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Study: Electroshock therapy more successful for depression than ketamine

today.uconn.edu

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Re: Study: Electroshock therapy more successful for depression than ketamine

#101

Post by heavyset_go »

tcj_phx wrote: post #40
chrsig wrote: post #29

Earlier quoted context omitted.

> But the doctors had already decided she was being "stabilized" by the anti-psychotic prescriptions they forced on her, so they just added this vitamin to their cocktail of prescriptions. Outside of very specific circumstances during hospitalization, doctors can't actually force you to take any medication.

Most states have provisions for involuntary mental health treatment. Arizona's laws for forced mental health treatment are in ARS Title 36, Chapter 5: https://www.azleg.gov/arsDetail/?title=36 As soon as the doctors got their order for involuntary treatment in November 2015, they cornered my friend and injected her with a time-release version of haloperidol, then released her to her mother's house. A day and a half l…

> All the anti-dopamine drugs are terrible. Some of the second-generation drugs that are forced on people are much worse than plain old haloperidol. The poor doctors are just implementing their training. Tragic.

Haloperidol has one of the highest rates of side-effects[1], like permanent movement disorders, in its class, and it is neurotoxic[2]. Movement disorders like tardive dyskinesia don't seem like a good time.

Second generation antipsychotics typically have lower affinities for dopamine receptors compared to older drugs, thus lowering the severity of side-effects associated with dopamine blockade. They have much lower risks of causing movement disorders. They also bind to dopamine receptors differently than the strongly antagonist first generation antipsychotics. Some of them are partial agonists, inverse agonists, and full agonists with lower affinities at dopamine receptors, so they have less "anti-dopamine" activity than haloperidol and older antipsychotics do.

I agree with you that these drugs have terrible side-effects, but I'd argue that being loaded with haloperidol is one of the worse options to be treated with when it comes to bad side-effects. There's immediate release inectable versions of olanzapine, ziprasidone and clozapine, all second generation antipsychotics, but I suspect they cost more than haloperidol.

[1] https://pubmed.ncbi.nlm.nih.gov/23810019

[2] https://pubmed.ncbi.nlm.nih.gov/28738100

Re: Study: Electroshock therapy more successful for depression than ketamine

#102

Post by fragmede »

operator-name wrote: post #62
nvr219 wrote: post #9

Yeah but ketamine is a lot more fun so I'm gonna stick with that.

This is a really strange mindset to me - if Ketamine is working why bother even considering switching?

Tolerance. It's possible to build up a tolerance to ketamine, such that it stops working. For those for whom ketamine once every while is sufficient (eg once a month), there's little danger of that, but for those that need to take it every day (under doctor supervision), it's not sustainable.

Re: Study: Electroshock therapy more successful for depression than ketamine

#104

Post by elevaet »

arcticbull wrote: post #11
Waterluvian wrote: post #7

Earlier quoted context omitted.

Without more information on likeliness, permanence, and magnitude, both sets of symptoms sound potentially intolerable.

People do ketamine recreationally; the symptoms really aren't intolerably bad, I'm led to believe.

ECT on the other hand has very few recreational users.

I imagine the physical effects of ECT must be very harsh and difficult for the body.

Re: Study: Electroshock therapy more successful for depression than ketamine

#105

Post by irq »

operator-name wrote: post #82
kingkawn wrote: post #6

This article completely neglects discussion of side effects. Ketamine has almost none, whereas ECT can cause horrible degradations to quality of life. Any discussion of efficacy that doesn’t include side effects is quackery.

I'll give you that it's a short article, but: > The side effect profiles of the two treatments differed, with ECT more likely to cause headaches, muscle pain and memory loss, while ketamine was more likely to cause dissociative symptoms, vertigo and double vision.

The way the article omits mentioning the ECT memory loss side effect is often permanent, and the way it omits that ketamine’s dissociative effects are always temporary, screams of quackery.

Re: Study: Electroshock therapy more successful for depression than ketamine

#106

Post by elevaet »

oldgradstudent wrote: post #91
operator-name wrote: post #78

Earlier quoted context omitted.

The same skepticism can be applied to any study, depression treatment or otherwise. Practically, self reporting is highly effective and well correlated with effects, especially for depression.

Of course. It's just that sometimes, the easiest and least confrontational way to stop a treatment with serious side effects is to claim that the treatment is no longer needed. Studies should find ways to control for such problems.

"The floggings will continue until morale improves!"

Re: Study: Electroshock therapy more successful for depression than ketamine

#107

Post by heavyset_go »

PeterisP wrote: post #80
ddxxdd wrote: post #65

Earlier quoted context omitted.

At this time, I mean every hormone and protein flowing in the bloodstream, along with the state of every single cell. Essentially, enough detail to get a list of symptoms and bodily sensations, and predict the outcome of any potential blood test or urinalysis. Or, alternatively, enough detail to take the results of a blood test/urinalysis, and predict the state of every single tissue in the body.

It's something way beyond our current capabilities. There's some interesting work on "organs on a chip" e.g. arrays of microfluidic cell cultures that allows some experimentation on a combination of a few types of tissue modeling an organ or some aspect of it, but even that's already pushing the state of art and not fully mature at the moment; doing something similar for many (much less all or most) organs is somethi…

Tangential to these are organoids[1] that emulate organs at much smaller scales, which I thought was cool.

[1] https://en.wikipedia.org/wiki/Organoid

Re: Study: Electroshock therapy more successful for depression than ketamine

#108

Post by pyuser583 »

elevaet wrote: post #104
arcticbull wrote: post #11

Earlier quoted context omitted.

People do ketamine recreationally; the symptoms really aren't intolerably bad, I'm led to believe.

ECT on the other hand has very few recreational users. I imagine the physical effects of ECT must be very harsh and difficult for the body.

Are there any recreational users?

Re: Study: Electroshock therapy more successful for depression than ketamine

#110

Post by robocat »

pyuser583 wrote: post #88
oldgradstudent wrote: post #64

Earlier quoted context omitted.

Or, more accurately, not reporting to the researchers that you're feeling incredibly depressed.

Severe depression has objective symptoms: severe sleep disturbances, psychotic like symptoms.

In my very unscientific opinion, severe sleep disturbances is usually a cause, not an effect.

Watch people get sleep problems, a few days of that, and then the mental health issues kick in.

Or cause sleep problems (stimulants or environmental), then see mental health issues produced.

The opposite can happen (mental health problem leads to sleeping problems) but in my circles I haven’t seen that as often. Of course then the mental health issues compound.

Fucking with your sleep is not healthy.

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