Ketamine for Anhedonia?

Interesting idea. The reasoning makes sense but I would probably try simpler options first before considering that path. It feels like adding quite a bit to the mix.

I started ketamine before beginning Tirz. It did not make a noticeable difference for me. I discontinued it and my therapist brought up the nasal version, but the approval process never got underway.

PT-141 could be one angle, but aside from short-term low-dose MT-2 or similar for the more basic brain areas like the hypothalamus, there are other peptides aimed at mood and cognition such as Selank, Semax, or PT-22-28. That is the idea at least. For energy, options include peptides like SS-31 along with things like caffeine. On the usual medication side, Wellbutrin or bupropion works for some and may offer minor help with weight or energy as a stimulating antidepressant that has low rates of sexual side effects. Hormonally, TRT or HRT can provide a lift too.

Ketamine is considered fairly effective for severe treatment-resistant depression. It probably would not be viewed as suitable for anhedonia by itself unless that was just part of the larger issue. It is more like using a brick to swat a fly. It is typically reserved for cases where several antidepressants and add-on strategies have already failed. There are some studies on lower oral doses but it is not near clinical use yet, and treatment needs professional oversight in a clinic or hospital setting with proper equipment. That makes it costly and hard to access in many areas. Doing it on your own is not very safe given the addiction potential, side effects, and risks of using anesthetic drugs without supervision. Bupropion would be a more practical starting point as noted earlier.

Cheers for the thoughts and those other possibilities shared. I see the point that the strong ketamine option is excessive, similar to using something massive against a tiny target. What I had in mind instead was smaller amounts or the swallowed versions that are becoming common.

The stronger ketamine infusions may work through a helpful kind of depersonalization similar to anesthesia. My family member has not seen dramatic improvement from the ketamine injections, though they seem to provide some help especially early on when starting from a low point. They are serious though since you need someone to drive you home. Based on that depersonalization idea and what I have observed, I suspect diluted forms like sublingual would not do much, probably no better than marijuana gummies.

Ketamine infusions seem to fit the mental health pattern of different approaches working for different people, but they stand out for acute or crisis situations like the one described. They also allow for talk therapy at the same time to support longer-term results. Some of the cognitive effects of ketamine are worth targeting in other ways too, such as through mindfulness or gummies for depersonalization. After years of therapy and meds, exercise and sunshine have worked better for me than traditional approaches. Exercise and reading are my preferred forms of meditation. Exercise-focused rehab programs make sense, and psychiatrists now emphasize movement even more through small steps like behavioral activation. Brain fog from GLPs like tirz can also improve with carbs and staying active.

I would suggest looking into Selank and Bromantane.

I dealt with chronic depression for many years and went through ketamine therapy, which helped me a great deal. It seems like a solid option for depression, so if GLP-1 use is leaving you feeling depressed I would discuss ketamine sessions with your doctor.