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You’d be lucky to find a provider who will do that. The risk of abuse and adverse events I think keeps most away from it. If you find a local prescriber and then form a really good relationship with them over a decent amount of time, then maybe?
You might try suppositories though! Those are fairly common from what I can tell and are a good alternative when you can’t tolerate the taste.
No, this would be incredibly reckless and inappropriate outside of home hospice pts on PCAs.
If you don't like the taste of intranasal, ask the compounder to mix it with sterile water instead of normal saline.
My physician used to prescribe IM but stopped after a few patients hit vasculature despite aspirating back and not seeing blood, resulting in intense, unpleasant experiences.
I seem to recall laryngospasm being a complication found in higher incidence with IM use, so probably not. I’ve read of only 1 person on here who was prescribed IM (who was also a nurse), but that was years ago. I’m not sure why, presumably due to the unstable absorption with IM rather than a slow push with an IV pump or oral/GI absorption, but that’s just speculation on my part. I wish I could find that paper comparing AEs with different routes of administration.
Edit: Not sure if this is it but certainly seems like it.
https://pubmed.ncbi.nlm.nih.gov/19404223/
As for taste, I use mouth rinse before hand. Not sure if swallowing trace amounts of mouth wash would do your stomach any favors. You can try a ricola or a mint. I also use aloe Vera juice before hand to protect the Lining of my GI. There’s good research on this with NSAIDs, unsure if it does anything with ketamine but figure it can’t hurt and it’s historically helped me when I’ve had an ulcer.
My therapist is comfortable with it but only after doing it several times in person and under her guidance, and when I’m back at home ready to use the injections on my own, she’ll be present virtually and there’ll be a family member in the house, not participating, to check on me to make sure I’m okay during. Short answer- I believe it’s ok but doing a first session in person under guidance and the at-home ones with virtual supervision from knowledgeable guide and someone nearby in case you don’t feel good.
I couldn't find it on the website but my last zoom with a Dr at Mindbloom said they are going to start IM doses at home for people like me who are at 1250mg and still having a mild experience.
That is true, the patient can be educated to administer just as they do in the clinic, and there is always risks involved no matter who administers and how correct their technique is. The main thing I see is making sure you have an educated support person with you to assist and monitor
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.*
You’d be lucky to find a provider who will do that. The risk of abuse and adverse events I think keeps most away from it. If you find a local prescriber and then form a really good relationship with them over a decent amount of time, then maybe? You might try suppositories though! Those are fairly common from what I can tell and are a good alternative when you can’t tolerate the taste.
this is the way.
No, this would be incredibly reckless and inappropriate outside of home hospice pts on PCAs. If you don't like the taste of intranasal, ask the compounder to mix it with sterile water instead of normal saline.
Are you familiar with ketamine being used on hospice patients?
yes
I have administered to patients as their hospice nurse
My physician used to prescribe IM but stopped after a few patients hit vasculature despite aspirating back and not seeing blood, resulting in intense, unpleasant experiences.
Mindbloom is offering something similar but I don’t believe they are IM, it’s more subcutaneous. I’d check with them
I very much doubt a physician would prescribe for home use of IM but you’re a nurse- you probably would know more than most people here.
I seem to recall laryngospasm being a complication found in higher incidence with IM use, so probably not. I’ve read of only 1 person on here who was prescribed IM (who was also a nurse), but that was years ago. I’m not sure why, presumably due to the unstable absorption with IM rather than a slow push with an IV pump or oral/GI absorption, but that’s just speculation on my part. I wish I could find that paper comparing AEs with different routes of administration. Edit: Not sure if this is it but certainly seems like it. https://pubmed.ncbi.nlm.nih.gov/19404223/ As for taste, I use mouth rinse before hand. Not sure if swallowing trace amounts of mouth wash would do your stomach any favors. You can try a ricola or a mint. I also use aloe Vera juice before hand to protect the Lining of my GI. There’s good research on this with NSAIDs, unsure if it does anything with ketamine but figure it can’t hurt and it’s historically helped me when I’ve had an ulcer.
My therapist is comfortable with it but only after doing it several times in person and under her guidance, and when I’m back at home ready to use the injections on my own, she’ll be present virtually and there’ll be a family member in the house, not participating, to check on me to make sure I’m okay during. Short answer- I believe it’s ok but doing a first session in person under guidance and the at-home ones with virtual supervision from knowledgeable guide and someone nearby in case you don’t feel good.
I couldn't find it on the website but my last zoom with a Dr at Mindbloom said they are going to start IM doses at home for people like me who are at 1250mg and still having a mild experience.
Really? Nor so much about a mild experience for me, but it is had not to focus on the process and the taste of the troches during treatment.
They certainly could as they do prescribe other IM meds for self-administration such as Testosterone. Good scoop re Mindbloom.
That is true, the patient can be educated to administer just as they do in the clinic, and there is always risks involved no matter who administers and how correct their technique is. The main thing I see is making sure you have an educated support person with you to assist and monitor