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> Some patients who have faced incurable depression for decades have had symptoms disappear within hours of taking low doses of the drug. So in other words the

> Some patients who have faced incurable depression for decades have had symptoms disappear within hours of taking low doses of the drug. So in other words they are getting high.

sivetic 13y ago
Yes, they are getting "high". I'm not sure what your point is however. I've never understood the stigma associated with all mind-altering drugs, regardless the relative 'safety' of certain drugs in comparison to legal, and far more dangerous alternatives (nicotine and alcohol).
- lutusp 13y ago
  > I've never understood the stigma associated with all mind-altering drugs ... One objection that comes immediately to mind is that it may divert from a search for the actual cause of depression. Remember that this treatment, like all depression treatments, is symptomatic. It doesn't either identify or treat the underlying condition, only its symptoms.
  - TillE 13y ago
    Drug-induced euphoria and depression are not mutually exclusive feelings. Ask any depressed person who's taken psychoactive drugs. If ketamine functions as an antidepressant, that's a distinct and unusual effect.
    - abruzzi 13y ago
      Very true. Some hallucinogenic can significantly intensify depression.
  - dragonwriter 13y ago
    > One objection that comes immediately to mind is that it may divert from a search for the actual cause of depression. That's an insane objection, because understanding of how different depressions (depression isn't one thing, its just a set of symptoms) respond to different treatments is one method of determining the causes. Linking observed symptoms to environmental factors (both those that precede the symptoms, those that occur with the symptoms, and those that cause changes to the symptoms) is a fairly essential part of the normal scientific method of determining the mechanism behind the symptoms. That it also helps people in the here and now is a not insignificant side benefit, of course.
    - lutusp 13y ago
      >> One objection that comes immediately to mind is that it may divert from a search for the actual cause of depression. > That's an insane objection ... Actually, it's called "science". Science isn't about descriptions, it's about explanations. If we knew why ketamine worked, we would have finally crossed the threshold of science. Without science, we will continue to see one "breakthrough" after another, each lasting a few months, to eventually be discarded as its questionable statistical basis comes to light. > Linking observed symptoms to environmental factors (both those that precede the symptoms, those that occur with the symptoms, and those that cause changes to the symptoms) is a fairly essential part of the normal scientific method of determining the mechanism behind the symptoms. That can only be a preliminary to science. Science is not about "links", it is about testable, falsifiable explanations for those links. Without an effort to explain "links", any correlation becomes science. But that's not how science works. > That it also helps people in the here and now is a not insignificant side benefit, of course. But that has no value at all, in fact it's an obstacle to understanding. And it explains the many drugs presently available that are either known to be ineffective or that have adverse effects -- all of them gained a foothold by a study like this one, a questionable study, over-reliant on self-reporting.
      - dragonwriter 13y ago
        >>> One objection that comes immediately to mind is that it may divert from a search for the actual cause of depression. >> That's an insane objection ... > Actually, it's called "science". No, actually, its an objection to a necessary step of science, on the supposed basis that it prevents science. Which is what makes it insane.
      - nanidin 13y ago
        So... Uhhh... Why does gravity work? I know we can describe it, but is it considered science yet?
        lutusp 13y ago
        > So... Uhhh... Why does gravity work? I know we can describe it, but is it considered science yet? Bad example. General relativity describes gravity in great depth, and made a number of testable predictions, all of which have been proven in experiments many years after the original predictions. So yes, modern physics is not only a science, but it's the science to which other sciences are unfavorably compared. Also, an explanation, a scientific theory, as useful as it is, doesn't say "why" something is so -- that's for philosophers.
  - jes5199 13y ago
    Yeah, but that's true of Prozac, as well. It turns out that depressed people are definitionally ineffective at finding the root causes of their problems, and if you cam artificially suspend the feedback loop, then they might have a chance to diagnose and fix the underlying problem. And then of course for some people, the underlying causes are already gone and the depression is just a standing wave of feedback, and temporarily inhibiting the cycle is enough to cause it to stop.
- damnmachine 13y ago
  I don't know why they reference it as an "Illegal Party Drug". It has been used in veterinary and human medicine forever.
dragonwriter 13y ago
Not...necessarily. As I understand, there can be a big difference -- even when the drug is the same -- between the effects of drugs at therapeutic doses for people with conditions that they are effective for treating and typical recreational uses. While its not always an accurate description of the mechanism, the difference can be thought of (and sometimes literally is) the difference between restoring a normal chemical balance where there had been a deficit, on the one hand, and creating an excess, on the other. So, calling it "getting high" can be very badly misleading.
- lutusp 13y ago
  > So, calling it "getting high" can be very badly misleading. If we understood what depression is, understood its cause, then a dismissive expression like "getting high" might be unjust. But as long as we're only treating symptoms, that's an appropriate description.
  - dragonwriter 13y ago
    No, even in terms of treating symptoms, its still unjust. Even from an external, symptomatic view, there's a difference between a recreational "high" from a drug and someone successfully treated for depression with the same drug. The fact that the observation of that difference precedes understanding of the underlying mechanism responsible for it doesn't make the difference any less real.
    - lutusp 13y ago
      > Even from an external, symptomatic view, there's a difference between a recreational "high" from a drug and someone successfully treated for depression with the same drug. To take this position you cannot have spent much time listening to drug addicts, who explain their behavior in just this way. > The fact that the observation of that difference precedes understanding of the underlying mechanism responsible for it doesn't make the difference any less real. On the contrary -- knowledge of the underlying mechanism is what separates science from quackery. Remember that all quack cures appear to work, for unknown reasons, mostly having to do with the Placebo effect. Remember also that the study under discussion relied on self-reporting for its conclusions.

> Some patients who have faced incurable depression for decades have had symptoms disappear within hours of taking low doses of the drug. So in other words they are getting high.

sivetic 13y ago

Yes, they are getting "high". I'm not sure what your point is however. I've never understood the stigma associated with all mind-altering drugs, regardless the relative 'safety' of certain drugs in comparison to legal, and far more dangerous alternatives (nicotine and alcohol).

lutusp 13y ago
> I've never understood the stigma associated with all mind-altering drugs ... One objection that comes immediately to mind is that it may divert from a search for the actual cause of depression. Remember that this treatment, like all depression treatments, is symptomatic. It doesn't either identify or treat the underlying condition, only its symptoms.
- TillE 13y ago
  Drug-induced euphoria and depression are not mutually exclusive feelings. Ask any depressed person who's taken psychoactive drugs. If ketamine functions as an antidepressant, that's a distinct and unusual effect.
  - abruzzi 13y ago
    Very true. Some hallucinogenic can significantly intensify depression.
- dragonwriter 13y ago
  > One objection that comes immediately to mind is that it may divert from a search for the actual cause of depression. That's an insane objection, because understanding of how different depressions (depression isn't one thing, its just a set of symptoms) respond to different treatments is one method of determining the causes. Linking observed symptoms to environmental factors (both those that precede the symptoms, those that occur with the symptoms, and those that cause changes to the symptoms) is a fairly essential part of the normal scientific method of determining the mechanism behind the symptoms. That it also helps people in the here and now is a not insignificant side benefit, of course.
  - lutusp 13y ago
    >> One objection that comes immediately to mind is that it may divert from a search for the actual cause of depression. > That's an insane objection ... Actually, it's called "science". Science isn't about descriptions, it's about explanations. If we knew why ketamine worked, we would have finally crossed the threshold of science. Without science, we will continue to see one "breakthrough" after another, each lasting a few months, to eventually be discarded as its questionable statistical basis comes to light. > Linking observed symptoms to environmental factors (both those that precede the symptoms, those that occur with the symptoms, and those that cause changes to the symptoms) is a fairly essential part of the normal scientific method of determining the mechanism behind the symptoms. That can only be a preliminary to science. Science is not about "links", it is about testable, falsifiable explanations for those links. Without an effort to explain "links", any correlation becomes science. But that's not how science works. > That it also helps people in the here and now is a not insignificant side benefit, of course. But that has no value at all, in fact it's an obstacle to understanding. And it explains the many drugs presently available that are either known to be ineffective or that have adverse effects -- all of them gained a foothold by a study like this one, a questionable study, over-reliant on self-reporting.
    - dragonwriter 13y ago
      >>> One objection that comes immediately to mind is that it may divert from a search for the actual cause of depression. >> That's an insane objection ... > Actually, it's called "science". No, actually, its an objection to a necessary step of science, on the supposed basis that it prevents science. Which is what makes it insane.
    - nanidin 13y ago
      So... Uhhh... Why does gravity work? I know we can describe it, but is it considered science yet?
      - lutusp 13y ago
        > So... Uhhh... Why does gravity work? I know we can describe it, but is it considered science yet? Bad example. General relativity describes gravity in great depth, and made a number of testable predictions, all of which have been proven in experiments many years after the original predictions. So yes, modern physics is not only a science, but it's the science to which other sciences are unfavorably compared. Also, an explanation, a scientific theory, as useful as it is, doesn't say "why" something is so -- that's for philosophers.
- jes5199 13y ago
  Yeah, but that's true of Prozac, as well. It turns out that depressed people are definitionally ineffective at finding the root causes of their problems, and if you cam artificially suspend the feedback loop, then they might have a chance to diagnose and fix the underlying problem. And then of course for some people, the underlying causes are already gone and the depression is just a standing wave of feedback, and temporarily inhibiting the cycle is enough to cause it to stop.
damnmachine 13y ago
I don't know why they reference it as an "Illegal Party Drug". It has been used in veterinary and human medicine forever.

dragonwriter 13y ago

Not...necessarily. As I understand, there can be a big difference -- even when the drug is the same -- between the effects of drugs at therapeutic doses for people with conditions that they are effective for treating and typical recreational uses. While its not always an accurate description of the mechanism, the difference can be thought of (and sometimes literally is) the difference between restoring a normal chemical balance where there had been a deficit, on the one hand, and creating an excess, on the other. So, calling it "getting high" can be very badly misleading.

lutusp 13y ago
> So, calling it "getting high" can be very badly misleading. If we understood what depression is, understood its cause, then a dismissive expression like "getting high" might be unjust. But as long as we're only treating symptoms, that's an appropriate description.
- dragonwriter 13y ago
  No, even in terms of treating symptoms, its still unjust. Even from an external, symptomatic view, there's a difference between a recreational "high" from a drug and someone successfully treated for depression with the same drug. The fact that the observation of that difference precedes understanding of the underlying mechanism responsible for it doesn't make the difference any less real.
  - lutusp 13y ago
    > Even from an external, symptomatic view, there's a difference between a recreational "high" from a drug and someone successfully treated for depression with the same drug. To take this position you cannot have spent much time listening to drug addicts, who explain their behavior in just this way. > The fact that the observation of that difference precedes understanding of the underlying mechanism responsible for it doesn't make the difference any less real. On the contrary -- knowledge of the underlying mechanism is what separates science from quackery. Remember that all quack cures appear to work, for unknown reasons, mostly having to do with the Placebo effect. Remember also that the study under discussion relied on self-reporting for its conclusions.