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Ketamine has 'fast-acting benefits' for depression

bbc.co.uk

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Re: Ketamine has 'fast-acting benefits' for depression

#41

Post by Knufen »

ry_ry wrote: post #5

@HN's chemists - I was under the impression regular ketamine use caused irreversible bladder damage[0] - Is that due to much higher recreational dosage vs medical, or would this be something that couldn't be prescribed long-term? [0] http://www.bbc.co.uk/newsbeat/article/29811499/k-bladder-the...

Ketamine can do that under the extreme dosages used by recreational users. It's also important to remember that a lot of the bad long term effects of drugs can be attributed to impurities, which there should be next to nothing off when you get it from a doctor.

https://www.addiction.com/4311/contaminants-illicit-drugs/

Re: Ketamine has 'fast-acting benefits' for depression

#42

Post by [deleted] »

Brybry wrote: post #29
TTPrograms wrote: post #22

If you're an American, every time you read a new article on Ketamine for depression your thought should be "Jeese, healthcare is screwed up". Pharma companies don't benefit from getting Ketamine approved (since it's no longer patent protected), so no one is putting it through FDA for depression. As a result insurance will never cover it (under the current model). The reason this treatment isn't mainstream isn't becau…

https://adisinsight.springer.com/drugs/800037644 The very article you're commenting on directly contradicts what you're saying. Big pharma is actively running studies and trying to get this fast tracked for treatment in the US and Europe. Granted the article is somewhat poor reporting because the title should read "esketamine" not ketamine.

[deleted]

Re: Ketamine has 'fast-acting benefits' for depression

#43

Post by wjnc »

saasthrowaway3 wrote: post #31
TTPrograms wrote: post #22

If you're an American, every time you read a new article on Ketamine for depression your thought should be "Jeese, healthcare is screwed up". Pharma companies don't benefit from getting Ketamine approved (since it's no longer patent protected), so no one is putting it through FDA for depression. As a result insurance will never cover it (under the current model). The reason this treatment isn't mainstream isn't becau…

Do you think something like "FDA-approval of Ketamine" could be successfully crowdfunded?

What I do not understand from a market perspective is why insurers don't cooperate more to fund such research. If a treatment goes from 20k to 1k p.a. the benefits for insurers are clear. They could even fund such research in an equity-fashion, that way steering clear of anti-competition law and free-rider problems (just sell it to the non-cooperators for 20k).

Re: Ketamine has 'fast-acting benefits' for depression

#44

Post by sneak »

Brybry wrote: post #29
TTPrograms wrote: post #22

If you're an American, every time you read a new article on Ketamine for depression your thought should be "Jeese, healthcare is screwed up". Pharma companies don't benefit from getting Ketamine approved (since it's no longer patent protected), so no one is putting it through FDA for depression. As a result insurance will never cover it (under the current model). The reason this treatment isn't mainstream isn't becau…

https://adisinsight.springer.com/drugs/800037644 The very article you're commenting on directly contradicts what you're saying. Big pharma is actively running studies and trying to get this fast tracked for treatment in the US and Europe. Granted the article is somewhat poor reporting because the title should read "esketamine" not ketamine.

esketamine is simply the S-ketamine stereoisomer. TFA calls it part of the ketamine molecule but it is the ketamine molecule.

Re: Ketamine has 'fast-acting benefits' for depression

#45

Post by sneak »

Knufen wrote: post #41
ry_ry wrote: post #5

@HN's chemists - I was under the impression regular ketamine use caused irreversible bladder damage[0] - Is that due to much higher recreational dosage vs medical, or would this be something that couldn't be prescribed long-term? [0] http://www.bbc.co.uk/newsbeat/article/29811499/k-bladder-the...

Ketamine can do that under the extreme dosages used by recreational users. It's also important to remember that a lot of the bad long term effects of drugs can be attributed to impurities, which there should be next to nothing off when you get it from a doctor. https://www.addiction.com/4311/contaminants-illicit-drugs/

In this specific case the bladder damage is from the ketamine (metabolites) itself, not impurities.

Re: Ketamine has 'fast-acting benefits' for depression

#46

Post by sneak »

mathieuh wrote: post #9
ry_ry wrote: post #5

@HN's chemists - I was under the impression regular ketamine use caused irreversible bladder damage[0] - Is that due to much higher recreational dosage vs medical, or would this be something that couldn't be prescribed long-term? [0] http://www.bbc.co.uk/newsbeat/article/29811499/k-bladder-the...

I'm not a chemist either but as someone who as partaken and knows other people who have also partaken, the dosages you have to take in order for this to become an issue are way beyond what would seem reasonable for someone who's not heavily dependent and tolerant. You would have to be taking grams and grams of the stuff on the regular; infrequent or one-off dosages won't cause bladder damage. Edit: even in the articl…

My guess is that 0.5-1g/day, if ingested every day, is sufficient to cause bladder damage.

However, for use as an antidepressant, 100-200mg (0.1-0.2g) twice a month is sufficient, so it shouldn’t be an issue.

Re: Ketamine has 'fast-acting benefits' for depression

#47

Post by sneak »

pw wrote: post #8
ry_ry wrote: post #5

@HN's chemists - I was under the impression regular ketamine use caused irreversible bladder damage[0] - Is that due to much higher recreational dosage vs medical, or would this be something that couldn't be prescribed long-term? [0] http://www.bbc.co.uk/newsbeat/article/29811499/k-bladder-the...

Not a chemist but according to the providers I’ve talked to the recreational dose is an order of magnitude larger than that given for depression. My understanding is the dose for depression is relatively small (even compared to what’s used during, say, anaesthesia).

Not an order of magnitude. Maybe 1.5-2x. Antidepressant doses are not far off of recreational for most recreational users.

The recreational doses are also relatively small (10-50%) compared to anesthetic doses, too. Being unconscious isn’t the recreational user’s aim.

Re: Ketamine has 'fast-acting benefits' for depression

#48

Post by sneak »

pw wrote: post #7

My girlfriend receives ketamine treatment for her depression, so I’ve the results first hand. It’s truly astounding. She’s seen more improvement from the ketamine than from a decade of psychotherapy and traditional psychopharmacology. The only downside is the cost (it’s not covered by insurance) and the potential that there are long term side effects that have yet to be discovered. We pay $375 for a 40-minute infusio…

The effects are so significant that I have gifted small amounts of ketamine to close friends who suffer from depression, so that they may store it long term as an emergency last resort to try in the event of irresistible suicidal ideation. It really is a lifesaver.

Re: Ketamine has 'fast-acting benefits' for depression

#49

Post by patricius »

TTPrograms wrote: post #22

If you're an American, every time you read a new article on Ketamine for depression your thought should be "Jeese, healthcare is screwed up". Pharma companies don't benefit from getting Ketamine approved (since it's no longer patent protected), so no one is putting it through FDA for depression. As a result insurance will never cover it (under the current model). The reason this treatment isn't mainstream isn't becau…

Getting a drug approved by the FDA is pretty expensive. Abolishing the FDA, thereby reducing the cost of introducing the drug, might be the real solution here.

Re: Ketamine has 'fast-acting benefits' for depression

#50

Post by tibuma »

TTPrograms wrote: post #22

If you're an American, every time you read a new article on Ketamine for depression your thought should be "Jeese, healthcare is screwed up". Pharma companies don't benefit from getting Ketamine approved (since it's no longer patent protected), so no one is putting it through FDA for depression. As a result insurance will never cover it (under the current model). The reason this treatment isn't mainstream isn't becau…

> Pharma companies don't benefit from getting Ketamine approved (since it's no longer patent protected), so no one is putting it through FDA for depression.

This is incorrect.

There are ongoing phase 3 clinical trials for nasally applied esketamine that will lead to FDA approval if succesfully reviewed. These trials are conducted worldwide and are very encouraging. The specific application seems to be patentable. First results should be available around 2019ish or 2020.

You can find the trials here:

https://clinicaltrials.gov/ct2/results?term=esketamine+depre...

And one of the patent applications here:

https://patents.google.com/patent/US20130236573A1

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