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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

#51

Post by LocalH »

padjo wrote: post #35
mtlmtlmtlmtl wrote: post #11

Unusual is an understatement. This just seems ill-conceived to me. You can't eliminate one effect on the brain by introducing other effects on the brain that might have their own consequences for the results. All this shows is that ketamine while under general anaesthesia is not more efficacious than placebo. Ok then. This just seems like a failed attempt to introduce better blinding to me. I'm not convinced it sheds…

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 point of blinding is to remove the subjective aspects of the study.

I know my DMT trips have been so potent of an experience, that if you took that out of the picture and just left the physical aspects, it would be little more than vasoconstriction and elevated heart rate, and I fail to see how that would do anyone any therapeutic good.

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

#53

Post by currymj »

bheadmaster wrote: post #38
tsimionescu wrote: post #28

Earlier quoted context omitted.

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…

If it's so obvious and well-established, it shouldn't be hard to find some reference to support it, no? How else would I know that the emperor is, indeed, wearing clothes?

As of a while ago, this was a very good discussion of the situation with research on this topic:

https://slatestarcodex.com/2014/07/07/ssris-much-more-than-y...

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

#54

Post by MagicMoonlight »

zone411 wrote: post #25

Nothing against the study, it seems interesting. But the article title is quite misleading considering that ketamine is not typically administered under general anesthesia for treating depression.

Exactly. So when they’re getting high they say it works but when you look at actual mechanisms there’s no difference. Aka the “patient wants opiates instead of physiotherapy” model of treatment

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

#55

Post by insickness »

huuhee3 wrote: post #6

Then it's still no worse than widely used SSRI's, which also mostly don't differ from placebo

The effect of SSRIs on depression is moderate but statistically significant:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667359/

I suspect the response varies greatly by individuals: some respond a lot and some don't respond at all.

My experience with SSRIs was very positive. I took a low dose for depression for a few years and it helped significantly. I went off it a few years ago and my depression hasn't returned.

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

#56

Post by triggerity »

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 tried MDMA a while back and it was great.

On one side it showed me (after a long time) how you can be very empathic for all people around you and also reminded me or showed me how really good happiness feels.

And while the effects lasted a little bit for 1-2 weeks, it also is something I know I could do again if I like to.

This definitely gave me an additional/new viewpoint.

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

#57

Post by bjt2n3904 »

Psychiatry, having failed to measurably solve any "mental health" problem is so desperate to find a solution that it's sampling the recreational drug cabinet. This isn't science. This isn't medicine. This is rolling back the clock to witch doctors and medicine men.

Can't be depressed if your mind has been chemically lobotomized.

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

#58

Post by namlem »

SiempreViernes wrote: post #27
mtlmtlmtlmtl wrote: post #11

Unusual is an understatement. This just seems ill-conceived to me. You can't eliminate one effect on the brain by introducing other effects on the brain that might have their own consequences for the results. All this shows is that ketamine while under general anaesthesia is not more efficacious than placebo. Ok then. This just seems like a failed attempt to introduce better blinding to me. I'm not convinced it sheds…

Actually, what it shows is both that getting ketamine while under general anaesthesia is roughly as effective as when taken without anaesthesia (40% here vs 45% in [1]), and as effective as just taking anaesthesia (their placebo treatment). [1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992936/

I believe propofol (common general anesthetic) is also known to have some antidepressant effect.

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

#59

Post by cypherpunks01 »

This is rubbish. Ketamine is a life-saver and has been proven to relieve depression, regardless of the administration setting. It is not magic and does not work in every case, but the effects are proven across countless studies. S-ketamine has even gone fully through FDA approval.

Personally I have used it at home, and at a treatment center. There is no difference in the antidepressant properties, whether someone was helping me administer it in a medical setting, or not. The antidepressant properties do not relate to the effects of simply being in a clinical trial.

I strongly believe the antidepressant properties arise from the psychedelic/dissociative experience, and not directly from the physical effects. I'm not terribly surprised that ketamine may not produce strong antidepressant effects if the patient is not conscious.

Anyone looking to read more about ketamine antidepressant properties should read "The Ketamine Papers: Science, Therapy, and Transformation" by Phil Wolfson, M.D., and Glenn Hartelius, Ph.D.

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

#60

Post by [deleted] »

ketaminethrow wrote: post #30

I've been taking oral ketamine for about 2 years now. Not super frequently, probably ~6-10x/year. I feel like it's been a pretty helpful addition to my life, but it's not what I expected at all. To me, ketamine isn't really "enjoyable" or seem to modify my mood directly or anything like that. What it does do is shift my perspective for a few minutes and makes me introspective in ways I can only see as healthy. Someti…

[deleted]
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