Why Ketamine Helps Fight Depression

What I'm disturbed by is all the hysterical railing in this thread, as if any mention of a possible positive effect from a controlled substance is implied license for illicit use that will lead to increased trauma and death. It's like the knee-jerk reaction against marijuana for legitimate medical use, where the "ban it all, everywhere, for any use" contingent would rather have people suffer with tremendous pain and nausea from something like cancer and chemotherapy than possibly experience any euphoria or altered state of consciousness, much less relief.

As a long-time sufferer of treatment-resistant major depression, and having taken 16 medications over the years, I can tell you that many can have drastic, terrible effects, even when taken exactly as prescribed. Ever heard of serotonin syndrome? I was unlucky enough to experience this when transitioning from one SSRI to another. It was as if every nerve in my body was firing simultaneously and uncontrollably: muscle tension, shaking, extreme pain, extreme overreaction and sensitivity to any stimulus, and definitely a profoundly unpleasant altered state of consciousness for the better part of a day. Other meds like several tricyclics caused severe cramps and muscle spasms that left me unable to eat, or even open my jaw. One dose of trazodone left me on my back for three days, feeling like I'd been hit by a truck. These are all approved antidepressants, administered to me as an outpatient and taken as prescribed or under the direct supervision of psychiatrists.

Nevertheless, after 18 years of struggle with this demon of a disease, and its ineffective and distressing treatments, I continue with new methods of treatment and look for new research ideas that may present clues to the mechanisms of my particular treatment-resistant variety. In the worst times, I wish I had the energy to bring death to myself. Such a vile, pathetic struggle of existence is what leads many to suicide, and to past drastic treatments like electro-convulsive therapy that do provide some immediate relief.

This is not hyperbole, as borne out by the numbers of depressives who also "off themselves," as Bob Tyson so callously put it. What is hyperbole is his statement that the article gave an "impression that a SINGLE DOSE can 'cure' depression... immediately." The specific word was "relief," and anyone such as myself that has suffered with this disease chronically knows that as much as can be hoped for is a little relief sometimes, and a *cure* is something we can't put hope in in our foreshortened lifetimes. Further, as I described above, we are well aware that many (and for me, most) treatments have severe side effects that make considering their use a careful weighing of possible benefit to further distress and destabilization of life through their bad effects. Am I going to go out and try some "Special K" to try to find relief on my own? Hell, no. Would I participate in a controlled study that uses sub-hallucinogenic levels of ketamine (this is the protocol) and looks for anti-depressive effects? Only after carefully looking at any other effects it may have, both short and long term. (Did I mention the liver damage that "safe" antidepressants like nefazodone and other medications have done over the years?) Participation would be with the hope that if not helping me, perhaps it will help others in the future by revealing mechanisms and the creation of other compounds.

The article was not about using ketamine as an antidepressant, as anyone that read through it with any care can see. It is about the clue provided by an unexpected effect of a ketamine dose, and research into compounds that directly act on the AMPA receptor and may be another mechanism for treatment of as yet untreatable varieties of depression-- hopefully without such a terrible trade-off as ketamine, and many *approved* antidepressants, present. Actually, for me, "trade-off" is not accurate. While causing many problems, none provided any significant benefit. Where's your outrage at my many terrible experiences with meds and 18 lost years of my life, Bob?