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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

#121

Post by atomical »

filmgirlcw wrote: post #2

My psychiatrist was mentioning this to me a few months ago. The data he’s seen mirrors the study referenced here. This could be a breakthrough for individuals in the midst of major depressions, which are often very hard to treat, considering how long it can take for other anti-depressants to start to work.

It's not a breakthrough because it has been used in the clinic for patients with suicidal ideation for a long time. You are hearing about it now because a small group of doctors have found a new income stream.

Contrary to the posts in this thread there isn't a body of evidence that suggests Ketamine's anti-depressant effect lasts longer than a week.

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

#122

Post by DenisM »

DanBC wrote: post #76
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?

The difference is that ketamine shows positive results in clinical trials (even for severe depression) while exercise doesn't, unless you include poor quality trials and you limit results to mild depression.

Whoa. Do you have a link to a meta-study or something like that?

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

#123

Post by atomical »

starpilot wrote: post #6

> The nasal spray is now undergoing phase three trials before it can be licensed for treatment. Can anyone comment on how long it might take for it to hit the market, from this stage?

It's possible to get the nasal spray prescribed and filled by a compounding pharmacy. Those doctors will want you to spend $3,000 for the initial infusions. It won't matter to them that you had the initial infusions elsewhere. They want the full treatment experience as well.

It's possible that the J&J spray will be approved in 2018.

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

#124

Post by atomical »

Fnoord wrote: post #69
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…

Infusion? Goodness grace, I got belonephobia and got scared shitless there. It doesn't have to be administered intravenous. The article is mainly referring to a nasal spray.

Typical infusion time is 40 minutes. How would one accomplish the same release with a nasal spray?

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

#125

Post by DenisM »

ergothus wrote: post #90
wjnc wrote: post #43

Earlier quoted context omitted.

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).

That is an incentive to insurers only if they are paying the price or if the lower costs to a specific group of consumers increases their market share. Since most costs are passed on to the consumers and most consumers don't get to pick their insurance (in the U.S.) , the incentives aren't there.

Employers do pick insurance companies, and cost is a big factor.

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

#126

Post by yabatopia »

aantix wrote: post #119
sgift wrote: post #62

Earlier quoted context omitted.

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.

I'll always remember a quote from a cancer researcher/professor on tv: "You don't have to be an elephant to talk about elephants." Sadly I don't have an elephant's brain so I don't remember the professor's name.

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

#127

Post by tmsh »

dvcrn wrote: post #73
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…

Where are you getting this treatment from? Did you directly ask for it?

New pathways ketamine treatment center. There’s a handful of other providers in the Bay Area too. Referred by psychiatrist (and internally recommended after TMS didn’t have beneficial effects - works for some though).

And yeah I’m not sure about the dosage. I know it’s much less than ketamine for pain management or for anesthesia. I’ll try to ask next time.

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

#128

Post by tibuma »

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.

> What if racemic ketamine performs better than esketamine? We'll never know because they won't test that.

It's quite likely some public institutions (e.g., universities, public research labs, etc.) or other countries (e.g., in India, China) will test exactly that. It's also in their interest to pubblish the results. So we'll get to know the differences between racemic ketamine, esketamine and arketamine.

The question is if different variants will also be approved, which is much more expensive.

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

#129

Post by atomical »

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.

> It looks like they're using up to 1/2 a gram for treatment.

Typically they use 0.5mg/kg. I think you may be confusing milligrams (mg) with grams (g).

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

#130

Post by pizza »

atomical wrote: post #121
filmgirlcw wrote: post #2

My psychiatrist was mentioning this to me a few months ago. The data he’s seen mirrors the study referenced here. This could be a breakthrough for individuals in the midst of major depressions, which are often very hard to treat, considering how long it can take for other anti-depressants to start to work.

It's not a breakthrough because it has been used in the clinic for patients with suicidal ideation for a long time. You are hearing about it now because a small group of doctors have found a new income stream. Contrary to the posts in this thread there isn't a body of evidence that suggests Ketamine's anti-depressant effect lasts longer than a week.

I think the posts here are almost all about comparing repeated-dose regimens of Ketamine vs SSRIs; otherwise if we were comparing the effectiveness of single doses, we might as well claim there isn't a body of evidence that suggests SSRIs have an anti-depressant effect for much longer than just a single day, right? Or do you mean that the repeat dose just a week later (, and so on,) would have little anti-depressant effect?
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