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Ketamine's effect on depression may hinge on hope

med.stanford.edu

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Re: Ketamine's effect on depression may hinge on hope

#101

Post by contrarian1234 »

tonnydourado wrote: post #48
omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

> that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience I thought the same thing when reading the article, but then I started to wonder how the fuck would you double blind that?

give patients a strong sedative (or after a period of sleep deprivation) and administer the drug while they're asleep?

Re: Ketamine's effect on depression may hinge on hope

#102

Post by growingkittens »

omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

Do studies commonly take into account a history of trauma? In my experience with medical professionals, trauma is barely considered or outright ignored. Screening processes, when used, are ...generic.

I notice that many transformational psychedelics stories involve some form of previous traumatic experience.

Re: Ketamine's effect on depression may hinge on hope

#103

Post by j45 »

omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

Relative to this article

Perhaps being able to keep a perspective on hope and of hope for long enough is part of the shift, assisted by ingestion or not.

Placebo as science is learning is relative. The body does literally change based on thought.

A recent Huberman podcast literally stated the brain itself is a pharmacy and creates certain substances as triggered. Not implying it’s the same for everyone, but interesting nonetheless.

If ketamine/shrooms push and hold a different perspective for long enough that it is difficult to unsee, unfeel or unexperience, that’s kind of interesting for sure .

Re: Ketamine's effect on depression may hinge on hope

#104

Post by xvedejas »

teaearlgraycold wrote: post #18
JohnMakin wrote: post #12

Earlier quoted context omitted.

It can also be harmful. I know someone who went through this treatment, they had an out of body/ego death experience, and were convinced that's what death felt like, and they really liked it. They had a suicide attempt just a few days later. It isn't the type of treatment one tries unless they've exhausted all other options. It's saddening to hear a lot of depression treatments seem largely reliant on placebo effect…

That sounds terrible. It really sounds like they were already pretty far gone. I was able to get help with my depression from magic mushrooms, but it was at most a moderate case.

I'll just add myself as a case where a mild amount of psychedelic drug use led to a mild amount of depression. Strictly negative for me, even if not profoundly negative. I'm mostly fine now, years later, but I feel possibly permanently slightly worse in mood. I am not now nor have ever been "far gone".

Re: Ketamine's effect on depression may hinge on hope

#105

Post by dr_dshiv »

RHSman2 wrote: post #98
brotchie wrote: post #96

Earlier quoted context omitted.

Simple size of 1, but you're correct in how a heroic dose psilocybin trip completely cured my existential depression, to the extent I can't even relate to the struggles of my past self. It certainly FELT to be a property of the transcendent experience and not a biological side effect of the substance. Being blasted out into the infinite space of all possible chaotic realities but being able to successfully "crawl bac…

If you’d had a crazy life experience that took you to the edge without said product, let’s say a full on mountaineering epic that bought close to the edge, would that remain in your consciousness and alter your being? Perhaps but data would suggest not or it has limited efficacy. There is something within these molecules that combine experiences and some change to alter awareness. And you don’t need to mountaineer

So the life changing nature of a cancer diagnosis relies on the “molecules” — or else it isn’t effective? I don’t understand.

Re: Ketamine's effect on depression may hinge on hope

#106

Post by astrange »

raydiatian wrote: post #86
Aurornis wrote: post #73

Earlier quoted context omitted.

> I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. Ketamine dosed at levels used in a lot of the original depression studies won’t result in anything resembling a “trip”. Many of the more res…

> at levels that only result in a little dizziness. Anecdotal first hand account, I would have to completely disagree with you. I tried intravenous ketamine therapy about a year ago. I’m plenty experienced with psychoactives, having experienced several at varying doses, so I knew what I was in for. My IVKT experience was a full on trip, definitely not just passive dizziness.

Is it possible that being an experienced tripper (psychonaut?) sensitizes you to new psychoactives?

Re: Ketamine's effect on depression may hinge on hope

#107

Post by weq »

Aurornis wrote: post #73
omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

> I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. Ketamine dosed at levels used in a lot of the original depression studies won’t result in anything resembling a “trip”. Many of the more res…

Only in the last 50 years have humans STOPPED tripping because of "saving the children". Before that, for 10s of thousands of years, humans, and animals, have used phsycoactive substances as a way of coping with and processing, reality.

Its such a dellusion that humanity has been "pure" at any point in time. Drug prohition, and all its tenticles, is a political tool of mass control. Nothing more, nothing less. Today we are seeing the reemergance of the teachings that have been passed down for generations by tribes around the world as this viel is lifted.

So please, this is not a trend. Its a rediscovery of aincent knowledge. I appreciate that low dose is how this remergence started, but there its not a cureall, and its not the only way this sustance provides benifits. 20 years ago, these same people were trapped to tables, eletroshocked until they became cataonic. Heroic doeses have their place in therapy.

Re: Ketamine's effect on depression may hinge on hope

#108

Post by astrange »

acchow wrote: post #39
omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

Much of the benefit of psychedelics is the introspection , which you can do sober as well (although the depth of the reflection is magnified and qualitatively different while tripping). This is confirmed by the linked study (which shows that placebo-ketamine is also very effective).

There's also reliable studies that it isn't that, and I actually expect it isn't, since antidepressants in general don't work by making you introspect. Actually "rumination" is a symptom of depression, so they would make you do it less, and IME meditation is not about introspection either.

Here's one showing a mechanism ketamine and antidepressants both act on:

https://www.science.org/content/blog-post/how-antidepressant...

Re: Ketamine's effect on depression may hinge on hope

#109

Post by CodeCounselor »

Aurornis wrote: post #73
omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

> I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. Ketamine dosed at levels used in a lot of the original depression studies won’t result in anything resembling a “trip”. Many of the more res…

I am happy to be sorted into the "responsible" category, since I prescribe IV ketamine with the mentioned 40 minute slow IV infusion at 0,5mg per kg of body weight.

I would like to chime in a thought about the choice of words... I think that we might be doing us a disservice when reducing the whole discussion down to "trip" or "no trip". Some patients have mild sensory experiences from the treatment, some have unpleasant dissociative-ish experiences, some done feel much at all. My belief is that the subjective experience, or the phenomenology of the treatment, is of importance even if the experience is far from a "trip". My patient who thus far has had the most convincing response did not "trip", but described a calm feeling of "everything will be alright" during the treatment - a response that none of 20-ish drugs or ECT had given.

Re: Ketamine's effect on depression may hinge on hope

#110

Post by TotalCrackpot »

omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

Maybe you don't really have to "fix" depression, I am very nihilistic and I do just fine - I don't kill myself because I don't give a fuck enough to do that. Looks easy to me. We are just on a flying stone in the cosmos, we shouldn't really except anything out of this.
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