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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

#191

Post by arthur2e5 »

PragmaticPulp wrote: post #87
arthur2e5 wrote: post #70

Earlier quoted context omitted.

The study actually shows ketamine works as well with anesthetia (45%) as without (40%), if you read the non-anesthetia study linked in https://news.ycombinator.com/item?id=36030251 . (Of course you can argue they are not using enough K at the 0.5 mg/kg mark, because disccociation starts at 1 to 3 mg/kg per StatPearls.)

> Of course you can argue they are not using enough K at the 0.5 mg/kg mark, because disccociation starts at 1 to 3 mg/kg Dissociation isn’t necessary for the antidepressant effect, according to studies. In fact, many of the more responsible clinics target longer duration, lower peak dose infusions for this reason.

Well, yeah. But the parent comment is insisting that the spiritual bits is doing something, and I was just way too lazy to look for a dose response study.

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

#192

Post by jjk166 »

bheadmaster wrote: post #188
jjk166 wrote: post #174

Earlier quoted context omitted.

Yes the burden of proof is on you. And in this analogy, the tea cups of saturn have been regularly observed for decades, so you have your work cut out for you.

The teacup is too small to be seen by any Earth's telescope. Is the burden of proof still on me? Why?

Yes the burden is still on you. You're not just claiming you have not yet seen sufficient evidence of something existing, you are claiming it explicitly doesn't exist, ie that there has been some search conducted that should have found it if it had been there, but got a null result.

Of course in this case, not only can the tea cup be seen by Earth's telescopes, pictures of it are widely published in every book on saturn.

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

#193

Post by Matticus_Rex »

FollowingTheDao wrote: post #176
Matticus_Rex wrote: post #106

Earlier quoted context omitted.

> Then why this singular focus on ketamine and psychedelics all the sudden? If it has many different causes why focus on activating a single serotonin receptor? Because it does work really well for a lot of people for whom other things don't work really well. Why would that be controversial?

No, in fact it does not "work well for a lot of people" as the study found. I am not making it controversial, you are, by denying what they found in the paper. What you are really hearing is the massive marketing that is flooding the airwaves so some corporations can make a profit off of sick people and when it does not work they can say "Oh well" and walk away with the money and all you get is rebound depression.

Erm... you realize this isn't the first study on ketamine, right?

This is one study, that has not yet been peer-reviewed, that explicitly acknowledged the study design could be subject to significant subject-expectancy bias, using one particular treatment regimen, with a treatment group of ~20 people. At most, this study tells us that we have more to learn about what's going on and why we see significant effects. Both groups did see significant effects relative to base rates that are unlikely to be random even at that small sample size! Funny how you've come to radically different conclusions on the findings than the scientists themselves.

I am actually only vaguely aware of the marketing around this -- I've been following this space for about a decade and have read quite a few studies around it. Even if this study is generalizable and ketamine is no more effective at treating depression than the idea that ketamine will have an effect in treating the depression (placebo), we know from the evidence that it's having a significant effect relative to simple regression to the mean (depressed people simply getting less depressed without treatment). If it's a placebo, it's a powerful placebo, and placebo effects that are effective aren't a bad thing.

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

#194

Post by BobbyJo »

operatingthetan wrote: post #146
BobbyJo wrote: post #144

Earlier quoted context omitted.

Never heard that before, source? Also, anesthesia would ruin whatever you hoped to see on an MRI.

Maybe I'm misunderstanding context, but my cat may need an MRI and I've learned it's standard in all veterinary medicine to use anesthesia for scans in order to keep the patients immobile.

Yeah, but they aren't trying to watch the effect of a drug happening. Anesthesia is accomplished with drugs. You can't give a person 3 different drugs, then expect a brain scan to tell you how one works in isolation.

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

#195

Post by vorpalhex »

BobbyJo wrote: post #144
vorpalhex wrote: post #116

Earlier quoted context omitted.

Pain has subjective parts but it is not merely subjective. You can measure how much effect ibuprofen or tylenol has, even with someone knocked out. You can see pain on an mri, even with someone knocked out.

Never heard that before, source? Also, anesthesia would ruin whatever you hoped to see on an MRI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5019436/

https://pubmed.ncbi.nlm.nih.gov/17512757/

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

#196

Post by replygirl »

Georgelemental wrote: post #141
replygirl wrote: post #66

Earlier quoted context omitted.

> a highly detailed critique from someone who will either be scooped or proven wrong, so they're looking for any reason to reject sounds like an ideal reviewer, tbh

"Reason" might be "major flaw in your statistical analysis", but it could also be "you should have cited my paper" or "insufficient jargon."

I'd want to hear that out and make sure I'm not mistaking "I've done some prior work that enriches yours" for "You should have cited my paper" or "You're not communicating clearly and succintly" for "insufficient jargon"
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