Ketamine has 'fast-acting benefits' for depression
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Re: Ketamine has 'fast-acting benefits' for depression
#2My psychiatrist was mentioning this to me a few months ago. The data he’s seen mirrors the study referenced here.
This could be a breakthrough for individuals in the midst of major depressions, which are often very hard to treat, considering how long it can take for other anti-depressants to start to work.
Re: Ketamine has 'fast-acting benefits' for depression
#3Googles ketamine. It's guys snorting something with dollar bills. I think people figured this out already.
Re: Ketamine has 'fast-acting benefits' for depression
#4Main 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 antidepressant effect than our current antidepressants.
- Benefits occur within hours rather than weeks
- Doesn't seem to interfere with sexual function, unlike many antidepressants
Main downsides of Ketamine for depression
- Much more expensive and normally not covered by insurance
- It's less well studied
- You have to go in for additional ketamine infusions to maintain the effects, it seems roughly ~1x a month long term
(The SMD for typical antidepressants seems to range from ~-0.13 to ~-0.35, with Tricyclic antidepressants slightly higher at around -~0.42.[4][5][6])
[1]: https://www.ncbi.nlm.nih.gov/pubmed/25038867
[2]: https://onlinelibrary.wiley.com/doi/pdf/10.1002/wps.20112
[3]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730804/
[4]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903535/
[5]: http://www.annfammed.org/content/3/5/449.full
[6]: http://www.cochrane.org/CD011735/MUSKEL_selective-serotonin-...
Re: Ketamine has 'fast-acting benefits' for depression
#5@HN's chemists - I was under the impression regular ketamine use caused irreversible bladder damage[0] - Is that due to much higher recreational dosage vs medical, or would this be something that couldn't be prescribed long-term?
[0] http://www.bbc.co.uk/newsbeat/article/29811499/k-bladder-the...
Re: Ketamine has 'fast-acting benefits' for depression
#6> The nasal spray is now undergoing phase three trials before it can be licensed for treatment.
Can anyone comment on how long it might take for it to hit the market, from this stage?
Re: Ketamine has 'fast-acting benefits' for depression
#7My girlfriend receives ketamine treatment for her depression, so I’ve the results first hand. It’s truly astounding. She’s seen more improvement from the ketamine than from a decade of psychotherapy and traditional psychopharmacology.
The only downside is the cost (it’s not covered by insurance) and the potential that there are long term side effects that have yet to be discovered. We pay $375 for a 40-minute infusion. The recommended initial course is six infusions over two weeks. After that a booster or two is usually needed very two to six weeks. (It’s been about every three weeks for my girlfriend.)
Re: Ketamine has 'fast-acting benefits' for depression
#8@HN's chemists - I was under the impression regular ketamine use caused irreversible bladder damage[0] - Is that due to much higher recreational dosage vs medical, or would this be something that couldn't be prescribed long-term? [0] http://www.bbc.co.uk/newsbeat/article/29811499/k-bladder-the...
Not a chemist but according to the providers I’ve talked to the recreational dose is an order of magnitude larger than that given for depression. My understanding is the dose for depression is relatively small (even compared to what’s used during, say, anaesthesia).
Re: Ketamine has 'fast-acting benefits' for depression
#9@HN's chemists - I was under the impression regular ketamine use caused irreversible bladder damage[0] - Is that due to much higher recreational dosage vs medical, or would this be something that couldn't be prescribed long-term? [0] http://www.bbc.co.uk/newsbeat/article/29811499/k-bladder-the...
I'm not a chemist either but as someone who as partaken and knows other people who have also partaken, the dosages you have to take in order for this to become an issue are way beyond what would seem reasonable for someone who's not heavily dependent and tolerant.
You would have to be taking grams and grams of the stuff on the regular; infrequent or one-off dosages won't cause bladder damage.
Edit: even in the article you can see that the guy developed "K bladder" after taking 15g per day. 15g is a truly scary amount of powder to be ingesting.
Re: Ketamine has 'fast-acting benefits' for depression
#10> The nasal spray is now undergoing phase three trials before it can be licensed for treatment. Can anyone comment on how long it might take for it to hit the market, from this stage?
It depends on the drug and it's usage, but "because of their size and comparatively long duration, Phase III trials are the most expensive, time-consuming and difficult trials to design and run" [1].
[1] https://en.wikipedia.org/wiki/Phases_of_clinical_research#Ph...