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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

#161

Post by spicymapotofu »

mnky9800n wrote: post #146
cnity wrote: post #139

Earlier quoted context omitted.

This system of scientific gatekeeping and law enforcement is a direct projection of the barriers put in place between individuals and god by the catholic church. For millennia authorities have attempted to prevent people from having meaningful spiritual experiences directly, of their own accord, via access to substances that grow e.g. in their nearest cow fields. In this way, your psychiatrist friend is simply the ne…

Maybe their friend is simply uninterested in having the liability as opposed to some millennia long conspiracy by the Catholic church making her do it. And anyways, your statements ignore that there's plenty of hippies on Instagram peddling their mushrooms and Ayahuasca in intense spiritual experiences for only 1500$ a pop. Does the Catholic church control them too?

I believe this comment minimized the structure of spiritual experience in a hyperrational way, which is exactly as the GP comment warned against.

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

#162

Post by mnky9800n »

spicymapotofu wrote: post #161
mnky9800n wrote: post #146

Earlier quoted context omitted.

Maybe their friend is simply uninterested in having the liability as opposed to some millennia long conspiracy by the Catholic church making her do it. And anyways, your statements ignore that there's plenty of hippies on Instagram peddling their mushrooms and Ayahuasca in intense spiritual experiences for only 1500$ a pop. Does the Catholic church control them too?

I believe this comment minimized the structure of spiritual experience in a hyperrational way, which is exactly as the GP comment warned against.

If your views in having a spiritual experience are exclusive to consuming psychedelic substances then you are minimizing what is available across the human experience in terms of spiritual explorations.

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

#163

Post by spacecadet »

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…

Predicted? I doubt anything has changed since his time.

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

#164

Post by pygy_ »

teaearlgraycold wrote: post #44
PlunderBunny wrote: post #19

I don't want to downplay depression (which I have no experience of), or come across as being flippant, but could the placebo effect in many of these kinds of trials be as simple as "a caring person (professional and/or stranger) interacting with the depressed subject improves their condition?"

That seems really easy to control for

That's the reason why drugs are tested in double-blind, randomized controlled trials.

The placebo effect is a major part of the effect of SSRI, which only improve 1 in 6-8 patients if you subtract the placebo effect [1].

The "number needed to treat" (NNT) mentioned below is the average number of patients that need to recieve the treatment for one of them to be in a better condition than if all of them had recieved a placebo.

1. https://www.cambridge.org/core/journals/psychological-medici...

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

#165

Post by tudorw »

CodeCounselor wrote: post #158
scotty79 wrote: post #142

Earlier quoted context omitted.

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 appro…

Thanks for all the detail, I'm interested to know if you have explored CYP gene expression (polymorphism) and it's impact on metabolising ketamine as factor in treatment?

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

#166

Post by dalbasal »

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…

Agreed.

Pop culture "obsession" may have been useful for overcoming blanket bans on research, funding, etc. It was obsession that created these bans in the first place, and obsession that triggered them.

Now obsession it's interfering with science and (especially) science communication.

Meanwhile, parent comment (the "trip" is the active substance) is a hypothesis... on the face of it. A reasonable hypothesis that needs to be considered, and if possible tested.

There's probably no getting around obsession here. This is literally the namesake "culture war," dating to 60s counterculture.

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

#167

Post by unmole »

cnity wrote: post #139
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…

This system of scientific gatekeeping and law enforcement is a direct projection of the barriers put in place between individuals and god by the catholic church. For millennia authorities have attempted to prevent people from having meaningful spiritual experiences directly, of their own accord, via access to substances that grow e.g. in their nearest cow fields. In this way, your psychiatrist friend is simply the ne…

What drugs are you on?

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

#168

Post by dangus »

cnity wrote: post #139
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…

This system of scientific gatekeeping and law enforcement is a direct projection of the barriers put in place between individuals and god by the catholic church. For millennia authorities have attempted to prevent people from having meaningful spiritual experiences directly, of their own accord, via access to substances that grow e.g. in their nearest cow fields. In this way, your psychiatrist friend is simply the ne…

The customer is not always right. Just because the customer wants something or believes something doesn’t make it factually true.

This really isn’t about being a lawful authority trying to buzz-kill society as much as it is about having principles as a doctor. The patient wants a cure to an ailment while their doctor has no evidence of its efficacy.

If I had someone coming into my auto repair shop telling me they didn’t need brakes, they let Jesus take the wheel like they heard in the song, my noncompliance to their request to remove them from their vehicle does not make me a gatekeeper like the Catholic priests you described.

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

#169

Post by nottorp »

cnity wrote: post #149
mnky9800n wrote: post #146

Earlier quoted context omitted.

Maybe their friend is simply uninterested in having the liability as opposed to some millennia long conspiracy by the Catholic church making her do it. And anyways, your statements ignore that there's plenty of hippies on Instagram peddling their mushrooms and Ayahuasca in intense spiritual experiences for only 1500$ a pop. Does the Catholic church control them too?

I believe you have misread my post. Powers that be continue to want me to not have mind altering experiences. I continue to have them anyway. So it goes.

But why call them spiritual experiences when hallucinations will do even better?

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

#170

Post by varispeed »

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…

> In other words, the trip is the point, not the mechanistic neuro-tinkering

It's bizarre that people would think any different of it?

It's like therapy on steroids.

It's an equivalent of scientist saying that eating an invoice for therapy doesn't get you "cured". Doh?

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