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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

#151

Post by mandmandam »

EmilyHughes wrote: post #97
suzzer99 wrote: post #87

Related to the psychological vs. physiological discussion: I can say with confidence that the first time I did ecstasy changed how I look at the world. We went for a walk barefoot on warm pavement and it was the most wonderful thing I ever felt. I realized on a visceral level that so much of our personal happiness is based on how we look at things, not what happens to us. I don't know if I got any chemical benefit fr…

Honestly the only thing extasy did for me was let me rave for hours to electronic music at clubs. It also opened the door for other chemical drugs which led to benders and hangovers that were so bad people who only drink alcohol have no idea are even possible. Granted, I never did it in a quiet "therapeutic" environment, I would have thought of it as a waste because I considered the music and dancing an integral part…

Ecstacy can have great therapeutic and profound effects...

It's not that surprising that if you only use it to "rave for hours" and "open the door for other chemical drugs", then you'll find it a "recreational and hedonistic substance". That's practically a tautology.

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

#153

Post by stavros »

rlt wrote: post #147
stavros wrote: post #125

Earlier quoted context omitted.

I was with you up until "Its a rediscovery of aincent knowledge". Which, technically yes, but the knowledge is "tripping is fun sometimes".

Out of curiosity, what is your level of experience with psychedelics?

I've done quite a bit of LSD, mushrooms less so, and then some assorted other stuff.

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

#154

Post by stavros »

raducu wrote: post #145
stavros wrote: post #134

Earlier quoted context omitted.

Yes, but if that were the case, we'd see it being universal around the world until a few decades ago, which, as far as I know, isn't the case.

Transcending death and a longing for deeper meanings for life are quite universal, but yeah, tripping, I don't think so. But some people might be more comfortable saying there's a fundamental need for tripping than saying there's a fundamental need for religion (which usually encompasses transcending death and deep meanings for life).

I can agree there, though I think the need for religion is a very interesting debate. It might be innate, but it does make me wonder.

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

#155

Post by bacza2 »

EmilyHughes wrote: post #97
suzzer99 wrote: post #87

Related to the psychological vs. physiological discussion: I can say with confidence that the first time I did ecstasy changed how I look at the world. We went for a walk barefoot on warm pavement and it was the most wonderful thing I ever felt. I realized on a visceral level that so much of our personal happiness is based on how we look at things, not what happens to us. I don't know if I got any chemical benefit fr…

Honestly the only thing extasy did for me was let me rave for hours to electronic music at clubs. It also opened the door for other chemical drugs which led to benders and hangovers that were so bad people who only drink alcohol have no idea are even possible. Granted, I never did it in a quiet "therapeutic" environment, I would have thought of it as a waste because I considered the music and dancing an integral part…

It can be great for party setting but I recommend doing it in the safe environment with family, friends at home or in nature. The feeling of deeper connection with people or nature you already have connection with is revealing. I felt love I knew in even more direct and pure way.

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

#157

Post by aftoprokrustes »

CodeCounselor wrote: post #109
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…

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 unplea…

Thanks a lot for your comment, it is very interesting to read directly from your experience. I am particularly pleased by your comment, because it kind of goes in the direction of my first reaction when I read this comment about "sub-trippy doses" being used.

I do not have experiences with psychedelics, but I do have quite some mileage with meditation, in particular approaches that aim at shifting the "way of looking". Those practices can lead to experiences that lead to profound shifts in the usual day-to-day way of looking at the world, but the experiences themselves are more subtle than what I expect a full blown trip to feel like. So I can totally picture that the experience, even if just subtle, can be a big part of the transformation.

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

#158

Post by CodeCounselor »

scotty79 wrote: post #142
CodeCounselor wrote: post #109

Earlier quoted context omitted.

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 unplea…

Isn't the "trip" just a side effect of it having some impact on the brain and if you adjust dosage and protocol so that the trip doesn't happen you are basically left with placebo effect proportional to hope of improvement which is positively correlated with opinions on ketamine? I'm not sure if I remember correctly but I think I've read ketamine makes neurons groe new dendrites in petri dish. I have no idea how this…

I apologize if I misunderstand you, which is very possible.

I interpret you as saying that unless there is a "trip" there is only a placebo effect left on the table so to speak. I think this is somewhat refuted by the fact that the standard ketamine infusion protocol (that does not normaly induce "trips") has an effect size that dwarfs the effect size of placebo (say 0.2 - 0.4). Some studies have shown ketamine approaching ECT-effect sizes. This makes me sound like a ketamine nut, which I am not. I am a bit of an ECT nut though. I have just not excluded the fact that the phenomenology of certain treatments actually mediate the treatment effects in a non-placebo way.

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

#159

Post by oldman_peter »

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…

> Fixing depression is not like fixing a car.

it's like fixing the way you drive your car

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

#160

Post by andybak »

TheFattestNinja wrote: post #141
astrange wrote: post #106

Earlier quoted context omitted.

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

While I can imagine it's possible that usage of substance A "breaks" new ground in your sensitivity to substance B by "opening" some new pathways, I find it unlikely: The "standard" pathways for most substances is to build a tolerance to it (and similar compounds) over time of use. If you drink coffee a lot you don't get hyped by the same dose of caffeine, if you drink lots of alcohol it's harder to get you drunk, et…

Personal experience again - there are definitely substances that exhibit "anti-tolerance".
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