7 ms·

Amygdala connectivity predicts ketamine treatment response

68 points by whack 4y ago

jokowueu 4y ago
Quite interesting . I have tried ketamine for my PTSD and hasn't worked but stellate gangelion block worked perfectly after just one session .
- cl0ckt0wer 4y ago
  How long has it worked for? I googled the procedure and it seems like it's an injection of "anesthetic" to a nerve in the neck. Is that what you're talking about?
  - jokowueu 4y ago
    Yes it is . The procedure wasn't really painful just uncomfortable and took about 20 minutes. I did it about 3 months ago I can't recall exactly. I was able to find a head and neck doctor that agreed to do it and did it for about 800$. 60 minutes made an episode about it that's when I first knew I had to try it There are 3 sites that they generally target but I just did right C6 .
    - bobmaxup 4y ago
      Do you plan on repeating it?
      - jokowueu 4y ago
        You generally repeat it if your symptoms come back . If it does then ya for sure
snapcaster 4y ago
This is really cool, I think there is a huge opportunity for analysis like this to allow drugs that are currently off market because some small percentage have bad side effects but it works for others. If we can start knowing who drugs will work for and who they won't it could be a game changer for our existing drugs, let alone what we can create in the future
jonnycomputer 4y ago
Ketamine has turned out to be a pretty effective treatment for episodes of severe depression, particularly when there is a risk of suicide; one reason is that it starts having an effect in hours instead of days or weeks like SSRIs do. See Jessica Gilbert's work over at NIH [1]. One of the big focuses of clinical neuroscience is to find features in the brain that will predict treatment responses (to cognitive behavioral therapy, anti-depressants, and so on). The amygdala is, as is generally known, strongly associated with fear responses, or other negative emotional responses. The subgenual cingulate cortex has been associated with emotion regulation (e.g. down-regulating responses to negative stimuli). I believe that other treatment-prediction studies have found that connectivity between the subgenual cingulate and other brain regions like the amygdala predict treatment responses, so, their result is pretty consistent with the literature as far as I understand. 1. https://scholar.google.com/citations?user=bSXKfxkAAAAJ&hl=en&oi=sra https://scholar.google.com/citations?user=bSXKfxkAAAAJ&hl=en...
- bheadmaster 4y ago
  This sounds really promising, but one thing that worries me is that ketamine is a sort-of painkiller (dissociative anesthetic). When heroin was first discovered, it was hailed as a wonder-drug, and it was also considered an effective treatment for severe depression. However, after some time, people realized that its addictive properties and high range of potential tolerance make it backfire pretty badly after a certain amount of (ab)use. Can we be sure that a similar thing won't happen with ketamine?
  - jonnycomputer 4y ago
    Good question. Ketamine has been a party drug for quite a while now, and as far as I know, hasn't been shown to be particularly dependency-inducing, though low-dose ketamine over the long term might be (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236511/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236511/) Also, as far as I know, ketamine treatment isn't intended as an ongoing medication, like an SSRI, but as a treatment for acute episodes of depression. I might be wrong about that; webmd says, "For treatment-resistant depression, patients usually get the nasal spray twice a week for 1 to 4 weeks; then once a week for weeks 5 to 9; and then once every week or 2 after that." However, the use-cases I know about (from talking to researchers studying it) is as an intervention to prevent suicide during severe depression (since it's relatively fast acting). As always, its a cost-benefit calculation, that should be carefully made in consultation with a professional. The cost of severe depression can be quite high.
programmarchy 4y ago
- zer0tonin 4y ago
  Ketamine is one of the most widely used emergency anesthetic for humans and has been approved for that use for decades. Ketamine use as an anti-depressant has been approved by the FDA for 3 years now. It is also part of the WHO list of essential medicines.
- kallistisoft 4y ago
  Ketamine is on the World Health Organization's list of essential medicines and is a primary anesthetic for infants, geriatric patients, and large areas of the developing world where access to general anesthetics is limited. It's also the field anesthetic of choice for situations where a patient has unknown allergens or is uncommunicative -- in the United States it's a standard issue medication for ambulances. But, please continue with your misinformed and unfunny meme...
- jokowueu 4y ago
  It can be used as a animal tranq because of it safety . It wasn't created for use in animals . Click below and educate yourself https://tonydagostino.co.uk/history-of-ketamine-other-dissociative-anaesthetics/ https://tonydagostino.co.uk/history-of-ketamine-other-dissoc...
pgt 4y ago
Most Ketamine users are unaware that even occasional usage can cause untreatable ulcerative cystitis, a.k.a. Ketamine Bladder Syndrome. Ketamine thins the urothelium while increasing the collagen to smooth muscle ratio and exacerbating interstitial fibrosis. The syndrome is untreatable and causes serious problems down the line. One promising rat study from 2015 shows that EGCG (epigallocatechin gallate) extracted from green tea has a protective effect on the bladder, reversing ketamine-induced damage to control levels. If you are taking ketamine for major depression or recreationally, taking EGCG before may prevent long-term bladder damage. Summary from the study: > "Objective To investigate the protective effect of green tea epigallocatechin gallate (EGCG) on long-term ketamine-induced ulcerative cystitis (KIC) using a ketamine addiction rat model. Materials and methods Thirty Sprague-Dawley rats were divided into three groups which received saline, ketamine (25 mg/kg/d), or ketamine combined with EGCG (10 μM/kg) for a period of 28 days. In each group, cystometry and a metabolic cage micturition pattern study were performed weekly. Masson's trichrome study was done to evaluate the morphologic changes. Western blot analyses were carried out to examine the expressions of inflammatory protein [transforming growth factor-β (TGF-β)] and fibrosis proteins (fibronectin and type I collagen) in bladder tissues. Results Chronic ketamine treatment resulted in bladder hyperactivity with a significant increase in micturition frequency and a decrease in bladder compliance. These alterations in micturition pattern were accompanied by increases in the expressions of inflammatory and fibrosis markers, TGF-β, fibronectin, and type I collagen after long-term ketamine treatment. Masson's trichrome stain showed that ketamine treatment decreased urothelium thickness while increasing the collagen to smooth muscle ratio and exacerbating interstitial fibrosis. By contrast, simultaneous EGCG and ketamine treatment reversed ketamine-induced damage to almost control levels, showing the protective effect of EGCG. Conclusion This protective effect of EGCG may come from its antiinflammatory and antifibrotic properties." [^1]: https://www.sciencedirect.com/science/article/pii/S1879522615004157?fbclid=IwAR3loLakNo0TV5xlboUqHsUDN8tDDOKN7O1z7WeqEvcrTLQoDxdnKu_IfhY https://www.sciencedirect.com/science/article/pii/S187952261...
- chimeracoder 4y ago
  > even occasional usage can cause untreatable ulcerative cystitis, a.k.a. Ketamine Bladder Syndrome. You'd have to stretch the definition of "occasional" to make this statement supportable. Clinical studies on the topic focus on chronic heavy users, whose usage far surpasses the dosing used by the median recreational user and typically persists for years. (In fact, most studies focus on recreational users who are using near-clinical levels, which is an order of magnitude more than the typical recreational dose, and doing so with regularity). While it's possible that occasional use can cause issues, it's far from established fact, and the widespread usage of large doses of ketamine in inpatient settings for decades without reports of issues for those users would actually suggest otherwise.
DontchaKnowit 4y ago
I dont understand why we arent looking into methoxetamine over ketamine. Or any of the derivatives with a stronger dose-response curve. DCK, O-PCE, etc. These all have similar chemical and psychoactive properties and the doses are orders of magnitude smaller ergo they dont completepy fuck your bladder up.
- jonnycomputer 4y ago
  >I dont understand why we arent looking into methoxetamine over ketamine. Seems like we are. https://scholar.google.com/scholar?start=10&q=methoxetamine+depression&hl=en&as_sdt=0,47 https://scholar.google.com/scholar?start=10&q=methoxetamine+...
- chimeracoder 4y ago
  > the doses are orders of magnitude smaller ergo they dont completepy fuck your bladder up. There is zero clinical evidence of bladder damage due to ketamine in the amounts used for clinical purposes. Yes, there is evidence for bladder damage in heavy, chronic users, but none of that has been shown in therapeutic schedules, and there is very strong evidence against the existence of any such link in therapeutic schedules.
anonymousnotme 4y ago
MDMA and psilocybin (magic mushrooms) and both in later stages of research and could be approved by FDA. From what information that I have read, one treatment of magic mushrooms can have a profound impact for one's life time. As I understand it, ketamine treatments don't last that long, so one needs to continue them. As far as magic mushrooms being toxic, they can't find a limit where it is toxic. The biggest problem as I understand it is that one might have a bad trip that could cause something like PTSD; so proper screening and preparation is needed. Check out youtube videos: https://youtu.be/kxFTWk9lLDU https://youtu.be/kxFTWk9lLDU, https://youtu.be/smBMn-CV9KE https://youtu.be/smBMn-CV9KE, https://youtu.be/SwMHr43fTqE https://youtu.be/SwMHr43fTqE, https://youtu.be/NGIP-3Q-p_s https://youtu.be/NGIP-3Q-p_s

68 points by whack 4y ago

Quite interesting . I have tried ketamine for my PTSD and hasn't worked but stellate gangelion block worked perfectly after just one session .

cl0ckt0wer 4y ago
How long has it worked for? I googled the procedure and it seems like it's an injection of "anesthetic" to a nerve in the neck. Is that what you're talking about?
- jokowueu 4y ago
  Yes it is . The procedure wasn't really painful just uncomfortable and took about 20 minutes. I did it about 3 months ago I can't recall exactly. I was able to find a head and neck doctor that agreed to do it and did it for about 800$. 60 minutes made an episode about it that's when I first knew I had to try it There are 3 sites that they generally target but I just did right C6 .
  - bobmaxup 4y ago
    Do you plan on repeating it?
    - jokowueu 4y ago
      You generally repeat it if your symptoms come back . If it does then ya for sure

snapcaster 4y ago

This is really cool, I think there is a huge opportunity for analysis like this to allow drugs that are currently off market because some small percentage have bad side effects but it works for others. If we can start knowing who drugs will work for and who they won't it could be a game changer for our existing drugs, let alone what we can create in the future

jonnycomputer 4y ago

Ketamine has turned out to be a pretty effective treatment for episodes of severe depression, particularly when there is a risk of suicide; one reason is that it starts having an effect in hours instead of days or weeks like SSRIs do. See Jessica Gilbert's work over at NIH [1]. One of the big focuses of clinical neuroscience is to find features in the brain that will predict treatment responses (to cognitive behavioral therapy, anti-depressants, and so on). The amygdala is, as is generally known, strongly associated with fear responses, or other negative emotional responses. The subgenual cingulate cortex has been associated with emotion regulation (e.g. down-regulating responses to negative stimuli). I believe that other treatment-prediction studies have found that connectivity between the subgenual cingulate and other brain regions like the amygdala predict treatment responses, so, their result is pretty consistent with the literature as far as I understand. 1. https://scholar.google.com/citations?user=bSXKfxkAAAAJ&hl=en&oi=sra https://scholar.google.com/citations?user=bSXKfxkAAAAJ&hl=en...

bheadmaster 4y ago
This sounds really promising, but one thing that worries me is that ketamine is a sort-of painkiller (dissociative anesthetic). When heroin was first discovered, it was hailed as a wonder-drug, and it was also considered an effective treatment for severe depression. However, after some time, people realized that its addictive properties and high range of potential tolerance make it backfire pretty badly after a certain amount of (ab)use. Can we be sure that a similar thing won't happen with ketamine?
- jonnycomputer 4y ago
  Good question. Ketamine has been a party drug for quite a while now, and as far as I know, hasn't been shown to be particularly dependency-inducing, though low-dose ketamine over the long term might be (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236511/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236511/) Also, as far as I know, ketamine treatment isn't intended as an ongoing medication, like an SSRI, but as a treatment for acute episodes of depression. I might be wrong about that; webmd says, "For treatment-resistant depression, patients usually get the nasal spray twice a week for 1 to 4 weeks; then once a week for weeks 5 to 9; and then once every week or 2 after that." However, the use-cases I know about (from talking to researchers studying it) is as an intervention to prevent suicide during severe depression (since it's relatively fast acting). As always, its a cost-benefit calculation, that should be carefully made in consultation with a professional. The cost of severe depression can be quite high.

programmarchy 4y ago

zer0tonin 4y ago
Ketamine is one of the most widely used emergency anesthetic for humans and has been approved for that use for decades. Ketamine use as an anti-depressant has been approved by the FDA for 3 years now. It is also part of the WHO list of essential medicines.
kallistisoft 4y ago
Ketamine is on the World Health Organization's list of essential medicines and is a primary anesthetic for infants, geriatric patients, and large areas of the developing world where access to general anesthetics is limited. It's also the field anesthetic of choice for situations where a patient has unknown allergens or is uncommunicative -- in the United States it's a standard issue medication for ambulances. But, please continue with your misinformed and unfunny meme...
jokowueu 4y ago
It can be used as a animal tranq because of it safety . It wasn't created for use in animals . Click below and educate yourself https://tonydagostino.co.uk/history-of-ketamine-other-dissociative-anaesthetics/ https://tonydagostino.co.uk/history-of-ketamine-other-dissoc...

pgt 4y ago

Most Ketamine users are unaware that even occasional usage can cause untreatable ulcerative cystitis, a.k.a. Ketamine Bladder Syndrome. Ketamine thins the urothelium while increasing the collagen to smooth muscle ratio and exacerbating interstitial fibrosis. The syndrome is untreatable and causes serious problems down the line. One promising rat study from 2015 shows that EGCG (epigallocatechin gallate) extracted from green tea has a protective effect on the bladder, reversing ketamine-induced damage to control levels. If you are taking ketamine for major depression or recreationally, taking EGCG before may prevent long-term bladder damage. Summary from the study: > "Objective To investigate the protective effect of green tea epigallocatechin gallate (EGCG) on long-term ketamine-induced ulcerative cystitis (KIC) using a ketamine addiction rat model. Materials and methods Thirty Sprague-Dawley rats were divided into three groups which received saline, ketamine (25 mg/kg/d), or ketamine combined with EGCG (10 μM/kg) for a period of 28 days. In each group, cystometry and a metabolic cage micturition pattern study were performed weekly. Masson's trichrome study was done to evaluate the morphologic changes. Western blot analyses were carried out to examine the expressions of inflammatory protein [transforming growth factor-β (TGF-β)] and fibrosis proteins (fibronectin and type I collagen) in bladder tissues. Results Chronic ketamine treatment resulted in bladder hyperactivity with a significant increase in micturition frequency and a decrease in bladder compliance. These alterations in micturition pattern were accompanied by increases in the expressions of inflammatory and fibrosis markers, TGF-β, fibronectin, and type I collagen after long-term ketamine treatment. Masson's trichrome stain showed that ketamine treatment decreased urothelium thickness while increasing the collagen to smooth muscle ratio and exacerbating interstitial fibrosis. By contrast, simultaneous EGCG and ketamine treatment reversed ketamine-induced damage to almost control levels, showing the protective effect of EGCG. Conclusion This protective effect of EGCG may come from its antiinflammatory and antifibrotic properties." [^1]: https://www.sciencedirect.com/science/article/pii/S1879522615004157?fbclid=IwAR3loLakNo0TV5xlboUqHsUDN8tDDOKN7O1z7WeqEvcrTLQoDxdnKu_IfhY https://www.sciencedirect.com/science/article/pii/S187952261...

chimeracoder 4y ago
> even occasional usage can cause untreatable ulcerative cystitis, a.k.a. Ketamine Bladder Syndrome. You'd have to stretch the definition of "occasional" to make this statement supportable. Clinical studies on the topic focus on chronic heavy users, whose usage far surpasses the dosing used by the median recreational user and typically persists for years. (In fact, most studies focus on recreational users who are using near-clinical levels, which is an order of magnitude more than the typical recreational dose, and doing so with regularity). While it's possible that occasional use can cause issues, it's far from established fact, and the widespread usage of large doses of ketamine in inpatient settings for decades without reports of issues for those users would actually suggest otherwise.

DontchaKnowit 4y ago

I dont understand why we arent looking into methoxetamine over ketamine. Or any of the derivatives with a stronger dose-response curve. DCK, O-PCE, etc. These all have similar chemical and psychoactive properties and the doses are orders of magnitude smaller ergo they dont completepy fuck your bladder up.

jonnycomputer 4y ago
>I dont understand why we arent looking into methoxetamine over ketamine. Seems like we are. https://scholar.google.com/scholar?start=10&q=methoxetamine+depression&hl=en&as_sdt=0,47 https://scholar.google.com/scholar?start=10&q=methoxetamine+...
chimeracoder 4y ago
> the doses are orders of magnitude smaller ergo they dont completepy fuck your bladder up. There is zero clinical evidence of bladder damage due to ketamine in the amounts used for clinical purposes. Yes, there is evidence for bladder damage in heavy, chronic users, but none of that has been shown in therapeutic schedules, and there is very strong evidence against the existence of any such link in therapeutic schedules.

anonymousnotme 4y ago

MDMA and psilocybin (magic mushrooms) and both in later stages of research and could be approved by FDA. From what information that I have read, one treatment of magic mushrooms can have a profound impact for one's life time. As I understand it, ketamine treatments don't last that long, so one needs to continue them. As far as magic mushrooms being toxic, they can't find a limit where it is toxic. The biggest problem as I understand it is that one might have a bad trip that could cause something like PTSD; so proper screening and preparation is needed. Check out youtube videos: https://youtu.be/kxFTWk9lLDU https://youtu.be/kxFTWk9lLDU, https://youtu.be/smBMn-CV9KE https://youtu.be/smBMn-CV9KE, https://youtu.be/SwMHr43fTqE https://youtu.be/SwMHr43fTqE, https://youtu.be/NGIP-3Q-p_s https://youtu.be/NGIP-3Q-p_s