4 ms·

I'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 ris

I'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 ago
Its claimed a stimulant helps hyperactive children. Similarly unintuitive.
c3534l 11y ago
Ketamine, 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 ago
While 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.
rednerrus 11y ago
Perhaps depression is your bodies attempt to tell you that you are experiencing too much stress and need to slow down. Taking an anesthetic may be just the relaxing experience that you need.

peter303 11y ago

Its claimed a stimulant helps hyperactive children. Similarly unintuitive.

c3534l 11y ago

Ketamine, 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 ago

While 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.

rednerrus 11y ago

Perhaps depression is your bodies attempt to tell you that you are experiencing too much stress and need to slow down. Taking an anesthetic may be just the relaxing experience that you need.