8 ms·

After dealing with depression myself, I dove deeply into this world, and actually ended up founding a ketamine and esketamine treatment startup in the Boston ar

After dealing with depression myself, I dove deeply into this world, and actually ended up founding a ketamine and esketamine treatment startup in the Boston area (lumin.health). We've seen pretty amazing results with patients who have otherwise failed antidepressants and/or ECT and TMS (Transcranial Magnetic Stimulation). The reality is that ketamine/esketamine are much more accessible from a patient perspective, and while considered "new" by many in the medical community, offer faster results and carry less stigma for patients than ECT in particular. If ketamine/esketamine don't work, patients typically know within 2-3 sessions, and can walk away with no long term side effects. With ECT, patients generally have to complete a whole course before they see effect, and then are stuck with some of the potential mid/long-term side effects. The space is also at the precipice of a whole new class of psychedelics coming online - MDMA, psilocybin, and more are all 1-5 years out (working through FDA drug trials), and hold promise of both faster results (versus 6-8 months of trialing traditional antidepressants) and fewer downside risks (versus weight gain, sex drive, etc. issues with antidepressants and memory loss, headaches, etc. with ECT and TMS). Bottom line, if you're suffering and considering those treatments, I highly recommend finding a local center and at least learning more about options available to you. Edit: If anyone wants to talk, advice, etc., email is in my profile.

boredtofears 4y ago
One rumination I have had about the medical application of psychedelics is to wonder how lasting the effects of all these initial studies will be over the long term. The effects of psychedelics are profound to a person who hasn't experienced them, which is the vast majority of people today. I think, when a person goes through a powerful experience they've never had, it makes them a lot more suggestive, which in turn makes therapies more effective. Will this still be the case if psychedelics usage is normalized? When a person knows what to expect out of the drug will they still remain as suggestible to therapy? My own experience with psychedelics tells me no: once you become familiar with the effects the "high" loses some of it's properties that make it a useful tool for introspection. I haven't done psychedelics in a purely therapeutic setting so there may be something to my observation that I'm missing completely.
- sneak 4y ago
  Ketamine’s effects on depression are not caused by the hallucinations or psychedelic effects. I can’t speak to other hallucinogens but I would imagine the situation is the same there. The day after an acid trip isn’t a new neurochemical environment because of the powerful hallucinations the day before, it is something else. > My own experience with psychedelics tells me no: once you become familiar with the effects the "high" loses some of it's properties that make it a useful tool for introspection. My own experiences run directly counter to this assertion.
  - boredtofears 4y ago
    > The day after an acid trip isn’t a new neurochemical environment because of the powerful hallucinations the day before, it is something else What is a "new neurochemical environment" exactly? I've had many acid comedowns, and they have all been affected by how the high was - emotionally, mentally, and physically. What do you mean by "its something else"?
    - tekknik 4y ago
      I’m far from an expert here, but as I understand it there is no repeated, or daily dose of the psilocybin. Instead it physically changes your brain. Here’s one study: https://www.mdpi.com/1422-0067/22/2/835/htm https://www.mdpi.com/1422-0067/22/2/835/htm
    - novok 4y ago
      IMO I think it is still a new neurochemical environment, much like how the body is different after intense exercise for the next few days, as it recovers. It gets sore, weaker, etc. There is definitely a training & depletion effect for the brain.
tomcam 4y ago
Thank you. Any help for insomnia or overeating?
- sshine 4y ago
  Insomnia: Have you heard Andrew Huberman’s podcast episode on sleep? https://hubermanlab.com/sleep-toolkit-tools-for-optimizing-sleep-and-sleep-wake-timing/ https://hubermanlab.com/sleep-toolkit-tools-for-optimizing-s... There are so many small things you can do, and they get summarised here. Drugs are just one dimension.
  - tomcam 4y ago
    Thanks . Love Huberman. Done almost everything to no avail! One thing I haven’t done is sauna and I just got one.
- joelrunyon 4y ago
  If you're struggling with sleep and "turning the lights off" around bed time - we made a custom natural sleep product for high performers focused on quality, restful sleep - https://impossible.co/products/sleep https://impossible.co/products/sleep Shoot me a DM if you want to try it out - happy to send one your way.
  - victor106 4y ago
    > Why Melatonin is Bad For You (coming soon). I am curious to read why this is bad. My doc thinks this is perfectly fine
    - KMnO4 4y ago
      Going out on a limb here, but I’m assuming it’s meant to be “why [exogenous] melatonin is bad for you”. Melatonin is naturally secreted by the pineal gland, which like other hormones gets downregulated when taken exogenously over long periods of time. There’s also studies showing a downregulation in dopamine and seratonin with long term use of melatonin.
bergenty 4y ago
What about developing a system that people can use to administer ECT to themselves. Obviously it will have to be sold as something else.
- waste_monk 4y ago
  As I understand ECT is basically just having a seizure while under some heavy-duty muscle relaxants and/or general anaesthetic (?), so you don't flail around and hurt yourself. Seems way too dangerous for home use.

boredtofears 4y ago

One rumination I have had about the medical application of psychedelics is to wonder how lasting the effects of all these initial studies will be over the long term. The effects of psychedelics are profound to a person who hasn't experienced them, which is the vast majority of people today. I think, when a person goes through a powerful experience they've never had, it makes them a lot more suggestive, which in turn makes therapies more effective. Will this still be the case if psychedelics usage is normalized? When a person knows what to expect out of the drug will they still remain as suggestible to therapy? My own experience with psychedelics tells me no: once you become familiar with the effects the "high" loses some of it's properties that make it a useful tool for introspection. I haven't done psychedelics in a purely therapeutic setting so there may be something to my observation that I'm missing completely.

sneak 4y ago
Ketamine’s effects on depression are not caused by the hallucinations or psychedelic effects. I can’t speak to other hallucinogens but I would imagine the situation is the same there. The day after an acid trip isn’t a new neurochemical environment because of the powerful hallucinations the day before, it is something else. > My own experience with psychedelics tells me no: once you become familiar with the effects the "high" loses some of it's properties that make it a useful tool for introspection. My own experiences run directly counter to this assertion.
- boredtofears 4y ago
  > The day after an acid trip isn’t a new neurochemical environment because of the powerful hallucinations the day before, it is something else What is a "new neurochemical environment" exactly? I've had many acid comedowns, and they have all been affected by how the high was - emotionally, mentally, and physically. What do you mean by "its something else"?
  - tekknik 4y ago
    I’m far from an expert here, but as I understand it there is no repeated, or daily dose of the psilocybin. Instead it physically changes your brain. Here’s one study: https://www.mdpi.com/1422-0067/22/2/835/htm https://www.mdpi.com/1422-0067/22/2/835/htm
  - novok 4y ago
    IMO I think it is still a new neurochemical environment, much like how the body is different after intense exercise for the next few days, as it recovers. It gets sore, weaker, etc. There is definitely a training & depletion effect for the brain.

tomcam 4y ago

Thank you. Any help for insomnia or overeating?

sshine 4y ago
Insomnia: Have you heard Andrew Huberman’s podcast episode on sleep? https://hubermanlab.com/sleep-toolkit-tools-for-optimizing-sleep-and-sleep-wake-timing/ https://hubermanlab.com/sleep-toolkit-tools-for-optimizing-s... There are so many small things you can do, and they get summarised here. Drugs are just one dimension.
- tomcam 4y ago
  Thanks . Love Huberman. Done almost everything to no avail! One thing I haven’t done is sauna and I just got one.
joelrunyon 4y ago
If you're struggling with sleep and "turning the lights off" around bed time - we made a custom natural sleep product for high performers focused on quality, restful sleep - https://impossible.co/products/sleep https://impossible.co/products/sleep Shoot me a DM if you want to try it out - happy to send one your way.
- victor106 4y ago
  > Why Melatonin is Bad For You (coming soon). I am curious to read why this is bad. My doc thinks this is perfectly fine
  - KMnO4 4y ago
    Going out on a limb here, but I’m assuming it’s meant to be “why [exogenous] melatonin is bad for you”. Melatonin is naturally secreted by the pineal gland, which like other hormones gets downregulated when taken exogenously over long periods of time. There’s also studies showing a downregulation in dopamine and seratonin with long term use of melatonin.

bergenty 4y ago

What about developing a system that people can use to administer ECT to themselves. Obviously it will have to be sold as something else.

waste_monk 4y ago
As I understand ECT is basically just having a seizure while under some heavy-duty muscle relaxants and/or general anaesthetic (?), so you don't flail around and hurt yourself. Seems way too dangerous for home use.