Open Thread: ‘Medical Miracle’ of the Week

Study touts horse tranquilizer Ketamine as ‘magic’ anti-depressant:

Ketamine, a general anesthetic usually administered to children and pets but perhaps best known as a horse tranquilizer, is also highly effective in low doses as an anti-depressant, according a study published Thursday.
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Researchers at Yale University wrote in the August 20 issue of the journal Science that unlike most anti-depressants on the market which can take weeks to take full effect ketamine can begin to counter depression in hours.
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“It’s like a magic drug — one dose can work rapidly and last for seven to 10 days,” said Ronald Duman, professor of psychiatry and pharmacology at Yale and senior author of the study.
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The researchers noted that ketamine was tested as a rapid treatment for people with suicidal thoughts. Traditional anti-depressants can take several weeks to take effect, they noted.
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The researchers found that ketamine improves depression-like behavior in rats by restoring connections between brain cells damaged by chronic stress.

Whatever the cost benefits of giving depressed individuals a shot of “Special K” as an alternative to long-term therapy, I wanted to highlight the “chronic stress” issue. For all the attention paid to the delicate feelings of Wall Street banksters and other highly-paid criminals, being poor is one of the main causes of chronic stress, as well as contributing to many other sources (untreated medical conditions, bad nutrition, family dysfunction, dangerous living environments). And chronic stress will shorten your lifespan even when it doesn’t lead directly to suicide. But I can confidently predict that this study will lead to a spate of thumb-sucking (finger-wagging) articles about the “dangers” of allowing people who can’t afford six weeks at Hazelden to “self-medicate”. And a bunch of pharmaceutical funding diverted to coming up with a “boutique” (i.e., patentable) version of ketamine that can be marketed to Medicare users as a longterm mood improver…

(h/t General Stuck for the link)

51 replies
  1. 1
    Mnemosyne says:

    This is, actually, very good news, because there’s a sizable minority of people for whom the current anti-depressants don’t work at all, or only work for a short time. It could quite literally be lifesaving for some people.

  2. 2
    Omnes Omnibus says:

    Didn’t PCP start out as an animal tranquilizer?

  3. 3
    demimondian says:

    As someone who spent years trying different anti-depressants before finding one which worked for me, I will tell you that any medicine that works for someone who is chronically depressed is no small matter. One that works quickly will save many, many lives — those two weeks while you wait to see if *this one* will work are horrible.

  4. 4
    Mike Kay says:

    Here lies Howard Dean’s political career.

    1979 — 2010

    I told you guys in December when he was shouting ‘kill da bill” he was unstable.

  5. 5
    Violet says:

    Article in Wired on chronic stress:

    In the decades since, Sapolsky’s speculation has become scientific fact. Chronic stress, it turns out, is an extremely dangerous condition. And not just for baboons: People are as vulnerable to its effects as those low-ranking male apes. While stress doesn’t cause any single disease — in fact, the causal link between stress and ulcers has been largely disproved — it makes most diseases significantly worse. The list of ailments connected to stress is staggeringly diverse and includes everything from the common cold and lower-back pain to Alzheimer’s disease, major depressive disorder, and heart attack. Stress hollows out our bones and atrophies our muscles. It triggers adult-onset diabetes and is a leading cause of male impotence. In fact, numerous studies of human longevity in developed countries have found that psychosocial factors such as stress are the single most important variable in determining the length of a life. It’s not that genes and risk factors like smoking don’t matter. It’s that our levels of stress matter more.
    __
    Furthermore, the effects of chronic stress directly counteract improvements in medical care and public health. Antibiotics, for instance, are far less effective when our immune system is suppressed by stress; that fancy heart surgery will work only if the patient can learn to shed stress. As Sapolsky notes, “You can give a guy a drug-coated stent, but if you don’t fix the stress problem, it won’t really matter. For so many conditions, stress is the major long-term risk factor. Everything else is a short-term fix.”

    Stress really is a killer.

  6. 6
    beltane says:

    I’d be a little cautious about this drug. According to an old ob/gyn book I have, Ketamine was used in the 1960s to treat women in labor. Some of the more unpleasant side effects were psychosis, memory blackout, and catatonia. It really doesn’t sound like a good candidate for casual self-medicating though it may be a valuable drug in a clinical setting.

    Why is Ecstasy considered so horrible? I forgot.

  7. 7
    KG says:

    Special K? That is soooooo 1999.

  8. 8
    Mike Kay says:

    In other tales of Feet of Clay:

    Jerome armstrong, co-author with dkos proprietor, His Holiness Markos Moulitsas, of “Crashin the Gates” is opposing the nyc mosque, comparing religious freedom defenders to “gun nuts”.

    http://www.balloon-juice.com/2.....nt-1969091

    This guy is actually in business with Markos. I think it’s time for markos to divest himself from this loon, otherwise Muslims and first amendment progressives should divest themselves from markos’ business properties.

  9. 9
    lamh32 says:

    I’m reluctant to share this story will y’all, since so many here are such big animal lovers, and maybe card carrying members of PETA, but I have a persoanl memory that deals with ketamine.

    When I was a lowly college senior (and until I became a Med Technologist) I used to work for a Opthalmology research lab in NOLA, as a “student” research assistant. For one of the studies we were working on, we used live animals, in this case white rabbits, to study the cause of “dry eye”/glaucouma diseases, by surgically removing the lacrimal gland (gland that utilized in making tears). Literally we collected, the rabbits tears from the surgically “de-hanced” (sp?) eye, and the normal eye, and comparing the lipid/protein composition of the tears. the info gathered from this experiment was financed by both the medical school, and Baussh & Lombes(sp?), I forget why, but I think something to do with contact lenses, and such…

    Anyway, I distintly remember that when we were finished with whichever particular rabbit, we had to terminate the animal before forwarding the carcass (for the lack of a better word) to animal control, we used a syringe of ketamine shot directly into the heart of the rabbit to stop the heart, which was more “humane” but took longer and was less effective than the simpler “stabbing in the heart with a scapel” method.

    I remember being told to make sure that I hit the heart with the syringe, because if not, then the heart would obviously not stop, and the ketamine may wear off, and the rabbit would become revived before animal control disposal.

    It was not my most favorite part of the job by any means, and I remember making every effort to never have to be the one who had to administer the ketamine “kiss of death” by myself.

    Gruesome story, but all true.

  10. 10
    beltane says:

    @Mike Kay: Here’s a tidbit of news you’ll enjoy: The Vermont Progressive party (which always ran third-party challengers against Dean, and which has been of immeasurable help to the Republicans over the years) officially endorsed Doug Racine in the Democratic primary, promising not to run a spoiler candidate in the general. This angered a splinter group of Progressive activists who have come out in support of another Dem. What are the odds that they still run a spoiler candidate?

  11. 11
    beltane says:

    @Mike Kay: Markos is still in business with that kook? Haven’t heard the name Jerome Armstrong since mid-2008; I just assumed he went Galt after Obama won the nomination.

  12. 12
    Mike Kay says:

    @beltane: no, he’s still full PUMA, even resorting to quoting Commentary magazine to bash the president.

    On the fun side, his site has complete collapsed. It used to get 100,000 visitors per day during the primaries, now it’s down to 4,200 per day.

    The wacky part is the elite bloggerotti still hold him in high regard. Glenn and whatshername hired him to run Halter’s website during the arkansas primary

  13. 13
    PeakVT says:

    @Mike Kay: If you have a complaint about Moulitsas or Armstrong, why don’t you take it up with them?

  14. 14
    BR says:

    This has been indicated for some time, but it’s good to see additional studies on it.

    Might I mention, numerous illicit-for-no-reason substances have valuable medical applications:

    MDMA has been shown to help treat PTSD.
    Cannabis has been shown to help treat numerous issues.
    Salvia Divinorum (not illegal in most places) has been shown to be useful to treat alcohol and cocaine addiction and is a mild anti-depressant.
    Psilocybin and LSD have been shown to treat cluster headaches and other issues.

    And don’t forget the 2006 Johns Hopkins study on Psilocybin:

    http://www.heffter.org/research-jhus.htm

    That study found that Psilocybin can produce meaningful and positive changes in one’s life.

  15. 15
    Arclite says:

    Great article. Someone close to me suffers from depression, much of it stress related. Perhaps something like this can turn her back to how she used to be…

  16. 16
    Bruce (formerly Steve S.) says:

    I can’t decide if I want the Muslim mail order bride or the Aerie bra model. Maybe both?

  17. 17
    Suffern ACE says:

    @Mike Kay: I don’t get it. I can understand some sentiment that perhaps the issue of one community center in NYC is not worth an existential battle, especially when public sentiment clearly isn’t on our side. I get that that “pragmatism.” It is also very possible that the center won’t get constructed because the funds to start construction will be slow in coming…but why the tweet that “Howard Dean is Correct. Islam in places like Iran is stuck in the 12th Century.”

    But we aren’t talking about an institution to serve Iranians in the 12th century. Is that supposed to calm “our side” down so that we can discuss the needs of Muslims in New York in the 21st century? Or is he saying that because Iranians are conservative, progressives should never be concerned when they are being treated unfairly?

  18. 18
    Ella in New Mexico says:

    @Mike Kay:

    lt’s called “Good Cop–Bad Cop”. Or maybe, if Democrats sound “reasonable” on the “9/11 Mosque” issue, then the Repukelickans can’t claim it as their own litmus test du-jour.

    Read his words carefully.

  19. 19
    cleek says:

    Ketamine, a general anesthetic usually administered to children and pets but perhaps best known as a horse tranquilizer,

    hmm… i actually know it best as a popular club drug, where being stoned on it is sometimes known as being in a K-hole. which sounds stupid.

    not that i’ve even been there personally… but i have friends.

  20. 20
    Mike Kay says:

    @PeakVT: what makes you think I haven’t. Plus, they’re public figures. Book authors of “Crashing the Gates”. Heh!

    Jerome is trash for muslim bashing and comparing religious freedom to “gun nuts”. He should be called out, as well as any of his partners.

  21. 21
    Keith G says:

    @KG: A “K” hole.

    Hmmm. Considering the way the news has been going, that might not be a bad idea.

  22. 22
    Ella in New Mexico says:

    @beltane:

    I believe that medication was Scopolamine, and it only induced memory loss, no pain relief.

  23. 23
    scarshapedstar says:

    @Ella in New Mexico:

    They gave Scopolamine to women in labor?!

  24. 24
    Mike Kay says:

    @Suffern ACE:

    “Islam in places like Iran is stuck in the 12th Century.”

    He’s always been a low rent knuckle dragger.

    It was only a year ago when we saw Iranians go into the street over a rigged election. Yet the slob dehumanizes patriots who fought and died for 21st century freedom.

  25. 25
    Mike Kay says:

    @Ella in New Mexico: oh please. he spent 20 minutes on Olbermann tonight backpeddling faster than lance armstrong.

  26. 26
    beltane says:

    @BR: The@Ella in New Mexico: What an awful thing to give to women. In the late ’60s, my mother was put under general anesthesia, which was common back then.

  27. 27
    beltane says:

    @Mike Kay: If Armstrong has been reading Commentary, this makes sense. He has gone over to the neocon side of town. Hope he enjoys the neighbors.

  28. 28
  29. 29
    Alwhite says:

    So, I don’t get it – we have had a bunch of threads where everyone gets to bash KOS/Firedog/whatever. Then there is this thread about a different issue & Mike Kay tosses off a pointless OT comment that gets ignored for a few comments so he strikes again. Then the thread is off on a rant about the evil people who do not agree with my opinion 100%. Its not like there won’t be a dozen more threads for this mental masturbation shortly.

    In the meantime has three been any investigation of the side affects of ketamine?

  30. 30
    beltane says:

    @BR: Sorry. I was going to write about cannabis and arthritis pain and then lost my train of thought when I went downstairs to let the cat in.

  31. 31
    Mnemosyne says:

    @beltane:

    It really doesn’t sound like a good candidate for casual self-medicating though it may be a valuable drug in a clinical setting.

    Trying to self-medicate a serious mental illness — which is what depression is — is always a bad idea.

    Just sayin’.

  32. 32
    Lysana says:

    My first reaction to ketamine is remembering my raver days and how it’d suck to get K instead of E (some dealers were that evil, thus the development of groups who’d test your pills for you and post warnings online as to which were what).

    Past that? If it’s low-dose once a week instead of club dosage? I do hope that works out. Suicidal ideation, PTSD, and other chronic stresses having a means of being healed in the brain? Sign me up.

  33. 33
    Mike Kay says:

    @Alwhite: dude, check the title of the thread, it says “open thread”.

    by definition, you can’t be off topic in an “open thread”.

  34. 34

    From reading the article, there is much work to do to find out which metabolites are responsible and what pathways in the brain they work through. The really big thing that sets it apart from the other anti depressants is not only that it showed to work at around 70 percent of the 40 percent that find no relief from the current stable of AD’s, but that they work in a matter of hours. It is a whole new process that they will need to map out and could lead to some awesome discoveries of treating mental illness of all kinds.

    BTW, we used to snort what we called Tee, or T, why I don’t know, to get high back when we were dumb as dirt. Word was it was animal tranquilizers.

    and thanks for HT Anne Laurie.

  35. 35

    And a bunch of pharmaceutical funding diverted to coming up with a “boutique” (i.e., patentable) version of ketamine that can be marketed to Medicare users as a longterm mood improver…

    I thought that what beer was for.
    Although when its cold, maybe its vodka.

  36. 36
    SBJules says:

    @Omnes Omnibus:

    I seem to remember that we called PCP the animal tranquilizer drug.

  37. 37
    BobS says:

    We use ketamine in our ER for what are referred to as ‘procedural sedations’ in pediatric patients, i.e. painful and/or anxiety producing procedures such as fracture reductions, suturing, longer imaging studies such as MRIs, etc.
    It’s a ‘dissociative’ anesthetic, which in a nutshell means it chemically severs the pathway from the limbic system to the cortex. It produces a ‘zombie’ like state in the patient while allowing them to maintain their protective airway reflexes. I have never had a bad experience with a patient sedated with ketamine.
    It’s use is discouraged in the adult population because of what are termed emergence reactions, which is essentially a hallucinatory state in an otherwise conscious patient. On the other hand kids, especially younger ones, approximate a hallucinatory state normally, inasmuch as reality is a rapidly evolving concept with them. I’ve never seen one as much as flinch as they emerge from sedation, and most of them are pretty entertaining. I suspect most adults would also handle it pretty well, particularly those with some familiarity with the psychedelic experience.
    The overuse of psychotropic medications for depression, ADHD, etc. is another story entirely. People would be shocked at the number of children taking not just a single antidepressant or amphetamine (like Ritalin), but in many instances taking 2, 3, or more medications.

  38. 38
  39. 39
    mclaren says:

    Judging by his posts, General Crackpot Fake Name probably uses this stuff. Along with PCP and who-knows-what-all.

    For the rest of us, listening to some music and drinking a tall glass of ice water suffices.

  40. 40

    @mclaren: when I first read this story, I thought of you Mclaren, that this discovery could bring you (and us) some much needed relief. Maybe you could volunteer for the next round of trials.

  41. 41
    Steeplejack says:

    @Bruce (formerly Steve S.):

    Man, I need to flush my browser cache. I’m getting ads for ADHD drugs and Shoes for Crews.

  42. 42

    i really don’t think the portion of our society that chooses its own reality, and is damned certain their choices are the only ones anyone should ever make, should experience something like the k-hole…where you must be conscious on some level that what you perceive may or may not be real, that what you are thinking, may not exist outside of your own mind

  43. 43
    Steeplejack says:

    @cleek:

    I am more familiar with the Floyd hole.

  44. 44
    Sheila says:

    Why is this better than marijuana — or meditation, for that matter?

  45. 45
    Steeplejack says:

    @Sheila:

    Apparently because it takes effect immediately. Marijuana is not as focused in its effect, and you actually have to do meditation, and we’re not really into that. We like our fixes quick and easy.

  46. 46
    Dead Ernest says:

    Ketamine is an interesting substance.
    As a Chronic Pain Management Doc, I prescribe it fairly frequently. It can have a profound effect on neuropathic pain – in which case it is compounded into a liquid suspension and swallowed.
    Recently (10 years?) it is being used for pre-surgical pain control. Studies have shown that when used pre-op, after surgery patients require less total pain medication.

    BobS is correct – it is a dissociative anesthetic. Odd thing it does to counter the experience of pain is unlike typical anesthetics which (roughly speaking) turn off painpathways temporarily, Ketamine sort of scrambles up the signal so the pain does not get to make sense. This is probably why it can cause the horrific nightmares when used intravenously during surgery. People have woken up and complained the nightmares were so bad they would have chosen the surgery without anesthetic if they had known beforehand. No idea of it is still more commonly used with non-human animals because they don’t have nightmares (no pun) or if it’s because no one asks them.

  47. 47
    SRW1 says:

    @BobS:

    We use ketamine in our ER for what are referred to as ‘procedural sedations’ in pediatric patients, i.e. painful and/or anxiety producing procedures such as fracture reductions, suturing, longer imaging studies such as MRIs, etc.

    That’s how I encountered ketamine: Friday evening at a farewell party our four year old daughter jumped off a scaffold and broke her arm. All doctor offices were already closed, so we had to take her to a hospital ER. After an X-ray it was determined that the bones needed to be adjusted. To be able to undertake that procedure she was given ketamine. Within minutes of its application the little girl that had been writhing in pain sat on the treatment table giggling because everything around her was hilariously funny. Amazing stuff.

  48. 48
    Karen says:

    Doesn’t Ketamine cause people to fall into a “K hole” when it wears off? If that’s anything like Effexor withdrawal or my crashes from my manic cycles, it sounds like a drug that could really be harmful to certain people.

    As a bipolar woman, I know what it’s like to plummet right to the ground and wondering if my life had any purpose and if not, to end it. I hope that K can help people but I also hope that it’s safe.

  49. 49
    OneMadClown says:

    Nah, the K-hole is the headspace you’re in when you take a decent dose of ketamine…like any dissociative, you feel sort of disconnected from reality, and there’s a feeling of a wide gulf between your brain and your body, time distortion, and all that. I used to get some interesting visual and auditory effects too, but no outright hallucinations. That said, these were party doses of insufflated ketamine, I doubt the researchers are suggesting that depressed folks line up to start doing bumps. At a low enough oral dosage, it’ll probably eliminate most or all of the trippy stuff, but as a person with major depressive disorder and a lot of drug experimentation under my belt, the article was definitely a fascinating read.

    Now when are they going to do some more LSD trials, and where can I sign up?

  50. 50
    Sheila says:

    Excellent points, Anne Laurie.

  51. 51
    The Main Gauche of Mild Reason says:

    Link to the actual publication:
    http://www.sciencemag.org/cgi/.....9/5994/959

    The actual paper is interesting, because they engage in some (well, semi ungrounded) speculation that the process that ketamine triggers actually reverses some of the signaling damage caused to the brain by stress/depression.

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