0.5 mg/kg intravenous. For frame of reference, a small recreational dose is between 5-25 mg (insufflated[0]), and a larger recreational dose (for people targeting a "k-hole") is more like 50-100mg. For clinical depression (ie, not this study, but for a similar purpose), the fixed dose is 84mg (not weight-based).

So assuming a 75kg individual, that would be a 37.5mg intravenous dose, which is definitely going to provide a noticeable effect for any ketamine-naive user (ie, someone who does not already have a tolerance for the drug from recent prior use).

> The problem with ketamine and suicidality studies is that suicides - thankfully don’t happen very often - so we have no direct evidence that ketamine prevents suicides.

That's not really a problem - suicidal ideation is a strong enough predictor for suicidality and mental health that it's common to use as a biomarker. In other words, nearly anything that reduces suicidal ideation is presumed to reduce suicidality (on a large scale) - it's not necessary to wait months or years to see what happens (and in fact, depending on the specifics of the study, it can be considered unethical to do so).

Source: former clinical researcher and drug counselor

[0] bioavailability when insufflated is significantly less than other means of ingestion

About the first point, I still disagree with the parent comment. The standard 0,5mg/kg ketamine is given under 40 minutes. I've seen two patients receive it. The room was dimly lit, silent and peaceful, as to not induce or exacerbate any possible dissociative or hallucinative side effects. The patients didn't report any side effects at first and later reported a little sedation. I wouldn't be a able to tell with certainty if they had received a placebo or ketamine, and certainly not within minutes.

Source: psychiatrist in training

Edit: I still think we need hard data about anti-suicide effect and not just surrogate markers. Variability in suicidal ideation is suggested to be a predictor of suicide attempts [1]. If ketamine first gets someone better and later on they relapse, they could, in theory, be at increased risk for suicide. More long term data is also needed about it's long term effects. Note that I do think it's a good thing that ketamine is becoming more available! I will continue to suggest it for e.g. patients with treatment resistant and severe depression.

[1] https://www.sciencedirect.com/science/article/abs/pii/S01650...

And I'm not drug naive by a very long shot. On my 2nd infusion there was an older gentleman across the hall from me who had never had anything stronger than scotch whiskey. He was not having a good time at all.

7 days falling in and out of the K-hole while hallucinating is not as much fun as it sounds.

.5 mg/kg

I was numb all over, my lips tongue and throat were numb.

I melted in to the chair and felt like I was up down and sideways at the same time.

You would not be able to tell immediately but I put on my blindfold within 7 minutes due to effects starting.

You certainly notice the effects of IV K. So do other people when you start to talk to a hairbrush. It's a bit draining after a few days though, and not terribly fun.

How numb does it make you. My mouth and throat being numb was very surprising.

However, I have no idea how other sedations feel, so who knows if they are a good placebo. Could be.

A friend of mine did it last week and he described it as the most intense experience of his life. He’s 40 and he has experience with other drugs.

I think possibly you don’t know what you’re talking about?

A lot of people take amphetamines as a medically prescribed treatment for ADHD (and other conditions such as narcolepsy too). A lot of people take amphetamines recreationally. Studies done on the negative heath consequences for recreational users are largely irrelevant to medically prescribed users, because your average recreational dose is an order of magnitude (or more) higher than the average prescribed dose. Increase the dose ten-told, it acts like a different drug altogether.

Plus, the irregular dosing schedule of recreational users probably isn’t helping either. And many recreational users try to get the drug into their bloodstream as fast as possible (injection, snorting, smoking), while most prescription drugs aim to be released more gradually (oral route, sometimes even extended release or an inactive prodrug such as Vyvanse/lisdexamfetamine)

What you're saying applies in other cases, but in the case of ketamine, the recreational dose is one or two orders of magnitude lower than the clinical dose.

It was more intense and less intense at the same time because I did not know what to expect.

At home treatments with sublingual trockies have much less side affects, but differently still noticeable. Nasal spray is the weakest with just some minor body numbing.