Among the drugs currently entering the psychiatric mainstream (MDMA, LSD, etc.), ketamine is an outsider. Most people have an idea of what is considered “acid” or “molly”, even if they have never tried them. Ketamine, meanwhile, remains outside the committed sect—— ngama this is not much Popular recreational drug. There is no standard Hollywood version of the ketamine journey. You listen to K-holes, and are sometimes used as a horse tranquilizer, but very little on its actual effects, and less so for taking it in a clinical setting , Who are more and more patients with depression and mood disorders Soon to be for this week, to fix the record Giz aks We have reached out to many people who have undergone clinical ketamine trials.
Researcher, Clinical Neuroscience, Karolinska Institute
In one of my studies, we treated thirty depressed patients with ketamine.
During treatment, most patients reported intensive ablation. They were separated from reality in different ways, and perceived things differently. One patient felt that the radio was playing in 3D, which he quickly absorbed. Later, returning to the same program, he realized that it was actually quite dull.
Approximately 20% of the patients had hallucinations, and most found the experience interesting; Some said its reason to be drunk. (Ketamine is addictive for this reason.) Two out of thirty thought it was a terrible experience, though — since they responded to treatment — they were ready to do it again. Overall, it was considered quite intense.
The drug was administered in a hospital setting, and nurses were present for the duration of the experience. These were nurses who worked extensively with severely depressed patients, and helped administer ECT, which is more of an LSD or psilocybin therapy than (in a sense) ketamine therapy. With ECT, as with ketamine, the goal is to get the patient into what we call remission – to return them to their lives before the onset of severe depression. This is different from, for example, silocobin therapy, where the psychotherapy component is really important. With ketamine, people do not get the insight that they can integrate into their day-to-day life, as they can with psychedelic therapy. He had a strange experience, but no insight.
The antidepressant effect came after treatment. It is very new: the most common antidepressant is considered an effect takes weeks before. In our trial, 70% of patients felt much better the next morning.
Associate Professor, Psychiatry, Columbia University
Most patients with mood disorders treated with ketamine infusions feel strange and / or differential. Some feel that they are swimming. Some register their arms or legs feeling different in some way – larger than normal, or numb, or harder to move. Some find a type of numbness around their face or mouth. Sometimes people get cold. A rare few experience mild hallucinations on walls or ceilings – shapes or colors.
Some percent of people may feel anxious when they are receiving ketamine, possibly because the sensations are not familiar; Some people may find it difficult to find the right words, which can cause anxiety. A small minority may also feel unhappy, or tearful, or experience a memory rush. Conversely, a small percentage of patients experience a type of euphoria. But more often, what one experiences most is awkwardness / fickleness. Typically, all these effects go away about 15–30 minutes after treatment.
Usually, the drug is given intravenously, in a slow drip over forty minutes, but a nasal spray version was recently approved. People may receive two or three treatments a week for a few weeks, and then decrease in frequency. There is still much research on what is the correct frequency for maintenance treatment, as well as how long treatment should be done, how safe they are, studies of ketamine addiction demonstrate a serious risk for long-term ketamine use, although therapeutic Doses are very low, perhaps as specific as one-tenth the typical street dose.
Clinical Director of Psychiatric Esketamine Clinic at José Hopkins University and Assistant Professor of Psychiatry and Behavioral Sciences
One of our patients, every time, turns off the light and enters a dreamy state, during which she flees to New York City, where she works. She was looking forward to it – her short trips to the city. Another woman swore that we were hiding lemons in the room. We had a patient for whom the colors outside the window trembled – she described a green as opposed to the green she had seen earlier. Another audible voice and noticed that spiders were crawling over the door.
All of which is to say that it runs a wide range, and depends for the most part on the patient. Virtually no one accused us, saying they did not want to continue. When ketamine works, it works dramatically – in the first dose or two, people get dramatically better; Some feel that they have returned to their old self. To counteract this in people with treatment-resistant depression, after just a few doses, it is surprising.
The people who were most upset by this were people who had never used drugs before. One person we treated, a musician, had treated his body like a temple – no drugs or alcohol for his entire life. So for her, ketamine was a frightening experience: she just didn’t know what was going to happen. But usually, people who have done drugs in the past consider it a good experience.
One thing that helped with the side effects – and I swear I’m not getting any money for it – was Anya. In fact, Anya landed our patients, even those patients who were hard rock participants. It was Anya that actually did it for him.
Associate Professor, Psychiatry and Psychology, University of Pittsburgh
During and immediately after the ketamine infusion, most patients feel faint, slightly “high”, or euphoric, and some feel what is happening around them. Some feel dizzy, nauseous, or a headache. Researchers generally do not feel that there is anything special about the acute experience of receiving ketamine. When ketamine therapy is successful, the “special” stuff comes down, as an accumulated feeling of relief from depression and other negative emotional symptoms, approximately 24 hours after the infusion, associated with subsequent neuroplastic changes. Has happened. time points. We usually think of those things that occur during and around infusions, mostly the nuisance side effects rather than the therapeutic things. This makes ketamine significantly different from other drugs that are now under investigation as psychiatric as psychiatric treatments.
Assistant Professor of Psychiatry and Clinical Leadership of the Ketamine Program at Columbia University
Patients report a range of experiences when receiving ketamine therapy for depression, but in general, the psychiatric dose ketamine is a “tamer” experience that many would imagine. Most patients describe a “spacey” feeling starting 5–15 minutes after initial treatment, and the feeling stops anywhere from 30–90 minutes. Some people describe it as high, and a small number of patients go a bit giddy. Some patients describe near-hallucinations as observing patterns around them. While almost all describe some meaning of dissociation, very few actually feel outside of their bodies and fewer still feel that they have lost contact with reality for a very short time. These feelings may intensify if high doses are used, and there is not a universal agreement among ketamine practitioners as to whether a high level of ablation is required to achieve the desired antidepressant effect.
Ketamine is given either via IV or through an intranasal inhaler in a clinically controlled setting where vital signs and the patient’s response can be monitored. The treatment session is usually two hours, after which the patient can go home.
Within one to two hours after administration the acute effect (feeling spacey, isolated or elevated) goes away, but any reduction in symptoms of depression can last from hours to days. It may take several treatments to strengthen an antidepressant effect and last longer. Once fully established, antidepressant effects may persist with maintenance treatments that may be 2–4 weeks apart. For some patients, long periods of maintenance treatment are required, while other patients receive remission after only a few months of maintenance.
Many patients report rapid improvements in mood, anxiety, and hedonic function, which initially attracted the psychiatric profession to the use of ketamine. It is the first treatment for depression that has the potential to work from minute to hour. But for many, the first one or two (or even four) treatments create a very subtle feeling with an improvement in overall mood – it fluctuates at first, but then consolidates. . About a third of patients have no response or no sustained response.
For most patients, the experience is either very pleasant or neutral, but on this occasion patients may feel depressed or disturbed for some time.
Ketamine treatment is different from psychedelic guided therapy designed in such a way that altered states gained therapeutic insight. The prevailing model for ketamine therapy is like a physical therapy designed to enhance synaptic connections that work faster than mechanisms used by traditional antidepressants. It has been said, in some patients, during ketamine treatment is described an insight or transfer approach that may contribute to recovering from depression, and some clinicians are finding out whether it is called “ego disruption” therapy. Can be used as enhancer because it is better. MDMA and psilocybin.
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