15 ms·
Ketamine’s effect bolsters a new theory of mental illness
- LesZedCB 11y agoI'm excited for there to be alternatives to SSRIs. I've never been diagnosed with depression, but my partner has and takes an SSRI. It certainly seemed to have a generally positive affect (totally subjectively), and relatively few negative side affects. That being said, having to take it every day sucks, and when she runs out, having forgotten to get it refilled, the mood affects are pretty terrible for us both. Hopefully this branch of research will continue and develop into a more positive alternative.
- stuxnet79 11y agoI have panic disorder and Pregabalin has literally saved my life. Otherwise I was going the Ian Curtis route. So many thanks to the scientists who developed this drug.
- toomuchtodo 11y agoAlso of note regarding SSRIs and pregnancy: https://www.washingtonpost.com/news/to-your-health/wp/2015/12/14/maternal-exposure-to-anti-depressant-ssris-linked-to-autism-in-children/ https://www.washingtonpost.com/news/to-your-health/wp/2015/1... > A new study provides some of the strongest evidence yet that using an antidepressant like Prozac, Paxil or Zoloft during the final two trimesters of pregnancy may be linked to a higher risk of autism spectrum disorder for the child, but researchers said the results should be interpreted with caution.
- goldenkey 11y agoAlso of note regarding SSRIs and causing pregnancy: https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor#Sexual_dysfunction https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_i... > SSRIs can cause various types of sexual dysfunction such as anorgasmia, erectile dysfunction, diminished libido, genital numbness, and sexual anhedonia (pleasureless orgasm). Sexual problems are common with SSRIs. Poor sexual function is also one of the most common reason people stop the medication. Very rarely, these effects persist after discontinuation of the medication.
- DanBC 11y agoPretty irresponsible to mention "increased risk" without saying what that risk is, nor what the increase actually is. Especially when suicide is one of the leading causes of death of women during the perinatal period.
- kafkaesq 11y agoPretty irresponsible to mention "increased risk" without saying what that risk is, nor what the increase actually is. The article makes it perfectly clear what the risk is, how much the increase is, and with what factors it is associated; and what the researchers caveats were about their own findings. The poster you were slamming wasn't spreading FUD or hyperbolizing; he was just simplifying. It's pretty irresponsible (and obnoxious) of you to suggest otherwise.
- DanBC 11y ago> The article makes it perfectly clear what the risk is, how much the increase is, Maybe I'm missing it, but from that article: what's the base rate, what's the rate if a woman takes SSRIs, and what's the increase? (And here rates are provided in X per 100,000)
- kafkaesq 11y ago(And here rates are provided in X per 100,000) I'm not playing this game with you. Obviously, the information wouldn't expressed that way in the WP article. You may recall that they're a newspaper, not a scholarly journal. So you know perfectly well that it wouldn't have expressed the information in those terms. The article does mention exactly what the increase is. As to the base rate, the WP article doesn't use that exact term -- but they do give hard numbers for the sample sizes involved, and took care to point out that the smallness of the proportion of infants who developed autism (with or without taking SSRIs) was one of the factors that led the researchers to point out that their findings should be taken with caution. If you want more data and specifics, read the JAMA article. If you think the researchers themselves made some basic flaw in their statistical reasoning -- and, correspondingly, you'd like to bring their reputations and their future funding channels into question -- then the burden of proof lies on you to show it. And I'm sure JAMA Pediatrics would be very interested in getting an email from you. But if you're going to fault the WP article for not conveying every facet of detail from the research article, in as many digits of precision -- even though its overall presentation was basically fair, and on point to the level of detail that would be meaningful to its readers -- then you're basically playing head games.
- MrBra 11y agoMay I ask what kind of SSRI?
- LesZedCB 11y agoEscitalopram (Lexapro branded)
- zo1 11y agoInitially misunderstood your question and went to look-up what SSRI stood for. If anyone wants to know: Selective Serotonin Reuptake Inhibitor. https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_i...
- ossreality 11y agoHey hey! You mean you're not happy about potentially life-long sexual side effects?! Talk about getting over depression only to find out that removing the SSRI did nothing to fix your gimped sex drive. Wooohoo.
- bigbugbag 11y agoI recently read that the theory behind serotonin reuptake inhibitors might actually be wrong and possibly cause more harm than good. The actual neurotransmitter mechanism behind depression would be dopamine. I'm sorry that I can't recall the source, but you should look into this.
- jacques_chester 11y agoIt varies from patient to patient, the causes are varied, the drugs have powerful effects and conditions can overlap. This is why it's important to trust your care to a psychiatrist or allied mental health professional.
- meowface 11y agoThere is no consensus on what the root causes of major depression are; there are probably many causes. Dopamine can definitely affect happiness, but giving a chronically depressed patient L-DOPA once per day generally won't treat their depression for very long. On that same note, people with ADHD are often missing dopamine in many parts of the brain, but ADHD isn't necessarily correlated strongly with depression. And quick dopamine-releasing drugs like amphetamine (Adderall/Dexedrine/Vyvanse), or dopamine reuptake inhibitors like methylphenidate (Ritalin/Concerta), tend not to be great treatments for depression, either. They can be a short term treatment by giving you a euphoric high the first few times you take them, or if you take big doses, but that's not a good long term treatment strategy.
- DanBC 11y agoKetamine is an exciting experimental approach for depression (especially with suicidal thinking) and anhedonia. http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(15)00392-2/fulltext http://www.thelancet.com/journals/lanpsy/article/PIIS2215-03... Researchers seem to be using an infusion of 5 mg per kg of body weight. That means you don't give a bunch of pills to a patient, which in itself helps a bit to reduce risk. There's a bit of a web-based discussion here: https://www.youtube.com/watch?v=5b6zrpd1trk https://www.youtube.com/watch?v=5b6zrpd1trk
- bigbugbag 11y agoIs ketamine some sort of wonder-drug for depression? Probably not, at least not according to most of the research conducted on it so far. Like many treatments for depression — including psychotherapy — it appears to change the way the brain processes certain information and effects the connections between neurons. But it’s not clear how long these changes last, or whether chronic ketamine treatment would be needed, similar to a diabetic taking insulin. http://psychcentral.com/blog/archives/2012/12/01/should-you-try-ketamine-for-depression/ http://psychcentral.com/blog/archives/2012/12/01/should-you-... Ketamine has been tested in treatment-resistant bipolar disorder, major depressive disorder, and people in a suicidal crisis in emergency rooms.[26] Benefit is often of a short duration.[27] The quality of the evidence supporting benefit is generally low.[27] The drug is given by a single intravenous infusion at doses less than those used in anesthesia, and preliminary data indicate it produces a rapid (within 2 hours) and relatively sustained (about 1–2 weeks long) reduction in symptoms in some people. https://en.wikipedia.org/wiki/Ketamine#Depression https://en.wikipedia.org/wiki/Ketamine#Depression Ketamine may have its use for treatment resistant depression and dealing with emergencies caused by suicidal bouts because it can make depression symptoms disappear for few days, but this is only temporary as better ketamine based drugs are developed.
- kruhft 11y agoMost (illegal) drugs are a wonder-drug for depression. At least until they wear off.
- spotman 11y agoThis makes me nervous. Ketamine has major issues with bladder damage when taken repetitively. Possibly with a low enough dosage this would be manageable, but speaking from experience from watching people that have been on the wrong end of the stick with this one. it can do some really serious long term damage in that department.
- DanBC 11y agoThey use a much smaller dose than is used recreationally. Here's someone who was using 15 g per day: http://www.bbc.co.uk/newsbeat/article/29811499/k-bladder-the-uks-secret-ketamine-epidemic http://www.bbc.co.uk/newsbeat/article/29811499/k-bladder-the... A therapeutic dose is 5 mg per kg. An average adult would be 80 kg, which gives a dose of 400 mg once every maybe 30 or 60 days.
- bigbugbag 11y ago15g per day is a ridiculous amount. Though not the most common ketamine induced bladder damage has been observed to occur in a few months of weekly recreative use of insuflated doses of 1-2g over the weekend. On the other hand some heavy chronic users in the several grams daily range had little to no damage after years of abuse so YMMV.
- civilian 11y agoThe depression-fixing threshold is smaller that most recreational use, and it would only be once every two weeks. That side effect trivial to rule it out. Educate yourself and stop being a pawn of the drug war. I watched two documentaries in short succession: Drugs Inc's episode on Ketamine, and a few episodes of Combat Medic. Drug Incs' played up the bladder damage, the persistant dissociative feeling with abusers, and how it's just horse and cat tranquilizer that's no longer used on humans. Combat Medic non-challantly showed medics giving ketamine to US soldiers in Afghanistan, because it's an effective and immediate anesthetic. They were subtle about it, but it was there. Our the dissonance in the media about drugs like this is indicative of fear mongering and propaganda.
- 11y ago
- siyer 11y agoOn the mechanistic side of things, http://www.pnas.org/content/112/26/8106.short http://www.pnas.org/content/112/26/8106.short is one of the more interesting papers to come out recently on ketamine's mode of action.
- atomical 11y agoThere are other drugs in the pipeline that have a faster onset of action than what is currently available, including GLYX-13 and NSI-189. I have taken NSI-189 and I can confirm that it works fast.
- rbinv 11y agoHow did you happen to take NSI-189? Were you part of the phase 1 trial?
- comrh 11y agoGoogle suggests you can buy it as a research chemical (here have this random white power...).
- cypherpunks01 11y agoNot sure about above, but I used to (~1yr ago) buy NSI-189 from THT.CO and other sources compiled/tested by the reddit r/nootropics community. Apparently since then, Neuralstem has sent cease & desist letters to all of the companies selling it, and sources have since been spotty. Also I know that some group buys/syntheses have been coordinated on Longecity.
- comrh 11y agoDid it work for you? Any side effects?
- cypherpunks01 11y agoI used it for a couple months at the oral dose that the early phase NIH clinical trial found to be effective. I did feel like i got a positive benefit from it with no side effects, though didn't do any extensive blind testing myself so it's purely anecdotal. I found it to lift some constant anxieties a bit, and help guide my overall outlook on life more positively. That said, I did find ketamine to be an extremely effective anti depressant with the primary effects being immediately noticeable and positive. I currently re-dose on ketamine every couple months and take bupropion daily--between all of these I've been able to greatly reduce fairly severe depression that went untreated and worsened over a 10+ yr period.
- altonzheng 11y agoIt doesn't surprise me one bit that we have a very poor understanding of how to treat depression. I think we often have a reductionist view of it. The fact that a whole constellation of causes is referred to as just 'depression' bugs me.
- johndevor 11y agoWell put. I find it troubling that we spend so much on research when it's a very -- dare I say -- wholistic problem with a myriad number of causes, some subtle and some more obvious. We may never understand fully the depth of the problem and shining a light on things like certain drugs, while helpful as short-term fixes for certain individuals, may just be masking those other issues.
- tcj_phx 11y agoHaving observed my girlfriend's "mental illness" [1], I can say, with confidence, that Psychiatry is the problem with America's approach to mental health. As Dr. McHugh observes [2], conventional Psychiatrists "diagnose" their patients' symptoms, and treat the diagnosis without much concern about the actual causes thereof. One of my girlfriend's problems is that she has low energy levels - certainly caused by previous stimulant use, and her body's inability to efficiently produce energy (ATP) by burning glucose/fructose. Before she met me, she treated this symptom (low cellular energy levels) by drinking alcohol regularly. Alcohol is an energy-rich molecule, the metabolites of which are easily burned by the insulin-resistant brain cells which have become insulin-resistant. She started drinking a month after starting methadone, a drug which is known to cause sugar cravings. Deciding to quit methadone was easy once she realized that she hated it. But when she lost access to alcohol, her brain went into a sort of 'survival' mode, which led to her being taken to the hospital [1]... The causes behind my girlfriend's condition are fairly obvious to me, having observed her for months now. But the hospital staff had no context for why their patient was acting the way she was, so they just treated her symptoms. The doctors at the inpatient facilities she's been at don't care about physiology either, they just reach into the pharmacy and try new drugs with the proper label ("anti-depressant", "anti-psychotic", "mood-stabilizer" - these are marketing terms, imho). She's still exhausted, but at least they're giving her the coconut oil capsules I dropped. There is another way. My grandfather, a dentist with an interest in hypnosis, didn't remember much of his one class with psychiatrist Milton Erickson, M.D., except that Dr. Erickson was always "bitching" - about having to go to medical school, having to learn anatomy, physiology and pharmacology, etc etc, when all he really wanted to do was hypnosis (this was Dr. Erickson's method of conversational hypnosis, applied to an audience of medical professionals). The Erickson Foundation released a really cool documentary [3] last year... [1] https://news.ycombinator.com/item?id=10639657 https://news.ycombinator.com/item?id=10639657 [2] https://www.commentarymagazine.com/articles/how-psychiatry-lost-its-way/ https://www.commentarymagazine.com/articles/how-psychiatry-l... [3] http://wizardofthedesertfilm.com/ http://wizardofthedesertfilm.com/
- chillingeffect 11y agoYes, it's shame, but medicine has a mainstream, industrial aspect as well as it has a high-quality, focused aspect. I hope it gets well for the two of you. Remember good old exercise, nutrition, sunlight and everything else. Success creates new realities! And most especially, thank you for pointing out that amazing documentary on Erickson! I've read the NLP foundation's first two books on him and they're incredible. I just picked up a copy of the DVD. BTW, have you tried any NLP of the therapy variety with your gf? How surprised would you be to find it working as well as you can imagine? ;)
- lilcarlyung 11y agoWhat with the pro-drug posts here all the time. I'm guessing that most of the HN audience is American. Is it common among techies in the U.S. to experiment with psychoactive drugs, hence the interest and knowledege? Please, do not mention Steve Jobs acid experiences.
- lilcarlyung 11y agoWhat with the pro-drug posts here all the time. I'm guessing that most of the HN audience is American. Is it common among techies in the U.S. to experiment with psychoactive drugs, hence the interest and knowledge? Please, do not mention Steve Jobs acid experiences.
- marssaxman 11y agoIt certainly is common among the techies of my acquaintance, which may explain why there is so much overlap with communities focused on arts and music.
- dismal2 11y agoare you anti-drug? if so, why?
- cpncrunch 11y agoI think the OP just found it curious. Turning the question around: do you think it's a good idea to screw around with your brain using something like ketamine (other than in a controlled way, such as a clinical trial or under guidance from a doctor)?
- user_0001 11y agoyes. Everyone should experience the k-hole
- isolate 11y agoWhat if you have a psychotic disorder? Prevalence is ~3%.
- Synaesthesia 11y agoMany drugs can precipitate a psychotic episode, including stimluants, psychedelics, even Alcohol. It's a risk you take when you take drugs but can be mitigated if you known what to expect and have support. Ketamine I don't think has a huge problem with this compared to other drugs. It may be a bit of a bizarre experience but not often a tramuatizing one.
- astazangasta 11y agoI have been depressed a significant fraction of my adult life. I am also a biologist who abhors the medical description of this problem. I don't even like the word 'mental illness'. This shit is not an illness, its a normal response to a fucked up life! Can I get at least some acknowledgment of this fact? The sine qua non for me was an issue of Nature a few years back that focused on depression, talked about how prevalent it is, how it is a 'drain on productivity', etc. Included therein was a graph of the worst affected populations, topping the list was Afghanistan. This passed without comment. How about: 'hey, the cause of depression seems to be human misery, like war, unemployment, alienation, etc.' But you can't sell a fucking pill to cure war and alienation, so ...
- johnchristopher 11y ago> This shit is not an illness, its a normal response to a fucked up life! Can I get at least some acknowledgment of this fact? Well, no you can't because it seems a lot of people with really good life are just struck by it. Although I believe the environment (physical, emotional, relational [edit: in recovery or/and prevention]) plays a huge role there still seems to be something extra going on.
- nprz 11y agoMaybe a distinction should be made between people who are aware of their source of depression and people who are not? Like it makes sense to be depressed if you're living in abject poverty. People can point to it and say I know why I'm depressed. That seems different from someone who lives in a secure environment, feels valued, has meaningful relationships, engages in rewarding work, etc. All these things that should lead to a happy life but this person still feels bad. That's definitely a different thing, no?
- andywood 11y agoDuring times when I lack rewarding work and relationships, I get diagnosed with clinical depression. During times when I have those things, I feel great. I don't think everybody will ever agree on the distinction.
- escape_goat 11y agoThe full article title is "A Vaccine for Depression?: Ketamine's effect holsters a new theory of mental illness." I have mixed feelings about posts being required to suffer from the title, as this is often an editorial rather than an authorial decision, but the submerged gist of the article, the novel content, is indeed the suggestion that Ketamine could be used as a "vaccine" for post-traumatic stress disorder. A few words about new theories. All new theories that can garner such enthusiasm for their presentation are invariably bolstered by something. No-one writes magazine articles about ambiguous signals from an exciting new theory. If the evidence presented is not in some way definitive, then it should be viewed as a precondition for the propagation of the theory, not evidence in favour of it. Few of us are expert judges of neurological theories, and we are not able to tell if there is anything substantial beyond the feeling that we experience that something valuable has been learned. I know that the effects of Ketamine in treating serious episodic depression are very exciting. I feel that I understand enough to suggest that neuroplasticity is not an especially 'new' theory, or a 'theory' by itself. The neuroplastic response is real, well documented, and undisputed. What is a theory, and had not been established as fact, the last time I discussed it with someone, is that idea that the neuroplastic response is the central intermediary between the physical effect of the drug and the clinical effect of the drug. It occurs, but it had not been established that it is causal. The central suggestion regarding the 'vaccine' effect seemed to be buried a bit in the article (unless I missed something in skimming), but it is the actual new information, which is interesting and heartening. Soldiers coming to a forward operating medical station with severe burns were treated with Ketamine rather than another anaesthetic because of its relative safety. They subsequently developed PTSD half as often as all soldiers and civilians treated for less or equally severe burns with other anaesthetics. On the basis of the theory that PTSD and depression emerge an erosion of neurosynaptic connections, the leap is made from there to the idea that Ketamine might perhaps serve as a true 'vaccine' when people were going into high-stress situations. From my relatively uneducated perspective, this seems a bit irresponsible in two separate ways. Firstly, the evidence is that the soldiers were 'vaccinated' against psychological disturbances associated with extreme trauma... after the initial extreme trauma had occurred. There is evidence from studies with mice that a Ketamine treatment changes their response to stressors in a way that seems both dramatic and positive. Ketamine is a common recreational drug. If we should be excited about the prospect of this response being replicated in humans, then why is there not already ample evidence that this response is replicated in humans? Secondly, there is absolutely no reason that we should conclude that the effect of the Ketamine on the burn victims has anything to do with neuroplastic response. Ketamine is an anesthetic. It limits pain, which is traumatic. Anesthetics operate in different ways. Ketamine seems to inhibit the transmission of pain signals in the spinal cord. This prevents them from reaching the limbic system. Other forms of anesthesia may not. Ketamine is, infamously, an amnesic and a dissociative. Stress disorders require memory formation. Ketamine prevents memory formation. Other forms of anesthesia may not. And so on. In the context of the surfeit of plausible explanations for this effect, to suggest that the effect is particular evidence supporting a theory that PTSD is cured by neuroplastic regeneration of synaptic connections is not particularly responsible. It might not be terrible journalism, but it is definitely bad science, and almost certainly not something that was presented as science to the journalist.
- openasocket 11y agoI'm skeptical of the long term benefits of Ketamine. It seems odd to give an anesthetic, a depressant, to someone with depression. They claim it reduces the risk of suicide and works quickly, but is that due to a curative neurological effect or is it just because you've given them a sedative? Not to mention the side effects: memory loss, delusions, psychosis, even schizophrenia-like symptoms. Sure, these tend to happen at higher doses, but the long term effects of low doses have not been studied thoroughly.
- peter303 11y agoIts claimed a stimulant helps hyperactive children. Similarly unintuitive.
- c3534l 11y agoKetamine, unaltered, would probably never a good treatment for depression except in some extreme cases. I think people are more interested in understanding how Ketamine can have this unexpected effect so that they can develop classes of drugs that are designed from the ground-up to treat depression. Kind of like how understanding how MAOIs led to tricyclics and then SSRIs. I think that's the direction research is going in.
- cjhveal 11y agoWhile a moderately high dosage of Ketamine does have anesthetic effects, through it's antagonism of the NMDA receptor at dosages (which suppresses activity required for signals to cross spine/brain), inhibition of nitric oxide production, and weak agonism of opioid receptors, it also has a slew of other interactions at various affinities. Ketamine inhibits the reuptake of all three major monoamines. Thus it mimics to some degree both the mechanisms of action of SNRIs (serotonin/norepinephrine reuptake inhibitor) such as venlafaxine (effexor), used to treat depression/anxiety and DNRIs (dopamine/norepinephrine) such as bupropion (wellbutrin)/methylphenidate (ritalin), which are used to treat depression/ADHD. Ketamine also impacts the acetylcholine receptors, which have been linked to anti-depressant effects, and the less-well-researched sigma receptor. While the above interactions may contribute to the reported anti-depressant effects, some of those same interactions make it undesirable as a medication. Dopamine reuptake inhibitors and mu-opioid antagonists are notoriously abused for their euphoric effects. However, those effects are contrasted with psychotomimetic effects of ketamine's interaction with NMDA, kappa-opioid, muscarinic acetylcholine, and simga receptors. Ultimately, it's incorrect to simply categorize ketamine as a depressant or a sedative. The body is an exceptionally complex chemical network, and you're right to be skeptical. But I think it's important that we not dismiss the positive reported effects of the drug because of the side effects that occur at various points on the dose-response curve. We may find out that by controlling dosage we can tune a beneficial level of antidepressant response without psychosis, dissociation, or amnesic effects due to hormetic effects. Or it might work exceptionally well for some otherwise treatment-resistant cases. Even if not, we'll be able to use that data to tweak the binding affinities to investigate drugs that have a better therapeutic use.
- paki123 11y agoHow are people so confidently ignorant on this site?
- c3534l 11y agoPersonal experience here. My depression has been an unending struggle since my tweens. I've been on every medication, spent fortunes in therapy. I also abused dissociatives like Ketamine. Ketamine's antidepressant effects seemed very real after the initial high and it was qualitatively different from SSRIs. SSRIs seemed more like a drug than Ketamine which felt more like relief (again, for the days following the high - the actual high was, you know, psychedelic and stuff). I think for some people research into this area would be a real boon. Not everyone responds well to traditional treatments. I'm not sure what's different about my brain that makes even high doses of SSRIs ineffective or even unpleasant, but I don't think we understand all that well how depression actually works at all, other than SSRIs and similar seem to kind of work. If you think depression is about just increasing serotonin in the brain, let me point out that "serotonin syndrome" is a very real risk of using antidepressants. It's essentially an overdose on serotonin. It's clear that messing with serotonin in the brain, you can give a sort of neurochemcial nudge that can help you overcome depression, but happiness is not itself the amount of serotonin in your system. Either way, I quit using drugs and alcohol many years ago and regular exercise with exercise, tons of CBT, and lots of vigilance has helped the best. But it would be nice to have a drug on the market that would make keeping depression at bay so effortful and so much hard, consistent work. Anecdote isn't worth much in medicine, but there really is something special about Ketamine.
- wdmeldon 11y agoI've responded fairly well to SSRIs, but I think it might be significantly influenced by how bad I had gotten without them. The side-effects I endure are objectively terrible (I hit almost all of the common ones and most of the uncommon ones) but the change for me has been night and day. I've always wanted to try Ketamine because of what I've heard about its effects on depression, but I've never gotten the opportunity. I do hope this starts a broader conversation about people like us.
- onga5v 11y agoI see several people in this thread welcoming the fact that there is "finally an alternative to SSRIs". I don't want to discuss whether Ketamine is or is not a good alternative to SSRIs -- instead, I'd like to point out that there are already a great number of alternatives to SSRIs. For one, there are tricyclics (TCAs), which were the first antidepressants on the market, and generally are not prescribed nowadays. Another category of older antidepressants includes MAOIs, which were the first mass-market antidepressants. These are also not generally prescribed nowadays due to interactions with common types of food, although modern MAOIs such as moclobemide [1] require far less diatary restrictions than the older MAOIs did. The final major category I'll mention are SNRIs, which along with SSRIs are the most commonly prescribed first-line antidepressants. Apart from these major categories, there are a bunch of atypical antidepressants on the market. There's bupropion, which I personally take, and which has far less side effects than SSRIs and SNRIs but may not be as effective for all patients. There's St. John's wort, which is available off prescription in many countries. There's lithium, which has recently gained popularity. In total, I would guess there are about a hundred different types of antidepressants in production around the world (including old Soviet concoctions that are not available in the West due to the huge price of getting just one of them to market). If you're unhappy with the side effects of SSRIs, I would encourage you to look up other types of antidepressants, as they have very widely varying side effects, and most atypicals have far fewer common side effects than SSRIs and SNRIs do. In particular, I would like to point out that bupropion usually increases sex drive instead of lowering it like SNRIs and SSRIs tend to do. [1]: https://en.wikipedia.org/wiki/Moclobemide https://en.wikipedia.org/wiki/Moclobemide
- DanBC 11y agoDepression is a major risk factor in suicide. Tricyclics are frequently used in attempted and completed suicide. Being more careful with prescribing tricyclics to people with suicidal ideation would probably reduce the numbers of attempted and completed suicide.
- throwaway439853 11y agoA warning to those considering experimenting with Ketamine. It may help alleviate depression, but the flip side is can reduce the 'technical ability' part of the brain to such an extent that you will no longer be able to code. This will wear off in a few days, but it is not side-effect free drug - there are still many unknowns.
- meowface 11y agoKetamine has a lot of mechanisms of action, but one of its big ones is that it's a major NMDA receptor antagonist. This prevents glutamate from affecting cells very well. A major decrease in glutamic activity may reduce depression, but it can effectively drop your IQ by quite a lot. People generally report feeling "very stupid" and "brain foggy" after taking strong NMDA antagonists. I don't know if ketamine has high risk of causing general intelligence reduction in the long term, but there are reports of that from people who abuse the drug in recreational doses for a long period of time. So, it's definitely something to be wary about.
- drharvey 11y agoI think some of these posts might be inadvertently debating dualism, "the philosophical position that mental phenomena are non-physical." You're arguing whether depression is caused by emotions and thoughts vs biology (mind vs brain), when Neuroscience doesn't make a distinction. Emotions and thoughts are biology - serotonin and glutamate and neurons are not considered to be separate from behavior, they are how behavior is encoded. In Neuroscience, the mind is usually considered an emergent property of the brain. It's like arguing that a bug is a problem with the UI, not the code... https://en.wikipedia.org/wiki/Dualism_(philosophy_of_mind) https://en.wikipedia.org/wiki/Dualism_(philosophy_of_mind)
- walmartian 11y agoI am surprised at the number of anecdotal experiences people are using here to describe depression as a non-disorder. It's unbelievable that people cannot distinguish between depression caused by environment factors and depression caused by physiological differences.
- NickHaflinger 11y ago'Either a green unicorn just raced across the lab, or I accidentally took some LSD.', Dr. Walter Bishop