
Behind the Buzz: How Ketamine Changes the Depressed Patient's Brain - laurex
https://www.scientificamerican.com/article/behind-the-buzz-how-ketamine-changes-the-depressed-patients-brain/
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609venezia
I am surprised that the piece does not mention last year's finding that the
anti depressive effects may be linked to the opioid system:

[https://med.stanford.edu/news/all-news/2018/08/ketamines-
ant...](https://med.stanford.edu/news/all-news/2018/08/ketamines-
antidepressive-effects-tied-to-opioid-system-in-brain.html)

The linked scientific American piece only mentions the glutamate system.

Does anyone know whether the opioid link ended up being valid?

~~~
atomical
The short answer is that no one knows. It's likely we won't know for a long
time.

As for this study, a side-effect of naltrexone is depression. That would seem
to me to make it unsuitable to use in a study with ketamine.

Relevant:

Caution Against Overinterpreting Opiate Receptor Stimulation as Mediating
Antidepressant Effects of Ketamine

[https://www.ncbi.nlm.nih.gov/pubmed/30818991](https://www.ncbi.nlm.nih.gov/pubmed/30818991)
[https://sci-hub.tw/10.1176/appi.ajp.2018.18091061r](https://sci-
hub.tw/10.1176/appi.ajp.2018.18091061r)

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starpilot
Ketamine is an NMDA antagonist, and there are other drugs in this class being
developed as antidepressants. AXS-05 was granted "breakthrough therapy" status
by the FDA and combines the NDRI bupropion with dextromethorphan which has
effects similar to ketamine's. We really are in exciting times for
antidepressants.

~~~
nitrogen
> dextromethorphan

Cough medicine? I'm astonished. I guess kids drinking NyQuil weren't just
doing it for the alcohol.

~~~
dthrowxawaym
When I was younger, I've done dextromethorphan quite a bit, and while I was
mostly doing it for the dissociative effect, it always had the side effect of
lifting my mood for a couple of weeks afterwards

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temp2903d
I wish I could feel what others feel when they try a certain drug. I've taken
ketamine recreationally and I mostly just feel a numbing sensation similar to
having a couple drinks that wears off fairly quickly. I don't totally get the
appeal as a party drug from that perspective.

~~~
revscat
I did professional ketamine treatments twice. The first session was over four
weeks, with weekly injections given for an hour each session.

It helped tremendously for about 4 months. Then my depression kicked in again,
and I enrolled again. This second round I cut off after only two sessions. It
was too intense. The first one was exciting and psychedelic. The second was
psychedelic but... uncomfortable? It’s hard to describe. I didn’t enjoy it,
and stopped after only two.

I can see the possibilities for it, and it did help, if only for a while. But
that brief respite from the constant “you’re a shit, James, no one loves you
and they never will,” that voice was silenced for a while.

And it was heaven.

~~~
pault
I know this sounds strange, but recently I ended up with a prescription for
Suboxone, and it has completely cured me of lifelong debilitating depression.
I really hope more research is being done. Within the span of one year my
career has gone from being on the rocks to skyrocketing success, all because
the crushing weight of depression has been lifted from my shoulders. YMMV.

~~~
behindmyscreen
Yeah, it didn’t work for my wife :-(. We were hopeful.

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atomical
Zarate is quoted in the article and is one of the authors of Ketamine for
Treatment Resistant Depression. A great book that will give you quite a bit of
background.

I take ketamine with a prescription at home. If anyone here knows someone who
is going to an IV clinic I can give out my doctor's information. He's taking
new patients and is okay with me giving out his e-mail.

When you're depressed it's easy to overlook the financial implications of
spending $500 for an IV. And then you end up in financial trouble. I tried to
contact Brooke, but I think I may have been too late...

[https://www.ketamineadvocacynetwork.org/forums/topic/despera...](https://www.ketamineadvocacynetwork.org/forums/topic/desperately-
need-intranasal-doc/)

~~~
lilsoso
What form do you take the drug? IV? Powder?

Could you please describe the process and the dosage?

~~~
throwaway0x69AF
I take 50mg weekly, insnuflation, but suddenly considering sublingual. It's
rid me of a lifetime of persistent ideation that had become a daily burden. It
seems like I need way less than clinics give people

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temp2903d
250mg seems exceptionally high (in reference to the OP's response below). The
esketamine nasal spray that was just approved contains only 28mg per dose
(1-2x/week). I don't know if that's because you need more if you take it
sublingually. Snorting/nasal is almost certainly the most efficient/most
effective way to take it.

~~~
atomical
1) The different ROAs have different bioavailability.

2) Ketamine is cheap. Convenience should be prioritized over efficiency.

~~~
throwaway0x69AF
It's not just about the expense, ketamine can damage liver and kidneys, and
reduce iron uptake. Efficiency, in this case, is more about harm reduction
than expense

~~~
atomical
I've read some of the most important papers and books and have never come
across this. Please post a source.

Depression is a very serious illness and ketamine is a very safe drug. We need
to give people more options.

