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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 typ

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-reuptake-inhibitors-ssris-fibromyalgia http://www.cochrane.org/CD011735/MUSKEL_selective-serotonin-...

taurath 8y ago
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 8y ago
  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.

taurath 8y ago

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 8y ago
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.