In a new study, researchers found that ketamine infusions failed to beat an active placebo as an adjunctive therapy for patients hospitalized with depression. The KARMA-Dep 2 study compared ketamine infusions to midazolam, an “active placebo” that mimics ketamine’s sedative effects.
There was no statistically significant difference between groups on measures ranging from depression severity (measured with two different assessments, the MADRS and the QIDS), to cognition, to quality of life.
“The KARMA-Dep 2 trial did not find evidence that serial ketamine infusions were superior to an active comparator for inpatients with moderate to severe depression,” the researchers write.
The study was led by Ana Jelovac at Trinity College Dublin and published in JAMA Psychiatry.
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Cool, now prove to me that “depression” is an objective thing that needs chemical “treatment”. If this study uses DSM criteria to select who’s “depressed”, it’s not a scientific study, it exists off the assumption that depression is an objective thing we can measure, and that we can compare depression between different people.
THIS is the problem with most of the “research” on this site. We (should) know the DSM is a bunch of pseudoscientific crap, so why are we still using it to select samples for “research”? It’s finding a solution in search of a problem and testing it by only finding those people who you think will see the biggest impact… and then calling that crap “science”.
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Do you think we should do research on emotions at all?
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“Continues to” seems a bit much given that there have been a number of studies that do show a difference. I think it’s important to note here that:
a. This was an inpatient trial, whereas ketamine is often used as an outpatient therapy, and
b. The participants were seemingly on a lot of other drugs at the time.
I think this study shows we are still learning when and where ketamine can be helpful, so a good question to ask is why it wasn’t helpful in this scenario but was in others. Does being stuck in a psychiatric ward undermine the effects? Is it more helpful for those who have direct support from and contact with friends and family? What was the environment like for the participants while on the drug in each of these studies, and does that affect how much difference they see? Does being on other drugs have an effect? I think seeing studies with seemingly opposing results is actually a great opportunity to find the differences and figure out exactly when something can help and when it can’t. These drugs shouldn’t be the first or only help offered, but it’s clear that they can help people have better lives in some circumstances.
In the US there’s definitely an overprescribing problem and no one who’s saying a drug is the solution to all of someone’s problems is being real. But that doesn’t mean drugs never help. Being open with my partner and family and getting their support, adjusting my diet and getting more exercise, pursuing things I’m excited about, sleeping enough, drinking enough water, finding the routines that help me function, spending time with friends, having cats, building financial stability, and, yes, going to therapy and being on an SSRI, have all changed my life tremendously. It’s never just one thing, and I think that’s what some of these studies (and reporting on them) forget.
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Prove by 5hiaa test that there is a shortage of serotonin before a treatment with antidepressants.
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Ketamine is a life raft for those who are drowning, a radical, temporary intervention when all else seems to be inadequate. However, we have not been creative enough to find other life rafts that do more good than ketamine, ones that allow us to onshore safely. Ketamine is not a bridge to anything else, it is a stand alone fire hose to douse a runaway forest fire. But, for now, it’s available, can be useful when other alternatives seem distant.
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Ketamine is far less radical then screwing up your brain (and body) neurotransmitter chemistry (possibly forever) using addictive drugs with myriad adverse effects.
This study and its conclusions are garbage. All these patients were each on multiple psych meds – the 62 patients were on a total of 175 psych meds = almost 3 meds per person! during the trial. The ketamine group was actually even higher on average at more than 3 psych meds per patient.
Ketamine (or any other actual helpful treatment) cannot reverse the ongoing negative effects and damage from psych med polypharmacy, nor hope to alleviate depression under that circumstance. Add to that the fact that these people were all in a hospital psych ward, where almost everyone leaves worse off than they came in! This study seems like planned failure, as in this is the result they wanted. Most well designed studies and overwhelming numbers of actual patient experiences show very high percentage of Ketamines effectiveness, with minimal side effects.
Psychiatrists played polypharmacy roulette with my brain and body for more than 15 years, causing multiple hospitalizations (always came out worse than I went in), permanent damage to my brain, hearing, and mind, with multiple antidepressant induced manias, and made me increasingly suicidal. They hurt my marriage, my children, and cost me my career. Tardive dysphoria and prolonged withdrawal are real and leave permanent, irreversible damage.
Ketamine infusions are the only reason I’m still alive. I have been getting them every 6-8 weeks for over 10 years. I know Ketamine doesn’t work for everyone, but it will help the majority of people who try it. But if you want it to have the best chance of success – be on minimal (or no) psych meds when you try it, (also DON’T be in withdrawal), and don’t be in a psych ward on 2,3, or 4 psych meds!
And, it should be used INSTEAD of psych meds, which cause irreparable harm and work long term for almost nobody. Most depression patients who finally find Ketamine have been through years and years the same miserable psych drug roulette.
This trials’ conclusions are similar to the recent British medical journal piece that has reiterated the claim (based on cherry-picked data/non-relevant studies) that antidepressant withdrawal was mild and minimal for all but a few people. (The hundreds of thousands of us who have lived/are living through it would beg to differ, and none of us survive it unchanged/ undamaged. For some (PSSD, Tardive dysphoria, Tardive dyskinesia) it never goes away. Many do not survive.
Big Pharma does not want you to know about psych med withdrawal until you are hooked. Then you will be told “it’s your disease getting worse and we need to up your dose/add (sell you) more & different (addictive) meds.” Customer for life is the goal.
Big Pharma also does not want you to know that Ketamine is safe and effective, cheap, and non-patentable. Who would they sell all their poison pills to, and what would all the “10 minute medication adjustment appointment” shrinks do if their patients discovered Ketamine.
BUT!!! -find a provider who has experience administering Ketamine for depression – clinic mills are bad for any kind of medicine, and you can have a really horrifying experience with Ketamine if they don’t understand you as a patient and this very unique treatment. I drive 800 plus miles round trip to another state for my infusions. Would anyone do that for 10 plus years if it didn’t work? (I have tried several local clinics – horrifying experiences referenced above.)
I will gladly recommend my Ketamine treatment provider to anyone. Also, talk to Ketamine patients before you try it. There are simple things that can make the experience much better, more successful.
If you have tried and failed in every other treatment and are ready to die so you can feel better, there’s a good chance Ketamine can save your life/make it liveable. If this is your first depression “rodeo”, try Ketamine first and save yourself from the medication hell thousands of us have lived through.
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I bet if you banned degree-holders and had the discussion be entirely psychiatric survivors, they would come up with some actual workable ideas for things that would help people right now.
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