
Ketamine acts fast to treat depression and its effects last – but how? - anythingnonidin
https://www.sciencedaily.com/releases/2018/06/180621172450.htm
======
anythingnonidin
Main 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]

Advantages of Ketamine vs other antidepressants

\- Ketamine seems to have a much stronger antidepressant effect than our
current antidepressants (To me this seems to be by far the most
important/interesting thing)

\- 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](https://www.ncbi.nlm.nih.gov/pubmed/25038867)

[2]:
[https://onlinelibrary.wiley.com/doi/pdf/10.1002/wps.20112](https://onlinelibrary.wiley.com/doi/pdf/10.1002/wps.20112)

[3]:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730804/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730804/)

[4]:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903535/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903535/)

[5]:
[http://www.annfammed.org/content/3/5/449.full](http://www.annfammed.org/content/3/5/449.full)

[6]: [http://www.cochrane.org/CD011735/MUSKEL_selective-
serotonin-...](http://www.cochrane.org/CD011735/MUSKEL_selective-serotonin-
reuptake-inhibitors-ssris-fibromyalgia)

~~~
taurath
There’s really no cost/benefit if you’re at the medical point if needing to
try ketamine - that usually means you’ve tried all the previous medication.
It’s not really expensive, just expensive for humans because pharmaceutical
companies set their own prices (veterinarians have been using it for decades).

My suspicion is that it works as a strong dissociative and allows for building
some new neural connections to things, away from having practically every
event/trigger in life being connected to a depressive spiral (depressed the
last time I ate lunch, triggers another depressive spiral).

~~~
atomical
It's not expensive at all. It's around $5-10 for a vial of ketamine.

The cost benefit definitely matters because it's possible to go broke with IV
infusions. I pay. around $5 a lozenge.

