Peer Review Request: Ketamine

https://astralcodexten.substack.com/p/peer-review-request-ketamine

by feross • 5 years ago

10 5 5 years ago

astralcodexten.substack.com

Ketamine is an interesting area of research, but it’s not a good candidate for long-term or even medium-term depression treatment for the reasons described in this article:

Second, because the effects of ketamine wear off quickly unless you continue taking it indefinitely, and continuing ketamine indefinitely is very poorly understood and makes me nervous.

To expand on this: Taking ketamine indefinitely doesn’t seem to produce the same effects, as tolerance builds over time. There are several new ketamine clinics that have popped up in my area that have drawn criticism for trying to draw patients back in for never-ending ketamine treatments with escalating doses. Ketamine may be useful to start other treatments, but it shouldn’t be the only treatment. The effects are apparently short lived.

Zababa• 5 years ago

I don't know much about antidepressant in general so please forgive my ignorance, but isn't it a problem that other antidepressants have too?

perl4ever2• 5 years ago

Some people report moderate or severe 'withdrawal effects' when trying to stop taking SSRI type antidepressants.

Apparently not everyone, since I was expecting that, but didn't experience it.

Also, as I'm implying, there are other drugs which are neither SSRIs nor ketamine, so I don't think there is such a thing as "antidepressants in general".

In any case, problems with withdrawal aren't the same thing as tolerance. Just because your body adjusts to it doesn't mean you are driven to an escalating dose. Again, this may differ for different people, but I never had any urge to take more of an SSRI.

I'm personally afraid of Ketamine, because it's been around for so long that suddenly deciding it has a huge new market seems opportunistic.

(note that I have no official medical credentials and do not give medical advice)

deertick1• 5 years ago

Thats not even the worst part : the molecule fucks your bladder up horribly. Ever escalating continued ketamine usage is a sure recipe for have a fubar urinary sytem. This is why methoxetamine is a better candidate for psychological treatment. Dosage is much much lower, ergo, less of the bladder shredding metabolites pass through your urinary sytem.

perl4ever2• 5 years ago

$6400/month is insane. $10 per dose is still like...10-60x times more expensive than covered drugs for me.

Also,

"Addiction is a biopsychosocial process and people without genetic and psychological predispositions to addiction are usually able to use these chemicals safely."

makes me think of Sackler and opiates. I just have a bad feeling about this.

Peer Review Request: Ketamine

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