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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

#41

Post by aftoprokrustes »

amelius wrote: post #37
logifail wrote: post #34

Earlier quoted context omitted.

> As a relatively seasoned meditator, I am absolutely sure that this is the trip that helps, not the chemistry The trip is (also) the chemistry!

Can we create a trip without drugs but e.g. using VR goggles only?

There are people looking at "psychedelic game design", see e.g. https://anticiplay.medium.com/chocolate-covered-magic-mushro...

They are not looking at creating a "trippy" experience per se, but rather to generate an experience that produces a potential shift in the way to relate with the world

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

#42

Post by aftoprokrustes »

logifail wrote: post #34
aftoprokrustes wrote: post #17

Earlier quoted context omitted.

As a relatively seasoned meditator, I am absolutely sure that this is the trip that helps, not the chemistry. One way to look at meditation (and, I hear, psychedelics) that fits my experience is that it has the potential effect of opening the range of "ways of looking", to change the way one builds the perceived world. What propulsed my meditation to a totally different level was to see it as a practice of actively e…

> As a relatively seasoned meditator, I am absolutely sure that this is the trip that helps, not the chemistry The trip is (also) the chemistry!

I think I see what you mean, in the sense that without the substance the trip does not exist. The distinction I was trying to make was between the subjective experience compared to potential brain changes induced by chemical reactions.

The "chemistry" side of the debate would be that the trip is a side effect of the substance modifying neurological pathways (or similar), but what is actually important are those physical modifications to the brain, not the experience.

The "trip" side of the debate would be that the only important thing is the experience, and that whether it is induced by drugs, fasting, meditation, prayer, video games, etc. does not matter that much.

Obviously, there is also the possibility that both sides are valid: the fact that the experience can be transformative in itself does not prevent the physical effect of the molecule on the brain to be beneficial as well. There is even the possibility that one of the two has a positive effect, while the other is rather negative.

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

#43

Post by arthur2e5 »

This kind of headline made some round in Twitter a while ago and got justifiably ridiculed, so let me repeat those old points here.

The study states "agents used for anesthetic maintenance included intravenous propofol and inhaled sevoflurane or isoflurane." All three have some known antidepressant activity:

- propofol: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276046/ (This story was pretty big back then, as propofol's a common electeoconvulsion anesthetic.)

- sevoflurane: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8851135/ (tiny sample, but idea comes from other tiny samples where it worked)

- isoflurane: https://pubmed.ncbi.nlm.nih.gov/23922809/

Does it mean this study is meaningless? No, but it definitely does not prove what the abstract wants to say. What it does show is well-summarized in https://news.ycombinator.com/item?id=36030251.

See replies under https://twitter.com/jonahdavids1/status/1654842991331213313.

(And no, having general anesthesia work about as well as ketamine does not make ket useless either. Ket is less likely to stop you from breathing. And you can stay awake, even non-hallucinating [see: nasal sprays], while it works.)

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

#44

Post by laratied »

tsimionescu wrote: post #28
bheadmaster wrote: post #13

Earlier quoted context omitted.

If you're gonna accuse someone of posting lies and FUD, at least have some sort of reference [0] to point to, please. Otherwise you're just participating in a "uh-huh!", "nuh-uh!" pissing contest. [0] https://www.nature.com/articles/s41380-022-01661-0

There's a simple reference that doesn't even need to be quoted: SSRIs are approved for treating depression in all major countries on Earth. And this approval required they pass phase 3 clinical trials, demonstrating effectiveness over placebo. Also, given that they are typically preferred over other classes of anti-depressants (try-cyclics etc), we also know they have demonstrated better effectiveness than other drug…

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

#45

Post by taraparo »

amelius wrote: post #37
logifail wrote: post #34

Earlier quoted context omitted.

> As a relatively seasoned meditator, I am absolutely sure that this is the trip that helps, not the chemistry The trip is (also) the chemistry!

Can we create a trip without drugs but e.g. using VR goggles only?

The Lumenate app.

Or if you don't count oxygen as a drug: Breathwork (Holotropic Breathwork, Quantum Light Breathing, Shamanic Breathing, Rebirthing, etc.).

Never tried but I heard that multi-day retreats in complete darkness can also induce some kind of (visual) trips.

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

#46

Post by LocalH »

api wrote: post #22
SiempreViernes wrote: post #18

Earlier quoted context omitted.

And you object to them trying to find out if it does?

The problem is that their conclusion is not going to be read as “wow, it’s the trip that helps more than just the chemical.” Instead it’ll be read as “well I guess this chemical doesn’t work at all.” The notion that the trip is the therapeutic element seems oddly frightening or threatening to a lot of people. … Or at least it’s not what they’re looking for. The quest is for a pill that works deterministically without…

>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 it, there are some people who would respond "well now we need to take the 'high' out of it, because getting 'high' is wrong". These type of people would never accept that the "high" might be the actual mechanism of psychological action, especially with psychedelics and dissociatives, where the user probably won't be able to interact with what passes for objective reality.

For example, DMT is very useful for, among other things, learning more about life and death. If the beliefs are correct, and DMT is released in the brain at the point of death, then DMT itself could be good preparation for the weirdness that happens at and before death (like Alzheimer's or dementia). Taking the "trip" out of DMT would make it completely useless.

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

#47

Post by hypercube33 »

aftoprokrustes wrote: post #17
cameronh90 wrote: post #3

> They gave volunteers ketamine while they were under general anesthesia, theoretically preventing the participants from going on a trip. Maybe it's the trip that helps.

As a relatively seasoned meditator, I am absolutely sure that this is the trip that helps, not the chemistry. One way to look at meditation (and, I hear, psychedelics) that fits my experience is that it has the potential effect of opening the range of "ways of looking", to change the way one builds the perceived world. What propulsed my meditation to a totally different level was to see it as a practice of actively e…

I look at it as shutting your computer off and plugging in a USB drive with repair software and wondering why nothing got fixed after you turned it back on. Aren't we just meat computers?

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

#48

Post by sfpotter »

aftoprokrustes wrote: post #17
cameronh90 wrote: post #3

> They gave volunteers ketamine while they were under general anesthesia, theoretically preventing the participants from going on a trip. Maybe it's the trip that helps.

As a relatively seasoned meditator, I am absolutely sure that this is the trip that helps, not the chemistry. One way to look at meditation (and, I hear, psychedelics) that fits my experience is that it has the potential effect of opening the range of "ways of looking", to change the way one builds the perceived world. What propulsed my meditation to a totally different level was to see it as a practice of actively e…

Thanks for sharing your very interesting experiences with meditation. Makes me want to have another go at it.

(FYI, you mean to use the word “propel” in place of “propulse” above… they aren’t synonymous, surprisingly.)

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

#49

Post by Spivak »

tokai wrote: post #14
mtlmtlmtlmtl wrote: post #12

Earlier quoted context omitted.

Well, what they're trying to do is provide better blinding. Doing proper blind studies of ketamine is quite hard because its subjective effects are far too noticable. That line just says people should do better at this in future to get more accurate results. It's not a statement about the ultimate form the treatment should take.

yes ofc, but if the treatment is the trip it will never work blinding it like this. If anything they should be looking for drugs that give comparable trips, with no potential for depression treatment.

You basically can't do science like this and prove anything useful outside of group A is the more effective than group B. And that's assuming your test subjects can't tell the difference. That would tell you that at minimum either A or B has a non-zero effect because they both can't do nothing and be different. But proving that A is an improvement over not A is the important bit. A and B could both be worse than nothing but A is just less bad.

"find something that has a similar trip but does nothing" is actually equivalent to the original problem.

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

#50

Post by moreshadowbans »

arthur2e5 wrote: post #43

This kind of headline made some round in Twitter a while ago and got justifiably ridiculed, so let me repeat those old points here. The study states "agents used for anesthetic maintenance included intravenous propofol and inhaled sevoflurane or isoflurane." All three have some known antidepressant activity: - propofol: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276046/ (This story was pretty big back then, as pro…

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