Re:Ketamine's effect on depression may hinge on hope
by tudorw on Friday October 20, 2023 @06:22AM
(#37954334)
Thanks for all the detail, I'm interested to know if you have explored CYP gene expression (polymorphism) and it's impact on metabolising ketamine as factor in treatment?
Re:Ketamine's effect on depression may hinge on hope
by CodeCounselor on Friday October 20, 2023 @10:36AM
(#37956703)
Hello. Sadly no. This is something that is probably overlooked and/or neglected on a regular basis. Often when the question comes up the most pragmatic next step is to switch drug or modality to something that doesn't rely on the suspected metabolic pathway in question...
Re:Ketamine's effect on depression may hinge on hope
by scotty79 on Friday October 20, 2023 @11:22AM
(#37957398)
But in the light of the study we are commenting on it might be that the effect of ketamine in previous non-doubleblinded studies was due to placebo effect heightened by the positive expectations towards ketamine of both patients and doctors.
At least it is what authors of this study consider.
I interpret you as saying that unless there is a "trip" there is only a placebo effect left on the table so to speak. I think this is somewhat refuted by the fact that the standard ketamine infusion protocol (that does not normaly induce "trips") has an effect size that dwarfs the effect size of placebo (say 0.2 - 0.4). Some studies have shown ketamine approaching ECT-effect sizes. This makes me sound like a ketamine nut, which I am not. I am a bit of an ECT nut though. I have just not excluded the fact that the phenomenology of certain treatments actually mediate the treatment effects in a non-placebo way.