Hugely anecdotally, I think ketamine might have fixed my depression for about 6 months with one heavy dose. It was early 2018, I had just gone through a really bad breakup the December previous. Around March, my friends invited me on a ski trip - where I promptly had a bad fall and ended up in the hospital with a dislocated shoulder. The doctors had a hard time getting it back in while I was conscious, so they knocked me out with ketamine (smaller, more rural hospital) to put it back in.

In the days and weeks following I felt amazing, with almost all of the post-breakup blues gone and a fantastic outlook on life - I chalked it up to the "near-death" experience, but later found out about the potential anti-depressive properties of the drug and I've wondered ever since.

Ketamine certainly is effective for depression, however that doesn't mean that the psychadelic effects are what does it, or that curing depression requires getting in touch with your feelings, or anything like that. Could just be a coincidence.

https://blogs.sciencemag.org/pipeline/archives/2021/02/19/ho...

Does it matter if it's a coincidence if it works?

The Placebo effect works, and doctors use it to treat patients all the time.

To be clear, it's not a placebo, ketamine definitely actually works and in fact works faster than prescription antidepressants.

The problem is you might have to hang out with the people in this article! They seem like jerks and they're going to make you tell them about why you hate your dad and stuff like that.

> This is something O’Brien has experience of. “Years ago I took [the powerful hallucinogen] ayahuasca in Iquitos, Peru. It was all a bit dodgy. I ended up in this dark little hut with breeze-block walls covered in sheets and 12 Peruvian ladies in deck chairs watching Friends really loudly next door. I thought I was going to be ritually sacrificed,” he says.

Seems disrespectful to his hosts, I don't remember any ritual sacrifice in Friends.

The Placebo effect works... sometimes. 30-60%. And it isn't something we can predict, so patient 1 might do well, but patient 2 and 3 do not get relief. It isn't something you can just give most people and expect it to work, in other words. That would be irresponsible.

When something works, it tends to perform better than a placebo. This is even true for drugs that don't work well on everyone (like antidepressants). Can you imagine how horrible the placebo results were on such things?

Irving Kirsch puts the placebo effect at 82 percent for anti-depressants (after accounting for studies that were stopped early) and argues it's probably higher than that because patients are likely able to break the blinding protocol. He says the evidence of efficacy is only strong when it comes to treating severe depression.

It means that it may be some other element of ketamine that treats depression, not psychedelics, not placebo

I suspect the same — I’d hypothesize the anti-inflammatory action is at work: https://pubmed.ncbi.nlm.nih.gov/30153598/

Dextromethorphan mildly works too for this purpose, in my experience. (not medical advice in the slightest)