4 ms·

Promising until you get here: "A follow-up test taken four weeks later – being four weeks from the final dose – saw a small but significant bump in suicidal th

by starkd 6y ago

Promising until you get here: "A follow-up test taken four weeks later – being four weeks from the final dose – saw a small but significant bump in suicidal thoughts, suggesting the effects of the drug fade with time." Pharma just wants another mass marketable drugs.

lhuser123 6y ago
This. It just never stops.
- starkd 6y ago
  They've exhausted the variants on standard anti-depressants.
- mhh__ 6y ago
  Ketamine is in probably every hospitals inventory so there's probably not that much money in it.
  - starkd 6y ago
    A lot of profit form generics. It's a common tactic for pharma to identify a syndrome with a commonly available drug, like ADHD with ritalin. The medicine need not be expensive or even novel.
LinuxBender 6y ago
Could it be that the drugs are to a degree just helping the person escape some level of stress, then they build a tolerance to it and those stress inducing thoughts or hormone levels return? Has anyone studied the persons hormone levels Serotonin, Cortisol, Epinephrine, Dopamine, Prolactin, etc... before, throughout and after the tests?
Nasrudith 6y ago
Ketamine is so incredibly generic it isn't funny. For a financial motive it would be pretty bad and not even evergreenable. Personally I find a more likely cause would anti-prohibitionist Zeitgeist from other discoveries like MDMAs effectiveness for treating PTSD being unsuppressed leading to attempts to replicate it. That happens in a lot of fields - the big tobbaco lawsuit class actiond lead lawyers to jump on other industries as the next one without similarly solid evidence - like the old frenzy in trying to say cell phones cause cancer.
- willcipriano 6y ago
  > Ketamine is so incredibly generic it isn't funny. For a financial motive it would be pretty bad and not even evergreenable. That's why you don't sell Ketamine, you sell Ketamine + an antacid or Ketamine in a timed relapse capsule and call it Relaxadol and have your friends in the FDA ensure it's the only approved treatment and not the generic Ketamine.
  - npunt 6y ago
    Except that compound pharmacies provide ketamine in various forms like nasal sprays and troches today, and availability is rising as evidence mounts and the field of psychiatry gets onboard with it as a mainstream antidepressant.
  - esperent 6y ago
    That's a problem with the US healthcare system, not a problem with the drug. The study linked in the article is by an Australian university so I don't think it's a relevant point here.
Delk 6y ago
> Pharma just wants another mass marketable drugs. Maybe. But I'm not sure how much money you could make out of ketamine, considering that it's old enough that it's AFAIK not under any patents, and it's not a daily drug so even volume and mass marketing might not make it that lucrative. If my memory serves, the related esketamine might actually be under some kind of a patent, but if you wanted to make money out of that, you'd probably want to show the efficacy of that particular enantiomer, including over plain old ketamine. I share the concern that ketamine might be yet another thing to try and treat symptoms with, and could make people even more dependent on medication-based approaches. However, doctors would probably just like to have further means of alleviating or treating conditions that they currently don't know how to treat, and although you could still call the medical field out for focusing too much on medication, I'm not sure the motivation in this case is "more money".
- rincebrain 6y ago
  Esketamine and its proprietary delivery nasal spray formulation, Spravato, are under patent, which you might reasonably claim was formulated and marketed instead of just ketamine in order to be able to patent it, since AFAIK there's still no good studies about either arketamine or esketamine efficacy versus ketamine. (There are a couple of studies of arketamine versus esketamine, but none that I immediately see comparing to ketamine.) edit: I found one study of esketamine versus ketamine shortly after posting this. [1] [1] - https://www.sciencedirect.com/science/article/abs/pii/S0165032719319780 https://www.sciencedirect.com/science/article/abs/pii/S01650...
npunt 6y ago
Oh please. It's a generic drug on the list of WHO's most essential medicines manufacturable by hundreds of labs worldwide for pennies a dose. Meanwhile it's a step change in both efficacy and speed of antidepressant effect relative to everything else on the market, opening up the possibility to treat people in emergency situations as well as lowering the cost of antidepressant treatment for millions that are taking on-patent drugs. Save your cynicism for something that you understand, you may as well be complaining about aspirin. Source: worked with psychiatrists and clinical psychologists that ran ketamine studies and treated severely mentally ill patients.
jtsiskin 6y ago
The next sentence is “Nonetheless, even at this point, it was still a roughly 50 percent drop in suicidal ideation compared to the pre-treatment levels. Secondary measures of depression and suicidality also saw improvements.”

by starkd 6y ago

lhuser123 6y ago

This. It just never stops.

starkd 6y ago
They've exhausted the variants on standard anti-depressants.
mhh__ 6y ago
Ketamine is in probably every hospitals inventory so there's probably not that much money in it.
- starkd 6y ago
  A lot of profit form generics. It's a common tactic for pharma to identify a syndrome with a commonly available drug, like ADHD with ritalin. The medicine need not be expensive or even novel.

LinuxBender 6y ago

Could it be that the drugs are to a degree just helping the person escape some level of stress, then they build a tolerance to it and those stress inducing thoughts or hormone levels return? Has anyone studied the persons hormone levels Serotonin, Cortisol, Epinephrine, Dopamine, Prolactin, etc... before, throughout and after the tests?

Nasrudith 6y ago

Ketamine is so incredibly generic it isn't funny. For a financial motive it would be pretty bad and not even evergreenable. Personally I find a more likely cause would anti-prohibitionist Zeitgeist from other discoveries like MDMAs effectiveness for treating PTSD being unsuppressed leading to attempts to replicate it. That happens in a lot of fields - the big tobbaco lawsuit class actiond lead lawyers to jump on other industries as the next one without similarly solid evidence - like the old frenzy in trying to say cell phones cause cancer.

willcipriano 6y ago
> Ketamine is so incredibly generic it isn't funny. For a financial motive it would be pretty bad and not even evergreenable. That's why you don't sell Ketamine, you sell Ketamine + an antacid or Ketamine in a timed relapse capsule and call it Relaxadol and have your friends in the FDA ensure it's the only approved treatment and not the generic Ketamine.
- npunt 6y ago
  Except that compound pharmacies provide ketamine in various forms like nasal sprays and troches today, and availability is rising as evidence mounts and the field of psychiatry gets onboard with it as a mainstream antidepressant.
- esperent 6y ago
  That's a problem with the US healthcare system, not a problem with the drug. The study linked in the article is by an Australian university so I don't think it's a relevant point here.

Delk 6y ago

> Pharma just wants another mass marketable drugs. Maybe. But I'm not sure how much money you could make out of ketamine, considering that it's old enough that it's AFAIK not under any patents, and it's not a daily drug so even volume and mass marketing might not make it that lucrative. If my memory serves, the related esketamine might actually be under some kind of a patent, but if you wanted to make money out of that, you'd probably want to show the efficacy of that particular enantiomer, including over plain old ketamine. I share the concern that ketamine might be yet another thing to try and treat symptoms with, and could make people even more dependent on medication-based approaches. However, doctors would probably just like to have further means of alleviating or treating conditions that they currently don't know how to treat, and although you could still call the medical field out for focusing too much on medication, I'm not sure the motivation in this case is "more money".

rincebrain 6y ago
Esketamine and its proprietary delivery nasal spray formulation, Spravato, are under patent, which you might reasonably claim was formulated and marketed instead of just ketamine in order to be able to patent it, since AFAIK there's still no good studies about either arketamine or esketamine efficacy versus ketamine. (There are a couple of studies of arketamine versus esketamine, but none that I immediately see comparing to ketamine.) edit: I found one study of esketamine versus ketamine shortly after posting this. [1] [1] - https://www.sciencedirect.com/science/article/abs/pii/S0165032719319780 https://www.sciencedirect.com/science/article/abs/pii/S01650...

npunt 6y ago

Oh please. It's a generic drug on the list of WHO's most essential medicines manufacturable by hundreds of labs worldwide for pennies a dose. Meanwhile it's a step change in both efficacy and speed of antidepressant effect relative to everything else on the market, opening up the possibility to treat people in emergency situations as well as lowering the cost of antidepressant treatment for millions that are taking on-patent drugs. Save your cynicism for something that you understand, you may as well be complaining about aspirin. Source: worked with psychiatrists and clinical psychologists that ran ketamine studies and treated severely mentally ill patients.

jtsiskin 6y ago

The next sentence is “Nonetheless, even at this point, it was still a roughly 50 percent drop in suicidal ideation compared to the pre-treatment levels. Secondary measures of depression and suicidality also saw improvements.”