Originally Posted by ketscrip

Nazgurl, very sorry to hear that your friend is suffering. I can't answer your question entirely, but hope my partial response might be useful to you.

I have personal experience with ketamine. I, too, had given up. I battled Major Depressive Disorder and constant suicidal thoughts for 30 years until I received a ketamine infusion last Dec, which relieved my symptoms 100%. Now I take intranasal ketamine periodically to extend the effects of the infusion.

I don't know if the ER you mentioned offers ketamine infusion. But in general, if someone is presenting as suicidal, I think admittance is mandatory; and they will require the patient "contract for safety" before being discharged. If they do indeed offer ketamine infusions, and if your friend is one of the 80% who responds, his mood will improve rapidly and he could possibly be discharged very quickly. The infusion itself does not require an overnight stay. But the hospital's duty to ensure the patient is not a danger to himself MIGHT require an overnight stay, depending on his response to the ketamine and their assessment of him.

There is a rapidly-growing population of doctors who offer ketamine for depression. The per-infusion cost seems to range from $500-$1000 and none of them accept insurance because they are using ketamine off-label (meaning it is not FDA approved for depression). So yes, it is costly, especially if travel is involved. I volunteered for a clinical trial and so I incurred no cost. You can search *edit* to find the nearest ketamine study. Perhaps there is one close to your friend's home? There is at least one currently underway in NYC, run by Dr. Murrough at Mount Sinai.

I hope you are able to help your friend get access to a ketamine clinician. It doesn't work for everyone, but the response rate is quite high. The people in my clinical trial were all extreme cases, with treatment-resistant depression lasting 20, 30, even 40 years. Most of us experienced a miraculous, rapid, near-total relief from our infusions.

Your friend is very lucky to have someone who cares enough to help him, although his pain probably prevents him from fully appreciating that. Good luck to you both.