10 ms·
Research into ketamine as a treatment for severe depression
- discardorama 11y agoFTA: "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?
- Bud 11y agoWe need not. We can fix this in a stroke of the pen with single-payer. Unlikely, but not impossible.
- merrywhether 11y agoI'm sure that some of the treatment cost involved the doctor's time as well. And unless single-payer means that patient's sign away their ability to make liability claims, that is also a huge part of any anesthetic-like procedure cost.
- refurb 11y agoThat 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 11y agoA 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 11y agoI 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.
- maxerickson 11y agoIt also includes the costs for people that don't pay (less of a thing at a clinic than a hospital) and probably some costs associated with Medicare and Medicaid (of course only if they reimburse below the actual cost). It'd be cool if the bill explicitly listed the actual costs separately from the implicit taxes (hospitals must provide stabilizing treatment, they don't get direct reimbursements for it, this is effectively a tax).
- Bud 11y agoAbsolutely extraordinary success rate here. 75% success in treating depression and suicidal ideation? That's a revolution.
- revscat 11y agoWhile 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 11y ago> 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
- arthur_pryor 11y agoif anything, for people who are trying to be functional, you'd want to gain tolerance to the recreational effects, but not the anti-depressant effects. tolerance to both seems more likely, but hopefully tolerance to the former outpaces the latter.
- amelius 11y agoHere 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.
- arprocter 11y agoAnecdotal again, but if it helps anyone else - my SO used to suffer with regular migraines, but since taking daily magnesium they have completely gone away
- KingMob 11y agoTechnically, 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.
- ricksplat 11y agoUgh Ketamine. "Only Fools and Horses" as we say on this side of the Atlantic.
- ricksplat 11y agoit was worth it
- pstuart 11y agoIs that the side of the Atlantic that has serious problems with binge drinking of alcohol?
- ricksplat 11y agoNo - the side that has a sense of humour.
- ricksplat 11y agoand I've been to New York, Boston and Cancun you can't tell me there isn't binge drinking over there too. sap.
- ricksplat 11y agoWhile I'm at it: http://www.newyorker.com/news/john-cassidy/why-is-the-death-rate-rising-among-middle-aged-white-americans http://www.newyorker.com/news/john-cassidy/why-is-the-death-...
- jlg23 11y agoA 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).
- 1024core 11y agoDo 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 11y agoYou'd probably have to insufflate (snort) it. That's the recreational method for most users, at least.
- jschwartzi 11y agoWhen you administer it to horses, it's also done IV but using a syringe. It may not necessarily be done using a bag and a drip.
- dfraser992 11y agoOral works as well - no pain in the nose, etc - but it does take more ketamine. As for the IV... these are doctors administrating it. An IV allows for more precision, and a point of the treatment, it seems, is to avoid the K-hole effect - which would seriously disturb a lot of patients. If I was using opiates for a medical purpose, I would want to be precise - heroin vs making poppy tea.
- cpncrunch 11y agoThe 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=668195&resultclick=1 http://archpsyc.jamanetwork.com/article.aspx?articleid=66819...
- nicholasjarnold 11y agoSo, 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?
- ukoms 11y agoFrom 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.
- dfraser992 11y agoand 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