[HN Gopher] Psychedelic drugs take on depression
       ___________________________________________________________________
        
       Psychedelic drugs take on depression
        
       Author : bookofjoe
       Score  : 81 points
       Date   : 2022-08-26 19:21 UTC (3 hours ago)
        
 (HTM) web link (www.nature.com)
 (TXT) w3m dump (www.nature.com)
        
       | kornhole wrote:
       | Psychedelics are illegal not because they create hallucinations
       | but rather because they help break down the hallucinations we
       | have about the world. In the land of the blind, the one eyed man
       | is a hallucinating idiot.
        
         | heavyset_go wrote:
         | One of my favorite stories about psychedelic experiences is a
         | friend's coworker dosing acid one weekend, coming back in on
         | Monday, saying "I hate it here" and quitting on the spot. They
         | went on to travel and start their own company, and are doing
         | great for themselves.
         | 
         | In my experience, psychedelics really help tear down the
         | justifications we put up for the BS we tolerate in our daily
         | lives and can help you connect with what you really appreciate
         | and want in life. Definitely helped me realize the kind of
         | person I want to be and appreciate the good things in my life.
         | And similarly to the story about the coworker quitting, my
         | tolerance for BS is nil, now, too.
        
           | kirse wrote:
           | _psychedelics really help tear down the justifications we put
           | up for the BS we tolerate in our daily lives_
           | 
           | Thing is you can do that with an extended weekend of
           | fasting/meditation and solitude in the woods. Bring a notepad
           | and pencil if you really want to lock in the new perspective.
           | Bonus is that fasting is also widely known to be healthy.
           | 
           | Plus how do you really know the causative agent of change was
           | the drugs, what if there was already the underlying emotional
           | desire to do something and having the experience was more
           | about creating the justification to act?
           | 
           | Surely one of the insights you had to have realized on drugs
           | is how little agency we really have. We easily back-fill
           | reasoning and stories to happenings that were bound to happen
           | anyway. Our brains always want a story for cause and effect,
           | but so much of what happens occurs outside of our control or
           | awareness. It's like riding on a rollercoaster and proudly
           | claiming "yea I decided to make it do a loop"
        
             | virgildotcodes wrote:
             | >what if there was already the underlying emotional desire
             | to do something and having the experience was more about
             | creating the justification to act?
             | 
             | That's definitely part of it, and I think kind of what OP
             | was alluding to in that the experience allows you to
             | dissolve many of the cognitive habits you've built up over
             | your life, allowing you to experience an extremely honest
             | perception of your own mind.
             | 
             | I'm not sure if you've tried it yourself, but I have yet to
             | find any other way to achieve that level of clarity. I
             | understand in theory that a lot of people find their way
             | there by meditation, but I don't have the discipline or
             | attention span to get there.
             | 
             | Psychedelics are a way of making that state of being
             | accessible to those who may lack the ability or the
             | motivation to get there through other means.
             | 
             | I'll also say that of those I know who partake in both,
             | psychedelics still offer incredibly powerful and profound
             | experiences even to those who practice meditation seriously
             | for years or decades.
        
         | Bakary wrote:
         | If that were true, we would likely see a greater variety of
         | discourse and testimonies from people who use hallucinogens.
         | 
         | On the contrary, they tend to sound surprisingly similar in
         | terms of world-view to each other. Once you experience
         | hallucinogens yourself, it becomes pretty clear why that might
         | be.
         | 
         | The obvious conclusion is, of course, that hallucinogens unlock
         | an objective, common reality. That's not what the depth and
         | quality of the observations produced suggest, however.
        
         | Natsu wrote:
         | I saw Ketamine remove depression immediately after a single
         | dose in a loved one. Thought it was magic, because it was, a
         | lifetime of depression just evaporated like nothing. But then
         | came the psychosis. Nearly got stabbed in my sleep because a
         | voice told them to do that.
         | 
         | So... let's just say I think there are other explanations, too.
        
       | ad404b8a372f2b9 wrote:
       | Ketamine is a magical drug, I've told this story a hundred times
       | on HN but it cured my depression overnight.
       | 
       | I was given a large hit of it by a doctor after a horrible
       | accident, I went into a K-hole and had a spiritual experience,
       | but even more profound was the effect it had for 4 to 6 months
       | after.
       | 
       | It was like a veil had been lifted from my mind, the simplest
       | pleasures of life made me happy, like smelling fresh coffee or
       | feeling the sun on my skin. I had been living in misery for
       | decades and suddenly I was awake and lucid and happy.
        
         | FollowingTheDao wrote:
         | Oh I've had that experience, and I'm just bipolar.
         | 
         | Ketamine has been known to trigger hypomania and mania in
         | patients.
         | 
         | https://pubmed.ncbi.nlm.nih.gov/33587793/
         | 
         | 10 mg of Prozac will do the same thing to me, but that's just
         | my genetics.
        
           | ad404b8a372f2b9 wrote:
           | I don't think that was it for me, though I see the parallels.
           | I just wasn't miserable, the examples I gave were the
           | highlights but really the core of it was that life felt
           | tolerable. Looking at the hypomania symptoms I didn't exhibit
           | any, beside the elevated mood.
        
         | colechristensen wrote:
         | Here's a reminder:
         | 
         | "Depression" is just a label put on a cluster of symptoms to
         | make diagnoses consistent across medical providers. It is
         | definitely not a singular condition with one cause and a
         | consistent treatment across patients. It is likely a multitude
         | of conditions which will respond differently to many
         | treatments.
         | 
         | Some people with a depression diagnosis will be very
         | disappointed with ketamine treatment.
        
           | esperent wrote:
           | No doubt, but that applies to all depression treatments. Most
           | of which have a far higher risk of side effects, and many of
           | which take weeks or months to show an effect if they do work.
           | 
           | Ketamine treatment takes an hour, with virtually no chance of
           | side effects, and you'll know if it works within a few hours.
           | Even if it only works for a tiny percentage of depression
           | sufferers, it should be first line treatment. As it is, it
           | seems to work for a reasonably large percentage of people.
        
           | ad404b8a372f2b9 wrote:
           | Yes, your mileage may vary, as they say. Our bodies are all
           | unique and so are our responses. It was a miracle for me, it
           | might be completely ineffective for someone else.
        
             | colechristensen wrote:
             | I think it is more, or different than "our bodies are
             | unique" and something else entirely.
             | 
             | Saying someone has "depression" is like saying someone has
             | "a stomach ache". The stomach ache might be Crohn's, an
             | ulcer, food poisoning, or the aftermath of too many hot
             | wings. All would show at least a somewhat similar cluster
             | of symptoms, different based on the person, but all
             | "stomach ache". Imagine the same for depression, but we
             | don't necessarily have the labels or causes pinned down
             | very well.
             | 
             | There probably _are_ many conditions under depression that
             | we 'll eventually have good diagnoses for and consistent
             | treatments for, just not yet.
             | 
             | It's not a matter of "everybody is unique" but that the
             | science and testing is quite primitive so far and only some
             | of the distinctions and treatments have been worked out.
        
               | tsol wrote:
               | Depression is a symptom, not exactly an illness. I mean
               | we often treat it like one-- and call that Major
               | Depressive Disorder-- but I expect in the future we'll be
               | able to break it down to 'inflammatory disorder causing
               | symptoms of depression', 'trauma disorder leading to
               | symptoms of depression', etc
        
           | FollowingTheDao wrote:
           | Yes, this. IMHO, there are two type of depression, both
           | immune mediated, and both drive my glutamate/GABA imbalance.
           | One is high glutamate the other is high GABA, either
           | effecting different region of the brain.
           | 
           | This imbalance affects serotonin and norepinephrine release.
           | 
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311508/
           | 
           | And this change is mediated by the immune system. Glutamate
           | is now known as an immunomodulator.
           | 
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997749/
        
         | mathgladiator wrote:
         | Been there, and I just did a booster. I'm now very happy as I
         | plug along on my project without any negative judgement:
         | https://www.adama-platform.com/2022/07/02/the-path-of-the-mo...
         | 
         | I'm doing silly things for silly reasons, and I've never been
         | this happy and at peace. It let me heal from the moral injury
         | of working in big tech for a decade.
        
           | programmarchy wrote:
           | Cool project. You seem like a fun and interesting person. I
           | genuinely mean that!
        
             | mathgladiator wrote:
             | Thanks!
        
           | birdyrooster wrote:
           | What is your moral injury? I admit I have guilt from working
           | in big tech too, but how did it affect your mental health?
        
           | ad404b8a372f2b9 wrote:
           | Very interesting. I've long sought the divine in the machine
           | but haven't found a satisfactory avenue to pursue it so I
           | went back to Catholicism instead. It provides answers to our
           | suffering that hedonism ignores.
        
             | mathgladiator wrote:
             | For me, I found the purpose as my role is to solve puzzles.
             | Ketamine gave me a sense of spirit that we are all
             | connected in this life, and gave me insights that are hard
             | to describe. However, I believe there is value in waking up
             | and solving puzzles for the sake of solving puzzles and it
             | may not be time to leverage it in the commerce (if at all).
        
           | FollowingTheDao wrote:
           | I am in no way diagnosing, but I have Bipolar Disorder, so
           | did my mother and my brother. I say things like this which
           | you wrote when I am hypomanic/manic:
           | 
           | "As I reflect on this, I've concluded that I exist with the
           | divine purpose of bringing beauty into the world. Beauty and
           | elegance require tremendous suffering because having taste is
           | expensive."
           | 
           | It is kind of typical of the condition.
           | 
           | I know nothing I saw will convince you that the state you are
           | living in is not a balanced state because I have been there
           | as well and no one could tell me otherwise, so I get it.
        
         | whiskyagogo wrote:
         | It replaced my lifelong fear (terror?) of death with what I can
         | honestly say is now curiosity. You can experience only so many
         | deaths in your mind before you learn to be comfortable with the
         | idea.
        
           | ad404b8a372f2b9 wrote:
           | After my spiritual experience 2 years ago, my latent worry /
           | conceptual fear of death was also replaced with curiosity.
           | But I was coincidentally faced with death recently and was
           | disappointed to see my primal terror is still alive and well.
        
           | etaioinshrdlu wrote:
           | I am not convinced that a ketamine-induced feeling of death
           | is at all relatable to actual death. There is plenty of
           | neural activity remaining.
           | 
           | Is it possible you're just convinced it feels like death?
        
             | whiskyagogo wrote:
             | The point isn't how similar (or not) the experiences in my
             | mind are to actual death, it's that at those times I'm
             | convinced I am experiencing not just death, but total
             | annihilation of my consciousness which is my personal best
             | guess about what happens to us when we die. It's not the
             | moments leading up to death I've feared, it's non-being and
             | attachment to my own thoughts.
             | 
             | So then when I've experienced a series of "welp, here we
             | go, I'm on my way to nothingness" and dealt with that
             | terror in those moments, I've had the opportunity to accept
             | that fate and even embrace the unknown. Because in a k-hole
             | you can be VERY convinced what's happening is real.
             | 
             | And now that I'm not gripped by existential terror when I
             | think of my own death, I find myself wondering if I'll be
             | surprised to find something else on the other side of it.
             | And that's way more fun :)
        
           | staticassertion wrote:
           | That sounds frightening. What do yo mean by 'experience only
           | so many deaths' ?
        
             | askafriend wrote:
             | As they say, "Six million ways to die, choose one"
        
             | whiskyagogo wrote:
             | At times I've become convinced that all of experienced
             | reality is narrowing to a point and about to wink into
             | nothingness, and myself along with it. It's hard to
             | explain, but it's very convincing at the time. So as I
             | experienced this sort of unraveling of the universe I have
             | to confront the idea of my own non-being. Until I come out
             | of it and realize it was all in my head :) Even my early,
             | terrified experiences felt like therapy, like the pain was
             | well spent, so to speak.
             | 
             | It's worth noting, this isn't necessarily representative of
             | what most ppl experience per se. These were times where I
             | really went "out there" and pushed myself.
        
           | TaupeRanger wrote:
           | I'm watching the Netflix doc "How to Change Your Mind" about
           | this subject. They use similar language: e.g. that psilocybin
           | causes terminal cancer patients to view death with
           | "curiosity". I find that really interesting, because implicit
           | in this "curiosity" must be the idea of consciousness
           | existing after death...otherwise what would be curious about
           | it? You just die and there's nothing otherwise. So I wonder
           | if, e.g. atheists or non-spiritually inclined folks have the
           | same experiences in these drugs.
        
             | krrrh wrote:
             | I'm basically an atheist and ketamine assisted
             | psychotherapy did change my background fear of mortality
             | very much in a before and after sort of way. It felt more
             | like a different relationship to time and free will. Like a
             | realization that the universe existed and unfolded like a
             | cellular automata and I was integrated within that. Talking
             | to the very experienced therapist afterwards he summed up
             | my scattered thoughts as, "you resolved your determinacy."
             | 
             | I still don't believe in an afterlife other than in the
             | abstract sense that that the brief existence of me as a
             | point of consciousness was impacted by all that came before
             | it and will have had an impact on all that comes after. I
             | would say more calmness and more acceptance are better
             | descriptions than curiosity.
             | 
             | Like a lot of psychedelic experience, there's an underlying
             | neurological phenomenon and common subjective experience
             | that gets differently interpreted based on your background
             | beliefs. It's like the DMT experience of entities is very
             | differently interpreted as inter-dimensional elves by those
             | DMT smokers who have read a lot of Terrance McKenna, as
             | plant spirits by Amazonian ayahuasca drinkers, and as
             | channeled spirits or Christian saints by Daimistas.
        
           | sibeliuss wrote:
           | It's so wonderful to hear that you were able to overcome
           | this.
        
         | dundercoder wrote:
         | Seconded. For me however, its a monthly treatment for an hour
         | in an office run by an anesthesiologist. The difference is
         | night and day compared to any SSRI, SNRI, or TCA I've ever been
         | on. Exempting the 3-4 hours post treatment, no ill side effects
         | either.
        
           | greymalik wrote:
           | > Exempting the 3-4 hours post treatment
           | 
           | What do you experience during that time?
        
             | dundercoder wrote:
             | Some visual distortions, difficulty focusing, occasional
             | nausea, slow speech, feeling groggy.
        
         | PragmaticPulp wrote:
         | > but even more profound was the effect it had for 4 to 6
         | months after.
         | 
         | It's important to note that this is an atypically long
         | duration. In clinical studies, the duration of effects is more
         | around 1-2 weeks. It's possible that the overall experience
         | (including surviving an accident and getting a "second lease on
         | life") was the trigger for 4-6 months of improvement, not just
         | the medication you were given once.
         | 
         | That's why, in clinical practice, ketamine is more successfully
         | used in conjunction with typical long-term treatments such as
         | SSRIs and therapy. Some studies used a sequence of 6 treatments
         | spread out over months in an attempt to kickstart the recovery,
         | but it's generally not sustainable as a solo therapy.
        
           | fragmede wrote:
           | Therapy is really key to sustainable improvement from
           | ketamine, and I worry that it's just being given to patients
           | without the therapy aspects, and what are they doing to do
           | when it stops working for them?
        
           | ad404b8a372f2b9 wrote:
           | It definitely wasn't because of the accident, my life is
           | ruined lol and at the time I was in horrific pain. But I can
           | accept the timeline could be non-typical.
           | 
           | It could also be the huge dose, the studies I've seen use
           | lighter doses.
        
             | nibbleshifter wrote:
             | Smaller doses of ketamine (recreational doses) taken via
             | nose tend to alleviate depression and anxiety for me for
             | 1-2 weeks, depending on how much of it I do.
             | 
             | I've been meaning to travel sometime to a clinic for the
             | infusion therapy (that comes with some talk therapy) as
             | where I am now its nearly impossible to source clean
             | ketamine reliably.
             | 
             | Pretty mild doses of psilocybin mushrooms tend to have a
             | longer lasting effect (a month or so), and extremely large
             | doses can work for a half a year or so.
        
           | krrrh wrote:
           | The shorter duration is also more common with lower dose IV
           | infusions. There is evidence that higher concentrations
           | (usually delivered infra-muscularly or sublingually), and the
           | k-hole experience OP describes delivers more long lasting
           | results. In the Ketamine Assisted Psychotherapy space, there
           | is a lot of criticism of the infusion model of a nurse
           | managing simultaneous infusions on several patients at sub-
           | psychedelic doses as a cash treadmill, as opposed to a deeper
           | psychedelic experience which can be more costly to deliver
           | because ideally it demands pre and post integration plus
           | administering to a group can be problematic if someone
           | experiences a "bad trip". With some preparation and screening
           | a lot of the doses in a series can be managed at home though.
        
         | fassssst wrote:
         | Regular SSRI had the same effect for me.
        
         | Overtonwindow wrote:
         | Ketamine also has the effect of creating neuroplasticity in the
         | 24 hours or so following administration. Even the nasal spray.
        
       | responsible wrote:
        
       | [deleted]
        
       | loceng wrote:
       | I've wondered: what are the chances that big pharma will attempt
       | to suppress these medicines that compete with their patentable
       | products, like seems to be the case with the majority of drugs
       | caught up in "the war on drugs"?
        
       | jahnu wrote:
       | The frequency of these kind of posts followed by anecdotes about
       | how it worked for the commenter (who I believe btw) makes me a
       | little uneasy. Somewhere buried in the discussion eventually is a
       | comment from a relevant professional urging caution in
       | interpreting and reacting to these news reports and anecdotes.
       | Now with something as serious as this I would not at all object
       | to such cautions being placed a bit more prominently. This isn't
       | reckless use of goto being discussed but something much more
       | serious. Anyway, I just wanted to get that off my chest. Perhaps
       | it's just me, don't take it as a holier than thou attitude.
        
         | PragmaticPulp wrote:
         | Your skepticism is warranted. Psychedelics are a hot topic and
         | journalists have been promoting a lot of one-sided articles
         | that make them sound like miracle cures. In clinical practice,
         | ketamine can be useful as part of a recovery and treatment
         | strategy, but it's not really an effective long-term treatment
         | due to the short duration of effects (1-2 weeks post dosing)
         | and the unsustainable nature of the drug (tolerance builds to
         | the anti-depressant effect with repeated dosing).
         | 
         | Some ketamine treatment providers are running very professional
         | and well-staffed businesses (source: had to do a lot of due
         | diligence on the industry for a potential investment) but some
         | of the others are shockingly under-qualified to be
         | administering high doses of ketamine to patients with little
         | evaluation. The regulatory bodies are slowly catching up to
         | some of these providers and instituting stricter regulations.
         | While there is some therapeutic potential, it needs to be
         | delivered in the context of a long-term treatment strategy
         | rather than just giving someone ketamine over and over again
         | (as some unscrupulous providers will gladly do as long as the
         | patient is willing to pay).
        
         | renewiltord wrote:
         | Honestly, I find HN's obsession with "professionals" annoying.
         | For long-tail conditions, the professionals are frequently far
         | less informed than fellow sufferers.
         | 
         | During the beginning of the pandemic, people on HN were telling
         | us that N95 masks do nothing without official fit training.
         | Bro, official fit training is something you can easily sub with
         | a free video from 3M's website. It's this hopeless obsession
         | with "official" and "professional" and shit like that when any
         | reasonably intelligent individual can work through stuff
         | themselves.
        
         | willhinsa wrote:
         | Something much more serious for many people is the specter of
         | suicide looming over them.
         | 
         | Caution is useful, but it's not always an unalloyed good.
         | 
         | Chemotherapy isn't healthy or safe, but the thing it's used to
         | stop is even worse.
        
         | akuro wrote:
         | As someone who has taken extremely heavy doses of some very,
         | very potent psychedelics (LSD, DMT, ketamine, mescaline and
         | psilocybin), I am inclined to agree with you. I acknowledge
         | that some people experience great benefits from psychedelics,
         | but the current push to label psychedelics as mental health
         | miracle solution doesn't sit right with me.
         | 
         | Make no mistake: these chemicals are not to be trifled with.
         | People with underlying mental health issues - the poeple who
         | would be most interested in using psychedelics - are at heavy
         | risk of exacerbating their illnesses. Even outside of those
         | special cases, I've seen normal people become heavily affected
         | by bad trips. I simply don't think that there is enough
         | scientific literature on the adverse effects of psychedelics. I
         | also do not like the heavy focus on the "spiritual" aspects
         | that these drugs are believed to confer: are you really
         | transcending, or are you just so heavily intoxicated that you
         | believe you are and no longer have the rational capabilities to
         | convince yourself otherwise?
         | 
         | If I can end on just a little anecdote myself, I personally
         | believe that heavy psychedelic use is especially
         | counterproductive to technical/knowledge-based work. I did
         | barely any work during the year that I was experimenting with
         | these drugs. I was so content with my life as it was that I
         | simply didn't feel the urge to exert myself. I was becoming
         | soft, more predisposed to magical thinking. I believed that
         | psychedelics had revealed unto me truths about how society
         | should be run, how life should be and the true nature of
         | mathematics. But I didn't know a damn thing! I just lost the
         | inclination to actually analyse my ideas (or notions, because
         | they barely qualified as ideas), instead being content to just
         | accept them as they were. After a long stretch of abstinence
         | from these drugs, I realised how worthless most of these
         | notions actually were. I also deeply regretted the amount of
         | time I spent taking these notions seriously, as well as the
         | amount of time I had wasted in thinking that I had actually
         | been experiencing any spiritual truths.
        
           | leto_ii wrote:
           | > I was becoming soft, more predisposed to magical thinking.
           | 
           | My experience is only with microdosing LSD and psilocybine
           | mushrooms, however this 'softness' does ring true to me.
           | 
           | The good part with microdosing though is that it doesn't last
           | anywhere near a year, while the positive effects I've felt
           | and the deep conclusions I reached about myself and life in
           | general I think will last a lifetime.
           | 
           | LSD has especially helped me get pretty much completely rid
           | of anxiety in a particularly tense moment of my life. It has
           | also 'thawed' some more ingrained thought patterns and ideas
           | I had about things.
        
           | ekzy wrote:
           | Thanks for sharing your experience. Most stories I read
           | online about psychedelics are overwhelmingly positive, so
           | much that it feels like you'd be missing out on life if you
           | didn't try it. It's good to read your kind of stories too.
        
       | tasty_freeze wrote:
       | There are many personal anecdotes about how one treatment was a
       | game changer. I don't doubt them, but as the article says, it
       | doesn't work for everyone. I am posting this as a counterweight
       | to all the glowing reports.
       | 
       | My wife has some chronic health conditions (EDS and ME/CFS and
       | depression); I'm sure they are at least partially related. While
       | ramping off of one antidepressant in anticipation of trying
       | something different, her depression came roaring back, so the
       | doctor prescribed ketamine infusions. It didn't help at all.
       | 
       | Part of the problem was the clinic. One of the (correct) refrains
       | about psychedelics is the importance of "set and setting". To the
       | employees, this was just one of eight infusions they were going
       | to do that day and it was all very routine, but for someone who
       | has never experienced psychedelics, an attentive, caring, gentle
       | environment would have helped a lot. Being a woman, it was
       | tremendously anxious for her to go into a closed room with a male
       | nurse she had never met before and give up consciousness and
       | control for half an hour. Having a different nurse every time
       | wasn't great for building trust. There were some other things
       | too, but ultimately the main thing was she experienced no
       | benefit.
        
         | jokoon wrote:
         | if it's so dependent on the environment, then the drug just
         | doesn't work in general, meaning it's not viable.
         | 
         | if doctors are unable to find ways to make a drug work and
         | predict it, then it's pointless.
         | 
         | A 4 days vacation every month will have better results, and
         | it's something most therapists and psychiatrist also say, that
         | lifestyle matters.
         | 
         | If a drug cannot do better than lifestyle change, then the drug
         | doesn't work.
        
       | PragmaticPulp wrote:
       | A word of caution: Ketamine treatment is far from standardized.
       | Most of the clinical studies I've read aren't using doses that
       | produce profound psychedelic trips. The more professional clinics
       | seem to have settled on dosing regimens that produce mild
       | impairment, but not the full-blown dissociative trips described
       | in many of these articles.
       | 
       | Meanwhile, there are a lot of questionable ketamine clinic
       | providers popping up all over the country that give much higher
       | doses. Some of them promote the psychedelic angle heavily in
       | their marketing materials, as it has become a major revenue
       | generator from patients who read articles like this one. While a
       | single medium to high dose of ketamine may not produce marked
       | negative effects, some of the high-dose, repeat-dosing regimens
       | used by alternative therapy providers are in the range where I'd
       | begin to be very concerned about lasting damage.
       | 
       | I would strongly caution anyone curious about ketamine treatment
       | to stick to the lower-dose clinics and providers. Avoid anyone
       | trying to sell you on "psychedelic therapy" or who has a
       | reputation on the internet of providing excessively large doses.
       | Also keep in mind that the antidepressant effects are short-
       | lived, so plan to engage with traditional long-term treatment
       | (therapy and/or antidepressants) to create a lasting strategy for
       | yourself when the short-term effects of the ketamine wear off.
        
         | nwienert wrote:
         | This would be far more helpful if you included the dose ranges
         | you allude to, how many you think are required to cause damage,
         | and threw in a few citations.
        
         | cypherpunks01 wrote:
         | Does anyone know what the therapeutic ranges are at different
         | clinics? I'm currently in IV infusion clinic where they start
         | at 0.5 mg/kg, and increase by 0.1 per session. They are trying
         | to target having a light psychedelic experience during the
         | infusion, as they've found that gives the desired
         | antidepressant effects later on, but not so much so as to be
         | really far out, or to be frightening, totally out of body, or
         | loss of consciousness at all.
         | 
         | I'm told the max therapeutic dose they administer is somewhere
         | between 1-2mg/kg, and I believe anesthetic effects come on
         | somewhere in between 2-4mg/kg? Anesthesia doses are
         | administered much faster, so I'm sure that it's not a direct
         | comparison.
        
       | FollowingTheDao wrote:
       | They should not be lumping ketamine in with all the other
       | psychedelics which act on the serotonin 2A receptor. I'm hesitant
       | to say ketamine is a psychedelic at all.
       | 
       | Regardless, I find .25 mg of Klonopin can get rid of my
       | depression as well, they've known for a long time that depression
       | has a strong linked glutamate excitation in certain parts of the
       | brain.
        
         | mathgladiator wrote:
         | > say ketamine is a psychedelic at all.
         | 
         | For me, whatever I experienced was definitely something.
         | https://www.adama-platform.com/2022/07/02/the-path-of-the-mo...
        
         | heavyset_go wrote:
         | Chronic benzo administration can cause depression, so that
         | might not work for everyone.
         | 
         | I'd argue that the term "psychedelic dissociative" accurately
         | captures what ketamine can be.
        
           | FollowingTheDao wrote:
           | I do not take it chronically and no one should. I take it
           | once, as needed. Works for a few days.
           | 
           | And chronic ketamine use can cause depression as well:
           | 
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035802/
           | 
           | All these drugs are not the answer. It is much more likely
           | there is a fundamental immune dysfunction causing the
           | depression. IMHO, all mood disorder patents should be seen by
           | rheumatologists, not psychiatrists.
           | 
           | https://en.wikipedia.org/wiki/Anti-
           | NMDA_receptor_encephaliti...
           | 
           | FYI: I have Sjogren's Syndrome and Discoid Lupus
        
         | krrrh wrote:
         | Amongst psychedelic therapists it's pretty normal to include
         | Ketamine under the rubric of psychedelics these days, even
         | though receptor purists might still object. Same is true of
         | MDMA. From a subjective experience there's no doubt that it's
         | different, but at psychedelic dose ranges most psychonauts will
         | characterize it is a psychedelic experience, and ketamine can
         | produce experiences every bit as weird and life altering as the
         | tryptamines.
         | 
         | One interesting line of research on thinking about new ways to
         | characterize this that they all can be characterized as re-
         | opening critical periods of development. Gul Dolen at Johns
         | Hopkins is spearheading this, and this interview with her is
         | worth a listen.
         | 
         | https://www.iheart.com/podcast/1119-psychoactive-84544756/ep...
        
           | nibbleshifter wrote:
           | Higher (recreational) doses of ketamine can induce extremely
           | interesting states that I would definitely classify as
           | "psychedelic" in effect.
           | 
           | It is an interesting drug.
           | 
           | There are also subjectively different effects between racemic
           | ketamine and pure S-ketamine. I have never been able to try
           | pure R-ketamine, it just doesn't seem to be available.
        
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