8 ms·

Listening to Ketamine

58 points by pmcpinto 8y ago

skilled 8y ago
I can't be the only one thinking that solving 'drug problems' with drugs is not the way to go? Meditation and yoga offer plenty of support for managing stress and in fact depression. But most people want a quick antidote, something that 'burns' the edge off and not fixes it for good.
- freedomben 8y ago
  Why not both? Why can't you just stick to meditation and yoga but let another person find something that works for them? I tried meditation and yoga for years to treat depression, and I suffered unnecessarily for years (including periods of being suicidal). Getting on pharmaceuticals vastly improved my life and I can't imagine going back. I'm really glad you found something that works for you, but I believe you actively harm others by suggesting that it will work for everyone else too.
  - skilled 8y ago
    You can be defensive all you want but facts speak for themselves. The pharmaceutical industry provide bandage fixes that lead to much deeper health problems down the line. Having a healthy Ego does not mean defending stupidity and ignorance. And you are proving my point exactly. People want a quick fix and not a long-term solution, so perhaps next time when you want to be snappy - add that as a disclaimer for your opinion. Also, I would love to hear your spiritual journey over those many years. Have you shared it in writing? Always open to reading a sincere story. :)
    - bashallah 8y ago
      Jesus, but not in the literally terms.
    - warent 8y ago
      There's a lot about the pharmaceutical industry that I don't like either but you're not going to persuade anyone by berating them with sneering rhetoric like this.
- pmoriarty 8y ago
  As you point out, meditation and yoga are not quick fixes. One usually has to practice them for a long time to get significant results. But people suffering from depression rarely have the motivation and endurance to stick with a practice long-term. Some have trouble getting out of bed in the morning or even doing simple chores.
- empath75 8y ago
  Meditation and yoga are also ‘quick fixes’ of a different kind. Suffering is part of being human and nothing is going to erase it.
  - robbiep 8y ago
    These may help significantly, but may also not move the needle at all
- adyavanapalli 8y ago
  Ketamine is usually prescribed to people with "treatment"-resistant severe depression, and these "treatments" include other types of medication, exercise, and meditation. That aside, often, severely depressed people can't do even the basic things like showering, going to work, or making dinner. Ketamine treatment offers a severely depressed person to bootstrap themselves into a state where they _can_ start doing things that will allow themselves to support themselves.
  - ridgeguy 8y ago
    Well said, thank you. Few seem to understand how debilitating treatment-resistant depression can be. Source: wife's cousin, who when s(he)'s ok, is super smart, capable, and lives a good life. When s(he)'s in the depression hole, s(he)'s nearly comatose. Ketamine has helped greatly in his/her case.
    - JshWright 8y ago
      Unrelated: Wouldn't "they" have worked fine as a pronoun there (and been less distracting)?
      - ridgeguy 8y ago
        Yeah, it would have. It's just that the ghost of my 5th grade English teacher would have emerged from the mists to point out that "they" is plural, whereas I was referring to an individual. Can't win.
        TheSpiceIsLife 8y ago
        Your 5th grade teacher, nor dictionaries, ought be considered authoritative sources of word meanings. Words mean what people who use them intend them to mean. But if you want something more authoritative than random-internet-comment, definition three from dictionary.com has you covered: https://www.dictionary.com/browse/they https://www.dictionary.com/browse/they they pronoun, possessive their or theirs, objective them. 1 nominative plural of he, she, and it. 2 people in general: They say he's rich. 3 (used with a singular indefinite pronoun or singular noun antecedent in place of the definite masculine he or the definite feminine she ): Whoever is of voting age, whether they are interested in politics or not, should vote. A person may apply only if they are over 21. They have been an actor since childhood.
- maxxxxx 8y ago
  If you are a real meditator or yogi you should have more compassion with others.
- ridgeguy 8y ago
  It's long settled that biochemistry affects mood, depression, and a host of other difficulties people encounter. It makes no sense to me to exclude agents that affect biochemistry ('drugs') from consideration as having therapeutic benefit.
- anticodon 8y ago
  Meditation and yoga help but they require lots of time and effort. And when you're stressed or depressed there's often not enough willpower.
- Broken_Hippo 8y ago
  It is great if these things have helped you. They have the ability to do absolutely nothing in some folks and the ability to make mental problems worse for other folks. This is why some retreats won't take people that have a history of mental health issued. You could simply stick with what works for you and let others do what works for them without judging them harshly for doing something you believe won't help (even when the research and their personal experience says otherwise).
- kasperni 8y ago
  > I can't be the only one thinking that solving 'drug problems' with drugs is not the way to go? I sure hope so, you obviously have no idea what you talk about. If you can postulate that meditation and offer plenty of support for depressed people. Can some depressed people be helped by meditation and yoga? Sure! But saying that it offers plenty of support, is like saying that people with cancer just need to eat healthy.
freedomben 8y ago
> Recent approval of a nasal spray promises to expand access, but much remains unknown about long-term use and the potential for abuse. This might surprise everybody, but if it's possible to "abuse" it, somebody will (turns out some humans will do that). I wish we'd stop restricting access to things that could help and improve people's lives because we're worried that somebody might do something with their body that we find morally objectionable.
- oceanghost 8y ago
  Ketamine is very addictive, and long term abuse at the very least leads to bladder problems. Source: I spend two years doing Ketamine and analogs on a regular basis.
  - grzm 8y ago
    Were you using recreationally or as prescribed under the supervision of a doctor?
    - oceanghost 8y ago
      Oh, if it wasn't clear, I was addicted to it :)
  - empath75 8y ago
    As someone who spent quite a few years in the rave scene hanging out with a lot of drug users and trying a lot of drugs, I’d probably put ketamine way down on the list if I’m ranking them on addictiveness. I’d say most people that tried it didn’t even like it. It’s a particular kind of personality that would take a dissociative anesthetic recreationally. I tried it a couple of times and never really enjoyed it much unless I was mixing it with mdma — at best I’d call it ‘an interesting experience’ Which isn’t to say that I didn’t know people who abused it way beyond “normal” recreational use, but those people were abusing every drug they could find.
    - homakov 8y ago
bitforger 8y ago
Coincidentally, I was talking to my neighbor this afternoon about how much ketamine has helped his depression. Apparently he loves the stuff, and each treatment lasts several months. He did mention, though, that every time you get a dose you basically hallucinate for an hour. But maybe that's fine, if you're into it.
- finaliteration 8y ago
  For me I guess it would depend on the kind of hallucinations we’re talking about. If it’s just “reality bending, things seem off” kind of hallucinations that’s one thing, but full blown warped reality akin to an acid trip is another. I’d be cool with the former, but I’m terrified of the latter (which is why I’ve never done any sort of psychedelics).
  - blackhatbiodude 8y ago
    high ketamine doses are much more warped than even high lsd doses. You are unable to move and your consciousness watches a totally different reality. It's quite scary, but it passes... when you come back though normal stresses seem to have passed away and you look at problems differently which is why I think it helps depression. It's like they don't matter so much so don't cause the same mental stresses.
    - TheSpiceIsLife 8y ago
      Is the psychedelic dose necessary for treatment of depression?
      - mathieuh 8y ago
        Probably not, as far as I have read it is ketamine metabolites that have anti-depressant properties, not the experience itself, which only lasts about 40-60 minutes
atomical 8y ago
> Zarate and others are still thrilled to see big pharma investing in ketamine, after decades of stalled efforts to find new psychiatric drugs. “As esketamine hits the market, venture capitalists will come up with better versions and move the field forward,” Zarate says. My doctor prescribes me sublingual ketamine for use at home. What we have now is good enough. We need doctors like mine that have the courage to prescribe off label.
neom 8y ago
Folks say really really positive things about Ketamine. I wouldn't say I'm an inexperienced psychonaut, yet ketamine scares me. Two close friends told me they have problems "abusing" ketamine. If anyone is able to help shed some light what abusing ket looks like, I'd appreciate it.
tmp192489 8y ago
I've done ketamine recreationally and haven't been that impressed. Not sure if it's the dosage or my personal reaction to the drug, but it's like a very temporary (30 min max) feeling that is similar to being drunk. There are better highs IMO.
no_identd 8y ago
Pah. The Ketamine Fast Track approval feels a bit like a bad joke. See Scott Alexander's recent blog post here: https://slatestarcodex.com/2019/03/11/ketamine-now-by-prescription/ https://slatestarcodex.com/2019/03/11/ketamine-now-by-prescr... Really wish they'd have gone for Arketamine. To quote in part from above: "Another possibility is that everyone made a huge mistake in using left-handed ketamine, and it’s right-handed ketamine that holds the magic. Most previous research was done on a racemic mixture (an equal mix of left-handed and right-handed molecules), and at least one study suggests it was the right-handed ketamine that was driving the results. Pharma decided to pursue left-handed ketamine because it was known to have a stronger effect on NMDA receptors, but – surprise! – ketamine probably doesn’t work through NMDA after all. So there’s a chance that this is just the wrong kind of ketamine – though usually I expect big pharma to be smarter than that, and I would be surprised if this turned out to be it. I don’t know if anybody has a right-handed ketamine patent yet." I don't think that quite covers it, tho. Personally, I suspect Esketamine, as the part of racemic Ketamine that causes hallucinations exhibits an 'antidepressant' effect similar to the one weakly associated with psychedelics, i.e. more by granting new high level psychological insight than via some low level neurological effect - whereas I'd speculate Arketamine causes the documented 'magic' and RAPID next-day antidepressive effect of racemic Ketamine. Which makes me suspect we'd probably do well doing the same thing done with some other stereoisomeric medications such as for example in the case of Adderall, which has a ratio of Dexamphetamine to Levo Amphetamine of 3:1(viz., 75% Dex, 25% Levo): Figure out the optimal ratio of the two stereoisomers (to each other) for depression treatment.

58 points by pmcpinto 8y ago

I can't be the only one thinking that solving 'drug problems' with drugs is not the way to go? Meditation and yoga offer plenty of support for managing stress and in fact depression. But most people want a quick antidote, something that 'burns' the edge off and not fixes it for good.

freedomben 8y ago
Why not both? Why can't you just stick to meditation and yoga but let another person find something that works for them? I tried meditation and yoga for years to treat depression, and I suffered unnecessarily for years (including periods of being suicidal). Getting on pharmaceuticals vastly improved my life and I can't imagine going back. I'm really glad you found something that works for you, but I believe you actively harm others by suggesting that it will work for everyone else too.
- skilled 8y ago
  You can be defensive all you want but facts speak for themselves. The pharmaceutical industry provide bandage fixes that lead to much deeper health problems down the line. Having a healthy Ego does not mean defending stupidity and ignorance. And you are proving my point exactly. People want a quick fix and not a long-term solution, so perhaps next time when you want to be snappy - add that as a disclaimer for your opinion. Also, I would love to hear your spiritual journey over those many years. Have you shared it in writing? Always open to reading a sincere story. :)
  - bashallah 8y ago
    Jesus, but not in the literally terms.
  - warent 8y ago
    There's a lot about the pharmaceutical industry that I don't like either but you're not going to persuade anyone by berating them with sneering rhetoric like this.
pmoriarty 8y ago
As you point out, meditation and yoga are not quick fixes. One usually has to practice them for a long time to get significant results. But people suffering from depression rarely have the motivation and endurance to stick with a practice long-term. Some have trouble getting out of bed in the morning or even doing simple chores.
empath75 8y ago
Meditation and yoga are also ‘quick fixes’ of a different kind. Suffering is part of being human and nothing is going to erase it.
- robbiep 8y ago
  These may help significantly, but may also not move the needle at all
adyavanapalli 8y ago
Ketamine is usually prescribed to people with "treatment"-resistant severe depression, and these "treatments" include other types of medication, exercise, and meditation. That aside, often, severely depressed people can't do even the basic things like showering, going to work, or making dinner. Ketamine treatment offers a severely depressed person to bootstrap themselves into a state where they _can_ start doing things that will allow themselves to support themselves.
- ridgeguy 8y ago
  Well said, thank you. Few seem to understand how debilitating treatment-resistant depression can be. Source: wife's cousin, who when s(he)'s ok, is super smart, capable, and lives a good life. When s(he)'s in the depression hole, s(he)'s nearly comatose. Ketamine has helped greatly in his/her case.
  - JshWright 8y ago
    Unrelated: Wouldn't "they" have worked fine as a pronoun there (and been less distracting)?
    - ridgeguy 8y ago
      Yeah, it would have. It's just that the ghost of my 5th grade English teacher would have emerged from the mists to point out that "they" is plural, whereas I was referring to an individual. Can't win.
      - TheSpiceIsLife 8y ago
        Your 5th grade teacher, nor dictionaries, ought be considered authoritative sources of word meanings. Words mean what people who use them intend them to mean. But if you want something more authoritative than random-internet-comment, definition three from dictionary.com has you covered: https://www.dictionary.com/browse/they https://www.dictionary.com/browse/they they pronoun, possessive their or theirs, objective them. 1 nominative plural of he, she, and it. 2 people in general: They say he's rich. 3 (used with a singular indefinite pronoun or singular noun antecedent in place of the definite masculine he or the definite feminine she ): Whoever is of voting age, whether they are interested in politics or not, should vote. A person may apply only if they are over 21. They have been an actor since childhood.
maxxxxx 8y ago
If you are a real meditator or yogi you should have more compassion with others.
ridgeguy 8y ago
It's long settled that biochemistry affects mood, depression, and a host of other difficulties people encounter. It makes no sense to me to exclude agents that affect biochemistry ('drugs') from consideration as having therapeutic benefit.
anticodon 8y ago
Meditation and yoga help but they require lots of time and effort. And when you're stressed or depressed there's often not enough willpower.
Broken_Hippo 8y ago
It is great if these things have helped you. They have the ability to do absolutely nothing in some folks and the ability to make mental problems worse for other folks. This is why some retreats won't take people that have a history of mental health issued. You could simply stick with what works for you and let others do what works for them without judging them harshly for doing something you believe won't help (even when the research and their personal experience says otherwise).
kasperni 8y ago
> I can't be the only one thinking that solving 'drug problems' with drugs is not the way to go? I sure hope so, you obviously have no idea what you talk about. If you can postulate that meditation and offer plenty of support for depressed people. Can some depressed people be helped by meditation and yoga? Sure! But saying that it offers plenty of support, is like saying that people with cancer just need to eat healthy.

freedomben 8y ago

> Recent approval of a nasal spray promises to expand access, but much remains unknown about long-term use and the potential for abuse. This might surprise everybody, but if it's possible to "abuse" it, somebody will (turns out some humans will do that). I wish we'd stop restricting access to things that could help and improve people's lives because we're worried that somebody might do something with their body that we find morally objectionable.

oceanghost 8y ago
Ketamine is very addictive, and long term abuse at the very least leads to bladder problems. Source: I spend two years doing Ketamine and analogs on a regular basis.
- grzm 8y ago
  Were you using recreationally or as prescribed under the supervision of a doctor?
  - oceanghost 8y ago
    Oh, if it wasn't clear, I was addicted to it :)
- empath75 8y ago
  As someone who spent quite a few years in the rave scene hanging out with a lot of drug users and trying a lot of drugs, I’d probably put ketamine way down on the list if I’m ranking them on addictiveness. I’d say most people that tried it didn’t even like it. It’s a particular kind of personality that would take a dissociative anesthetic recreationally. I tried it a couple of times and never really enjoyed it much unless I was mixing it with mdma — at best I’d call it ‘an interesting experience’ Which isn’t to say that I didn’t know people who abused it way beyond “normal” recreational use, but those people were abusing every drug they could find.
  - homakov 8y ago

bitforger 8y ago

Coincidentally, I was talking to my neighbor this afternoon about how much ketamine has helped his depression. Apparently he loves the stuff, and each treatment lasts several months. He did mention, though, that every time you get a dose you basically hallucinate for an hour. But maybe that's fine, if you're into it.

finaliteration 8y ago
For me I guess it would depend on the kind of hallucinations we’re talking about. If it’s just “reality bending, things seem off” kind of hallucinations that’s one thing, but full blown warped reality akin to an acid trip is another. I’d be cool with the former, but I’m terrified of the latter (which is why I’ve never done any sort of psychedelics).
- blackhatbiodude 8y ago
  high ketamine doses are much more warped than even high lsd doses. You are unable to move and your consciousness watches a totally different reality. It's quite scary, but it passes... when you come back though normal stresses seem to have passed away and you look at problems differently which is why I think it helps depression. It's like they don't matter so much so don't cause the same mental stresses.
  - TheSpiceIsLife 8y ago
    Is the psychedelic dose necessary for treatment of depression?
    - mathieuh 8y ago
      Probably not, as far as I have read it is ketamine metabolites that have anti-depressant properties, not the experience itself, which only lasts about 40-60 minutes

atomical 8y ago

> Zarate and others are still thrilled to see big pharma investing in ketamine, after decades of stalled efforts to find new psychiatric drugs. “As esketamine hits the market, venture capitalists will come up with better versions and move the field forward,” Zarate says. My doctor prescribes me sublingual ketamine for use at home. What we have now is good enough. We need doctors like mine that have the courage to prescribe off label.

neom 8y ago

Folks say really really positive things about Ketamine. I wouldn't say I'm an inexperienced psychonaut, yet ketamine scares me. Two close friends told me they have problems "abusing" ketamine. If anyone is able to help shed some light what abusing ket looks like, I'd appreciate it.

tmp192489 8y ago

I've done ketamine recreationally and haven't been that impressed. Not sure if it's the dosage or my personal reaction to the drug, but it's like a very temporary (30 min max) feeling that is similar to being drunk. There are better highs IMO.

no_identd 8y ago

Pah. The Ketamine Fast Track approval feels a bit like a bad joke. See Scott Alexander's recent blog post here: https://slatestarcodex.com/2019/03/11/ketamine-now-by-prescription/ https://slatestarcodex.com/2019/03/11/ketamine-now-by-prescr... Really wish they'd have gone for Arketamine. To quote in part from above: "Another possibility is that everyone made a huge mistake in using left-handed ketamine, and it’s right-handed ketamine that holds the magic. Most previous research was done on a racemic mixture (an equal mix of left-handed and right-handed molecules), and at least one study suggests it was the right-handed ketamine that was driving the results. Pharma decided to pursue left-handed ketamine because it was known to have a stronger effect on NMDA receptors, but – surprise! – ketamine probably doesn’t work through NMDA after all. So there’s a chance that this is just the wrong kind of ketamine – though usually I expect big pharma to be smarter than that, and I would be surprised if this turned out to be it. I don’t know if anybody has a right-handed ketamine patent yet." I don't think that quite covers it, tho. Personally, I suspect Esketamine, as the part of racemic Ketamine that causes hallucinations exhibits an 'antidepressant' effect similar to the one weakly associated with psychedelics, i.e. more by granting new high level psychological insight than via some low level neurological effect - whereas I'd speculate Arketamine causes the documented 'magic' and RAPID next-day antidepressive effect of racemic Ketamine. Which makes me suspect we'd probably do well doing the same thing done with some other stereoisomeric medications such as for example in the case of Adderall, which has a ratio of Dexamphetamine to Levo Amphetamine of 3:1(viz., 75% Dex, 25% Levo): Figure out the optimal ratio of the two stereoisomers (to each other) for depression treatment.