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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

#61

Post by tonyarkles »

SiempreViernes wrote: post #29
api wrote: post #22

Earlier quoted context omitted.

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…

How is people misinterpreting the result that way a fair criticism of their work?

> How is people misinterpreting the result that way a fair criticism of their work?

Part of it comes down to overall scientific responsibility and being careful about defining the scope of the claims and conclusions. I haven't seen the final paper here, but if the Conclusions section says "This research indicates that ketamine given while patients are already sedated with general anesthesia doesn't not appear to provide a benefit for patients suffering from depression." then that's great.

If their Conclusions section says "By isolating ketamine-the-substance from the ketamine trip by administering the substance while the patient is under general anesthesia, this work demonstrates that there is nothing inherently anti-depressant about ketamine and that ketamine treatment for anti-depression is no better than placebo.", that's going to potentially have a huge ripple effect.

Throughout this thread there's a fair bit of discussion about "the trip is the treatment". The first conclusion leaves a number of other lines of inquiry open for exploration. The second conclusion opens the door for funding agencies and physicians to put an end to additional research and terminating treatments that are potentially effective.

Scientific communication absolutely must be very careful with the breadth of the claims and state them loudly and explicitly. While journal and conference proceedings have historically been generally only consumed by other practitioners of a field, now that everything is online and accessible to the general public there is definitely an increased burden for clear communication with explicit, conservative, narrow unless otherwise warranted conclusions.

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

#63

Post by LocalH »

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?

Only if it's so immersive that it feels more real than reality. If you can at all tell that it's not "real", then it all falls apart.

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

#64

Post by waythenewsgoes »

This study seems inherently flawed to me, how are you isolating what is happening while simultaneously administering other brain—chemistry altering drugs to the patient? These patients are all undergoing surgery, yet another variable with drastic consequences on mental health. Just taking the drug alone doesn’t even seem to accurately reflect the primary treatment path of having talk therapy while the drug is taking effect. What if the anesthesia simply inhibits the drug from working? Additionally the sample size (40 people) is extremely small to extrapolate this to the general population. I’m not sure how these flaws can be reconciled.

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

#65

Post by cypherpunks01 »

hprotagonist wrote: post #23

which form of ketamine?

If the term 'Ketamine' is used, that typically indicates racemic ketamine.

If you mean administration route, it was IV infusion. Not too many other methods are available for a patient under anesthesia :)

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

#66

Post by replygirl »

passwordoops wrote: post #20
peterlk wrote: post #2

> In a new study that is yet to be peer reviewed Thank you very, very much to the author for saying this

For all practical purposes, peer review is mostly useless today. More often than not, it's either: -a cursory glance by someone who doesn't have time to care -a highly detailed critique from someone who will either be scooped or proven wrong, so they're looking for any reason to reject the paper, good or bad -a grad student who puts in the effort but probably still lacks the experience for a good review And if peer r…

> 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

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

#67

Post by webnrrd2k »

causi wrote: post #15
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.

Exactly. This is like testing to see whether scaring someone with a spider cures hiccups but in order to keep it blind only showing them the spider when their back is turned.

It reminds me of an old Onion article, "Study: Dolphins Not So Intelligent On Land”[1].

[1] https://www.theonion.com/study-dolphins-not-so-intelligent-o...

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

#68

Post by mensetmanusman »

LocalH wrote: post #46
api wrote: post #22

Earlier quoted context omitted.

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…

'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.

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

#69

Post by GreenWatermelon »

ModernMech wrote: post #26
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…

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 allowed her to break a deeply-ingrained false belief about he past, which helps with one's healing journey.

The question is: does she believe her current looks are pretty?

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

#70

Post by arthur2e5 »

cypherpunks01 wrote: post #59

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…

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.)

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