Personally, I have no issues with the dissociative effects per se. However, studies have determined that they aren't related to the antidepressant effect. Fwiw, a full clinical dose feels like ~1/4 of a 'rail'. There's no introspective trip here, just slight drunkenness.
(Incidentally, we have some evidence that the metabolite that causes the effect can be blocked via concurrent CBD administration - without reducing the dissociative effect)
The standing appointment to get slightly high for a couple of hours every three days does get inconvenient (though it's not as problematic as the resultant insomnia). I expect esketamine will be more so, for less antidepressant effect. And, being a controlled substance, I'm concerned I'll be unable to increase my dosage to make up the difference.
(Incidentally, we have some evidence that the metabolite that causes the effect can be blocked via concurrent CBD administration - without reducing the dissociative effect)
The standing appointment to get slightly high for a couple of hours every three days does get inconvenient (though it's not as problematic as the resultant insomnia). I expect esketamine will be more so, for less antidepressant effect. And, being a controlled substance, I'm concerned I'll be unable to increase my dosage to make up the difference.