Positives

• Daily micro-dose troches from the Joyous program “made my brain fog non-existent… my brain hasn’t been this clear in years.”

• After nearly a year of twice-weekly sublingual doses, one long-hauler said ketamine left them “75 % recovered,” easing POTS, fatigue and migraines.

• Several forum members describe each infusion as a “break-through moment,” lifting ME/CFS-style cognitive fog and pain without worsening PEM.

• A HealthRising case report credits 800 mg infusions for cutting chronic-pain scores from 8/10 to 2–3 for weeks and “saving my life” in severe CFS.

• A Munich pilot study combining six ketamine infusions with rTMS dropped fatigue scores from 60 → 11 and improved smell/taste in most post-COVID patients.

Negatives

• “Ketamine didn’t do ANYTHING for my LC symptoms—only depression,” warns one long-COVID poster who still lacks smell and taste.

• Another ME/CFS user reports worse brain-fog, memory lapses and insomnia for up to 24 h after dosing.

• Twice-weekly IV trips left a patient “atrociously unwell” with rolling crashes despite mood gains.

• A long-term oral user (200 mg weekly) paused therapy after new cognitive problems and persistent fog.

• Press pieces label the booming ketamine market a “wild west,” citing addiction risk, hallucinations and scant COVID-specific data.

Hurdles & Side Effects

• Cost: clinics commonly charge about $2,250 for a six-infusion starter series (~$375 each) and require cash or financing.

• Severe exertion intolerance makes the 2-hour round-trip to infusion centers—and the need for a driver—unmanageable for some.

• Acute effects patients mention include dissociation, vivid dreams, blood-pressure spikes, nausea and a 24-hour “out-of-sorts” hangover.

• Feeling “too good” can mask limits; over-doing activity afterward often triggers post-exertional malaise.

• Even clinics note the approach is experimental—the GW Center only just scheduled its first dedicated long-COVID ketamine retreat. gwcim.com