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Ketamine no better than placebo at alleviating depression, unusual trial finds

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Re: Ketamine no better than placebo at alleviating depression, unusual trial finds

#111

Post by tsimionescu »

bheadmaster wrote: post #38
tsimionescu wrote: post #28

Earlier quoted context omitted.

There's a simple reference that doesn't even need to be quoted: SSRIs are approved for treating depression in all major countries on Earth. And this approval required they pass phase 3 clinical trials, demonstrating effectiveness over placebo. Also, given that they are typically preferred over other classes of anti-depressants (try-cyclics etc), we also know they have demonstrated better effectiveness than other drug…

If it's so obvious and well-established, it shouldn't be hard to find some reference to support it, no? How else would I know that the emperor is, indeed, wearing clothes?

Do you disagree that SSRIs are an FDA-approved treatment for depression, should I find references for that? Or do you not know what is the standard for FDA approval?

Re: Ketamine no better than placebo at alleviating depression, unusual trial finds

#112

Post by cpncrunch »

cypherpunks01 wrote: post #59

This is rubbish. Ketamine is a life-saver and has been proven to relieve depression, regardless of the administration setting. It is not magic and does not work in every case, but the effects are proven across countless studies. S-ketamine has even gone fully through FDA approval. Personally I have used it at home, and at a treatment center. There is no difference in the antidepressant properties, whether someone was…

>I'm not terribly surprised that ketamine may not produce strong antidepressant effects if the patient is not conscious.

That's incorrect, it actually produced larger antidepressant effects (50% response rate and 40% remission [1]) than when the patient is conscious (40% response rate and 30% remission according to a large meta-analysis [2]).

[1] https://www.medrxiv.org/content/10.1101/2023.04.28.23289210v... [2] https://pubmed.ncbi.nlm.nih.gov/35688035/

But that large response had nothing to do with ketamine, as the non-ketamine group had the same or higher response.

Re: Ketamine no better than placebo at alleviating depression, unusual trial finds

#113

Post by bjt2n3904 »

FollowingTheDao wrote: post #72
cypherpunks01 wrote: post #59

This is rubbish. Ketamine is a life-saver and has been proven to relieve depression, regardless of the administration setting. It is not magic and does not work in every case, but the effects are proven across countless studies. S-ketamine has even gone fully through FDA approval. Personally I have used it at home, and at a treatment center. There is no difference in the antidepressant properties, whether someone was…

> It is not magic and does not work in every case, That is exactly what they are saying in the study. No better than placebo means Ketamine does not cure depression. If ketamine cured depression it would work in every case. Increasing serotonin receptor density trough Ketamine use may relieve depression, but so can being cared for. Your beliefs do not matter, biology matters. And it may in fact be that your "strong b…

[flagged]

Re: Ketamine no better than placebo at alleviating depression, unusual trial finds

#114

Post by atchoo »

triggerity wrote: post #56
aftoprokrustes wrote: post #17

Earlier quoted context omitted.

As a relatively seasoned meditator, I am absolutely sure that this is the trip that helps, not the chemistry. One way to look at meditation (and, I hear, psychedelics) that fits my experience is that it has the potential effect of opening the range of "ways of looking", to change the way one builds the perceived world. What propulsed my meditation to a totally different level was to see it as a practice of actively e…

I tried MDMA a while back and it was great. On one side it showed me (after a long time) how you can be very empathic for all people around you and also reminded me or showed me how really good happiness feels. And while the effects lasted a little bit for 1-2 weeks, it also is something I know I could do again if I like to. This definitely gave me an additional/new viewpoint.

I saw an amusing post a while back along the lines of: "I was a libertarian until I tried MDMA and realised other people had feelings too".

Re: Ketamine no better than placebo at alleviating depression, unusual trial finds

#115

Post by vasco »

PragmaticPulp wrote: post #104
reubenmorais wrote: post #8

Earlier quoted context omitted.

I see so many studies trying to somehow distill trippy drugs into an isolated, side-effect free, take a pill and get back to work treatment. Maybe there's something to be found there, would be huge, but my hope is that we don't waste all the will and funding down this path without more fully exploring the path where we admit that yes, the trip helps, and we'll just need to deal with the lack of blinding.

The problem is real, though. Drugs with overt recreational effects very frequently distract the patient from the therapeutic effect in unproductive ways. The recreational effects generally disappear quickly as tolerance develops, which can give patients the false impression that the medication “stopped working”. A common example would be ADHD stimulants, where the early stimulating and mood-boosting effects disappear…

I took LSD twice in my life only and it changed my outlook ever since. It's been almost 10 years. I wasn't depressed and had other benefits from it, but I can see how that experience could've fixed depression, and know of people who say it did for them even though I'm not in any hippy-like community or whatever.

I think a possible reason why medical research prefers a pill that works forever for continued use is that if you buy something cheap twice in your life and it fixes whatever needs fixing the pharma industry can't make money off of you the same way they can put you on antidepressants for life. I'm not in the medical field so I'm just speaking out of my ass based on personal anecdotes though.

Re: Ketamine no better than placebo at alleviating depression, unusual trial finds

#116

Post by vorpalhex »

BobbyJo wrote: post #96
cubefox wrote: post #83

> But it’s a problem for researchers running double-blinded clinical trials, as participants can usually tell whether they have received ketamine or a placebo. [...] The scientists gave the volunteers ketamine or saline as placebo right after they were put under anesthesia, but before their surgery, essentially blinding them to any psychedelic or dissociative effects. That's a genius way to avoid unblinding. All psyc…

If I did drug trials for pain killers this way, would it give any useful data? Depression and pain are subjective. Personally, I think removing the subjectivity from the trial voids the trial. It is a clever design, but it really just proves the benefit is in the experience and not the physical mechanism.

Pain has subjective parts but it is not merely subjective. You can measure how much effect ibuprofen or tylenol has, even with someone knocked out. You can see pain on an mri, even with someone knocked out.

Re: Ketamine no better than placebo at alleviating depression, unusual trial finds

#117

Post by bagacrap »

cpncrunch wrote: post #112
cypherpunks01 wrote: post #59

This is rubbish. Ketamine is a life-saver and has been proven to relieve depression, regardless of the administration setting. It is not magic and does not work in every case, but the effects are proven across countless studies. S-ketamine has even gone fully through FDA approval. Personally I have used it at home, and at a treatment center. There is no difference in the antidepressant properties, whether someone was…

>I'm not terribly surprised that ketamine may not produce strong antidepressant effects if the patient is not conscious. That's incorrect, it actually produced larger antidepressant effects (50% response rate and 40% remission [1]) than when the patient is conscious (40% response rate and 30% remission according to a large meta-analysis [2]). [1] https://www.medrxiv.org/content/10.1101/2023.04.28.23289210v... [2] htt…

They only measured response for the next three days. Is it possible k has an effect for longer than three days while placebo only lasts three days or so?

Re: Ketamine no better than placebo at alleviating depression, unusual trial finds

#118

Post by ativzzz »

vasco wrote: post #115
PragmaticPulp wrote: post #104

Earlier quoted context omitted.

The problem is real, though. Drugs with overt recreational effects very frequently distract the patient from the therapeutic effect in unproductive ways. The recreational effects generally disappear quickly as tolerance develops, which can give patients the false impression that the medication “stopped working”. A common example would be ADHD stimulants, where the early stimulating and mood-boosting effects disappear…

I took LSD twice in my life only and it changed my outlook ever since. It's been almost 10 years. I wasn't depressed and had other benefits from it, but I can see how that experience could've fixed depression, and know of people who say it did for them even though I'm not in any hippy-like community or whatever. I think a possible reason why medical research prefers a pill that works forever for continued use is that…

Or because it's not really medicine and person specific? I've taken LSD several times in varying doses and it's never been anything more than "a really really fun time". Nothing profound, but damn fun times, the same effect as any fun memorable party

Perhaps if you are looking for something profound or want a change of mindset, psychedelics might be able to help you reach it - similar to how shamans used psychedelics to talk to their gods or whatever - but if you're just looking to have fun that's what you'll get

Re: Ketamine no better than placebo at alleviating depression, unusual trial finds

#119

Post by cpncrunch »

bagacrap wrote: post #117
cpncrunch wrote: post #112

Earlier quoted context omitted.

>I'm not terribly surprised that ketamine may not produce strong antidepressant effects if the patient is not conscious. That's incorrect, it actually produced larger antidepressant effects (50% response rate and 40% remission [1]) than when the patient is conscious (40% response rate and 30% remission according to a large meta-analysis [2]). [1] https://www.medrxiv.org/content/10.1101/2023.04.28.23289210v... [2] htt…

They only measured response for the next three days. Is it possible k has an effect for longer than three days while placebo only lasts three days or so?

Unlikely. I see another comment says "The duration of the antidepressant effect is relatively short (days to weeks) and the antidepressant effect appears to diminish with repeated dosing."

Re: Ketamine no better than placebo at alleviating depression, unusual trial finds

#120

Post by kibwen »

cameronh90 wrote: post #3

> They gave volunteers ketamine while they were under general anesthesia, theoretically preventing the participants from going on a trip. Maybe it's the trip that helps.

In which case, the headline would be correct. If ketamine can only treat depression by inducing a trip, then it's the trip that treats the depression, not the ketamine, which suggests future avenues of research into trips themselves, possibly excluding ketamine altogether.
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