26 ms·

Ketamine therapy is going mainstream

138 points by elsewhen 5y ago

ch0I9daAiO 5y ago
I wonder how they address the urinary tract issues, especially the bladder. It's one thing when they use it for anesthesia, which is quite rare and sporadic to receive, compared to something like therapy, which might happen more frequently and for longer. Does anyone have any data about that?
- dymk 5y ago
  My understanding is that ketamine therapy doesn't involve many doses of ketamine over a long time, but rather a handful of guided sessions over weeks/months.
  - Den-vr 5y ago
    The actual implementation of the therapy varies from place to place. In my locale, the treatment does not involve any guides. It's really unfortunate
- johnisgood 5y ago
  Urinary tract issues are not that common. They would have to pretty much take higher doses, long-term. It is not a concern as far as this therapy goes.
- ParanoidShroom 5y ago
  Last I heard about this in hard reduction groups, people experience this after 1-2 years of chronic daily usage. It's definitely something to keep an eye on. But people would be able to get through many sessions before being at risk. I'm more worried about people stop being able to afford it, going to black market and and up having a dependency.
- Symmetry 5y ago
  Apparently there's a big difference in the quantities of ketamine consumed by recreational users versus people who are prescribed it, 90 grams per month being common for recreation versus 300 mg for treatment. https://astralcodexten.substack.com/p/drug-users-use-a-lot-of-drugs https://astralcodexten.substack.com/p/drug-users-use-a-lot-o...
  - thomashop 5y ago
    I know many heavy and moderate recreational ketamine users and 90g is completely absurd.the really heavy users I know go through a gram per day max. During parties or festivals it can be more. Not to say that there isn't a big difference to therapeutic use.
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  - Honga 5y ago
    I think it's worth reevaluating the word 'recreational' here. Except for festivals, or longer parties as someone already mentioned 300mg is an enormous amount to consume in one sitting, especially without a good understanding. 90g per month seems quite unsafe.
    - GordonS 5y ago
      You could k-hole every night for a month IM'ing 100mg, and that'd still only be 3,000mg. 30 grams of ketamine is an absolutely crazy amount.
  - Scoundreller 5y ago
    If I do the math right, that’s like $5k/month or more. I doubt many recreational users consume that much. Not for long anyway.
- loeg 5y ago
  The urinary issues are in people using 100-200x the ketamine you might use even in regular therapy. https://astralcodexten.substack.com/p/drug-users-use-a-lot-of-drugs https://astralcodexten.substack.com/p/drug-users-use-a-lot-o...
- Jerrrry 5y ago
  Too bad the world's first "synthetic" to combat this issue, MXE, was made illegal. It has no bladder problems, and shines light where ketamine is cold. MXE is the perfect drug. 5g in a few months, stopped cold turkey, felt fine - due to the long lasting and dissipating metabolites that these drugs degrade into. I am planning on getting some Ketamine soon for my own Christmas present. Too bad I can't have MXE, which is safer, better, and fuckn awesome. you can even smoke it! (very small amounts. makes you feel like a golden greek god)
  - samatman 5y ago
    Those were the days my friend. We thought they would never end...
    - Jerrrry 5y ago
      I busted out the 3-MEO-PCP that I had literally buried - at the time, I had thought it was too manic, to schizophrenic. 10 day regime of a small bump for breakfast had be happy for weeks. do drugs, people
      - samatman 5y ago
        not too much. mostly plants
  - goldcountry 5y ago
    If you know where to look on the dark web, MXE can occasionally still be found. The fine folks over at Lizard Labs in NL have also developed DMXE, which is apparently qualitatively nearly identical, though I have yet to be able to acquire any in the US.
    - Jerrrry 5y ago
      I searched for weeks for a domestic Lizard Labs reseller, no luck. I don't do custom, especially from NL. Good to know they are still around! May look into their new new new novel lysergamides.
andrewfromx 5y ago
for those in the LA area: https://www.revitalifemedicalcenter.com/ketamine-therapy https://www.revitalifemedicalcenter.com/ketamine-therapy
- andrewfromx 5y ago
  my review of Dr. Vu K therapy: You are lead into a room with a very comfortable chair, amazing head phones, great relaxing music, think first class airline seat but without being in an airplane. A nurse comes in and injects the K into your arm muscle (not a vein) and within seconds you feel the effect. Soon you forget all about how nervous you were coming to this office or worrying about urinary track issues, worrying about anything at all. For about an hour you are in this wonderful state. The nurse comes in to check on you every so often. I can barely speak but I'm able to give a thumbs up and mumble "yes yes doing great." The end reminds me of that Guns n' roses song, "when you're high you never, wanna come down..." But even after the hour is over and you can walk again and you are safe to drive, you are very happy the rest of the day. I will say Dr. Vu sells a lot of other stuff besides K shots so be careful what you agree to. It can get very expensive! But overall I think it's a wonderful service he is offering.
  - GordonS 5y ago
    Hmm, I've read a lot about ketamine infusions, and I don't think I've ever come across them delivering it via the intramuscular route before. Was it just a single injection, and do you know how many mg? I thought the whole point was to keep plasma levels high for a long time. Anyone with access to a vial of ketamine could easily perform a single IM injection at home without paying thousands of dollars for the privilege.
    - andrewfromx 5y ago
      The dosage can vary by patient. I got 30mg.
      - GordonS 5y ago
Overtonwindow 5y ago
Psilocybin may have saved my life, after a lifetime of PTSD. It threw off the “wet blanket” that had enveloped me for decades. At this point in my medical history, I’ve tried just about everything else, what have I got to lose?
- Den-vr 5y ago
  Did you get any assistance from insurance?
  - Overtonwindow 5y ago
    HA! None. Fortunately where I live psychedelics have been decriminalized, so I was able to get some shrooms from a reliable source.
- MobileVet 5y ago
  I have been monitoring this research for years as it could be potentially life changing for a family member. I am so happy your blanket was lifted. I am curious, was your comment about trying Ketamine just a general nod or are you seriously considering it? Much of what I have read indicates psilocybin has a more long term and profound affect vs ketamine, are you still looking for further improvements?
  - Overtonwindow 5y ago
    I am seriously considering it. I found can get ketamine therapy here but it's upwards of $400 per dose, needing multiple doses, and not covered by insurance. With the psilocybin, I confess it was just shrooms eaten with a bottle of water. Not tasty. What I experienced was nothing short of profound. About an hour after swallowing four grams I started feeling giggly, and happy. I looked at old photos of my cat that died some years back, and she started to pulse slightly and seemed to move almost in the photo, but that was the extent of the hallucinations. It's what happened next that changed everything. I remember drinking some water and then going to lay in the bed. My brain started thinking about a very depressive episode that happened to me this year. I thought through it, specifically what it meant for my life, friendships, etc. This is something that would have left me crying in a dark bathroom in the middle of the night before, but this time, it didn't. I didn't feel the usual guilt, embarrassment, and humiliation about my past mistakes. The best way I can describe it is this: I was walking alongside my depression, having a conversation with it, and at some point, my depression stopped and I kept walking. It was a sudden realization of "wow, that ..isn't making me depressed, or feel guilty, humiliated, etc. !" About three hours after consuming the shrooms I came out of it and looked around my bedroom as if I was a different person; "holy crap this place is a mess!" I went downstairs and finally did the stack of dishes in the sink, put away the laundry, and spent hours just cleaning joyfully. I was able to process considerable trauma that night, and my therapist said a few days later that I was a total 180 degrees from where I had been the week before. We've been very careful to monitor to make sure it's not just a manic episode. The positive has kept up. I've had a few down days, but that's mostly due to anxiety and relationship issues, which a little marijuana helps considerably. Overall these past four months have been some of the best of my life. I wake up with a forward outlook. I can sleep easier, thoughts are no longer dwelling on me. I don't feel this weight on top of me, reminding me of my failures, fears, etc. Above all, I just don't feel like a sad sack all the time. I've taken maybe two dozen medications in my life for anxiety, depression, and PTSD. Nothing can hold a candle to the immediate, calming effects of marijuana, but nothing has also come even close to the sheer relief from the shrooms. Edit: Grammar and clarified a few things.
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IceWreck 5y ago
Ketamine ? Is it that thing Yoda takes to get drunk ?
- dymk 5y ago
  Specifically, to go drive his Honda Civic on
  - BeFlatXIII 5y ago
    And to think that I thought it was only for horses all this time
- deleted 5y ago
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Den-vr 5y ago
My wife went through the therapy. Three days a week for two weeks. It was hell, she changed as a person. There was a lot more expression of anger, she described it like having gasoline poured into her veins when they were already on fire. But, a month later, she was able to interact with her family members again. Without PTSD triggering for the first time in years. It really reduced the control PTSD had over her life. I'm not sure if it was worth it though.
- whalesalad 5y ago
  Part of the healing process for people who’ve suffered through trauma is releasing all of that energy out of the body. It’s very common to go through big up/down swings during this process.
  - actually_a_dog 5y ago
    Most definitely. I'm going through some of this with therapeutic MDMA use for my PTSD. It's definitely been a journey, and not always a pleasant one, but, I believe I'm better off now after a few sessions than when I started.
    - gavinray 5y ago
      Do you mean you've been approved/are able to get clinically administered MDMA taken with a therapist -- or is this self-administered? I had similar very positive + life-changing experiences from taking MDMA but it wasn't clinical.
      - augustuspolius 5y ago
        I was trying to find a legal MDMA assisted therapy recently but apparently it’s still illegal outside of clinical trials.
      - actually_a_dog 5y ago
        Self administered, unfortunately. I do have a therapist with whom I discuss things related to the sessions, but he's not directly involved. Also unfortunately, I'm about out of the drug, and will soon need to either try and find a reliable source, or call it quits on this particular treatment avenue.
JohnTHaller 5y ago
Ketamine therapy is fantastic. It saved the life of a close friend. And greatly helped another. It helps to find a reputable provider and pair it with good therapy. One friend found a provider that paired it with a therapy session part way through which helped him a lot. These were all with depression therapy, though I've heard from the providers that it's amazing with PTSD.
helloworld653 5y ago
Can anyone share their experience consuming Lithium Orotate? Years ago I remembered reading this article - https://www.nytimes.com/2015/06/28/magazine/i-dont-believe-in-god-but-i-believe-in-lithium.html https://www.nytimes.com/2015/06/28/magazine/i-dont-believe-i... The one compound I've used (on and off, for maybe a few weeks at a time over the past 18 years) intermittently is Clonazepam. Recently however I don't find the dosage to be very effective, and reading the literature, upping benzo dosage has a high risk of increased dependency. I'd like to avoid that. I happened to randomly start Googling about Lithium and stumbled upon Lithium Orotate, which is sold as a supplement pretty much everywhere. There's a little bit of literature on Pubmed, but not much. I bought this - https://www.amazon.com/gp/product/B00PB4II68/ref=ppx_yo_dt_b_asin_title_o00_s00?ie=UTF8&psc=1 https://www.amazon.com/gp/product/B00PB4II68/ref=ppx_yo_dt_b... And it arrives on Friday. The reviews on this and other Lithium Orotate seem almost too good to be true, but for $10, I'm willing to give it a shot.
- jacobmartin 5y ago
  I can't say anything about low-dose lithium so I'm sorry if this is out of scope. I did however take 600mg daily of Lithium Carbonate for a long time and it really helped me with my anxiety, and, importantly, it reduced my suicidal thoughts/self harm urges to basically zero from multiple times a day. This isn't as low as the doses people seem to use with Orotate, but it's still "subclinical".
- mannanj 5y ago
  I tried this for a short time. Hard to recall the affect on me, I don't feel depressed any longer so safe to say it probably worked. I'd say the bigger impact on me was def. psychedelics though.
- scoopertrooper 5y ago
  I’ve known people that took lithium for bipolar. It’s not a drug I’d recommend taking without professional supervision. Its side effects can include personality disassociation, weight gain, and memory loss. The people that I knew fought tooth and nail to get off it. Obviously, the effects will differ between people, but best to go into things with your eyes open and a professional to supervise things.
whalesalad 5y ago
Before you go spending thousands of dollars on ketamine infusions I urge you to do two things: 1. read Michael Pollan’s book, How to Change Your Mind 2. Look into the process of cultivating your own mushrooms at home - it’s ultimately very easy to produce your own medicine
- after_care 5y ago
  Clearly ketamine infusions are about being legal and all the benefits of doing business out in the open. Anyone could buy illicit ketamine for 1/50th the cost and administer at home, but that is a felony.
  - whalesalad 5y ago
    Ketamine is not a psychedelic.
    - nisegami 5y ago
      I think GP commenter was replying to your remark that ketamine infusions cost thousands of dollars, not your remark about mushrooms.
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    - Jerrrry 5y ago
      have you ever k-holed? Nitrous is also a dissociative, with psychedelic properties. Alcohol can even push this boundary.
  - samatman 5y ago
    It is in fact a misdemeanour, within the US at least, outside of the most benighted states.
    - after_care 5y ago
      Some states allow for small amounts of ketamine to be a misdemeanor, but for many (most?) it’s a felony. In Texas and Florida, the second and third most populous states, possession of any amount of Ketamine is a felony.
tehjoker 5y ago
Fun to read trip reports in The New Yorker
ajay-d 5y ago
another recent experience https://www.nytimes.com/2021/12/26/opinion/depression-ketamine.html https://www.nytimes.com/2021/12/26/opinion/depression-ketami...
hprotagonist 5y ago
what's the current state of the enantiomer disparities? IIRC S-ketamine is less good than R-ketamine or racemic mixtures, but this is stuck in regulatory paperwork.
newbamboo 5y ago
Things go in cycles. LSD was a potential miracle drug but then it got a bad name due Leary et al. Ketamine will not make any pharmaceutical companies rich, therefore it will be a fad. Money matters, even moreso with mental health.
- bagacrap 5y ago
  have you checked out the prices for esketamine, the FDA-approved version? the markup is about 10000%.
  - Den-vr 5y ago
    The nasal spray? An anesthesiologist told me that it's 1/10th as effective as IV therapy due to some aspect of bioavailability and how it ultimately didn't produce the same sort of norketamine levels required. edit: For context, he subsequently complained of how big pharma was conspiring to destroy ketamine iv therapy access in order to better control the "legal ketamine" market.
    - GordonS 5y ago
      IV is not 10x more effective than intranasal - it's maybe twice as effective. IV bioavailability is 100%, intramuscular 93%, intranasal around 50%, and oral around 20%. This is something I just don't understand about IV ketamine therapy - IV protocols vary wildly, and I haven't been able to find any reasons why IV would be more effective than any other route of administration with an increased dose.
- pessimizer 5y ago
  Delivering ketamine will make a lot of people rich. It probably already has for a few people. Opening a depression clinic will simply involve having a bunch of rooms (or maybe just a bunch of chairs) for people to trip in, a nurse on duty, and a doctor somewhere on the letterhead. Medicare et al. will be charged hundreds an hour for each occupied room.
- augustuspolius 5y ago
ZanyProgrammer 5y ago
If I had a dollar for every HN story about how technically illegal drugs are being used for psychiatric purposes and we're just on the verge of them going mainstream and legal and licit, I could fund a bunch of YC startups.
- retrac 5y ago
  Esketamine isn't "technically illegal" or "on the verge". It has been approved by the FDA. It's available legally now.
- capableweb 5y ago
  Hard doubt. Searched for "mushroom", "psilocybin", "cannabis", "marijuana", "cocaine", "lsd", "ecstasy", "heroin", "ketamine" on HN search and in total came up with just ~4450 submissions in total, and I'm over-estimating by including just mentions of some illicit drugs, not just psychiatric purposes. I'd love to see you fund any startup with just ~5000 USD.
  - ZanyProgrammer 5y ago
    This is the most stereotypically perfect HN response ever.
    - capableweb 5y ago
      Thank you! I tried really hard, and seems I succeeded, I'm glad it worked.
  - starkd 5y ago
    - capableweb 5y ago
      You relax. I was only making the comment in jest. I guess low-quality comments spawn low-quality comments, and for that, I'm sorry.
bserge 5y ago
I have not been able to get ketamine, however I did find my cure for anxiety and depression (mostly). No SSRIs worked, I'm simply immune to that shit. It makes me feel worse, even more suicidal than usual, even if taken long term. And withdrawals ain't pretty. So, enter gabapentin and pregabalin. Which no doctors would prescribe as they're for those with epilepsy or something and I'm just a fucking idiot in their eyes. No matter, I can buy it freely right now. Both of them work on voltage gated calcium channels, something I do not fully understand. But I do understand they work, and they work well. As long as I take either, I'm chill, content and even creative. Doesn't help with attention/focus, but at least it works for the anxiety and depression. Apparently they're prescription only because a small percentage of people reported euphoric feelings. Damn narcs lol. Yes, when initially taken in high enough dosages, both gabapentin and pregabalin gave me very euphoric feelings, insane waves of energy, somewhat between alcohol and cannabis, really nice. However that subsided after several months and now it's only the quiet chill feeling. Withdrawal is fast, if you taper down over a week there are no effects. If you quit cold turkey, it's a few nights of nightmares or insomnia. Overall, really not bad compared to anything else. So yeah, they work, they work well and I wish doctors actually put their brains to use and made them more readily available. Just make them OTC because few people can put up with the regular begging they have to do for life changing medication.
neom 5y ago
Link to the Ketamine Erowid Vault: https://erowid.org/chemicals/ketamine/ketamine.shtml https://erowid.org/chemicals/ketamine/ketamine.shtml Trip reports: https://erowid.org/experiences/subs/exp_Ketamine.shtml https://erowid.org/experiences/subs/exp_Ketamine.shtml
- unixhero 5y ago
  There should be one report vault from psychiatrists reporting on treatment successes.
  - netizen-936824 5y ago
    I would love to read those! Sort of trip sitter reports but the sitter is a psychiatrist or neuropsychologist. That would be absolutely fascinating (of course with patient permission)
pessimizer 5y ago
Eventually, the consumption of all recreational drugs will be medicalized. Turns out that taking drugs makes you feel good, and that if you can keep taking them, you'll keep feeling good unless the body physically adopts, like with heroin. I always wondered why people took them. Medical ketamine for depression could potentially be an even greater windfall than methadone was. There are a lot more people that can be diagnosed as depressed than as heroin-addicted. I supposed this is all working towards massive state subsidy.
alkalizedis 5y ago
A close friend's startup has an oral alternative to Ketamine that hits a subset of the mechanisms in a more controlled fashion for this purpose. They are raising their first round of funding at around ~1,000,000 USD. If interested, please feel free to email me at the email in my profile.
ehPReth 5y ago
I asked my psychiatrist about this and he said he tried with a couple patients but didn’t see any long term results so didn’t want to put me on it. I was hopeful for a good fix but he says it’s not it? :/
- deleted 5y ago
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- capableweb 5y ago
  I've been through my fair deal of psychiatrists, and the best tip I can give you: if you're not happy with what your psychiatrist is doing with you, or with what help they are giving you, find another one. Repeat until you find someone who actually can help you improve. It might take many weeks to find someone you finally click with, but once you do, you'll improve a lot quicker than you thought was even possible.
  - belval 5y ago
    Considering the comment you are replying to, that amounts to just "shopping" for a psychiatrist that will prescribe you the treatment you want and not the one you need. I can 100% get behind the idea that you want to find a psychiatrist that understands you or that you "connect" with, but if your gripe with your current one is that he won't prescribe ketamine even though you read online that it might help, I'd say reassess.
    - leetcrew 5y ago
      especially with treatments for depression, where the state of the art is essentially "keep trying different drugs until one seems to work", it can be a fine line. the psychiatrist knows much more about the drugs than you do, but that doesn't give them much advantage in actually predicting which, if any, will work for you. at the end of the day, you go to psychiatrists to access pharmaceutical treatments for mental health issues. if the one you pick doesn't prescribe something that solves your problem, it's rational to either try another one or stop seeing psychiatrists.
    - 5y ago
pipeline_peak 5y ago
How do we know ketamine is physically harmless?
- narag 5y ago
  It's been used in emergency care for decades. It's one of the most used drugs and part of the basic kit in an ambulance or ER. It's safer than other anesthetics because it doesn't affect respiration so much.
  - pipeline_peak 5y ago
    As an anesthetic sure, but what about it's effect on the brain?
    - timbit42 5y ago
      Can make you feel loopy and nauseous depending on amount and how quickly it goes into your body. You should go back to feeling normal again after about 10 minutes after it stops coming in. (This is based on what a friend experienced when given it by a doctor.)
    - GordonS 5y ago
      This has been much studied. There have been a few recent papers showing brain lesions in very, very heavy recreational users, but otherwise it appears to be a very safe drug.
    - narag 5y ago
      The effect on the brain is that.. it's an anesthetic, not sure I follow you. Trying to guess what you mean: it isn't used as a local anesthetic, but always on the central nervous system, causing disociation in big dosis. For depression they use much less than that, so many decades with heavy dosage it's a very convincing safety record.
      - pipeline_peak 5y ago
        I meant as in any neurological impairment. Effects on cognitive functionality or memory retention. You know, the types of damage often reported over extended use of psychoactive drugs.
tonguez 5y ago
Ketamine is really interesting drug but let's be honest, the reason you're depressed is probably not because you haven't done enough ketamine. Yes it's fun to do drugs... Going to Six Flags with good friends would also probably make you less depressed for a couple of weeks. Why are we excited that now there's a way for rich people to do a fun drug in the most boring context possible? This feels like part 2 of microdosing LSD or psilocybin at your boring office job. Is ketamine going to make it less depressing that you work in ad-tech? Why not also microdose magic mushrooms as you work in ad-tech? Why not buy from your local farmer's market as you work in ad-tech? Why not volunteer for a local organization in your free time while you work in ad-tech? The problem is that you work in ad-tech. No amount of microdosing or macrodosing LSD or mushrooms or ketamine is going to change the fact that you probably have no social skills and your life work in ad-tech is meaningless, and having slightly more money than the average prole and being able to afford drugs they can't isn't going to make you happy.
- LocalH 5y ago
  >let's be honest I really dislike that phrase. It comes off as arrogant, condescending - dismissing the quite real change that these drugs can foster when used with a productive intention, in a proper setting. Not everyone uses various substances for "fun". Some people use them to understand their existence better, or do help combat debilitating mental constructs and experiences.
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throwaway599281 5y ago
Can't wait for regular people that have a few solvable issues in their life but perceive themselves as "depressed" to just take a shortcut where Ketamine, or whatever is the miracle drug at the moment, will fix everything. Many doctors won't have any problem prescribing them, as they can always say "it was <national drug institution> approved and the patient should stick to the prescribed dosage". What the vast majority of people need in their lives are discipline and sense of fulfilling, which they won't get from drugs or other material things they can buy.
- armatav 5y ago
  Ketamine is used to induct children into surgery it’s so safe. Depressed people cannot maintain the discipline required to undo their learned helplessness - which is burned into their neurons as structured physical loops. There are neuronal changes that cannot be rapidly modified without drugs that release BDNF, like infusion-levels of ketamine. In the time you aren’t treating your patient with the most effective systems, of which ketamine is one of them, they may do irreversible damage to themselves or others. All depression treatments should short-circuit to ketamine as a first line - the efficacy is incredible. The greatest issue with ketamine infusions is that they cost $800 per session.
  - throwaway599281 5y ago
    >Ketamine is used to induct children into surgery it’s so safe. Which is not the topic of the article, nor am I debating that fact. >Depressed people cannot maintain the discipline required to undo their learned helplessness Those deeply depressed people are not the ones I am mentioning in my comment. And as with any other serious disease, sometimes taking experimental treatments are worth the risk if more conventional treatments don't help patients improve. If I wasn't clear enough, I'm talking about people who think they are depressed but would most accurately be described as "sad", for any given reason that could be happening in their lives.
    - armatav 5y ago
      "Miracle drug" is a sidelining attempt to dismiss infusion therapy, your primary concern in your post is the patient's health - with recommendations to maintain discipline, which is usually done through a focused, repeated and consistent healthy activity - like running, or weightlifting - known positive recreational activities. Since your concern is for the patients health, and your recommendation is against the use of first line infusion therapy, and your alternative is a known positive recreational activity with the intent to build discipline; it is implied that you believe the infusion is not safe for the patients health in the particular circumstance of short-term sadness. You are not debating the fact, you are simply dismissing the efficacy of the infusion with regard to assisting patients undergoing "short-term sadness", and working around it when confronted. The mistake here is somehow believing that all patients can handle "short-term sadness" without undergoing a mental break; it is analytically correct to assault the issue on all available fronts, and if a small infusion dose assists someone in rectifying their issues, it should be done. The patients perception of their mental state becomes their mental state, which is why psychedelic drugs have such a high efficacy in the first place, the BDNF literally rewires their brain and how they view their issues. So what exactly is implied when you say "Can't wait for regular people that have a few solvable issues in their life but perceive themselves as "depressed" to just take a shortcut where Ketamine, or whatever is the miracle drug at the moment, will fix everything." - these issues are perhaps solvable for you because you would view it how you view their "short-term sadness". This is not the case, each patient is N = 1.
peanut_worm 5y ago
Does anyone know if Ketamine is more effective for depression than Psilocybin/classical psychedelics? Is it being used in place of psychedelics because it is already schedule 3 or is there a different reason?
- timbit42 5y ago
  I am not a doctor but I did some research on this a couple of months ago. I recommend you carefully do your own research and talk to qualified doctors, but here is what I found: Psilocybin is for depression, trauma, PTSD, addiction, coping with pain, and generalized anxiety disorder. One dose induced rapid growth of dendritic spine size by 10% and density by 10% in the frontal cortex within 24 hours and lasted at least one month (they didn't monitor beyond that). Depression is associated with synaptic atrophy in the frontal cortex. Ketamine is for major depressive disorder, bipolar disorder, obsessive compulsive disorder, and social anxiety disorder.

138 points by elsewhen 5y ago

I wonder how they address the urinary tract issues, especially the bladder. It's one thing when they use it for anesthesia, which is quite rare and sporadic to receive, compared to something like therapy, which might happen more frequently and for longer. Does anyone have any data about that?

dymk 5y ago
My understanding is that ketamine therapy doesn't involve many doses of ketamine over a long time, but rather a handful of guided sessions over weeks/months.
- Den-vr 5y ago
  The actual implementation of the therapy varies from place to place. In my locale, the treatment does not involve any guides. It's really unfortunate
johnisgood 5y ago
Urinary tract issues are not that common. They would have to pretty much take higher doses, long-term. It is not a concern as far as this therapy goes.
ParanoidShroom 5y ago
Last I heard about this in hard reduction groups, people experience this after 1-2 years of chronic daily usage. It's definitely something to keep an eye on. But people would be able to get through many sessions before being at risk. I'm more worried about people stop being able to afford it, going to black market and and up having a dependency.
Symmetry 5y ago
Apparently there's a big difference in the quantities of ketamine consumed by recreational users versus people who are prescribed it, 90 grams per month being common for recreation versus 300 mg for treatment. https://astralcodexten.substack.com/p/drug-users-use-a-lot-of-drugs https://astralcodexten.substack.com/p/drug-users-use-a-lot-o...
- thomashop 5y ago
  I know many heavy and moderate recreational ketamine users and 90g is completely absurd.the really heavy users I know go through a gram per day max. During parties or festivals it can be more. Not to say that there isn't a big difference to therapeutic use.
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- Honga 5y ago
  I think it's worth reevaluating the word 'recreational' here. Except for festivals, or longer parties as someone already mentioned 300mg is an enormous amount to consume in one sitting, especially without a good understanding. 90g per month seems quite unsafe.
  - GordonS 5y ago
    You could k-hole every night for a month IM'ing 100mg, and that'd still only be 3,000mg. 30 grams of ketamine is an absolutely crazy amount.
- Scoundreller 5y ago
  If I do the math right, that’s like $5k/month or more. I doubt many recreational users consume that much. Not for long anyway.
loeg 5y ago
The urinary issues are in people using 100-200x the ketamine you might use even in regular therapy. https://astralcodexten.substack.com/p/drug-users-use-a-lot-of-drugs https://astralcodexten.substack.com/p/drug-users-use-a-lot-o...
Jerrrry 5y ago
Too bad the world's first "synthetic" to combat this issue, MXE, was made illegal. It has no bladder problems, and shines light where ketamine is cold. MXE is the perfect drug. 5g in a few months, stopped cold turkey, felt fine - due to the long lasting and dissipating metabolites that these drugs degrade into. I am planning on getting some Ketamine soon for my own Christmas present. Too bad I can't have MXE, which is safer, better, and fuckn awesome. you can even smoke it! (very small amounts. makes you feel like a golden greek god)
- samatman 5y ago
  Those were the days my friend. We thought they would never end...
  - Jerrrry 5y ago
    I busted out the 3-MEO-PCP that I had literally buried - at the time, I had thought it was too manic, to schizophrenic. 10 day regime of a small bump for breakfast had be happy for weeks. do drugs, people
    - samatman 5y ago
      not too much. mostly plants
- goldcountry 5y ago
  If you know where to look on the dark web, MXE can occasionally still be found. The fine folks over at Lizard Labs in NL have also developed DMXE, which is apparently qualitatively nearly identical, though I have yet to be able to acquire any in the US.
  - Jerrrry 5y ago
    I searched for weeks for a domestic Lizard Labs reseller, no luck. I don't do custom, especially from NL. Good to know they are still around! May look into their new new new novel lysergamides.

andrewfromx 5y ago

for those in the LA area: https://www.revitalifemedicalcenter.com/ketamine-therapy https://www.revitalifemedicalcenter.com/ketamine-therapy

andrewfromx 5y ago
my review of Dr. Vu K therapy: You are lead into a room with a very comfortable chair, amazing head phones, great relaxing music, think first class airline seat but without being in an airplane. A nurse comes in and injects the K into your arm muscle (not a vein) and within seconds you feel the effect. Soon you forget all about how nervous you were coming to this office or worrying about urinary track issues, worrying about anything at all. For about an hour you are in this wonderful state. The nurse comes in to check on you every so often. I can barely speak but I'm able to give a thumbs up and mumble "yes yes doing great." The end reminds me of that Guns n' roses song, "when you're high you never, wanna come down..." But even after the hour is over and you can walk again and you are safe to drive, you are very happy the rest of the day. I will say Dr. Vu sells a lot of other stuff besides K shots so be careful what you agree to. It can get very expensive! But overall I think it's a wonderful service he is offering.
- GordonS 5y ago
  Hmm, I've read a lot about ketamine infusions, and I don't think I've ever come across them delivering it via the intramuscular route before. Was it just a single injection, and do you know how many mg? I thought the whole point was to keep plasma levels high for a long time. Anyone with access to a vial of ketamine could easily perform a single IM injection at home without paying thousands of dollars for the privilege.
  - andrewfromx 5y ago
    The dosage can vary by patient. I got 30mg.
    - GordonS 5y ago

Overtonwindow 5y ago

Psilocybin may have saved my life, after a lifetime of PTSD. It threw off the “wet blanket” that had enveloped me for decades. At this point in my medical history, I’ve tried just about everything else, what have I got to lose?

Den-vr 5y ago
Did you get any assistance from insurance?
- Overtonwindow 5y ago
  HA! None. Fortunately where I live psychedelics have been decriminalized, so I was able to get some shrooms from a reliable source.
MobileVet 5y ago
I have been monitoring this research for years as it could be potentially life changing for a family member. I am so happy your blanket was lifted. I am curious, was your comment about trying Ketamine just a general nod or are you seriously considering it? Much of what I have read indicates psilocybin has a more long term and profound affect vs ketamine, are you still looking for further improvements?
- Overtonwindow 5y ago
  I am seriously considering it. I found can get ketamine therapy here but it's upwards of $400 per dose, needing multiple doses, and not covered by insurance. With the psilocybin, I confess it was just shrooms eaten with a bottle of water. Not tasty. What I experienced was nothing short of profound. About an hour after swallowing four grams I started feeling giggly, and happy. I looked at old photos of my cat that died some years back, and she started to pulse slightly and seemed to move almost in the photo, but that was the extent of the hallucinations. It's what happened next that changed everything. I remember drinking some water and then going to lay in the bed. My brain started thinking about a very depressive episode that happened to me this year. I thought through it, specifically what it meant for my life, friendships, etc. This is something that would have left me crying in a dark bathroom in the middle of the night before, but this time, it didn't. I didn't feel the usual guilt, embarrassment, and humiliation about my past mistakes. The best way I can describe it is this: I was walking alongside my depression, having a conversation with it, and at some point, my depression stopped and I kept walking. It was a sudden realization of "wow, that ..isn't making me depressed, or feel guilty, humiliated, etc. !" About three hours after consuming the shrooms I came out of it and looked around my bedroom as if I was a different person; "holy crap this place is a mess!" I went downstairs and finally did the stack of dishes in the sink, put away the laundry, and spent hours just cleaning joyfully. I was able to process considerable trauma that night, and my therapist said a few days later that I was a total 180 degrees from where I had been the week before. We've been very careful to monitor to make sure it's not just a manic episode. The positive has kept up. I've had a few down days, but that's mostly due to anxiety and relationship issues, which a little marijuana helps considerably. Overall these past four months have been some of the best of my life. I wake up with a forward outlook. I can sleep easier, thoughts are no longer dwelling on me. I don't feel this weight on top of me, reminding me of my failures, fears, etc. Above all, I just don't feel like a sad sack all the time. I've taken maybe two dozen medications in my life for anxiety, depression, and PTSD. Nothing can hold a candle to the immediate, calming effects of marijuana, but nothing has also come even close to the sheer relief from the shrooms. Edit: Grammar and clarified a few things.

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IceWreck 5y ago

Ketamine ? Is it that thing Yoda takes to get drunk ?

dymk 5y ago
Specifically, to go drive his Honda Civic on
- BeFlatXIII 5y ago
  And to think that I thought it was only for horses all this time
deleted 5y ago
[deleted]

Den-vr 5y ago

My wife went through the therapy. Three days a week for two weeks. It was hell, she changed as a person. There was a lot more expression of anger, she described it like having gasoline poured into her veins when they were already on fire. But, a month later, she was able to interact with her family members again. Without PTSD triggering for the first time in years. It really reduced the control PTSD had over her life. I'm not sure if it was worth it though.

whalesalad 5y ago
Part of the healing process for people who’ve suffered through trauma is releasing all of that energy out of the body. It’s very common to go through big up/down swings during this process.
- actually_a_dog 5y ago
  Most definitely. I'm going through some of this with therapeutic MDMA use for my PTSD. It's definitely been a journey, and not always a pleasant one, but, I believe I'm better off now after a few sessions than when I started.
  - gavinray 5y ago
    Do you mean you've been approved/are able to get clinically administered MDMA taken with a therapist -- or is this self-administered? I had similar very positive + life-changing experiences from taking MDMA but it wasn't clinical.
    - augustuspolius 5y ago
      I was trying to find a legal MDMA assisted therapy recently but apparently it’s still illegal outside of clinical trials.
    - actually_a_dog 5y ago
      Self administered, unfortunately. I do have a therapist with whom I discuss things related to the sessions, but he's not directly involved. Also unfortunately, I'm about out of the drug, and will soon need to either try and find a reliable source, or call it quits on this particular treatment avenue.

JohnTHaller 5y ago

Ketamine therapy is fantastic. It saved the life of a close friend. And greatly helped another. It helps to find a reputable provider and pair it with good therapy. One friend found a provider that paired it with a therapy session part way through which helped him a lot. These were all with depression therapy, though I've heard from the providers that it's amazing with PTSD.

helloworld653 5y ago

Can anyone share their experience consuming Lithium Orotate? Years ago I remembered reading this article - https://www.nytimes.com/2015/06/28/magazine/i-dont-believe-in-god-but-i-believe-in-lithium.html https://www.nytimes.com/2015/06/28/magazine/i-dont-believe-i... The one compound I've used (on and off, for maybe a few weeks at a time over the past 18 years) intermittently is Clonazepam. Recently however I don't find the dosage to be very effective, and reading the literature, upping benzo dosage has a high risk of increased dependency. I'd like to avoid that. I happened to randomly start Googling about Lithium and stumbled upon Lithium Orotate, which is sold as a supplement pretty much everywhere. There's a little bit of literature on Pubmed, but not much. I bought this - https://www.amazon.com/gp/product/B00PB4II68/ref=ppx_yo_dt_b_asin_title_o00_s00?ie=UTF8&psc=1 https://www.amazon.com/gp/product/B00PB4II68/ref=ppx_yo_dt_b... And it arrives on Friday. The reviews on this and other Lithium Orotate seem almost too good to be true, but for $10, I'm willing to give it a shot.

jacobmartin 5y ago
I can't say anything about low-dose lithium so I'm sorry if this is out of scope. I did however take 600mg daily of Lithium Carbonate for a long time and it really helped me with my anxiety, and, importantly, it reduced my suicidal thoughts/self harm urges to basically zero from multiple times a day. This isn't as low as the doses people seem to use with Orotate, but it's still "subclinical".
mannanj 5y ago
I tried this for a short time. Hard to recall the affect on me, I don't feel depressed any longer so safe to say it probably worked. I'd say the bigger impact on me was def. psychedelics though.
scoopertrooper 5y ago
I’ve known people that took lithium for bipolar. It’s not a drug I’d recommend taking without professional supervision. Its side effects can include personality disassociation, weight gain, and memory loss. The people that I knew fought tooth and nail to get off it. Obviously, the effects will differ between people, but best to go into things with your eyes open and a professional to supervise things.

whalesalad 5y ago

Before you go spending thousands of dollars on ketamine infusions I urge you to do two things: 1. read Michael Pollan’s book, How to Change Your Mind 2. Look into the process of cultivating your own mushrooms at home - it’s ultimately very easy to produce your own medicine

after_care 5y ago
Clearly ketamine infusions are about being legal and all the benefits of doing business out in the open. Anyone could buy illicit ketamine for 1/50th the cost and administer at home, but that is a felony.
- whalesalad 5y ago
  Ketamine is not a psychedelic.
  - nisegami 5y ago
    I think GP commenter was replying to your remark that ketamine infusions cost thousands of dollars, not your remark about mushrooms.
  - deleted 5y ago
    [deleted]
  - Jerrrry 5y ago
    have you ever k-holed? Nitrous is also a dissociative, with psychedelic properties. Alcohol can even push this boundary.
- samatman 5y ago
  It is in fact a misdemeanour, within the US at least, outside of the most benighted states.
  - after_care 5y ago
    Some states allow for small amounts of ketamine to be a misdemeanor, but for many (most?) it’s a felony. In Texas and Florida, the second and third most populous states, possession of any amount of Ketamine is a felony.

tehjoker 5y ago

Fun to read trip reports in The New Yorker

ajay-d 5y ago

another recent experience https://www.nytimes.com/2021/12/26/opinion/depression-ketamine.html https://www.nytimes.com/2021/12/26/opinion/depression-ketami...

hprotagonist 5y ago

what's the current state of the enantiomer disparities? IIRC S-ketamine is less good than R-ketamine or racemic mixtures, but this is stuck in regulatory paperwork.

newbamboo 5y ago

Things go in cycles. LSD was a potential miracle drug but then it got a bad name due Leary et al. Ketamine will not make any pharmaceutical companies rich, therefore it will be a fad. Money matters, even moreso with mental health.

bagacrap 5y ago
have you checked out the prices for esketamine, the FDA-approved version? the markup is about 10000%.
- Den-vr 5y ago
  The nasal spray? An anesthesiologist told me that it's 1/10th as effective as IV therapy due to some aspect of bioavailability and how it ultimately didn't produce the same sort of norketamine levels required. edit: For context, he subsequently complained of how big pharma was conspiring to destroy ketamine iv therapy access in order to better control the "legal ketamine" market.
  - GordonS 5y ago
    IV is not 10x more effective than intranasal - it's maybe twice as effective. IV bioavailability is 100%, intramuscular 93%, intranasal around 50%, and oral around 20%. This is something I just don't understand about IV ketamine therapy - IV protocols vary wildly, and I haven't been able to find any reasons why IV would be more effective than any other route of administration with an increased dose.
pessimizer 5y ago
Delivering ketamine will make a lot of people rich. It probably already has for a few people. Opening a depression clinic will simply involve having a bunch of rooms (or maybe just a bunch of chairs) for people to trip in, a nurse on duty, and a doctor somewhere on the letterhead. Medicare et al. will be charged hundreds an hour for each occupied room.
augustuspolius 5y ago

ZanyProgrammer 5y ago

If I had a dollar for every HN story about how technically illegal drugs are being used for psychiatric purposes and we're just on the verge of them going mainstream and legal and licit, I could fund a bunch of YC startups.

retrac 5y ago
Esketamine isn't "technically illegal" or "on the verge". It has been approved by the FDA. It's available legally now.
capableweb 5y ago
Hard doubt. Searched for "mushroom", "psilocybin", "cannabis", "marijuana", "cocaine", "lsd", "ecstasy", "heroin", "ketamine" on HN search and in total came up with just ~4450 submissions in total, and I'm over-estimating by including just mentions of some illicit drugs, not just psychiatric purposes. I'd love to see you fund any startup with just ~5000 USD.
- ZanyProgrammer 5y ago
  This is the most stereotypically perfect HN response ever.
  - capableweb 5y ago
    Thank you! I tried really hard, and seems I succeeded, I'm glad it worked.
- starkd 5y ago
  - capableweb 5y ago
    You relax. I was only making the comment in jest. I guess low-quality comments spawn low-quality comments, and for that, I'm sorry.

bserge 5y ago

I have not been able to get ketamine, however I did find my cure for anxiety and depression (mostly). No SSRIs worked, I'm simply immune to that shit. It makes me feel worse, even more suicidal than usual, even if taken long term. And withdrawals ain't pretty. So, enter gabapentin and pregabalin. Which no doctors would prescribe as they're for those with epilepsy or something and I'm just a fucking idiot in their eyes. No matter, I can buy it freely right now. Both of them work on voltage gated calcium channels, something I do not fully understand. But I do understand they work, and they work well. As long as I take either, I'm chill, content and even creative. Doesn't help with attention/focus, but at least it works for the anxiety and depression. Apparently they're prescription only because a small percentage of people reported euphoric feelings. Damn narcs lol. Yes, when initially taken in high enough dosages, both gabapentin and pregabalin gave me very euphoric feelings, insane waves of energy, somewhat between alcohol and cannabis, really nice. However that subsided after several months and now it's only the quiet chill feeling. Withdrawal is fast, if you taper down over a week there are no effects. If you quit cold turkey, it's a few nights of nightmares or insomnia. Overall, really not bad compared to anything else. So yeah, they work, they work well and I wish doctors actually put their brains to use and made them more readily available. Just make them OTC because few people can put up with the regular begging they have to do for life changing medication.

neom 5y ago

Link to the Ketamine Erowid Vault: https://erowid.org/chemicals/ketamine/ketamine.shtml https://erowid.org/chemicals/ketamine/ketamine.shtml Trip reports: https://erowid.org/experiences/subs/exp_Ketamine.shtml https://erowid.org/experiences/subs/exp_Ketamine.shtml

unixhero 5y ago
There should be one report vault from psychiatrists reporting on treatment successes.
- netizen-936824 5y ago
  I would love to read those! Sort of trip sitter reports but the sitter is a psychiatrist or neuropsychologist. That would be absolutely fascinating (of course with patient permission)

pessimizer 5y ago

Eventually, the consumption of all recreational drugs will be medicalized. Turns out that taking drugs makes you feel good, and that if you can keep taking them, you'll keep feeling good unless the body physically adopts, like with heroin. I always wondered why people took them. Medical ketamine for depression could potentially be an even greater windfall than methadone was. There are a lot more people that can be diagnosed as depressed than as heroin-addicted. I supposed this is all working towards massive state subsidy.

alkalizedis 5y ago

A close friend's startup has an oral alternative to Ketamine that hits a subset of the mechanisms in a more controlled fashion for this purpose. They are raising their first round of funding at around ~1,000,000 USD. If interested, please feel free to email me at the email in my profile.

ehPReth 5y ago

I asked my psychiatrist about this and he said he tried with a couple patients but didn’t see any long term results so didn’t want to put me on it. I was hopeful for a good fix but he says it’s not it? :/

deleted 5y ago
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capableweb 5y ago
I've been through my fair deal of psychiatrists, and the best tip I can give you: if you're not happy with what your psychiatrist is doing with you, or with what help they are giving you, find another one. Repeat until you find someone who actually can help you improve. It might take many weeks to find someone you finally click with, but once you do, you'll improve a lot quicker than you thought was even possible.
- belval 5y ago
  Considering the comment you are replying to, that amounts to just "shopping" for a psychiatrist that will prescribe you the treatment you want and not the one you need. I can 100% get behind the idea that you want to find a psychiatrist that understands you or that you "connect" with, but if your gripe with your current one is that he won't prescribe ketamine even though you read online that it might help, I'd say reassess.
  - leetcrew 5y ago
    especially with treatments for depression, where the state of the art is essentially "keep trying different drugs until one seems to work", it can be a fine line. the psychiatrist knows much more about the drugs than you do, but that doesn't give them much advantage in actually predicting which, if any, will work for you. at the end of the day, you go to psychiatrists to access pharmaceutical treatments for mental health issues. if the one you pick doesn't prescribe something that solves your problem, it's rational to either try another one or stop seeing psychiatrists.
  - 5y ago

pipeline_peak 5y ago

How do we know ketamine is physically harmless?

narag 5y ago
It's been used in emergency care for decades. It's one of the most used drugs and part of the basic kit in an ambulance or ER. It's safer than other anesthetics because it doesn't affect respiration so much.
- pipeline_peak 5y ago
  As an anesthetic sure, but what about it's effect on the brain?
  - timbit42 5y ago
    Can make you feel loopy and nauseous depending on amount and how quickly it goes into your body. You should go back to feeling normal again after about 10 minutes after it stops coming in. (This is based on what a friend experienced when given it by a doctor.)
  - GordonS 5y ago
    This has been much studied. There have been a few recent papers showing brain lesions in very, very heavy recreational users, but otherwise it appears to be a very safe drug.
  - narag 5y ago
    The effect on the brain is that.. it's an anesthetic, not sure I follow you. Trying to guess what you mean: it isn't used as a local anesthetic, but always on the central nervous system, causing disociation in big dosis. For depression they use much less than that, so many decades with heavy dosage it's a very convincing safety record.
    - pipeline_peak 5y ago
      I meant as in any neurological impairment. Effects on cognitive functionality or memory retention. You know, the types of damage often reported over extended use of psychoactive drugs.

tonguez 5y ago

Ketamine is really interesting drug but let's be honest, the reason you're depressed is probably not because you haven't done enough ketamine. Yes it's fun to do drugs... Going to Six Flags with good friends would also probably make you less depressed for a couple of weeks. Why are we excited that now there's a way for rich people to do a fun drug in the most boring context possible? This feels like part 2 of microdosing LSD or psilocybin at your boring office job. Is ketamine going to make it less depressing that you work in ad-tech? Why not also microdose magic mushrooms as you work in ad-tech? Why not buy from your local farmer's market as you work in ad-tech? Why not volunteer for a local organization in your free time while you work in ad-tech? The problem is that you work in ad-tech. No amount of microdosing or macrodosing LSD or mushrooms or ketamine is going to change the fact that you probably have no social skills and your life work in ad-tech is meaningless, and having slightly more money than the average prole and being able to afford drugs they can't isn't going to make you happy.

LocalH 5y ago
>let's be honest I really dislike that phrase. It comes off as arrogant, condescending - dismissing the quite real change that these drugs can foster when used with a productive intention, in a proper setting. Not everyone uses various substances for "fun". Some people use them to understand their existence better, or do help combat debilitating mental constructs and experiences.

deleted 5y ago

[deleted]

throwaway599281 5y ago

Can't wait for regular people that have a few solvable issues in their life but perceive themselves as "depressed" to just take a shortcut where Ketamine, or whatever is the miracle drug at the moment, will fix everything. Many doctors won't have any problem prescribing them, as they can always say "it was <national drug institution> approved and the patient should stick to the prescribed dosage". What the vast majority of people need in their lives are discipline and sense of fulfilling, which they won't get from drugs or other material things they can buy.

armatav 5y ago
Ketamine is used to induct children into surgery it’s so safe. Depressed people cannot maintain the discipline required to undo their learned helplessness - which is burned into their neurons as structured physical loops. There are neuronal changes that cannot be rapidly modified without drugs that release BDNF, like infusion-levels of ketamine. In the time you aren’t treating your patient with the most effective systems, of which ketamine is one of them, they may do irreversible damage to themselves or others. All depression treatments should short-circuit to ketamine as a first line - the efficacy is incredible. The greatest issue with ketamine infusions is that they cost $800 per session.
- throwaway599281 5y ago
  >Ketamine is used to induct children into surgery it’s so safe. Which is not the topic of the article, nor am I debating that fact. >Depressed people cannot maintain the discipline required to undo their learned helplessness Those deeply depressed people are not the ones I am mentioning in my comment. And as with any other serious disease, sometimes taking experimental treatments are worth the risk if more conventional treatments don't help patients improve. If I wasn't clear enough, I'm talking about people who think they are depressed but would most accurately be described as "sad", for any given reason that could be happening in their lives.
  - armatav 5y ago
    "Miracle drug" is a sidelining attempt to dismiss infusion therapy, your primary concern in your post is the patient's health - with recommendations to maintain discipline, which is usually done through a focused, repeated and consistent healthy activity - like running, or weightlifting - known positive recreational activities. Since your concern is for the patients health, and your recommendation is against the use of first line infusion therapy, and your alternative is a known positive recreational activity with the intent to build discipline; it is implied that you believe the infusion is not safe for the patients health in the particular circumstance of short-term sadness. You are not debating the fact, you are simply dismissing the efficacy of the infusion with regard to assisting patients undergoing "short-term sadness", and working around it when confronted. The mistake here is somehow believing that all patients can handle "short-term sadness" without undergoing a mental break; it is analytically correct to assault the issue on all available fronts, and if a small infusion dose assists someone in rectifying their issues, it should be done. The patients perception of their mental state becomes their mental state, which is why psychedelic drugs have such a high efficacy in the first place, the BDNF literally rewires their brain and how they view their issues. So what exactly is implied when you say "Can't wait for regular people that have a few solvable issues in their life but perceive themselves as "depressed" to just take a shortcut where Ketamine, or whatever is the miracle drug at the moment, will fix everything." - these issues are perhaps solvable for you because you would view it how you view their "short-term sadness". This is not the case, each patient is N = 1.

peanut_worm 5y ago

Does anyone know if Ketamine is more effective for depression than Psilocybin/classical psychedelics? Is it being used in place of psychedelics because it is already schedule 3 or is there a different reason?

timbit42 5y ago
I am not a doctor but I did some research on this a couple of months ago. I recommend you carefully do your own research and talk to qualified doctors, but here is what I found: Psilocybin is for depression, trauma, PTSD, addiction, coping with pain, and generalized anxiety disorder. One dose induced rapid growth of dendritic spine size by 10% and density by 10% in the frontal cortex within 24 hours and lasted at least one month (they didn't monitor beyond that). Depression is associated with synaptic atrophy in the frontal cortex. Ketamine is for major depressive disorder, bipolar disorder, obsessive compulsive disorder, and social anxiety disorder.