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Holy shit: > there are concerns about the drug’s withdrawal effects after three of the study’s participants committed suicide within 20 days of its end It doe

Holy shit: > there are concerns about the drug’s withdrawal effects after three of the study’s participants committed suicide within 20 days of its end It doesn't say how many people committed suicide from the control group, but regardless, 3 suicides sounds pretty bad for an anti-depressant. Who would approve a drug like this? The cynic in me says an addictive drug with severe withdrawal effects is exactly what pharma companies want...

ggm 7y ago
The question about the control group is pretty important because the test subjects had to severely depressed to qualify (I believe)
DanBC 7y ago
The drug is licensed for people with treatment resistant depression. This group has significantly higher risk of death by suicide. I dislike speculating on causes of suicides, but if they've been told "here's this thing that appears to give relief from depression for people like you", and they try it, and it doesn't, I can see how that would further increase their risk.
Broken_Hippo 7y ago
I cannot imagine being severely depressed, entering a study for it since I'm resistant to most of the drugs, finding one that works.... and then having to stop the thing that works and return to a crappy mind state. Only it is worse because I now have withdrawal symptoms on top of my severe depression, which already put me at risk for suicide. In my opinion, the issue isn't that there is dependency nor that there is withdrawal effects. After all, these are things that happen and despite the risks, might still be the best available choice for relief. The bigger issue is that we didn't do enough to help folks during this time. We should have provided adequate medical care to keep folks safe. Perhaps we should wean folks off in a better manner and/or provided better psychiatric care to this vulnerable group of folks after trials ended.
- tempguy9999 7y ago
  I understand that. I was on prozac for years. I chose to come off it because it was messing me up, otherwise I'd have been happy to take it for the rest of my life (why not?) I was aware that if the blackness returned and going back onto prozac failed to work (which can happen) then my lifespan would be a few months at the most. People without really bad depression can't understand how bad it can be. Death really is better.
soulofmischief 7y ago
There's definitely a readjustment period where your brain tries to reach homeostasis again, which can lead to depressive episodes. But it's important to remember these people were likely morbidly depressed to begin with, and taking ketamine trials was an act of desperation.
pdpi 7y ago
Suicidal ideation is one symptom of depression, but so is demotivation and lack of energy. It's well understood that this depression-induced demotivation is a key factor in keeping depressive people from acting on their suicidal thoughts. It naturally follows that there is a risk factor with starting on antidepressants — because antidepressants might work for you in a way that helps you with your motivation issues before they do anything about your suicidal thoughts, you are at a heightened suicide risk immediately after starting on antidepressants. It could very well be the case that this is the exact opposite effect — on discontinuation, you could have the suicidal ideation symptoms come back before demotivation does.
- rjkennedy98 7y ago
  > It's well understood that this depression-induced demotivation is a key factor in keeping depressive people from acting on their suicidal thoughts. First of all, NOTHING is well understood in psychiatry. We are talking about drugs that get approved on a sliver of evidence (if any) on trails being run by some of the most corrupt organizations on the planet. No one understands how or why any anti-depressant works. And saying any of these drugs creates less "demotivation" isn't documented at all. That being said, we can clearly say anti-depressants (specifically SSRIs) can and do cause suicidal ideation. Yes, suicidal ideation is symptom of depression, but when you give these drugs for non-depression cause such as OCD it still causes suicidal thinking. There is a reason for black box warning on many anti-depressants (and its not because of changes in demotivation).

ggm 7y ago

The question about the control group is pretty important because the test subjects had to severely depressed to qualify (I believe)

DanBC 7y ago

The drug is licensed for people with treatment resistant depression. This group has significantly higher risk of death by suicide. I dislike speculating on causes of suicides, but if they've been told "here's this thing that appears to give relief from depression for people like you", and they try it, and it doesn't, I can see how that would further increase their risk.

Broken_Hippo 7y ago

I cannot imagine being severely depressed, entering a study for it since I'm resistant to most of the drugs, finding one that works.... and then having to stop the thing that works and return to a crappy mind state. Only it is worse because I now have withdrawal symptoms on top of my severe depression, which already put me at risk for suicide. In my opinion, the issue isn't that there is dependency nor that there is withdrawal effects. After all, these are things that happen and despite the risks, might still be the best available choice for relief. The bigger issue is that we didn't do enough to help folks during this time. We should have provided adequate medical care to keep folks safe. Perhaps we should wean folks off in a better manner and/or provided better psychiatric care to this vulnerable group of folks after trials ended.

tempguy9999 7y ago
I understand that. I was on prozac for years. I chose to come off it because it was messing me up, otherwise I'd have been happy to take it for the rest of my life (why not?) I was aware that if the blackness returned and going back onto prozac failed to work (which can happen) then my lifespan would be a few months at the most. People without really bad depression can't understand how bad it can be. Death really is better.

soulofmischief 7y ago

There's definitely a readjustment period where your brain tries to reach homeostasis again, which can lead to depressive episodes. But it's important to remember these people were likely morbidly depressed to begin with, and taking ketamine trials was an act of desperation.

pdpi 7y ago

Suicidal ideation is one symptom of depression, but so is demotivation and lack of energy. It's well understood that this depression-induced demotivation is a key factor in keeping depressive people from acting on their suicidal thoughts. It naturally follows that there is a risk factor with starting on antidepressants — because antidepressants might work for you in a way that helps you with your motivation issues before they do anything about your suicidal thoughts, you are at a heightened suicide risk immediately after starting on antidepressants. It could very well be the case that this is the exact opposite effect — on discontinuation, you could have the suicidal ideation symptoms come back before demotivation does.

rjkennedy98 7y ago
> It's well understood that this depression-induced demotivation is a key factor in keeping depressive people from acting on their suicidal thoughts. First of all, NOTHING is well understood in psychiatry. We are talking about drugs that get approved on a sliver of evidence (if any) on trails being run by some of the most corrupt organizations on the planet. No one understands how or why any anti-depressant works. And saying any of these drugs creates less "demotivation" isn't documented at all. That being said, we can clearly say anti-depressants (specifically SSRIs) can and do cause suicidal ideation. Yes, suicidal ideation is symptom of depression, but when you give these drugs for non-depression cause such as OCD it still causes suicidal thinking. There is a reason for black box warning on many anti-depressants (and its not because of changes in demotivation).