Ketamine has 'fast-acting benefits' for depression • Hacker News Board

Re: Ketamine has 'fast-acting benefits' for depression

#131

Post by kingofhdds » Mon, Apr 16, 2018, 3:55 PM UTC

arkades wrote: post #63

patricius wrote: post #49

Earlier quoted context omitted.

Getting a drug approved by the FDA is pretty expensive. Abolishing the FDA, thereby reducing the cost of introducing the drug, might be the real solution here.

I find public health inspectors also make it more expensive to run a restaurant. Perhaps the solution to their tight margins would be to abolish health inspections.

>abolish health inspections.

Well, it would be interesting to look at impartial cost/efficiency research regarding "health inspections". I routinely travel to countries where those inspections are just a pure formality, or completely non-existent - and, I must say, in most cases there's no trouble finding a good, safe place to eat.

Re: Ketamine has 'fast-acting benefits' for depression

#132

Post by themodelplumber » Mon, Apr 16, 2018, 3:56 PM UTC

ada1981 wrote: post #98

themodelplumber wrote: post #15

Ketamine is an anesthetic. Has anyone compared it to e.g. ibuprofen for this use case? Ibuprofen works very well for me when experiencing depressive symptoms. I'm down to about 2h max per depressive episode (logged at 10-30 depressing thoughts per minute, compared to none after). Mechanism intuitively "feels" inflammatory and looking at my logs seems related to exhaustion due to over-productivity, lack of rest, etc.

Your emotional body is your physical body, to a large degree. Emotional pain can be mitigated with ibuprofen just as easily as physical pain can. Congrats on the self study and experimentation and on finding an over the counter solution. Have you tried any non-ordinary states of concioisness work, like Holotropic Breathwork?

I haven't ever heard of holotropic breathwork, will give it a go, thanks. I have had really good results from meditation, especially when sleep is out of the question.

Re: Ketamine has 'fast-acting benefits' for depression

#133

Post by selectodude » Mon, Apr 16, 2018, 3:56 PM UTC

mmcwilliams wrote: post #120

toomanybeersies wrote: post #95

Earlier quoted context omitted.

Ket will set you back anywhere from $50-$150 per gram, depending on where in the world you are, and is of varying quality. It looks like they're using up to 1/2 a gram for treatment. I think the most of that $375 goes towards staffing costs, rather than the drug itself. Ketamine though legitimate channels costs about $5-$10 per gram from what I've heard.

Do you have a source on that 1/2 gram number? My reading has lead me to believe that a typical therapeutic dose for these treatments is between 60-75mg. I could be way off, though.

It's .5mg/kg, so even 50 mg is enough for a pretty big guy. 500mg would knock you out for awhile. He might be misplacing a decimal there.

Re: Ketamine has 'fast-acting benefits' for depression

#134

Post by selectodude » Mon, Apr 16, 2018, 3:59 PM UTC

aantix wrote: post #119

sgift wrote: post #62

Earlier quoted context omitted.

How often did you have depression? Especially major depressive episodes where you have trouble to even motivate yourself to move out of the bed or do ANYTHING but just "exist" and even that seems hard? If the answer is zero (which I think it is) do those who have it a favor and shut up. Depression is hard enough without "you just have to exercise, huahua" comments.

>do those who have it a favor and shut up Nothing is more irksome than the trend in public discussions to tell others to "shut up" if they haven't specifically experienced something. This is a public forum. We're discussing a publicly posted article. The OP brought to the table a valid point. Let them talk.

A lot of depressed people who have been able to pull themselves out of the hole can be pretty touchy about stuff like being told to exercise. OP was maybe a bit more aggressive than he needed to be, but it can be a pretty raw feeling, and mental illness has such a stigma.

Re: Ketamine has 'fast-acting benefits' for depression

#135

Post by man2525 » Mon, Apr 16, 2018, 4:00 PM UTC

odammit wrote: post #113

Don’t get caught in a k-hole or it might have some fast acting disadvantages for depression.

I was wondering about this. A co-worker's daughter was given ketamine during a spinal tap. After the procedure, she said that she no longer felt real.

Re: Ketamine has 'fast-acting benefits' for depression

#136

Post by atomical » Mon, Apr 16, 2018, 4:02 PM UTC

pizza wrote: post #130

atomical wrote: post #121

Earlier quoted context omitted.

It's not a breakthrough because it has been used in the clinic for patients with suicidal ideation for a long time. You are hearing about it now because a small group of doctors have found a new income stream. Contrary to the posts in this thread there isn't a body of evidence that suggests Ketamine's anti-depressant effect lasts longer than a week.

I think the posts here are almost all about comparing repeated-dose regimens of Ketamine vs SSRIs; otherwise if we were comparing the effectiveness of single doses, we might as well claim there isn't a body of evidence that suggests SSRIs have an anti-depressant effect for much longer than just a single day, right? Or do you mean that the repeat dose just a week later (, and so on,) would have little anti-depressant…

Doctors and patients are claiming that the effects last much longer than a week between maintenance infusions. I'm not making any comparison with SSRI's. It's a costly treatment and the duration of effect as reported is probably bullshit. Buyer beware.

Re: Ketamine has 'fast-acting benefits' for depression

#137

Post by logfromblammo » Mon, Apr 16, 2018, 4:03 PM UTC

Fnoord wrote: post #116

patricius wrote: post #72

Earlier quoted context omitted.

I agree. Just because a thing exists (the FDA or taxes for instance), doesn't make it a good thing.

Although I don't disagree with your point, that wasn't my point. My point is that these things have different aspects (some of which are arguably useful, some perhaps in your eyes less so or not) but removing them has serious consequences. It is easy to be against something (for example, paying taxes) but removing taxation has serious consequences which have to be accounted for.

Keeping them as they are also has serious consequences that are rarely examined, or even raised for consideration.

The public interest is for medical treatments to have the following qualities: safe, effective, affordable. The business interest for healthcare providers is for medical treatments to have the following property: profitable. Those interests only partially overlap.

It is possible to imagine many different institutional architectures that cater to the public's interests, and a large number of them are theoretically better than the actual results yielded from the FDA and the rest of the modern American health care system.

Thus, one of the consequences of maintaining the status quo is the foregone advantage of moving to a different and wholly incompatible system. That's the kind of argument only an economist could love, because it ties your brain up in knots trying to figure it out, and you can plausibly justify any prejudicial opinion you might care to support.

Re: Ketamine has 'fast-acting benefits' for depression

#138

Post by themodelplumber » Mon, Apr 16, 2018, 4:05 PM UTC

spiralx wrote: post #109

themodelplumber wrote: post #15

Ketamine is an anesthetic. Has anyone compared it to e.g. ibuprofen for this use case? Ibuprofen works very well for me when experiencing depressive symptoms. I'm down to about 2h max per depressive episode (logged at 10-30 depressing thoughts per minute, compared to none after). Mechanism intuitively "feels" inflammatory and looking at my logs seems related to exhaustion due to over-productivity, lack of rest, etc.

Pain killers can affect your emotional state indeed: https://www.smithsonianmag.com/smart-news/painkillers-might-...

Thank you for the link, that's interesting. In my case any dulling of the emotional state when in a depressed situation is probably helpful. A return toward an emotionally-colder systematizer's state of mind seems, again in my case, to be associated with healthier outcomes.

Re: Ketamine has 'fast-acting benefits' for depression

#139

Post by selectodude » Mon, Apr 16, 2018, 4:05 PM UTC

atomical wrote: post #66

anythingnonidin wrote: post #4

Main upsides of Ketamine for depression vs typical antidepressants (SSRIs, etc) - Ketamine seems to have a much larger effect size (-~0.99 [1] vs -~0.35 for typical antidepressants [2]) [If anyone spots an error, please let me know] For context, an SMD of 0.2 is small, >0.5 is medium, and >0.8 is large.[3] To me this seems to be by far the most important/interesting thing: Ketamine seems to have a much stronger antid…

It's expensive because doctors are using it to make a lot of money. The drug is cheap.

That and I bet the malpractice insurance for this kind of off-label use is going to be pretty high.

Re: Ketamine has 'fast-acting benefits' for depression

#140

Post by rincebrain » Mon, Apr 16, 2018, 4:07 PM UTC

I've posted this in other ketamine news stories before, but I'm offering it as a firsthand testimonial here.

Ketamine was both the best and most depressing depression treatment option I've ever tried. Within a couple of weeks after having had the initial round of six treatments in two weeks, I was the most functional and productive human being I've _ever_ been - things that used to be impossible or utterly agonizing to complete were as trivial as they "should" be, I was enjoying life, it was great.

After a couple of months of periodic booster treatments, over the course of a week, I felt it completely drain out of me, and no variance or repetition of ketamine treatments has been able to reproduce it since. (We spent months varying dosage levels, frequency, and trying a few OTC things that the doctor had seen synergize ketamine response in people before, to no avail.)

It was...possibly the single worst experience of my life, feeling that slip away, and now having recent crystal-clear memories of how much that fog had been complicating my life.