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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

#111

Post by jeffreyrogers »

shawnz wrote: post #80
tibuma wrote: post #50

Earlier quoted context omitted.

> 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. Fir…

> This is incorrect. There are ongoing phase 3 clinical trials for nasally applied esketamine that will lead to FDA approval if succesfully reviewed. Specifically esketamine, not ketamine, because focusing on this specific isomer was the only way to get a new patent. What if racemic ketamine performs better than esketamine? We'll never know because they won't test that.

Do you have a source for that? You can get a patent on a new use for something that already exists if the new use is a non-obvious advance over the prior art.

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

#112

Post by enkephalin »

antihero wrote: post #103
tmsh wrote: post #14

Earlier quoted context omitted.

Can confirm. I’m in a similar boat. Some other tidbits of information: - only thing that seemed to work even after TMS and other treatments. - New pathways (SF and San Mateo locations) is really good. - more and more treatment places opening up in different cities etc. - uber assist or drive the patient home (full lucidity afterwards but you don’t want to drive). - long-term benefits aren’t apparent after the first t…

How easy would it be to do this at home by snorting half a gram but over the course of an hour?

half a gram seems pretty excessive to me. if you snorted that over the course of an hour, with zero tolerance, you'd very likely knock yourself out.

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

#114

Post by TTPrograms »

shawnz wrote: post #80
tibuma wrote: post #50

Earlier quoted context omitted.

> 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. Fir…

> This is incorrect. There are ongoing phase 3 clinical trials for nasally applied esketamine that will lead to FDA approval if succesfully reviewed. Specifically esketamine, not ketamine, because focusing on this specific isomer was the only way to get a new patent. What if racemic ketamine performs better than esketamine? We'll never know because they won't test that.

Racemic ketamine is also dirt cheap, while esketamine might be absurdly expensive after being patented.

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

#115

Post by TTPrograms »

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 the patentable isomer they're trying to use to enable this process of patenting + FDA so the drug companies can make a return. So the end result is a very expensive drug that insurance would pay for vs a cheap drug with 90% of the benefits that insurance won't pay for.

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

#116

Post by Fnoord »

patricius wrote: post #72
Fnoord wrote: post #67

Earlier quoted context omitted.

While you're at it, tax makes it more difficult to run a business and making a living. Let us abolish tax as well.

I agree. Just because a thing exists (the FDA or taxes for instance), doesn't make it a good thing.

Although I don't disagree with your point, that wasn't my point. My point is that these things have different aspects (some of which are arguably useful, some perhaps in your eyes less so or not) but removing them has serious consequences. It is easy to be against something (for example, paying taxes) but removing taxation has serious consequences which have to be accounted for.

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

#117

Post by patricius »

ergothus wrote: post #94
patricius wrote: post #49

Earlier quoted context omitted.

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.

Honest question: consumers are notoriously ill-informed, companies are good at propaganda and fake "clinical" evidence, and finding out if medicines ate effective AND safe is really complex. How do you imagine abolishing the FDA would improve outcomes instead of increasing supplies (and marketing) of snake oil?

You know who is also good at propaganda? Government and state.

Can you prove that FDA improves the outcome? Is FDA somehow free from lobbying, or are the people working there consistently uninfluenced by certain counterproductive incentives? How could we go about ever proving that the absence or existence of a government agency has improved conditions overall? Sorry if this comes off as lecturing, but these are questions that I think should be asked and is not intended for you specifically.

In any case, you cannot take away that FDA approval likely costs millions of dollars and makes it more costly to introduce a drug. It is self-evident that making something more expensive to do reduces the incentive to do it (weighed against the potential profit).

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

#118

Post by atomical »

andrewingram wrote: post #56
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…

That's still cheaper than a private psychologist or psychiatrist (after the initial course).

The cheapest per infusion cost is around $350 and the most expensive is around $1000. It's not actually cheaper.

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

#119

Post by aantix »

sgift wrote: post #62
proverbialbunny wrote: post #35

Earlier quoted context omitted.

Doesn't ketamine stimulate growth in the same areas of the brain that exercise does, and does therapy prescribe routine daily exercise? I can imagine there being a great short term benefit to ketamine, as people who are severely depressed can't exercise due to the depression. Has there been any mention switching from ketamine to daily exercise, or doing both?

How often did you have depression? Especially major depressive episodes where you have trouble to even motivate yourself to move out of the bed or do ANYTHING but just "exist" and even that seems hard? If the answer is zero (which I think it is) do those who have it a favor and shut up. Depression is hard enough without "you just have to exercise, huahua" comments.

>do those who have it a favor and shut up

Nothing is more irksome than the trend in public discussions to tell others to "shut up" if they haven't specifically experienced something.

This is a public forum. We're discussing a publicly posted article. The OP brought to the table a valid point. Let them talk.

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

#120

Post by mmcwilliams »

toomanybeersies wrote: post #95
mabbo wrote: post #87

Earlier quoted context omitted.

> We pay $375 for a 40-minute infusion Having no knowledge on the matter, what's the price comparison to just buying ketamine illegally and taking it without a doctor's help? Depression is like (or possibly is ) a form of chronic pain. People suffering from it severely might be willing to do anything for relief. Here's good information that a currently-illegal drug can help but if you want to do it legally you might…

Ket will set you back anywhere from $50-$150 per gram, depending on where in the world you are, and is of varying quality. It looks like they're using up to 1/2 a gram for treatment. I think the most of that $375 goes towards staffing costs, rather than the drug itself. Ketamine though legitimate channels costs about $5-$10 per gram from what I've heard.

Do you have a source on that 1/2 gram number? My reading has lead me to believe that a typical therapeutic dose for these treatments is between 60-75mg. I could be way off, though.
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