Current Events > When will Ketamine become more commonly used to treat depression?

(+) Yeah! (+)

I searched the board but couldn't find anything on this, so I'm not sure if it's already old news for most of you but for me it is new and exciting so I thought I should share.

Typically, Selective Serotonin Reuptake Inhibitors (SSRIs) are used to treat depression but these are not ideal because they take weeks to start working and cause uncomfortable side-effects like weight gain and stomach issues, and one of the main issues is that patients need to take it daily and this is typically hard to achieve. On the other hand, Ketamine has been shown to reduce depression symptoms for up to 7 days when administered just once.

https://pubmed.ncbi.nlm.nih.gov/25698228/

The quantitative meta-analysis showed that ketamine significantly reduced depressive symptoms. The overall effect size at day 1 was large and statistically significant ... with the effects sustained at 7 days postinfusion.

Here is a nice review article for those who are interested, where you can find links to the original resources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225830/

Ketamine, a drug introduced in the 1960s as an anesthetic agent and still used for that purpose, has garnered marked interest over the past two decades as an emerging treatment for major depressive disorder. With increasing evidence of its efficacy in treatment-resistant depression and its potential anti-suicidal action, a great deal of investigation has been conducted on elucidating ketamines effects on the brain. Of particular interest and therapeutic potential is the ability of ketamine to exert rapid antidepressant properties as early as several hours after administration. This is in stark contrast to the delayed effects observed with traditional antidepressants, often requiring several weeks of therapy for a clinical response.

It really makes me think, why not speed up the use of ketamine for depression similar to how we sped up the creation of Covid vaccines? There was a huge public health crisis before the pandemic, which can only be worse now and likely will get even worse when the pandemic is over. People need help now, and it really doesn't make sense to wait and try whatever SSRI you can throw at them when something possibly more efficacious and less dangerous is readily available.

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Could be side effects? Could also just be its history as a recreational drug has given it a kind of "do not touch" status, much like cannabis had until recently.

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Trumble posted...

Could also just be its history as a recreational drug has given it a kind of "do not touch" status, much like cannabis had until recently.

I think its primarily this.

Same reason the use of magic mushrooms and mdma in treating brain injuries and ptsd hasn't seen as much widespread use and study as early results indicate they should.

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Trumble posted...

Could be side effects? Could also just be its history as a recreational drug has given it a kind of "do not touch" status, much like cannabis had until recently.

But the side-effects of SSRIs are worse than Ketamine's so it can't be that.

You are most likely right on your second point though, which means the whole war on drugs is the main problem that needs to be solved.

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Towelie1727 posted...

But the side-effects of SSRIs are worse than Ketamine's so it can't be that.

People seem to be surprisingly more willing to accept side effects with already-established things (or slight variations thereof), than they are with anything "new".

Case in point, look at how many people freak out over 1 in a million chances of side effects from the covid vaccine, while taking medications with a 1 in 1000 or similar chances.

Actually, on that note, I believe ketamine is extensively used in veterinary medicine? That might also be off-putting for some, although I'd think those who actually matter (researchers doctors etc) would not care about this link, so IDK.

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Price

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Trumble posted...

People seem to be surprisingly more willing to accept side effects with already-established things (or slight variations thereof), than they are with anything "new".

Case in point, look at how many people freak out over 1 in a million chances of side effects from the covid vaccine, while taking medications with a 1 in 1000 or similar chances.

Actually, on that note, I believe ketamine is extensively used in veterinary medicine? That might also be off-putting for some, although I'd think those who actually matter (researchers doctors etc) would not care about this link, so IDK.

Its literally a horse tranquilizer. I think its veterinary uses are limited to tranquilizaton... but you have a point.

For Joe citizen the idea of taking a horse tranquilizer as medication could well be off putting.

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Ketamine can be an incredible monster sometimes...in ways other substances just cant be. Im sure thats not playing a role in legality because the lawmakers arent trying it out but its definitely something to keep in mind

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lemondrop7 posted...

Ketamine can be an incredible monster sometimes...in ways other substances just cant be. Im sure thats not playing a role in legality because the lawmakers arent trying it out but its definitely something to keep in mind

When i was working out of town a couple dudes I went to the bar with bought coke that turned out to be ketamine.

The k hole is definitely frightening. Thankfully the bar was owned by another co-workers wife and she said she'd take care of them so I wasn't stuck baby sitting them all night.

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Sexypwnstar posted...

Price

[LFAQs-redacted-quote]

Yeah, one of the main problems is that it's not covered by insurances yet, which is the first thing that needs to be changed.

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lemondrop7 posted...

Ketamine can be an incredible monster sometimes...in ways other substances just cant be. Im sure thats not playing a role in legality because the lawmakers arent trying it out but its definitely something to keep in mind

When given to treat depression, the doses are strictly regulated and given in the presence of the psychiatrist/physician. So while you make a good point, this would be controlled for.

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CanuckCowboy posted...

Its literally a horse tranquilizer. I think its veterinary uses are limited to tranquilizaton... but you have a point.

For Joe citizen the idea of taking a horse tranquilizer as medication could well be off putting.

But if the public doesn't know enough about the science, they shouldn't influence the decisions.

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Towelie1727 posted...

But if the public doesn't know enough about the science, they shouldn't influence the decisions.

I agree.

Just thinking of all the potential reasons.

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Trumble posted...

Could also just be its history as a recreational drug has given it a kind of "do not touch" status

FDA rules, summarized:

1. must be safe.
2. must be effective.
3. must not be fun.
4. 1 & 2 aren't particularly important.

Towelie1727 posted...

But if the public doesn't know enough about the science, they shouldn't influence the decisions.

They shouldn't get a say on legality / approvals / etc, but ultimately, if most of the public won't be willing to take it - and it is fair for them to have a say on that - then it's pretty much not worth the effort for any private company to get a ketamine-based treatment authorised, nor for govt to spend much time on it if there are better-tolerated (by the end users) products.

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Hopefully the American Society of Ketamine becomes stronger and promotes the potential more broadly.

https://askp.org/

https://www.prweb.com/releases/ketamine_therapy_essential_service_during_covid_19_pandemic/prweb16992449.htm

The American Society of Ketamine Physicians has been at the forefront of advocating for patients who have benefited from this forward-leaning therapy. Ketamine therapy is an essential service that cannot be interrupted during this crisis. Our patients who suffer from severe depression and suicidality do not suddenly get better just because there is a pandemic. In fact, they are likely to struggle more. Continuing to offer treatment to high risks populations significantly alleviates the additional strain that would otherwise be placed on emergency rooms and urgent care settings, says Sandhya Prashad, MD, a psychiatrist from Houston and Secretary for ASKP.

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Everything I know about ketamine I learned from Mr. Krabs.

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