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Comment by Jerrrry | Hacker News Reader

Similar thoughts. I think SSRI's are the wrong direction.

Acute drug experiences with therapy and behavioral modification are the future.

do some molly and ketamine and have a good talk.

As someone who has done both on multiple occasions and not come out of the experiences suffering any less, I can say that these are by no means the panacea they're often held out to be. It's fantastic that these options seem to be very helpful to many, but I feel that MDMA and Ketamine - as well as Psilocybin - are suggested with far too much confidence on the outcome.

If you don't want to mess with serotonin don't go take MDMA…

Lot's of cases of depression actually start with inflammation in the gut or in the brain, or other gut related diseases. Diet and lifestyle is a safer and better treatment.

Caveat: If you have dissociative symptoms, are prone to anxiety, have a family history of psychosis or have a psychosis in your symptom profile, seriously reconsider the above advice.

How does the dissasociative ketamine help?

Ketamine (as its S-isomer) is approved by the FDA for treatment-resistant depression.

Note that while the evidence for Ketamine's antidepressant effect is actually strong, that does not mean you should get into the habit of snorting a gram of special K a day.

Ketamine abuse is known to cause serious, practical damage to the GI tract, the urinary system, the liver, and the brain.

Although a ketamine treatment plan for depression requires subanesthetic doses once a week at first, and then once every two weeks. It's also habit forming enough that it's difficult to not overdo it due to its effects on dopamine. It has some definite utility, but it's the kind of medication that is hard to use alone

Thank you for this information. My question was - how does it help?

What does it do and why is that helpful?

If I get my mail today, I will let you know.

I hope it helps you - but are there any studies on how it works and why? What’s the mechanism of “disassociation” resulting in “getting better”?

The honest answer is that we don't know.

Experimentally, it works. There are theories (google will give you a couple vaguely plausible mechanisms), but it's too early to say. And it's likely that the antidepressive effect of ketamine has nothing to do with its NMDA antagonism, given that other NMDA receptor antagonists do not work as antidepressives.

Neuroscience theory lags far behind applied psychiatry, so all know is people whose depression resists normal treatment now have another very promising option, with a very different mechanism from normal antidepression treatment.

Thank you, this is what I was looking for.

Dissociatives are the most under-appreciated class of drugs.

Mechanisms of action are difficult to be objective about. It is a lot more complicated than dopamine and serotonin regulation and uptake, receptors and antagonists.

Today was pleasant, despite every reason not to be. It's like the "hope" qualia.

Thank you, this is what I was looking for. So - on biochemistry level we don’t know why it works. But somehow, controlled temporary disassociation seems to… interrupt negative ideation?

Also TIL “qualia” - what a wonderful word.

Yes. Depression originates from the ego. Vitamin K suppresses the ego.

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