Wednesday, December 10, 2014

Ketamine and Depression

The Times has a long article on ketamine treatment for depression. A quick summary would be that it has dramatic benefits for some people but nobody knows what the long term effects might be. Studies of addicts have shown that the street version (Special K) can damage your brain. But there are lots of stories like this:
One patient, Maggie, said that when she got her first infusion she was aware enough to change the tunes on her iPod, albeit slowly, but was “transported into a completely different dimension.” She added, “Everything there is completely vibrant or molten.” The trip ended quickly, but within hours, a lifetime of depression began to lift. “Never ever ever before have I felt like that,” said Maggie, 53, who lives in Orange County, Calif., and spoke on the condition that her full name not be used because of the stigma associated with depression. “I woke up the next morning, and I didn’t take an antidepressant for the first time in 20 years.”
Is that sustainable? I guess we'll find out.


G. Verloren said...

I can't help but wonder if these sorts of results are more the product of tinkering with brain chemistry, or with providing people with new experiences. Depression sets in when a person's life seems routine, unfulfilling, and hopeless. Is it such a stretch to imagine that a sudden change of world perspective is going to counteract that?

I imagine similar results could be obtained by taking someone suffering from depression and stranding them in a foreign country where they don't know the language, or marooning them on a tropical island, or otherwise physically upsetting their little personal world order enough to kick start their survival instincts and get their brain to focus on coping with a novel and challenging situation. Surely depression thrives in the banality of the familiar and the normal, and shrinks away when confronted with the exotic and the curious?

This treatment seems like essentially the crude chemical equivalent of a change of scenery and a spiritual experience rolled into one. Instead of a physical relocation, it seens like a virtual one - experiencing hallucinations so powerful and bizarre as to challenge a person's complacency and shift their entire worldview, even if only slightly.

Personally, I feel there is an alarming focus in modern psychiatry on drug-based treatments in place of meaningful personal therapy, but I suppose if we're stuck with a society in which the average person simply will never be able to undergo a physical journey to broaden their closed in mental horizons, relying on a drug induced virtual analogue is better than nothing?

pootrsox said...

I beg to differ with you, Mr. V.

Depression is a malfunction of brain chemistry and/or a literal brain deficiency in the hippocampus (fewer serotonin uptakers.) True clinical depression does not simply "set in when a person's life seems routine, unfulfilling, and hopeless." It can also set in when from the outside everything in a person's life is exciting, fulfilling, and inspiring.

Depression is a product of, among other things, genetic predisposition.

According to WebMD,
"What Are the Main Causes of Depression?

There are a number of factors ***that may increase the chance of depression*** [emphasis mine, to highlight the fact that these are not actually causes but rather triggers that MAY precipitate clinical depression in those with a predisposition to depression], including the following:

Abuse. Past physical, sexual, or emotional abuse can cause depression later in life.
Certain medications. Some drugs, such as Accutane (used to treat acne), the antiviral drug interferon-alpha, and corticosteroids, can increase your risk of depression.
Conflict. Depression in someone who has the biological vulnerability to develop depression may result from personal conflicts or disputes with family members or friends.
Death or a loss. Sadness or grief from the death or loss of a loved one, though natural, may increase the risk of depression.
Genetics. A family history of depression may increase the risk. It's thought that depression is a complex trait that may be inherited across generations, although the genetics of psychiatric disorders are not as simple or straightforward as in purely genetic diseases such as Huntington's chorea or cystic fibrosis.
Major events. Even good events such as starting a new job, graduating, or getting married can lead to depression. So can moving, losing a job or income, getting divorced, or retiring.
Other personal problems. Problems such as social isolation due to other mental illnesses or being cast out of a family or social group can lead to depression.
Serious illnesses. Sometimes depression co-exists with a major illness or is a reaction to the illness.
Substance abuse. Nearly 30% of people with substance abuse problems also have major or clinical depression. [Another observation here-- substance abusers may be self-medicating because of a pre-existing condition, not merely precipitating one.]"

And no, simply providing a clinically depressed person with novel stimuli does not drive away the depression.

Also, given that clinical depression is a brain chemistry issue in many cases, there absolutely is a case for combining talk therapy with chemical therapy.

With due respect, I would suggest you do some reading on the subject of clinical depression.

(Note: I was a psych minor in college; my daughter was a psych major. We have a family history of bi-polar disorder which has added to our ongoing fascination with the subject. My daughter actually has been diagnosed with a mild anxiety disorder, as well.)

Anonymous said...

WOW! It seems big Pharma companies will just throw any drug at a problem and say the results are promising as long as it makes them money. Today it is nitrus oxide and ketamine they say may work - what tomorrow? Heroin? Maybe Demerol?
This is the problem with our culture, we are bombarded with info that says "Got a problem? Then take this pill!"
Taking drugs for an illness like this only masks the illness, it does not cure it. Therefore, you keep taking the drugs, the big Pharma companies keep making money!
For anyone suffering from depression, I suggest they try a more natural approach besides drugs. The system helped me massively. Written by a former depression sufferer, it teaches a natural 7 step process which helps to eliminate depression from your life, without getting addicted to useless drugs or suffering the side effects.