
Research into ketamine as a treatment for severe depression - moosov
https://www.washingtonpost.com/national/health-science/a-one-time-party-drug-is-helping-people-with-deep-depression/2016/02/01/d3e73862-b490-11e5-a76a-0b5145e8679a_story.html
======
revscat
While this is undeniably impressive and hopeful, it should be noted that these
are short-term affects. The article mentions this: "So far, there is no
evidence of addiction at the low dose in which infusions are delivered.
Ketamine does, however, have one major limitation: Its relief is temporary.
Clinical trials at NIMH have found that relapse usually occurs about a week
after a single infusion."

It then goes on to talk about possibly alleviating this with booster
treatments.

For me, even the possibility of there being temporary relief makes it
something I would seriously consider pursuing, for two reasons. First, when my
depression gets really acute it basically means that I simply am unable to
leave the house. If I were free of that chain I strongly suspect/hope it would
be easier to seek out -- and be consistently dedicated to -- treatments that
were more long term: meditation, therapy, etc.

Second, just the thought of being happy for a few moments. Well, the allure of
that is likely obvious. Were the almost omnipresent internal dialog of "you
suck, you stupid fuck, dumb faggot, stupid fucking nigger," etc. able to be
minimized or eliminated, even if temporarily, it would make such a great
difference in my life that I almost can't quite imagine it.

Right now I escape it by playing video games. This is not exactly the most
positive way to live, however.

~~~
chimeracoder
> Its relief is temporary. Clinical trials at NIMH have found that relapse
> usually occurs about a week after a single infusion." It then goes on to
> talk about possibly alleviating this with booster treatments.

I know some people will naturally object to this, but to be honest -
_assuming_ people don't build up a tolerance to the effects[0], what's wrong
with that?

People are accustomed to taking all sorts of drugs on a _daily_ basis, from
antidepressants to sleeping aids to coffee (caffeine!). If someone invented
from scratch an antidepressant that could only be taken once a week, we'd be
heralding it as a miracle drug.

The main opposition to Ketamine is likely to be its history of recreational
use ("Special K"). But _that_ narrative - opposing medicine because of its
potential psychoactive effects - is nothing new.

[0] I don't mean a tolerance to Ketamine in general, but a tolerance to this
anti-depressive effect

~~~
rincebrain
The basic problem is that it requires IV infusion, not oral or nasal
administration (trials of the latter have issues with consistent dosage,
AIUI), and that requires trips to a doctor to do, weekly.

------
jlg23
A good resource on Ketamine is Erowid's Ketamine vault:
[https://www.erowid.org/chemicals/ketamine/](https://www.erowid.org/chemicals/ketamine/)

The list of Ketamine related publications at
[https://www.erowid.org/references/refs.php?S=ketamine](https://www.erowid.org/references/refs.php?S=ketamine)
lists the first study on effects on depression as from 2000 (just a quick
Ctrl-F search, their might be earlier studies).

------
amelius
Here is anecdotal evidence for another interesting "drug":

[http://www.ncbi.nlm.nih.gov/pubmed/16542786](http://www.ncbi.nlm.nih.gov/pubmed/16542786)

In this study, N=small, but nevertheless, I think it is a very interesting
article. Because the effects are so rapid, and magnesium supplementation is in
general harmless, it is imho definitely a good idea to see if a magnesium
deficiency is the cause of the disorder. Please take note that not all
magnesium supplements are equal.

~~~
KingMob
Technically, it's not a study. They present a few case histories, which is
basically, "we found a few patients whose depression went away after taking
magnesium, maybe we should look into it".

That being said, it would be pretty easy to investigate.

------
Bud
Absolutely extraordinary success rate here. 75% success in treating depression
and suicidal ideation? That's a revolution.

------
discardorama
FTA: "While a single dose of ketamine is cheaper than a $2 bottle of water,
the cost to the consumer varies wildly, running anywhere between $500 and
$1,500 per treatment."

Sigh.... why? Why must we turn any opportunity into a money grab?

~~~
refurb
That seems like a silly statement. Treating a patient with a dose of ketamine
includes _a lot_ more costs than just the drug.

If a patient comes in and gets an infusion of ketamine, even if the procedure
only takes 1 hr (infuse and observe), you need to pay for the building, the
nurse, the physician, all the backroom staff, etc.

Hell, I go into my primary care doctor for an annual physician and it costs
~$200. I see the doctor for maybe 5 minutes and a nurse for maybe another 5
min.

It's like saying "the cost of a bottle of coke is only $0.20, and it's such a
shame that it costs me $1.50 at a gas station".

~~~
mc808
A bottle of Coke would be even more than $1.50 if you were legally required to
pay a team of upper middle class salaried attendants to sit you in a very
expensive chair in a very expensive building and hand-feed it to you. Don't
get me wrong, that _is_ how I would like to enjoy a Coke now and then, but
it's good to have less luxurious options available at a lower price.

~~~
rudolf0
I agree with you. There needs to be something like insulin autoinjector pens,
but for ketamine.

This increases the chances of abuse, but ensuring a prescription only lasts 6
doses or whatever would reduce that.

Hopefully once drug laws become a bit more relaxed, this will be seen as
acceptable.

------
cpncrunch
The results from ketamine are very impressive, however there is still the
possibility that it is due to the placebo effect:

"Consistent with all of the published randomized, placebo-controlled studies
with ketamine, we also found short-lived perceptual disturbances26,49,50; such
symptoms could have affected study blind. Hence, limitations in preserving
study blind may have biased patient reporting by diminishing placebo effects,
thereby potentially confounding results. One potential study design in future
studies with ketamine might be to include an active comparator such as
intravenous amphetamine (a dopamine agonist), which also produces
psychotogenic effects."

[http://archpsyc.jamanetwork.com/article.aspx?articleid=66819...](http://archpsyc.jamanetwork.com/article.aspx?articleid=668195&resultclick=1)

------
ukoms
From my point of view - and I've gone through almost each available
antidepressants in 10 years battle with depression - every new solution, that
will relieve patients from their struggles (even for short part of time) - is
a bless. Sure ketamine won't solve problem permanently, but todays 2nd and 3rd
generation medicaments dont do it either. There is a moment, when you simply
want to feel a relief - from sorrow, stagnation, fear, guilt and hopelessness.
If it's true, that ketamine gives you this relief, then sign me up! :) And it
don't have to do anything else. Because, there are people who simply cannot
remember how it feels to live without depression - if you can somehow remind
them how it is not to feel anything depressing, this may be powerfull boost
for keep fighting.

------
nicholasjarnold
So, the ~75% efficacy rate is seemingly great news for those suffering from
depression. However, what stuck out to me was the reported synaptogenic effect
that ketamine is thought to have.

An interesting study would posit that ketamine could potentially be used as a
nootropic. If the synaptogenic effect is strong enough, could it not be used
to restore brain function after head trauma, stroke, to treat cognitive
decline with age, ect?

------
dfraser992
and no mention of John Lilly? I expected more of HN! Lilly of course is the
exemplar of cautionary tales and why highly analytic people ought to treat K
with much respect.

[https://en.wikipedia.org/wiki/John_C._Lilly](https://en.wikipedia.org/wiki/John_C._Lilly)

------
1024core
Do you have to take it via an IV? Can taking it orally have similar benefits?
I'm just curious why you need an IV.

~~~
wavefunction
You'd probably have to insufflate (snort) it. That's the recreational method
for most users, at least.

~~~
1024core
Can't you just take a pill?

~~~
joeyo
Many drugs undergo first-pass metabolism by the liver and their metabolites
are much less active or much more non-specific. I don't know if that is the
case for ketamine, but I suspect that it must be.

------
ricksplat
Ugh Ketamine. "Only Fools and Horses" as we say on this side of the Atlantic.

