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Ketamine Improved Bipolar Depression Within Minutes, Study Suggests
- phren0logy 14y agoStudies about ketamine have been rolling in over the past few years. Some important notes: 1. Almost all of these are looking at IV ketamine at very low doses (lower than anestheic or "recreational" dosing). 2. Like most of these trials, this is also a small trial (18 patients). 3. This was an adjunctive therapy, for patients who were on stable dosing of lithium or valproic acid which are first line for bipolar disorder. Cool stuff, but preliminary at this point. Hopefully it will lead to options that are safer, more convenient, and with less abuse potential but maintain the rapid response that appears to be related to glutamatergic activity.
- rdl 14y agoRecreational ketamine use is almost all insufflated (snorted) or intramuscular (IM) injection, right? I'm not sure how different the effects would be for IM vs. IV, except maybe a slightly faster onset and higher peak. The "rule of halves" for different forms of drugs (pill vs. mucous membrane/sublingual vs. insufflated vs. smoked vs. injected) is interesting, but I'm not sure where IM vs. IV falls.
- ArmstrongRSBC 14y agoInsufflated it takes about ten minutes to come on. It is extremely overwhelming - not necessarily in a bad way. Disassociates are by far the weirded class of drugs.
- mikescar 14y agoI've witnessed enough weird ketamine trips to hope nobody close bothers with it again. It's too sketchy and has a wide variety of effects on people, depending on your brain chemistry. It can produce sedation, or very fast anti-depressant effects, and/or other unusual body responses [1]. [1] http://en.wikipedia.org/wiki/Ketamine#Adverse_effects http://en.wikipedia.org/wiki/Ketamine#Adverse_effects
- rdl 14y agoWhereas I think it is dramatically underused -- it's a great battlefield or improvised conditions anaesthetic, since it doesn't depress respiration very much. All of the psychiatric features are minor compared to being able to do surgery quickly and not kill the patient.
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- Alex3917 14y agoNot sure if this is legit or not, but here is a post from Reddit from someone claiming to be a ketamine researcher giving advice on how one could approximate this methodology on one's own: http://www.reddit.com/r/Drugs/comments/h3lbk/ketamine_as_a_powerful_antidepressant_if_you_have/ http://www.reddit.com/r/Drugs/comments/h3lbk/ketamine_as_a_p... It addresses the issue of how one would do this via insufflation instead of IV. For reference here is the methodology of the actual study: http://www.ncbi.nlm.nih.gov/pubmed/22297150 http://www.ncbi.nlm.nih.gov/pubmed/22297150
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- fractalcat 14y agoHeroin also improves depression within minutes. Ketamine is even more dangerous, and may cause severe cognitive difficulties with long-term use like other NMDA antagonists like ethanol and the benzodiazapenes (which, it should be noted, actually worsen depression in the long run).
- phren0logy 14y agoYou are touching on some legitimate reasons for skepticism, however I think it's a bit more complicated than you are suggesting. Clinically, the response to alcohol, benzos, and heroin on mood is reported less as improvement than making the symptoms easier to ignore. I'd be surprised to see those agents prompt this kind of change on the MADRS. Plus alcohol and benzos act primarily through GABA, and heroin via mu opioid receptors, so the mechanisms are not totally comparable. The long-term effect of ketamine is not yet understood, but establishing safety and effectiveness in these very small trials is the first step.
- spot 14y agoketamine is being studied as single (for depression) or occasional (two week interval in the case of this study) dose, at which frequency there are no known deleterious effects. if you have evidence to the contrary, let's see it. saying it is more dangerous than heroin is pretty dubious don't you think? Do you have any evidence better than this: http://en.wikipedia.org/wiki/File:Rational_scale_to_assess_the_harm_of_drugs_(mean_physical_harm_and_mean_dependence).svg http://en.wikipedia.org/wiki/File:Rational_scale_to_assess_t... ?
- shortlived 14y agoStudy Suggests Let's talk when it reads "study proves . . ."
- roguecoder 14y agoThat typically means "scientist is willing to lie to journalist".
- jlgreco 14y agoScience does not "prove" in the technical sense of the word.
- zbuc 14y ago> When the patients received ketamine, their depression symptoms significantly improved within 40 minutes, and remained improved over 3 days. Overall, 79% of the patients improved with ketamine, but 0% reported improvement when they received placebo. So they only checked up on them for three days. Bipolar depression is generally chronically recurring. Sufferers will feel "better" for a short period of time, and then slip back into depressive mind-states. This would be much more interesting if it was a longer-reaching study.
- tambourine_man 14y ago0% placebo effectiveness sounds strange.
- phren0logy 14y agoIt is in a typical treatment group, but not all that strange in a treatment-resistant population who have specifically been selected because they haven't responded to other things.
- bashour 14y agoWow - that is exciting and readily applicable research which can save many lives in a short amount of time.
- TheRevoltingX 14y agoHard to be depressed when Jesus got you....
- tokenadult 14y agoWow! This press release, on an important issue of treatment of a dangerous illness, triggers more than the usual number of warning signs http://norvig.com/experiment-design.html http://norvig.com/experiment-design.html of an overinterpreted study. I wish the researchers well. Other thoughtful comments here have already pointed out issues such as the very small sample size and limited follow-up given to the patients.
- Anirak 14y agoWouldn't this be much more significant if the effects were found to last longer than, say, 3 days? I was actually under the impression that ketamine and psychedelics had been shown in the past to do just that.
- someone_welsh 14y agoYMMV; Annecdotes != data; correlation != causation etc. but I've known a lot of modest, moderate and heavy recreational ket users - It's been quite a popular recreational drug in the UK for about 15 years. I would perceive (being not a doctor or anything useful) that the proportion of them which are depressed in some way is a noticeably higher than the rest of the people I've ever met. It's an addictive drug (perhaps not physically, but definitely behaviourally/psychologically). In my opinion it grossly interferes with peoples' ability to interact with those who don't partake. I find it difficult to recall a single example of its use improving someone's well-being - the converse in fact. Anyway, just adding my observations/bit of life experience.
- losethos 14y agoTorturing my shrink would drive away depression. Ya nigger. God says... Please anon performing blindness Infinite subtle plainer dry hasting