Study: Suicidal Thoughts Rapidly Reduced with Ketamine
Ketamine was significantly more effective than a commonly used sedative in reducing suicidal thoughts in depressed patients, according to researchers at Columbia University Medical Center (CUMC). They also found that ketamine's anti-suicidal effects occurred within hours after its administration.
The findings were published online last week in the American Journal of Psychiatry.
Ketamine for Rapid Reduction of Suicidal Thoughts in Major Depression: A Midazolam-Controlled Randomized Clinical Trial (DOI: 10.1176/appi.ajp.2017.17060647) (DX)
The reduction in SSI score at day 1 was 4.96 points greater for the ketamine group compared with the midazolam group (95% CI=2.33, 7.59; Cohen's d=0.75). The proportion of responders (defined as having a reduction ≥50% in SSI score) at day 1 was 55% for the ketamine group and 30% for the midazolam group (odds ratio=2.85, 95% CI=1.14, 7.15; number needed to treat=4.0). Improvement in the Profile of Mood States depression subscale was greater at day 1 for the ketamine group compared with the midazolam group (estimate=7.65, 95% CI=1.36, 13.94), and this effect mediated 33.6% of ketamine's effect on SSI score. Side effects were short-lived, and clinical improvement was maintained for up to 6 weeks with additional optimized standard pharmacotherapy in an uncontrolled follow-up.
Wikipedia's entry on midazolam notes:
Midazolam, marketed under the trade name Versed, among others, is a medication used for anesthesia, procedural sedation, trouble sleeping, and severe agitation. It works by inducing sleepiness, decreasing anxiety, and causing a loss of ability to create new memories. It is also useful for the treatment of seizures
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(Score: 0) by Anonymous Coward on Sunday December 17 2017, @03:01AM (4 children)
Death! Death reduces suicidal thoughts in depressed patients. Let's proscribe "death"? No???
(Score: 2) by takyon on Sunday December 17 2017, @03:09AM (2 children)
That's for the control group.
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(Score: 0) by Anonymous Coward on Sunday December 17 2017, @03:25AM (1 child)
No problem. A full frontal lobotomy may also work, or how about opiate addiction? Have you ever taken a serious dose of Ketamine? I'm not sure you'd have posted this story if you had.
(Score: 1, Touché) by Anonymous Coward on Sunday December 17 2017, @04:36AM
What about Jimsonweed? I want to hear that story about Jimsonweed again.
(Score: 2) by Hartree on Sunday December 17 2017, @07:58PM
Ok. You first!
(Score: 3, Interesting) by Ethanol-fueled on Sunday December 17 2017, @03:27AM (10 children)
Isn't that that horse tranquilizer shit that causes people to disrobe outside and walk down the streets laughin' and pissin'?
Midazolam doesn't sound much better, Hannibal Lecter comes to mind in drugging others with meds that are given to brain surgery patients to remain responsive during a neurosurgery.
(Score: 1, Interesting) by Anonymous Coward on Sunday December 17 2017, @03:50AM
Ketamine works better than the alternatives and can be done with one weekend session every couple of months along with therapy to work through the long term issues.
Given that said member is in a high stress job, this has worked out quite well for them, and unlike alternative treatments doesn't run afoul of their on-the job drug restrictions like other solutions would. By the time they are back at work they are clean, clearheaded, and stress free.
That is better than 9/10s of us out here working a 9-5.
(Score: 2) by JoeMerchant on Sunday December 17 2017, @04:27AM (2 children)
Ketamine isn't just for horses... I've used it on little pigs too, really takes the edge off their anxiety.
Seems that most of the key to curing suicidal depression is forgetting why you want to kill yourself, and special K is right up there with ECT for memory wiping, at least temporarily.
Now, if people could only rearrange their lives and their expectations of what life should be, so they weren't miserable in the first place, the drugs wouldn't be necessary.
🌻🌻 [google.com]
(Score: 4, Insightful) by Anonymous Coward on Sunday December 17 2017, @05:06AM (1 child)
You fundamentally misunderstand depression.
(Score: 3, Interesting) by Hartree on Sunday December 17 2017, @08:19PM
Bingo. As someone who has had to deal with (well controlled) major depression for decades, I can tell you it's a lot more than just letting things build up on you. That's what you see from the outside, but the effect is that of putting a negative cast on the world no matter what the reality is. And that viewpoint is just as hard to disbelieve as telling yourself that the fire your hand is smoldering in is not real and you should ignore it. (Yes, it can be done to some extent, but just telling someone to do it without a lot of training (therapy, etc.) is probably futile)
The way it's starting to appear Ketamine works for depression is to some extent unrelated to the subjective feelings it generates in your mind. Though it dissociates some of the pain, it apparently (the research is still ongoing) causes the rapid formation of many more synapse junctions between nerve cells in some parts of the brain. That may be why the antidepressant effects seem to be delayed by a few hours. You have to synthesize all the proteins and other components of those new synapses and move them into place.
Similarly, some researchers suspect that the delay of weeks for SSRIs to take effect is that nerve cells are developing from neural stem cells and moving into position. Not surprisingly, this takes time.
I put all those qualifiers in because this is a very active area of research and we don't understand it very well. This is the best guess the last I knew, but is subject to someone finding out that parts or all of it is wrong. That's science in action.
(Score: 2, Interesting) by Azuma Hazuki on Sunday December 17 2017, @04:38AM (4 children)
Why do you always sound like you have firsthand experience with stuff like this?
I am "that girl" your mother warned you about...
(Score: 1) by Ethanol-fueled on Sunday December 17 2017, @04:44AM (3 children)
Maybe because I don't. Or maybe because I didn't need the excuse of a hard drug to walk down the streets pissin' and laughin'.
(Score: 2) by Hartree on Sunday December 17 2017, @08:00PM (2 children)
I'd classify alcohol as a hard drug.
(Score: 0) by Anonymous Coward on Sunday December 17 2017, @08:37PM (1 child)
Nah, it's pretty easy. You drink it, and it just works.
(Score: 2) by Hartree on Sunday December 17 2017, @08:44PM
You've probably never tried to find a bootlegger in an unfamiliar dry town on Sunday morning.
(Score: 0) by Anonymous Coward on Sunday December 17 2017, @10:05AM
Due to its safety its also been used on children, the 're-emergence' effected experienced by adults results in too many people babbling about seeing god which embarrassed the doctors who had a job to do and didn't want to explain or discuss it. In the absence of a skilled anesthetist ketamine is an obvious choice.
(Score: 0) by Anonymous Coward on Sunday December 17 2017, @03:51AM (3 children)
This is now two drug articles in a row from martyb and takyon. I think they ought to check into rehab.
(Score: 3, Touché) by takyon on Sunday December 17 2017, @03:59AM (1 child)
If we did that, we wouldn't be able to inform you of these great treatments for your crippling depression.
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(Score: 2) by Runaway1956 on Sunday December 17 2017, @08:38AM
They don't have wifi at the rehab center? Hell, man, just take a router with you, and hook the damned thing up! The luddites won't have any idea what you're doing!
“I have become friends with many school shooters” - Tampon Tim Walz
(Score: 2) by Hartree on Sunday December 17 2017, @08:03PM
It's strictly for medicinal and research purposes. ;)
(Score: 0) by Anonymous Coward on Sunday December 17 2017, @03:52AM (5 children)
Drugs make you feel good! News at 11
(Score: 0) by Anonymous Coward on Sunday December 17 2017, @04:13AM (4 children)
Well, the way I heard it, the illegal drugs make you feel good. Legal ones not so much. But my information is from the dark ages (1970s), haven't kept up since getting out of college.
(Score: 2, Insightful) by Anonymous Coward on Sunday December 17 2017, @04:24AM (3 children)
All illegal drugs were legal once, legality is just a filter for effectiveness in this puritanical age.
(Score: 1, Interesting) by Anonymous Coward on Sunday December 17 2017, @05:09AM (2 children)
Yep. If you want something that will help cure a mental difficulty holding you back, you're not going to find it in the legal selection. You might become successful without that mental difficulty, and people who are already successful hate competition.
(Score: 5, Insightful) by deimios on Sunday December 17 2017, @05:59AM (1 child)
No need to go looking for conspiracy theories when you can blame capitalism: Treatments that temporarily suppress symptoms bring in boatloads more money than treatments that eliminate the sickness.
(Score: 2, Insightful) by Anonymous Coward on Sunday December 17 2017, @06:39AM
There's also the control element - if people depend on you for medicine, you have power over them. Curing people relinquishes that power. Keeping addictive drugs illegal is also a power thing. When someone has a dependency on a substance that isn't legal you can exploit and control them at every turn, whether it's through the law or through the substances. Prohibition is an authoritarian's wet dream.
(Score: 3, Interesting) by Pav on Sunday December 17 2017, @07:40AM (6 children)
I was given Ketamine, but it doesn't kill pain... it just makes you not care. I was in agony due to gallstone pain, and in less than 24 hours they took my gall bladder out (yay universal healthcare). The head nurse said they should discontinue the ketamine. I KNEW I was in screaming agony, and I also knew if they stopped I'd begin to care about it again, but even though I KNEW this I also didn't care enough to tell them. Weird weird stuff, and I can't understand why anyone would want to do it recreationally, although if someone is in emotional pain I can certainly see how it would help.
(Score: 2) by cubancigar11 on Sunday December 17 2017, @11:21AM (3 children)
Hallucinations?
(Score: 2) by Pav on Sunday December 17 2017, @12:21PM (2 children)
I never hallucinated. Is that meant to be a side-effect?
(Score: 2) by cubancigar11 on Sunday December 17 2017, @02:54PM (1 child)
That is what I have heard. https://erowid.org/chemicals/ketamine/ketamine_effects.shtml [erowid.org]
(Score: 2) by Pav on Monday December 18 2017, @01:41AM
The only effect close to a hallucination was auditory right after I was injected... like industrial noise... a jet engine except lower pitch. Not pleasant... quite the opposite actually.
(Score: 2) by Hartree on Sunday December 17 2017, @08:06PM (1 child)
It's a dissociator. I've heard their effects described as thinking "Wow. That's a lot of pain. I'm glad it's not happening to me."
(Score: 3, Interesting) by Pav on Sunday December 17 2017, @09:03PM
Vilanor Ramachandrin, the brain anatomist (and excellent communicator) talks about Capgras delusion - thinking that someone close to you is an imposter, often after a brain injury. His theory is that emotion becomes disassociated from vision because a "wire" has been cut somewhere, and the person in question develops a theory on-the-fly as to why this is. Having been administered ketamine it's certainly a strange experience, and I would have never otherwise understood how fundamental emotion is to the perception of pain.
(Score: 0) by Anonymous Coward on Monday December 18 2017, @11:21AM
... reduces all thoughts (whether suicidal or not) in all patients (whether depressed or not).