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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

#131

Post by mensetmanusman »

LocalH wrote: post #71
mensetmanusman wrote: post #68

Earlier quoted context omitted.

'There is a significant perception that "altering your state of mind" is immoral ' This is probably a straw man. The immoral part comes from some percentage of the trippers ending up doing things like climbing naked up power lines to steal the copper for future trips. It's a question of whether society should tolerate the % damage that occurs versus the % high it gives those not participating in the damage.

That's an issue of set and setting, and of proper education. Also, what in the world scenario have you put forth? Who is "climbing naked up power lines to steal the copper for future trips"? I've never heard that one in all the years of propaganda I've heard (like the old canard about someone taking LSD and believing after the trip that they're an orange).

You must not be familiar with the bath salt scenarios in Florida :)

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

#132

Post by andybak »

cubefox wrote: post #125
andybak wrote: post #110

Earlier quoted context omitted.

Am I missing something blindingly obvious here? I would have assumed that the therapeutic effects of a strong mind-altering substance relies on being conscious to, you know, experience the effects. Saying "It didn't work while the subject was asleep so therefore must be placebo" is just a bizarre position to take. Imagine if a study stated "Cognitive Behavioural Therapy found to be ineffective on unconscious patients…

The trip is very short, but the effect as a useful antidepressant has to last a lot longer. It's not clear why the trip itself would have anything but short term effects on depression.

Well, it's a hell of a lot clearer than a trip you slept through having a lasting effect.

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

#133

Post by ModernMech »

GreenWatermelon wrote: post #69
ModernMech wrote: post #26

Earlier quoted context omitted.

Indeed, I remember a while back there was a TikTok filter going around where it made old people look younger. One of the people using it said it basically had cured her self-perception issues; she had been bullied for her looks as a child and internalized that she was ugly. But as an adult when she saw her younger face in the app, she realized immediately how the characterization of that face as ugly was just the per…

Depending on how I interpret what you wrote, I reach either a negative or positive conclusion. To start with the negative: She's basically fooling herself. She's avoiding the real problem of "not accepting herself for who she is, abd changing what can be changed" IMO, The filtr only shows her a big lie, merely suppressing the pain, and not helping solve the real psychological problem. On the positive hand, the filter…

Yeah I think there needs to be some serious research here to answer these questions.

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

#134

Post by dietnexercise »

tonyarkles wrote: post #62
throwawaaarrgh wrote: post #36

Amazingly, talk therapy also is no better at reducing depression than placebo while under general anesthesia.

Thanks for that! Having a bit of a rough morning and that was a great laugh :)

Could be another doctor that sells medical services and writes pharmaceutical prescriptions for free, as gifts.

(Granting Equal Liberty, a non-delegable inalienable right that's not granted to Congress by the US Constitution either).

/? Are diet and exercise more effective than pharmaceuticals (and talk therapy) https://www.google.com/search?q=are+diet+and+exercise+more+e...

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

#135

Post by armatav »

mensetmanusman wrote: post #68
LocalH wrote: post #46

Earlier quoted context omitted.

>The notion that the trip is the therapeutic element seems oddly frightening or threatening to a lot of people. The result of years of "altered state of mind" anti-drug propaganda. There is a significant perception that "altering your state of mind" is immoral (even though we do that every day, all day, and in fact even some foods can "alter your state of mind"). If cannabis could actually cure cancer just by smoking…

'There is a significant perception that "altering your state of mind" is immoral ' This is probably a straw man. The immoral part comes from some percentage of the trippers ending up doing things like climbing naked up power lines to steal the copper for future trips. It's a question of whether society should tolerate the % damage that occurs versus the % high it gives those not participating in the damage.

People can’t even move properly on therapeutic doses.

Climbing power lines, lmfao.

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

#136

Post by dietnexercise »

dietnexercise wrote: post #134
tonyarkles wrote: post #62

Earlier quoted context omitted.

Thanks for that! Having a bit of a rough morning and that was a great laugh :)

Could be another doctor that sells medical services and writes pharmaceutical prescriptions for free, as gifts. (Granting Equal Liberty, a non-delegable inalienable right that's not granted to Congress by the US Constitution either). /? Are diet and exercise more effective than pharmaceuticals (and talk therapy) https://www.google.com/search?q=are+diet+and+exercise+more+e...

Protection racket: https://en.wikipedia.org/wiki/Protection_racket :

> A protection racket is a type of racket and a scheme of organized crime perpetrated by a potentially hazardous organized crime group that generally guarantees protection outside the sanction of the law to another entity or individual from violence, robbery, ransacking, arson, vandalism, and other such threats, in exchange for payments at regular intervals. Each payment is called "protection money" or a "protection fee".

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

#137

Post by tsimionescu »

bheadmaster wrote: post #130
tsimionescu wrote: post #111

Earlier quoted context omitted.

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?

Does drug being approved by FDA prove its effectiveness? If you can demonstrate without reasonable doubt that it does, i.e. that it's virtually impossible for a drug to be both approved by the FDA and as effective as placebo, then that would make a good argument. In any case, any argument is better than just a "Stop spreading FUD and misinformation, you antivaxxer"-style comment.

The standard for drug approval by the FDA is that the drug has proven to be more efficient than the controls in a phase 3 clinical trial, to the satisfaction of the FDA's experts. The ESA has similar requirements, as do the NHS and other national bodies.

Given this, I consider that the right prior is to believe that a drug that has been FDA, ESA, NHS and many other national bodies is actually more effective than placebo. Which means, the onus is on you to bring evidence if you want to claim they are not - otherwise, "Stop spreading FUD and misinformation" is the exact right response.

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

#138

Post by thomastjeffery »

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…

Continuing your ADHD example, the mood-boosting effects may very well be secondary, not directly caused by the drug itself. It feels great to finally have the balance of stimulation you always needed, but never had. The experience also has novelty, which is known to be very important to ADHD brains; because novelty is stimulating.

After some time, the novelty of the experience wears off, and you start to get more familiar with the limitations of medication. That's disappointing. Disappointment feels bad. Again, this is not caused by the drug itself, but by the surrounding experience.

ADHD itself is riddled with secondary experiences: they make up the name itself! People with ADHD do not struggle to pay attention, we struggle to direct it. Hypoactivity is a reaction to living without enough simulation. Neither is a direct symptom of the disorder, but they are ubiquitous enough to

People who live with undiagnosed/untreated ADHD are likely to end up with a lot of trauma. That trauma is unaffected by medication.

So if you start taking ADHD medication, you need to know what it does and doesn't help with. Medication can't make up the entirety of treatment, just like cognitive behavioral therapy can't replace medication.

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

#139

Post by padjo »

LocalH wrote: post #51
padjo wrote: post #35

Earlier quoted context omitted.

But it did also find that using Ketamine to treat depression had about the same efficacy as knocking them out and shooting saline into them. So maybe Ketamine does nothing and people just feel better when someone cares for them. Anyway in the absence of an objective measure of depression everything seems to be on a loose footing

I've never personally done ketamine, but what these studies fail to take into account is the simple fact that for most of these classes of compounds, the subjective psychological experience is the entire mechanism of useful action , and looking purely at the physiological side is missing the forest for the trees. Unfortunately, delving into the subjective with double blinding is damn near impossible, since the whole…

I think this was the entire point of this study. The interesting and positive experience is what knocks people out of their depression. It’s not that drug experiences are particularly magical in and of themselves, apparently getting anaesthetised is about as effective. Taking hallucinogens or disassociatives just happens to be a low effort way of having an interesting experience. It helps that it also feels a little transgressive and edgy.

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

#140

Post by thomastjeffery »

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…

It's not just about money.

How do you test a medication that only needs to be taken once or twice? This is very challenging to study scientifically.

Psychedelics bridge the gap between medication and therapy. A trip is not guaranteed to be therapeutic, but a trip with proper guidance it's more likely to be.

How can we know which aspects of that guidance are useful, and which are superfluous?

It's going to take a lot of work to get to the level of certainty that our medical system expects for medication.

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