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Ketamine blocks bursting in the lateral habenula to rapidly relieve depression

nature.com

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Re: Ketamine blocks bursting in the lateral habenula to rapidly relieve depression

#21

Post by achileas »

aaavl2821 wrote: post #16

i did some work around ketamine a few years ago and many physicians i spoke with said it was incredibly helpful for their patients. however there are many others who have said it doesnt work for many of their patients. there are many studies that suggest it works and a lot of other unpublished data suggesting maybe it isnt as great the mechanism of action is also poorly understood, and while this article may certainl…

The dirty argument is not a great one, though, because most illnesses (especially depression) cause changes to a number of networks, and not just one particular receptor subtype or subunit of that receptor subtype. I agree that more mechanistic studies (and more clinical studies) need to be done anyways, but having multiple action sites isn't necessarily a bad thing.

As far as the "jolt" and continued therapy with CBT - this is how treating MDD is generally supposed to be done. Policy issues making it difficult aside, the CBT + antidepressant combo is empirically more effective than drugs alone (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918025/ - there are more but this is a meta-analysis so it captures a lot of data).

Re: Ketamine blocks bursting in the lateral habenula to rapidly relieve depression

#22

Post by nylonstrung »

newnewpdro wrote: post #12

Isn't regular Ketamine use especially bad for the bladder? I recall reading multiple anecdotes from the Erowid ketamine vaults where people lost their bladders due to recreational Ketamine use.

It is in the way that alcohol use is bad for one's liver- the cases where it results in bladder issues are those of abuse where doses massively larger than the therapeutic psychiatric dose are used on an ongoing basis.

"A young adult male taking 1 g of ketamine could expect 85% of the drug to be excreted in the urine within 24 hours, and taking into account the average voiding rate of 6 × 300 mL per day, a urine concentration in excess of 1 mmol/L is theoretically possible, suggesting the scale of in vitro toxicity reported [in the study] and by others in cancer cell lines is relevant clinically,"

For reference, the dosages this is referring to are generally .5mg/kg, which of course is comparatively small

Re: Ketamine blocks bursting in the lateral habenula to rapidly relieve depression

#23

Post by nylonstrung »

foobaw wrote: post #15
starpilot wrote: post #5

I have been looking into Ketamine as there is a clinic which administers Ketamine therapy in my area. The disappointing thing is that it looks like the effects are short lived, and one may need "booster" treatments every 4 weeks, at $400 a shot, for years and possibly forever. I hope with this understanding, we come up with something more permanent.

curious: are you based in the US? Would it not be covered by insurance? $400/shot is a lot for Ketamine.

Insurance absolutely does not cover ketamine therapy in the US

Re: Ketamine blocks bursting in the lateral habenula to rapidly relieve depression

#24

Post by blobwalker »

foobaw wrote: post #15
starpilot wrote: post #5

I have been looking into Ketamine as there is a clinic which administers Ketamine therapy in my area. The disappointing thing is that it looks like the effects are short lived, and one may need "booster" treatments every 4 weeks, at $400 a shot, for years and possibly forever. I hope with this understanding, we come up with something more permanent.

curious: are you based in the US? Would it not be covered by insurance? $400/shot is a lot for Ketamine.

$400 is a fairly typical price. The ketamine itself is cheap, but operating a clinic doing off-label infusions that take an hour or two each is expensive. And nope... no insurance in the US that I know of covers it.

Re: Ketamine blocks bursting in the lateral habenula to rapidly relieve depression

#25

Post by blobwalker »

mabbo wrote: post #9
Ophelias_Rue wrote: post #7

I know it's anecdotal, but I've been receiving ketamine at a local clinic for a few years for chronic depression and a spinal injury. It has proven too be the most effective treatment I've had for treating depression. As another poster said, it is short lived (around two months) But the release from depression, and back pain is life changing for me. To go with the article, it is incredibly fast acting. Like same day…

You get this done at a clinic- what's the effects like? I've heard terms like "K-hole" for heavy off-prescription users getting zonked by the stuff. I'm assuming you're taking a light dose? Can you drive yourself home?

I generally leave my clinic about half an hour after my infusion ends, but I'm taking the subway. If I were going to drive I'd probably hang out for 60-90 minutes. The dissociative and psychotomimetic effects wear off pretty quickly. But this depends on dose... my doc used to use higher doses before there was as much research around what works, and back then it would sometimes take a few hours before I felt back to normal in terms of cognitive and motor skills.

Re: Ketamine blocks bursting in the lateral habenula to rapidly relieve depression

#26

Post by Ophelias_Rue »

txru wrote: post #11
Ophelias_Rue wrote: post #7

I know it's anecdotal, but I've been receiving ketamine at a local clinic for a few years for chronic depression and a spinal injury. It has proven too be the most effective treatment I've had for treating depression. As another poster said, it is short lived (around two months) But the release from depression, and back pain is life changing for me. To go with the article, it is incredibly fast acting. Like same day…

How specific is the dose? Do they calibrate it by weight or body fat or anything?

Body weight. I'm unsure at the moment/can't remember what their metrics are though.

Re: Ketamine blocks bursting in the lateral habenula to rapidly relieve depression

#27

Post by refurb »

foobaw wrote: post #15
starpilot wrote: post #5

I have been looking into Ketamine as there is a clinic which administers Ketamine therapy in my area. The disappointing thing is that it looks like the effects are short lived, and one may need "booster" treatments every 4 weeks, at $400 a shot, for years and possibly forever. I hope with this understanding, we come up with something more permanent.

curious: are you based in the US? Would it not be covered by insurance? $400/shot is a lot for Ketamine.

Ketamine is a generic drug and dirt cheap. I just checked and it's under $10 for a vial with enough to use in surgery, not even this setting.

The $400 must be the clinic charge. I'm not sure what administration looks like, but a regular doctor's visit is $100-$150 and if the patient needs to stay for a longer period of time until it's safe to release them, $400 doesn't seem that far off of what you'd expect.

Re: Ketamine blocks bursting in the lateral habenula to rapidly relieve depression

#28

Post by Ophelias_Rue »

mabbo wrote: post #9
Ophelias_Rue wrote: post #7

I know it's anecdotal, but I've been receiving ketamine at a local clinic for a few years for chronic depression and a spinal injury. It has proven too be the most effective treatment I've had for treating depression. As another poster said, it is short lived (around two months) But the release from depression, and back pain is life changing for me. To go with the article, it is incredibly fast acting. Like same day…

You get this done at a clinic- what's the effects like? I've heard terms like "K-hole" for heavy off-prescription users getting zonked by the stuff. I'm assuming you're taking a light dose? Can you drive yourself home?

Yes it's at a clinic, and it's not a light dose. It does cause "K-Holes", it'll completely incapacitate you for the day of, and you'll be dizzy and sluggish the day after. So no you can't drive yourself home.

Re: Ketamine blocks bursting in the lateral habenula to rapidly relieve depression

#29

Post by Ophelias_Rue »

ankushnarula wrote: post #19
Ophelias_Rue wrote: post #7

I know it's anecdotal, but I've been receiving ketamine at a local clinic for a few years for chronic depression and a spinal injury. It has proven too be the most effective treatment I've had for treating depression. As another poster said, it is short lived (around two months) But the release from depression, and back pain is life changing for me. To go with the article, it is incredibly fast acting. Like same day…

Any side-effects? Bladder/urinary issues? What happens to you as it wears off?

During you can suffer from some intense anxiety and strong nausea, so they'll give stuff for that. After the only thing that I notice is that my emotions are put to 11 and I'll just be extremely uncoordinated and exhausted.

Re: Ketamine blocks bursting in the lateral habenula to rapidly relieve depression

#30

Post by Ophelias_Rue »

blobwalker wrote: post #25
mabbo wrote: post #9

Earlier quoted context omitted.

You get this done at a clinic- what's the effects like? I've heard terms like "K-hole" for heavy off-prescription users getting zonked by the stuff. I'm assuming you're taking a light dose? Can you drive yourself home?

I generally leave my clinic about half an hour after my infusion ends, but I'm taking the subway. If I were going to drive I'd probably hang out for 60-90 minutes. The dissociative and psychotomimetic effects wear off pretty quickly. But this depends on dose... my doc used to use higher doses before there was as much research around what works, and back then it would sometimes take a few hours before I felt back to n…

I'm in the opposite boat, the dose I receive is fairly high and I'm unable to even stand for around 20 minutes after it ends. There's no way I can drive the day of. As for the events, the feeling of dissociation takes around a day to fade for me. I also have a high deal of cognitive impairment from it, or detachment in my thoughts?
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