I agree that Ketamine should be avoided. I have TRD. Have tried CBT, acupuncture, any number of antidepressants, a lot of therapists, Xanax, AND Ketamine. K just crap and absolutely zero help with anxiety, depression. Seemed psychedelic. I dunno; seemed like a legal way for crack heads to get high or whatever, tho I don’t know what “high” is. I tried legal medical marijuana. But never having used marijuana, tobacco or “recreational drugs” I probably didn’t do it right. The one time, I seemed to see MYSELF talking nearby with my wife about whether I actually “were there or not” or had “passed on” or something. Very gradually the drug (M) must have worn off and I kinda merged back to my actual self. Never tried it again. But still have the expired state of AZ card. Just FYI, what I take daily: Lexapro, Xanax only 1.5mg per day, Adderall XR 30mg in morning, Adderall IR 30mg around noon. Always tired but Adderall gives me maybe 5-6 productive hours a day. A former Dr. thought I had ADD & prescribed it maybe 25 years ago. Gave me energy without other noticeable side-effects. Maybe did hurt sleep if taken too late in the day. Had 2 sleep studies (bogus) and tried CPAP, also racket. I truly hope that you’ll find a positive outcome. Tom