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Ketamine has 'fast-acting benefits' for depression

bbc.co.uk

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

#191

Post by sedeki »

marsrover wrote: post #150
NeutronStar wrote: post #142

Earlier quoted context omitted.

Imho, dissos are for short term depression fixing, you need them psychedelics to open your mind for long term.

Just for a little anecdotal evidence: I ate some psychedelic mushrooms multiple times about 8 years and and haven't been depressed since. I was previously diagnosed with clinical depression and took a moderate amount of Seroquel for it. I haven't taken anything since and I've been great.

Seroquel for clinical depression, really? I thought it only was used to treat psychotic episodes (I’ve taken it for that specifically).

Oh well, you learn something new every day.

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

#192

Post by marsrover »

sedeki wrote: post #191
marsrover wrote: post #150

Earlier quoted context omitted.

Just for a little anecdotal evidence: I ate some psychedelic mushrooms multiple times about 8 years and and haven't been depressed since. I was previously diagnosed with clinical depression and took a moderate amount of Seroquel for it. I haven't taken anything since and I've been great.

Seroquel for clinical depression, really? I thought it only was used to treat psychotic episodes (I’ve taken it for that specifically). Oh well, you learn something new every day.

The doctor thought I might also be bipolar or something but wasn't sure which is why it was chosen.

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

#193

Post by DanBC »

DenisM wrote: post #122
DanBC wrote: post #76

Earlier quoted context omitted.

The difference is that ketamine shows positive results in clinical trials (even for severe depression) while exercise doesn't, unless you include poor quality trials and you limit results to mild depression.

Whoa. Do you have a link to a meta-study or something like that?

For exercise?

I've posted this before. There's a newer study that has better results.

http://www.cochrane.org/CD004366/DEPRESSN_exercise-for-depre...

---begin

Exercise is moderately more effective than no therapy for reducing symptoms of depression. Exercise is no more effective than antidepressants for reducing symptoms of depression, although this conclusion is based on a small number of studies. Exercise is no more effective than psychological therapies for reducing symptoms of depression, although this conclusion is based on small number of studies. The reviewers also note that when only high-quality studies were included, the difference between exercise and no therapy is less conclusive. Attendance rates for exercise treatments ranged from 50% to 100%. The evidence about whether exercise for depression improves quality of life is inconclusive.

---end

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

#194

Post by marssaxman »

GordonS wrote: post #177
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…

Anyone know why it always seems to be given as an infusion, and not any other route? If it was just about bioavailability, I guess they'd just give large oral doses. I recall reading of people self treating with ketamine off the darknet, and I imagine they are not giving themselves an infusion?

Oral ingestion is unpopular due to inefficiency and the likelihood of stomach upset. People who are self-administering ketamine are most likely insufflating. I have friends who have reported very positive results with intramuscular injection, but most people don't have access to hygienic injection apparatus, nor any experience using it safely, so insufflation is most common.

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

#195

Post by jtmcmc »

kylek wrote: post #189
laythea wrote: post #171

Earlier quoted context omitted.

Without specifying the relative proportion of those who went up, in your experience, along with the massive amount of people who went down, your counter anecdote is weakly armed.

I think either case is weak. Parroting Leary here seems appropriate - set and setting are just as important as dosage when it comes to these substances.

I think this is really what I'm trying to say - that these anecdotes about psychedelics curing / not curing depression to be profoundly useless.

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

#196

Post by rincebrain »

_bdog wrote: post #190
rincebrain wrote: post #140

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…

This easily explained: Ketamine seems to repair some kind of cell damage, thereby increasing neural plasticity. That is a huge asset, but long endured depressions leave many unhealthy neural circuits over the years. These have be unlearned one by one, which takes time. Ketamine increases freedom of thought and emotion, but you still need a goal and long-term plan to precisely target and unwork all the patterns that c…

Neuroprotective behavior is one of the theories I've heard about ketamine's efficacy, as well as lithium's, but that doesn't explain the immediate gross improvement, just the eventual semi-permanent tolerance in some cases.

In my case, while it was effective, I was a much more productive and healthy person than I'd ever been, cleaning up lots of mess and accumulated dross I'd never been able to convince myself to go through, more physical activity, more consistent eating...but then it all abruptly came crashing down, eventually, so either the learned behaviors have quite a thresholding behavior, or it's a more complex mechanism.

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

#197

Post by proverbialbunny »

pjc50 wrote: post #40
proverbialbunny wrote: post #35

Earlier quoted context omitted.

Doesn't ketamine stimulate growth in the same areas of the brain that exercise does, and does therapy prescribe routine daily exercise? I can imagine there being a great short term benefit to ketamine, as people who are severely depressed can't exercise due to the depression. Has there been any mention switching from ketamine to daily exercise, or doing both?

I know exercise is good for depression, but this is an extremely patronising response to someone else's description of their medical treatment.

Sorry. That wasn't the intent. I could have been clearer.

More, I don't know what ketamine does in the long term to the brain beyond stimulating the parts of the brain that get strengthened during exercise. Maybe it's doing something else and that was the motive for the curiosity. What exactly is ketamine doing in the long run to the brain?

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

#198

Post by rincebrain »

sedeki wrote: post #191
marsrover wrote: post #150

Earlier quoted context omitted.

Just for a little anecdotal evidence: I ate some psychedelic mushrooms multiple times about 8 years and and haven't been depressed since. I was previously diagnosed with clinical depression and took a moderate amount of Seroquel for it. I haven't taken anything since and I've been great.

Seroquel for clinical depression, really? I thought it only was used to treat psychotic episodes (I’ve taken it for that specifically). Oh well, you learn something new every day.

I've heard it being used as an augment for people who have trouble with other treatments, or if they're also looking for synergies with the other effects of it.

A couple of antipsychotics or even more esoteric drug types are used (off-label and otherwise) for antidepressant effects, often at dosages lower than they'd usually be thought to be effective for whatever the primary usage would be. Why does it work? Ask again in 50 years, maybe.

- Seroquel (off-label)

- Adderall/Ritalin for people with drive problems

- Wellbutrin is a smoking addiction aid, antidepressant, and SAD-specific antidepressant (because why not, biochemistry)

- Strattera is nominally an ADHD med but has been using it as an antidepressant off-label for at least 15y (source: I was given it for that, then)

- Abilify is on-label used as an anti-psychotic, anti-depressant augment, and Tourette's med, because again, why not

- Also, one thing a lot of people don't realize is that you don't want to mix a unipolar antidepressant with untreated bipolar, because surprise, side effects may include P(manic episodes) approaching 1, so the options for each of those can sometimes overlap and sometimes not

Biochemistry is really weird, and neurochemistry is one of the densest places for it in the body.

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

#199

Post by rincebrain »

mabbo wrote: post #176
rincebrain wrote: post #140

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…

Your story reminds me of "Flowers for Algernon" ( https://www.amazon.com/dp/B003WJQ74E ). If you haven't read it, you might enjoy it for the parallels.

I've considered picking that up a couple of times from very positive reviews, but I'm rather concerned from having heard what the overall mood is at the end of the novel.

Ironically, perhaps when I find a sufficiently effective combination again, I'll give it a look. Thanks!

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

#200

Post by topmonk »

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…

> - 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]

I've heard that 35% figure bandied about for awhile now. Does this take into account multiple SSRI's? If one took Welbutrin and it didn't work, for example, and then one decides to try Paxil, is there still a 35% chance that Paxil will work? (both Paxil and Welbutrin are SSRI's)

Or is the 35% figure meaning that if one tried all the SSRI's out there, there is only a 35% chance that any of them at all will help you?

I tried reading your reference, but it doesn't seem to mention this.

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