[HN Gopher] Ketamine for Depression: How It Works (2024) [video]
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Ketamine for Depression: How It Works (2024) [video]
Author : ViktorRay
Score : 69 points
Date : 2025-02-07 16:59 UTC (6 hours ago)
(HTM) web link (www.yalemedicine.org)
(TXT) w3m dump (www.yalemedicine.org)
| Trasmatta wrote:
| I would like to try it someday, but I had some really bad trips
| on dissociative drugs in the past, and I'm worried ketamine will
| invoke flashbacks.
| orasis wrote:
| The low dose lozenges very rarely lead to negative experiences.
| dinfinity wrote:
| It's a blanket fix for all bad trips, but it really does work:
| Do some MDMA first (just enough to feel the effects, don't go
| all out). It will put you in a positive state of mind and allow
| you to experience all the crazy mind-alterations of
| psychedelics and/or dissociatives without being scared to shit.
| quchen wrote:
| MDMA and ketamie synergize nontrivially and strongly. I
| highly recommend against taking MDMA to ease off the ketamie.
| If you want to combine them for the resulting experience then
| power to you, but taking MDMA to make ketamie "simpler" is a
| very bad idea.
|
| I've taken care of multiple ketamie and MDMA overdoses (in
| the sense of unexpected effects, not just the amount) and
| they did not have a good time.
| CannonSlugs wrote:
| I've never tried Ketamine but I have tried shrooms, LSD, and DMT.
| I have never found the effects be to lasting though, regardless
| of dose. After one or two days I'm always back to baseline.
|
| I've wondered if a similar thing can be how much people are
| affected by things like Virtual Reality. After the initial five
| minute first try I never could get very immersed in VR (more than
| a regular 2D game). I could never feel any fear of height or
| anything for instance, it didn't grab me.
|
| I've wondered a while if that is a correlation that spans other
| people. If the people who get blown away by VR would also have
| large lasting effects of psychedelics, and vice versa.
| Obscurity4340 wrote:
| You should try DXM for an interesting "baby ketamine"
| experience. Just get the pure Robotussin gelcaps, I wouldn't do
| less than 2 bottles and actually thats generally a good place
| to start for a decent 2nd plateau trip without getting into the
| more crazy upper echelon dissociative effects and experience
| giraffe_lady wrote:
| Mix with sprite, pour it over some ice, and add a couple of
| your favorite jolly ranchers. That's the start of a good
| weekend.
| Obscurity4340 wrote:
| You're thinking of codeine (purple drank). DXM is different
| giraffe_lady wrote:
| Oh true sorry I hope that didn't undermine your
| recommendation of recreational megadoses of OTC
| medication.
| itronitron wrote:
| 2 bottles of gelcaps? that seems ill-advised
| Obscurity4340 wrote:
| Its seems crazy right? I mean I guess you can start with
| one but its best used a bit stronger than that and for a
| purpose like resetting when you'vr been in a bit of a rut.
|
| Be sure to keep something around to catch any vomit,
| personally I've almost never not vomited once when it
| starts to kick in. Have music and media to consume
| konfusinomicon wrote:
| ehh it wont(ymmv?) kill ya but it sure will rock your world
| that is certain. truly ill-advised would be to take
| 60-100mg of benedryl with them, that will shatter reality
| itself
| ericjmorey wrote:
| Have you been seeing a therapist about your "baseline" state?
| What do they say about prescriptions for you?
| CannonSlugs wrote:
| Maybe I should have clarified, I don't have any diagnoses and
| don't consider myself depressed in the layman usage of the
| word. The baseline I'm talking about is whatever you call the
| regular Joe state.
|
| Since I anticipate some people might go "so what lasting
| effects did you expect?" I guess I'm thinking more about all
| the amazing stories you read everywhere about psychedelics.
| Even in movies and media it's usually presented as something
| that transforms you in one way or another. I've never quite
| found that to exist.
| brotchie wrote:
| Have done both clinical Ketamine and Psilocybin therapy.
|
| Ketamine was very interesting. Proper completely dissociative
| "K-hole" experience. I feel like it helped with Anxiety, but I
| can't pinpoint "why" from an introspective perspective.
|
| Psilocybin on the other hand. Was a hero dose, and I'm a
| changed person afterwards.
|
| Could feel the "layers" of my identity being stripped off,
| almost regression to a more child-like state. Very interesting
| experience. Had strong synesthesia: sounds would produce
| colors, colors would produce tastes, fun experience.
|
| Near the peak of the experience I had these strong recurring
| auditory hallucination of my mothers says all these random
| words from my youth, these were accompanied by strong feeling
| of anxiety. After a lot of post-experience integration and
| reflection I realized that my mothers anxiety about the world
| was effectively "programmed" into my brain during my
| upbringing. e.g. Generationally transmitted anxiety.
|
| Therapy always talks about childhood trauma, etc, but actually
| experiencing it was another level, and really helped me on my
| journey to being a less anxious person.
|
| Before the Psilocybin experience, I suffered from existential
| depression: what's the point of living if the sun is going to
| explode in ~x billion years. Towards the peak of the experience
| everything was super chaotic, I felt like I was being
| transported into different realities (e.g. realities with
| different laws of physics, or different space time geometries).
| This was hugely anxiety inducing and would otherwise be called
| a "bad trip." I felt "lost" in this sea of all different
| realities.
|
| As I was coming down from the peak and started to reintegrate,
| I had a strong distinct sense of "coming back" to our current
| reality. It felt like finding a safe tropical island in a sea
| of chaos: e.g. our currently reality is a safe space and point
| of stability in a sea of chaos and uninviting realities.
|
| I was truly, deeply, grateful to be able to return to the
| familiar and it made me really really deeply appreciate myself
| and the blessing that our reality is to us.
|
| Post the experience I also acquired the ability to observe my
| emotions from a third person perspective. e.g. rather than
| feeling "angry" I could tag the emotion "angry" and react
| accordingly, almost as if I gained ring 0 access to my brain
| when I previously only have ring 1 access.
|
| All-in-all probably the most profound and healing experience of
| my life. 1. Deeply felt and understood my
| anxiety was generationally passed on from my mother's anxiety,
| 2. Eliminated my existential depression, giving me a deep
| appreciation for the beauty of our reality, 3. Gave me
| ring 0 access to my emotions making me a much more stable, calm
| person.
| ycdavidsmith wrote:
| Beautiful description of your experiences. The psilocybin
| experience sounds like it was guided by a professional? was
| it and if so, how did you find that person?
| junon wrote:
| Have not tried DMT but have the three others. K is... weird.
| It's totally different from shrooms and LSD. With those, you
| can kind of steer your trip. With K, it steers you a bit.
|
| Someone I'm very close to was also addicted, using it for
| emotional suppression. They're luckily off of it and in therapy
| but it can get nasty. Fair warning.
| RomanPushkin wrote:
| > tried Ketamine but I have tried shrooms, LSD, and DMT...
| After one or two days I'm always back to baseline
|
| You did it wrong. You need to micro-dose psilocybe shrooms over
| the course of ~30 days.
| onemoresoop wrote:
| There's not only one way that works for all. Glad microdosing
| works for you
| RomanPushkin wrote:
| Also, try Amanita Muscaria microdosing that has legal and
| different active alkaloid (muscimol, not psilocybin), look for
| the new "Microdosing with Amanita Muscaria" book.
| carabiner wrote:
| I think for some forms of treatment-resistant depression, no
| "rapid" treatment can work because the depression has caused
| physical atrophy, mostly in the hippocampus, over many years.
| Various studies have shown this atrophy, both in MRI and
| cadaver studies. So the tissue loss might take years to recover
| unless we discover some new neurogenic compound (RIP NSI-189).
| Ketamine, SAINT TMS might still work for other depression
| though.
| nbf_1995 wrote:
| I underwent this treatment (Esketamine) a few years ago. I found
| the acute effects (the "trip") right after taking it quite
| unpleasant. But as the treatment went on, my mental state
| improved dramatically.
| user3939382 wrote:
| I knew someone with a horrible addiction/dependence on ketamine
| and justified it by always talking about how it cured depression
| like it was a vitamin.
| sneak wrote:
| I know people who had horrible addictions to ketamine and
| adderall (who also had depression and ADHD) who managed to
| recover from those addictions and years later use them
| appropriately and in reasonable therapeutic doses on a normal
| therapeutic schedule for treatment of same.
|
| Anecdotes are not data and abuse potential isn't really
| relevant to their clinical utility. Do we need to have a
| comment about junkies whenever someone mentions that they
| received fentanyl for a major surgery?
| user3939382 wrote:
| Maybe there's a danger in 100% of the time discussing this
| drug's benefits with no discussion of the risks.
| amanaplanacanal wrote:
| Aren't there _always_ risks with any treatment though? I 'm
| not sure why psychedelics need to be specially called out.
| cantSpellSober wrote:
| Were they the director of the Yale Depression Research Center?
| itronitron wrote:
| and are they hiring?
| konfusinomicon wrote:
| perks include padded floors and walls in the office (yes
| they are pushing RTO too), and free adult diapers for when
| your bladder inevitably fails.
| vajrabum wrote:
| I came here to say this. I know someone who had one dose of
| ketamine for PTSD after a terrible fire. Worked like magic, but
| being a regular ketamine user is mind altering in a way that
| isn't good. These days there are quite a few people who are
| getting ketamine through a doctor on a weekly basis. John C
| Lilly was a regular ketamine user and his crazy-seeming
| thinking and writing later in life is an example to avoid and
| consider.
| thatguysaguy wrote:
| If you find this appealing, make sure to do it with a medical
| professional. If you still want to try it by yourself, read Felix
| Hill's suicide note first.
| ray_v wrote:
| I had to do some digging, but I did find this (who knows if
| it's legitimate or not)
|
| https://docs.google.com/document/d/1-jBoSEVlryiX1IaSzV4vKuih...
| jdthedisciple wrote:
| that was something:/
| throw-qqqqq wrote:
| A friend of a friend took MDMA + Ketamine every weekend. K-hole
| doses. Developed monday-blues which turned into a sort of
| servere depression as he pressed on. It took a year of
| abstinence before he felt "normal" again.
|
| Drugs that affect the serotonine system can do this. Burnout
| from (repeated) overload sort of situation IIUC.
|
| I'm no doctor, but I suspect it's extra dangerous if you're
| already suffering depression.
|
| I couldn't read the whole note. What a tragedy :'(
| golergka wrote:
| Taking MDMA every weekend is like drinking a few glasses of
| hard liquor every day. Meaning, only completely delusional
| and uninformed people would think it won't destroy your life.
|
| Of course, many people still do it. But they are fully aware
| of what road they're taking.
| throw18376 wrote:
| i generally consider myself an enemy of psychedelic advocates,
| because I think they want to make it effectively socially
| mandatory to do these drugs, which is really bad.
|
| ("sure, it's your choice what you put in your body, but a
| really enlightened person wouldn't be so frightened and closed-
| minded that they don't want to see what psychedelics can show
| them...")
|
| of course ketamine for depression has this giant downside risk
| of adverse effects and psychosis, and we should talk about it
| more, not just sell it as a safe miracle drug.
|
| however... safe, neutral, bland, boring well-tolerated SSRIs,
| also have a massive downside risk, in that they can trigger a
| manic episode, which in severe cases also involves psychosis.
|
| so i find myself in the position of being glad there are
| different depression treatments for different people, including
| psychedelics and dissociatives, and hopefully we can find a way
| to make sure people get sorted to the treatments where they are
| least exposed to the tail risk side effects.
| golergka wrote:
| > i generally consider myself an enemy of psychedelic
| advocates, because I think they want to make it effectively
| socially mandatory to do these drugs, which is really bad. >
| ("sure, it's your choice what you put in your body, but a
| really enlightened person wouldn't be so frightened and
| closed-minded that they don't want to see what psychedelics
| can show them...")
|
| I'm sorry WHAT? I've been to many open airs and other events
| where MOST of the people around have been under the effect of
| psychedelic and in other drug-friendly places, and I have
| never hear manipulative shit like that ever. On the contrary,
| if I heard people talk about this drugs it was always "it
| worked for me but might be a bad experience for you", "be
| safe, don't take it if you're not sure" and "you can always
| have a great time here completely sober".
| throw18376 wrote:
| i think that "we all want to get high on drugs" situations,
| like festivals, are actually a lot better. it's about
| personal choice.
|
| when i talk about psychedelic advocates, i mean the people
| who think that widespread use of psychedelic drugs would
| massively improve mental health, make people more
| productive and happier, etc.
| BjoernKW wrote:
| SSRIs are by no means safe or well-tolerated. They have all
| sorts of severe, life-altering, mostly permanent side
| effects: https://en.wikipedia.org/wiki/Selective_serotonin_re
| uptake_i...
|
| There are countless heartbreaking stories of people who were
| prescribed these drugs not knowing what they were subscribing
| to. In many cases, the effects of those drugs are worse than
| the symptoms they are supposed to alleviate. With "I Don't
| Wanna Be Me" there's even a song by Type O Negative (from
| Peter Steele's own experience with Prozac) about the
| devastating effects SSRIs can have on people's lives.
|
| These drugs are handed out like candy while the physicians
| prescribing them often point-blank deny any side effects or
| even attribute those to the illness they are meant to treat.
|
| Psychedelics, on the other hand, have actually been proven to
| be effective for many syndromes SSRIs are commonly used for
| and by comparison are very safe when used with proper
| preparation, medical surveillance, and in the right setting.
|
| The only reason psychedelics are still widely shunned is a
| Puritan attitude to human well-being: You're not supposed to
| feel better than the common neutral base level. Any drugs
| achieving that (alongside with other, more specific and
| intended medical effects) are maligned and ostracized.
| ub-volta-toss wrote:
| I did this a few times and found it miraculous. The doses were
| sub k-hole, it just made the world seem cottony and soft. The
| effect on my psyche was lasting and positive.
|
| A friend who struggles with depression found it useful for a
| while, but its effects didn't continue after a number of doses.
| jgambier wrote:
| When I was going through a rough time and SSRIs weren't helping,
| read all the research on what other solutions were out there.
| Psilocybin seems to be the most effective but is only legal in
| Oregon and price quotes were $3,500 for one session. Ketamine
| coupled with TMS (Transcranial Magnetic Stimulation) was the
| second. Since both are legal and my insurance covered them, opted
| to choose these. I will say that the various meta-analyses have
| some conflicting results.
|
| TMS seemed to be pretty effective for me. It feels incredibly
| silly to have your brain zapped and is a big time commitment (30
| days, 1X a day for 10 minutes) but I can't argue with the
| results.
|
| Ketamine was something else. I did it intravenously, which seemed
| to be the best way to manage dosage but required going into a
| clinic. The biggest downside to the whole treatment is that
| you'll be very drowsy and sometimes down after, and all I wanted
| to do was go to bed. Taking the Uber home is not pleasant. The
| esketamine nasal sprays allow you to do it at home at lower
| dosages.
|
| Once you get over the feeling of leaving your body, it can be
| quite nice. Overall, it led to unblocking some life time hold ups
| I had, and made me a better person. I had 5 sessions, 4 of them
| were overwhelmingly positive. The last was a dark couple hours
| where I hyperfocused on all my internal fears and failures. It
| also led to a lot of existential thoughts and questioning the
| fabric of reality which isn't all bad in small doses. I can see
| how excessive use could start to be counterproductive, it's good
| to stay connected to this reality. I don't understand how people
| use this as a party drug.
|
| I would absolutely recommend it in a controlled setting for
| limited treatment, but would caution those with addictive
| personalities to be careful, not to see it as a silver bullet or
| a crutch, to make sure you're in a neutral mental space and that
| you're comfortable wherever you're doing it. In tandem, I
| listened to a fair amount of buddhist podcasts from Joseph
| Goldstein that helped build out the spiritual/learning side.
|
| I'd like to see psylocibin treatment be more readily available at
| a lower price across the nation as an alternative.
| golergka wrote:
| > Psilocybin seems to be the most effective but is only legal
| in Oregon and price quotes were $3,500 for one session
|
| That's a completely ridiculous price, about 300-500 times the
| "street" price of shrooms. In countries that I have familiarity
| with (not USA), shrooms have always been "technically illegal"
| drug which law enforcement never actually actively enforced,
| either formally through procedure (with doses below 100 grams
| considered fine-only territory), or informally, because the
| cops just don't take it seriously.
|
| So to me it seems like you're choosing to follow the law even
| though it would not hurt anyone and you would not get into any
| trouble, just out of pure principle. That's actually quite
| impressive.
| avtar wrote:
| > That's a completely ridiculous price, about 300-500 times
| the "street" price of shrooms
|
| I'm not going to argue that the exact rates are justified,
| but chances are the person you're replying to was referring
| to psilocybin assisted therapy in clinical settings. So
| someone would be signing up to pay for having at least one
| therapist oversee the process, if not physicians and other
| staff as well. Factor in their time, operating costs,
| insurance, etc. it shouldn't be a surprise that the legal
| option will cost considerably more than buying mushrooms in a
| paper bag :)
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