Ketamine Improved Bipolar Depression Within Minutes, Study Suggests
sciencedaily.com
sciencedaily.com
1. Almost all of these are looking at IV ketamine at very low doses (lower than anestheic or "recreational" dosing).
2. Like most of these trials, this is also a small trial (18 patients).
3. This was an adjunctive therapy, for patients who were on stable dosing of lithium or valproic acid which are first line for bipolar disorder.
Cool stuff, but preliminary at this point. Hopefully it will lead to options that are safer, more convenient, and with less abuse potential but maintain the rapid response that appears to be related to glutamatergic activity.
The "rule of halves" for different forms of drugs (pill vs. mucous membrane/sublingual vs. insufflated vs. smoked vs. injected) is interesting, but I'm not sure where IM vs. IV falls.
It's too sketchy and has a wide variety of effects on people, depending on your brain chemistry. It can produce sedation, or very fast anti-depressant effects, and/or other unusual body responses [1].
but I've known a lot of modest, moderate and heavy recreational ket users - It's been quite a popular recreational drug in the UK for about 15 years. I would perceive (being not a doctor or anything useful) that the proportion of them which are depressed in some way is a noticeably higher than the rest of the people I've ever met.
It's an addictive drug (perhaps not physically, but definitely behaviourally/psychologically). In my opinion it grossly interferes with peoples' ability to interact with those who don't partake. I find it difficult to recall a single example of its use improving someone's well-being - the converse in fact.
Anyway, just adding my observations/bit of life experience.
The long-term effect of ketamine is not yet understood, but establishing safety and effectiveness in these very small trials is the first step.
saying it is more dangerous than heroin is pretty dubious don't you think? Do you have any evidence better than this: http://en.wikipedia.org/wiki/File:Rational_scale_to_assess_t... ?
- The rankings are creating by combining a lot of different factors that don't have anything to do with each other, e.g. by combining harm to the user with harm to society. This means that drugs like coffee end up being more dangerous than drugs like heroin, simply because more people use coffee than heroin so the total social costs are greater.
- The harms for drugs are measured as they are typically used, rather than correcting for things like differences in demographic and route of administration. This leads to drugs like heroin looking more dangerous than they are, because people who have drug abuse problems tend to gravitate toward drugs like heroin. (Whereas people who use, say, Khat tend not to be the worst of the worst as drug abusers go.)
- The harms of the drugs caused by prohibition are not accounted for. (E.g. they are counting people using dirty needles and impure/unknown/fake drugs as being a harm that stems from heroin, but they aren't counting using dirty needles and fake Starbucks as being a harm that stems from drinking coffee.)
- They're not accounting for the benefits of drug use, only the harms.
I could keep going, but I think I've sufficiently proven my point and then some.
Whereas opiates, to my knowledge, don't actually have any serious side effects, or long term health issues (apart from constipation and perhaps lowered testosterone). Apart from the overdose risk, that is.
The brain damage effect is uncharacterized in humans. Several NMDA drugs cause this effect in rats, but none of them have been found to cause devastating problems in humans except PCP.
There is some suggestion that opioids cause cancer, but the only study was small and observational.
http://norvig.com/experiment-design.html
of an overinterpreted study. I wish the researchers well. Other thoughtful comments here have already pointed out issues such as the very small sample size and limited follow-up given to the patients.
So they only checked up on them for three days. Bipolar depression is generally chronically recurring. Sufferers will feel "better" for a short period of time, and then slip back into depressive mind-states.
This would be much more interesting if it was a longer-reaching study.
Study Suggests