In 200 years, people will study this as a crazy tale from the dark ages. The worst thing for depressed people has been the idea that it's a random/genetic phenomenon as opposed to ecological misalignment with their biospirit.
Study: Electroshock therapy more successful for depression than ketamine
131–140 of 176 posts
Re: Study: Electroshock therapy more successful for depression than ketamine
#132In 200 years, people will study this as a crazy tale from the dark ages. The worst thing for depressed people has been the idea that it's a random/genetic phenomenon as opposed to ecological misalignment with their biospirit.
Tell that to people born with genetic issues leading to increased serotonin transporter density which creates chronic depression in many.
Learn some neuroscience.
Re: Study: Electroshock therapy more successful for depression than ketamine
#133Ketamine is a prescription medicine that can be taken oral, intranasal or IV drip. ECT is an inpatient procedure that need one anesthesiologist and one psychiatrist plus nurses to administer, two to three times weekly for three to four weeks. Who pays for the healthcare, definitely want to try the former and use the latter only if the former works poorly.
ECT, due to the potential side effects and Ketamine due to how recent it is are both near the "last lines of defence". IRRC both of them cannot compare to psychotherapy, which has far higher effectiveness at the cost of far more resources.
> IRRC both of them cannot compare to psychotherapy,
The whole point of this, and numerous other articles is that this statement is objectively false.
If you have treatment resistant depression, PTSD, etc that treatment includes therapy.
Which is why ketamine and ECT are being investigated - for plenty of people these treatments have resolved things such that they do not need medical or therapy based treatment.
> which has far higher effectiveness at the cost of far more resources.
I'm guessing this is a typo, but given the cost of 1+ hours a week at easily $100-200/hr, for years - often without any limit at all - I'd be curious what the total cost is. This is especially important in this case as ECT, ketamine, etc treatments are _required_ to demonstrate efficacy, whereas psychotherapy has no such requirements.
There's been plenty of research over the years that has found pretty underwhelming outcomes from therapy based treatment outside of specific areas - more extreme are the therapy group/out-patient scams which have been shown very clearly to only work for groups of people with exactly the same trauma, and even then, only specific types of trauma.
It's a real problem in mental health treatment that only treatments that require the use of drugs and/or "surgical" procedure are required to provide evidence that they actually work.
Re: Study: Electroshock therapy more successful for depression than ketamine
#134Earlier quoted context omitted.
ECT, due to the potential side effects and Ketamine due to how recent it is are both near the "last lines of defence". IRRC both of them cannot compare to psychotherapy, which has far higher effectiveness at the cost of far more resources.
ECT has the highest cost of resources.
I'm guessing this was a typo, but if you look at how unbounded the time for psychotherapy to work, I would not be surprised if it did actually end up being the most expensive.
Re: Study: Electroshock therapy more successful for depression than ketamine
#135No post body was provided.
Re: Study: Electroshock therapy more successful for depression than ketamine
#136Earlier quoted context omitted.
One rumination I have had about the medical application of psychedelics is to wonder how lasting the effects of all these initial studies will be over the long term. The effects of psychedelics are profound to a person who hasn't experienced them, which is the vast majority of people today. I think, when a person goes through a powerful experience they've never had, it makes them a lot more suggestive, which in turn…
Ketamine’s effects on depression are not caused by the hallucinations or psychedelic effects. I can’t speak to other hallucinogens but I would imagine the situation is the same there. The day after an acid trip isn’t a new neurochemical environment because of the powerful hallucinations the day before, it is something else. > My own experience with psychedelics tells me no: once you become familiar with the effects t…
> The day after an acid trip isn’t a new neurochemical environment because of the powerful hallucinations the day before, it is something else
What is a "new neurochemical environment" exactly? I've had many acid comedowns, and they have all been affected by how the high was - emotionally, mentally, and physically. What do you mean by "its something else"?
Re: Study: Electroshock therapy more successful for depression than ketamine
#137In 200 years, people will study this as a crazy tale from the dark ages. The worst thing for depressed people has been the idea that it's a random/genetic phenomenon as opposed to ecological misalignment with their biospirit.
Tell that to people born with genetic issues leading to increased serotonin transporter density which creates chronic depression in many. Learn some neuroscience.
There isn't even evidence that depression is caused by serotonin levels.
They never even checked that out in the first place.
https://www.ucl.ac.uk/news/2022/jul/no-evidence-depression-c...
https://www.ucl.ac.uk/news/2022/jul/analysis-depression-prob...
Re: Study: Electroshock therapy more successful for depression than ketamine
#138“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.” I’ll take milder effects over pain and memory loss, thanks. No mention of longevity of effect, or specific studies and who paid for them.
Yes, an acquaintance from college went through ECT. The guy was previously brilliant. Yes, his illness was part of his later problems, but he was wholly convinced that the ECT was a much larger problem. So much so that as soon as he got out of the institution, he commenced lawsuits against his parents who had set up his treatment (as far as I could tell for legit reasons; it wasn't one of those horror stories of abus…
The rules for use of ECT are much more strict than they were in the past, so when this happened would be extremely important.
ECT as used well into the 80s, possibly even the 90s, was pretty much aversion therapy - essentially just: "you'll behave properly or we'll torture you".
In CA at least the rules for use of ECT nowadays are extremely strict, and required frequent confirmation of understanding of what you think you are doing, what is involved, why you are doing it, etc administered by a party not involved in the treatment.
> I was thinking that was just so obsolete.
Why? The studies for ECT for treatment resistant depression show that it _is_ effective for more than 50% of candidates who undergo it. Note that these are treatment resistant cases, e.g. people for which there is by definition a 100% failure rate for every other option.
> Indeed, longevity of effect, or specific studies
For some people ECT appears to provide a permanent relief. Some it provides significant improvement for extended (e.g. years) periods, and for some it does not do anything.
I can't point to specific studies because at this point there are so many, and that they all have very similar outcomes of more than 50% of recipients having extended or permanent (presumably within bounds of time) improvement in symptoms.
> and who paid for them.
Generally it's government funded institutions, but I get the general "evil business" conspiracy vibe from this comment. It's important to realize that ketamine and ECT aren't things that you can make profitable. If they work for a given patient they both have extended periods where the patient is not likely to need any treatment, if ever again - the general worst case for a profit driven treatment.
Your ability to have a high profit margin is limited by ketamine being a generic drug in the US, and being cheap and easy (in terms of drugs) to manufacture. ECT on the other hand has a large array of costs that can't be avoided, but that also aren't profit centers: you need hospital facilities due to the general anesthesia, an anesthesiologist, the actual doctor, nurses, and a third party to audit and interview patients.
Re: Study: Electroshock therapy more successful for depression than ketamine
#139“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.” I’ll take milder effects over pain and memory loss, thanks. No mention of longevity of effect, or specific studies and who paid for them.
The musician Townes Van Zandt underwent ECT and the loss of his memory haunted him his whole (very tragic) life. It's well-known how deep of an impact that had on him, and not for the better. As if the often pleasant, often interesting, often terrifying yet short term and proven harmless side-effects of Ketamine can even compare to the ECT! I would like to see how _much_ better ECT is, given all the factors. Addition…
That was "Insulin Shock Therapy" which had no actual solid support - certainly nothing that would withstand modern scrutiny - and frequently included "improvement" in schizophrenic patients that were clearly docility caused by direct neurological damage.
You also don't just get "hooked up to an ect machine" - it's well established that ECT as used historically was almost entirely aversion therapy - modern ECT does not ever occur on a conscious patient, and because of how it was used historically there are extremely strict controls on patient consent and patient awareness of what they are consenting to - all questionnaires, surveys, consents, etc are taken by a third party that is not part of the treatment.
Re: Study: Electroshock therapy more successful for depression than ketamine
#140Earlier quoted context omitted.
A single data point may be a interesting, but strong evidence it does not make. Nor does speculating about a doctors caution without citations. Ketamine in recreational use has equally documented side effects, some quite severe. Extreme circumstances that have caused irreparable damage are rare, but not unheard of. There are also numerous other anecdotes from people that have undergone numerous session of ECT with mi…
What sort of side effects are we talking about? As far as I know, bladder damage is the only actual physical effect of ket
Falling over can do a lot of damage :D