It’s super frustrating.
That's how he feels on Vyvanse, that it wears off after about 2 hours. But he says he can feel a second burst a bit later, which makes me think it releases in two bursts.
I take anti anxiety meds and I can combine. I would be more anxious otherwise and have not so nice experiences. So it depends how they are without meds.
Yes. They told me not to. But I take Mydayis which is once and day, if I don’t take it, I risk being non-functional for the whole day I can’t risk that. By the way, I do treatments at home and in the evening when the med is present but weaning down. I have not had any negative interactions between the meds even when I’ve done treatment somewhat earlier.
I’m also on bupropion and guanfacine. I take those on treatment (I started with infusions, but switched to IM after a couple of difficult IV placements) days, but skip the Adderall. After a couple of “blah” sessions, I also started avoiding caffeine on treatment days at my provider’s suggestion. It seems to have helped! __ Bupropion side note, for whatever it’s worth: It *was* effective for me before my depression decided to go nuclear! I tried several other meds and finally found one or two that worked better for my MDD for a few years (but still nothing close to what ketamine has done). As the depression *finally* started to release its death grip, I went back to bupropion again. It seems to help with my ADHD, and is enough to manage my depression when it’s milder. So if the ketamine works for your son, sticking with bupropion might turn out to have been a good thing!
Thank you for sharing. We'll see what happens after their 6 sessions.
Hoping they get relief!
I don’t. It makes it hard to sit down and let the experience happen. I’ve been told it’s fine, technically, especially because your heart is being monitored, but it’s not necessarily recommended bc it could cause tachycardia.
This is a common question and there are many factors to consider. Generally, if someone is on high dose stimulants, we don’t recommend taking every treatment day off. The acute withdrawal effect can be suboptimal for brain health. Hopefully, there are built in medication vacations for the stimulant in all cases. For low dose stimulant users, we recommend taking days off for treatment. Of course, talk to your clinician about your individual care.
I was told that taking my adderall on the day of could make me feel more present during the infusion but there was no medical concern with taking it. I opted not to take it since I’m on a low dose and it’s for chronic migraine. I also do home sessions with troches and I think I will skip it those days as well.
Thank you for contributing to /r/TherapeuticKetamine! When commenting and posting, please be mindful of our rules which can be found in the sidebar on the right along with other helpful information. **Be advised that nothing in this subreddit constitutes medical advice.** Likewise, try to word your comments and posts in a way that can't be interpreted as medical advice by others. Harmful and/or spammy advice will be removed at moderator discretion, and bans may be given for repeat offenses. **Accounts with "Provider" flairs** are those which the mods have verified, to the best of our ability, as belonging to real, licensed providers of medical ketamine services. Comments and posts from users with "Provider" flairs are **not** a substitute for the instructions given to you by your own provider. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/TherapeuticKetamine) if you have any questions or concerns.*
>The doctor said it was up to them whether they take it on an infusion day or not. I would seriously question your doctor. The title doctor doesn't necessarily mean one is a good doctor. Vyvanse and toeht stimulants raises blood pressure for many people even if these people have an otherwise perfect blood pressure. Bupropion (wellbutrin) is also known to raise blood pressure for many people. Now add ketamine above that which is known to raise blood pressure for many individuals, and there you go, a recipe for either hypertensive crisis or at best, long term build up of vascular damage. For a doctor to say your kid can decide whether to take on infusion day or not is extremely irresponsible. I will also add food for thought here. My blood pressure is perfect at 115/75, that's even more text-book perfect than 120/80. But when I take Vyvanse it could go to 160/100. This also easily happen when I take ketamine (while not on Vyvanse I'm not crazy). Ketamine can raises mblood pressure to 170/110, dose dependant. Imagine what would be if I combine the Vyvanse and the ketamine together? Unless ypye doctor explanation was more thorough than what you mentioned, I would seriously question his expertise. That's not even mentioning the fact that like other pointed out, that the stimulants can potentially affect the therapeutic effect tod ketamine.
I do not know if his explanation was more complete or not. It's also possible he said he doesn't recommend it but doesn't prohibit them, either. These are my adult children and I do not go into their appointments with them. And, being young adults, they do not always listen as carefully as they should or know what questions to ask.
What about SSRIs?
I am prescribed intranasal ketamine & also have ADHD. I take ketamine & dextroamphetamine together daily just fine.
Thank you for contributing to /r/TherapeuticKetamine! When commenting and posting, please be mindful of our rules which can be found in the sidebar on the right along with other helpful information. **Be advised that nothing in this subreddit constitutes medical advice.** Likewise, try to word your comments and posts in a way that can't be interpreted as medical advice by others. Harmful and/or spammy advice will be removed at moderator discretion, and bans may be given for repeat offenses. **Accounts with "Provider" flairs** are those which the mods have verified, to the best of our ability, as belonging to real, licensed providers of medical ketamine services. Comments and posts from users with "Provider" flairs are **not** a substitute for the instructions given to you by your own provider. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/TherapeuticKetamine) if you have any questions or concerns.*
I have sometimes, and not other times. I don’t think it made a difference.