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posted by martyb on Sunday December 17 2017, @02:55AM   Printer-friendly
from the improved-outlook dept.

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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Study Suggests Psilocybin "Resets" the Brains of Depressed People


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  • (Score: 3, Interesting) by Ethanol-fueled on Sunday December 17 2017, @03:27AM (10 children)

    by Ethanol-fueled (2792) on Sunday December 17 2017, @03:27AM (#610844) Homepage

    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.

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  • (Score: 1, Interesting) by Anonymous Coward on Sunday December 17 2017, @03:50AM

    by Anonymous Coward on Sunday December 17 2017, @03:50AM (#610845)

    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)

    by JoeMerchant (3937) on Sunday December 17 2017, @04:27AM (#610855)

    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)

      by Anonymous Coward on Sunday December 17 2017, @05:06AM (#610866)

      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.

      You fundamentally misunderstand depression.

      • (Score: 3, Interesting) by Hartree on Sunday December 17 2017, @08:19PM

        by Hartree (195) on Sunday December 17 2017, @08:19PM (#611070)

        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)

    by Azuma Hazuki (5086) on Sunday December 17 2017, @04:38AM (#610860) Journal

    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)

      by Ethanol-fueled (2792) on Sunday December 17 2017, @04:44AM (#610864) Homepage

      " Isn't that that horse tranquilizer shit that causes people to disrobe outside and walk down the streets laughin' and pissin'? "

      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)

        by Hartree (195) on Sunday December 17 2017, @08:00PM (#611064)

        I'd classify alcohol as a hard drug.

        • (Score: 0) by Anonymous Coward on Sunday December 17 2017, @08:37PM (1 child)

          by Anonymous Coward on Sunday December 17 2017, @08:37PM (#611074)

          Nah, it's pretty easy. You drink it, and it just works.

          • (Score: 2) by Hartree on Sunday December 17 2017, @08:44PM

            by Hartree (195) on Sunday December 17 2017, @08:44PM (#611079)

            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

    by Anonymous Coward on Sunday December 17 2017, @10:05AM (#610939)

    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.