Ketamine Found No Better Than Placebo for Depression in Unique Experiment | Hacker News Reader

Ketamine Found No Better Than Placebo for Depression in Unique Experiment

gizmodo.com

36 pointswebmaven14 comments

What kind of surgery was each patient going in for? To me, these results speak less about ketamine and more about how solving longstanding health issues with surgery is highly likely to improve depression. Reduce daily suffering noticeably and people are likely to be less depressed.

Also, how long before the general anesthesia were these patients given either the saline or ketamine? Most ketamine therapy I have seen involves taking a dose of ketamine during a special session with a therapist, or given to people as an inhaler for panic attack treatment. I'd wager if they didn't get time to sit with the ketamine, introspect, and dissociate it won't actually help their mental state.

Iagree, Seems like it's a bad study design. Unfortunately this will not be discussed in these types of articles. and at the end people only remember the headlines.

More correct headline:

Ketamine found no better than placebo for depression when both were given to people under general anesthesia.

Sounds like the dose was before general anesthesia. If ketamine helps with depression, we should expect to see improvements in depressed people who were given ketamine vs placebo. The surgery is immaterial, just a clever way to try and hide people from knowing if they got a placebo (it sounds like ketamine has a pronounced effect/high, so a person tends to know for sure if they got drugs or saline) .

From the article: > Their study involved 40 people with major depressive disorder who were scheduled for routine surgery that required the use of general anesthesia. Half were randomized to receive a single dose of saline solution, the placebo, just before the surgery, and the other half a single dose of intravenous ketamine. The act of going under, the researchers theorized, would eliminate the chances of people going on a typical trip. Then they observed the patients for up to three days.

The article does mention small sample sizes, which should be emphasized.

Right. So if the effect of the ketamine on depression relates to the conscious experience of taking it, and not simply the unconscious chemical interactions, then isn't scheduling the dose at a time when the person is unconscious a significant factor in whether or not it's going to be more effective than placebo?

We could likely replicate this format to show that mushrooms are no better than placebo for depression or that MDMA is no better for PTSD than placebo.

Your assumption that "if ketamine helps with depression we should improvements vs placebo" ignores the considerable likelihood that previous effects in research are the result of conscious interactions with the drug which aren't present in this study. "It sounds like ketamine has a pronounced effect/high" - yeah, and maybe that's the meaningful effect on depression, no?

Doesn’t it seem likely that it’s the trip itself that reduces depression?

I agree, but this is also what makes it difficult to do a placebo trial, as stated in the article.

They still need to find a method of creating a state where the subject doesn't know if they are getting ketamine or not.

I haven't done ketamine, but I have experimented with dextromethorphan in the past. Both are classified as dissociatives, but ketamine is much stronger.

On DXM, I tended to "feel the love energy of the universe" which was a very positive experience when I was depressed and unmedicated. It did have some effect the days after, but nothing terribly long lasting because I was still chronically depressed.

Something that did help reduce my depression for a noticeable amount of time was doing a mix of psilocybin mushrooms and LSD (aka hippy flipping). In the weeks afterward, I seemed to still have a slight separation between what I was doing and what I was thinking/feeling. I would act impulsively (usually tending toward anger) and in the middle of it, instead of being strapped to the anger like a roller coaster, I realized my reaction was not justified in any way and realized I was triggered by something and I started thinking about what was actually bothering me.

It's a skill I still have to this day, and it's a lot easier to do while on Zoloft lol

https://www.nature.com/articles/s44220-023-00140-x

I don't have full text access from home. Says "during" anesthesia (not before). Was curious because I use ketamine to induce deep sedation in people routinely, wondering about the dose, administration, and timing.

Interesting note:

> R code used for data analysis is publicly available at https://osf.io/zdkr8/ (https://doi.org/10.17605/OSF.IO/ZDKR8).

Par for the course in terms of antidepressants, sounds like a success!

Its a dirty drug people. Herion too yeilds theraputic benifits. Ketamine is sold next to dope and coke in the cities. Is causes olney lesions, bladder issues.. it has an intereating effect but life has interestong muses and artifacts all over so realy what are we seeing pushed on people???

The aesthetics around ketamine seem like a poor argument against its use.

Well of course a drug that is difficult to get legally is going to be sold next to drugs that are difficult to get legally

Give me a break. You're suggesting that the other drugs that are sold by drug dealers are bad, so ketamine must also be bad. Where the hell else would you buy it?! Fifteen years ago people said the same things about weed, along with the brain damage and negative effects it supposedly brought to users. Now you can buy your weed legally in a shop that looks like an Apple store. Your argument is the regurgitation of decades of War on Drugs propaganda. Ketamine hasn't even been illegal in the US for half of its nearly seventy year history.

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