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Friday, October 24, 2014

Ketamine

There's been a bit of upheaval at the house...all will be well, but in the mean time, I'm trying to blog more and get some more clicks over at Psychology Today. Clicks support the writing and research I do and they are much appreciated! There's a new post up about ketamine, the noncompetitive inhibitor of the NMDA receptor that, in one single IV infusion, can alleviate a suicidal depression in about 30 minutes. However, the magic doesn't last, and depression comes back after a week or two. Still, the mechanism and understanding of this phenomenon is important to figuring out the physiology underlying depression.

For right now, ketamine is being used experimentally in hospitals and also in some "salvage" clinics where folks who've responded poorly to other treatments pay for to get a short break from depression.   Other NMDA receptor antagonists might be useful drug targets for experimentation...but to be honest glutamate has been the holy grail neurotransmitter for several psychiatric disorders (schizophrenia, major depressive disorder, and bipolar disorder among them) for the past 20 years, and I've not seen anything come of it, or anything new in the drug pipeline that has panned out.

The supplement NAC utilizes the glutamate pathway via a somewhat convoluted mechanism. I've seen it work for obsessive thoughts, hair pulling (but never for picking behaviors in general) and, interestingly, bipolar depression when every other treatment has already been tried. There's only one study for bipolar depression, but the trichotillomania efficacy is solid and NAC should be part of the clinical arsenal for that symptom.

Here's the post: The Ketamine Key

And here's a new Lorde song I like a lot: Yellow Flicker Beat

7 comments:

  1. I've just started hearing local radio ads for ketamine as a treatment for depression. Wondered if it worked, or just a scam. Thanks for doing the research for us.
    -Steve

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  2. There is something to ketamine. Would be nice if the effect persisted though.

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  3. Could ketamine work by making people forget bad memories that won't go away? Magnesium has a similar effect. See Ketamine, magnesium and major depression--from pharmacology to pathophysiology and back. Epsom Salts, for the win.

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  4. Ketamine works exactly by this mechanism: The increase in protein translation following administration of ketamine is hypothesized to be mediated through blockade of NMDARs at rest, which inhibits eEF2K, resulting in decreased phosphorylation of eEF2 followed by desuppression of BDNF protein translation.

    That's from this very interesting paper: http://www.ncbi.nlm.nih.gov/pubmed/24912158

    Also I'm trapped in some sort of gmail loop and can't seem to approve your most recent comment, Nigel, but I'm working on it.

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  5. Rummaging through my blog posts labelled "Magnesium" shows that it was you who brought the study linked in my previous comment to my attention in August 2014! Thanks for the link to the other study.

    It looks like you've broken out of your Gmail loop (if you're referring to my comment on your previous post). I have a habit of inserting clickable hyperlinks with text that differs from the url. This gets flagged as SPAM on many blog comment sections.

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  6. I have an adult son with schizoaffective that is taking Invega along with NAC and Sacrosine from Profrontal.com. I have not seen much of a difference yet but he has only taking it a few days and I suspect he is dealing with a UTI or some other infection right now as nothing seems to be helping at the current time. I also found it interesting that you made the connection with Infection and Psychosis in Schizophrenia. When my son had his first break a little over 10 years ago, he had one infection after another literally one on top of another. I always suspected there was a connection. I should also note we have found another connection..he twice had some natural path give him high doses of Folic Acid, once in shot form and once in a drink mix that was very high in Folic Acid. I assume they where going on findings that some people with Schizophrenia tend to have a Folate deficiency. My son is the opposite, he is allergic to most things and produces histamine at the drop of a hat. On both occasions, they doubled and even tripled his anti-psychotic medication and it still had no effect. I connected the dots when I realized he was taking Folic Acid and within days he was able to go back to his low dose of anti-psychotic and he was fine. Which brings me to your other article you linked to about the research on genes and genetics playing a role on the proper treatment for people with Schizophrenia. I find that very exciting as in the past everyone has been lumped together and some succeed and some don't with different treatments. It has almost been like the old saying, about throwing mud on a wall and seeing what sticks. Anyway..interesting blog and kudos for keeping an open mind and staying abreast of new research, Candance

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    1. Even though I am not a person who has any qualification to give a medical advice, I want to tell you couple things because I am a mom of a son myself and I hope that sharing my experience may be helpful in your case.
      I used to have one UTI (and other things like yeast infections and some more) after another until I went on a ketogenic diet for a migraines prevention. It doesn't suggest for me that everybody with frequent infections must do the same, but rather that the people with infections have to check what levels of a blood sugar they have during the day, not only fasting BS which is often normal even when it fluctuates too much during the day.

      BTW, ketosis is beneficial for a mental health, you may find another blog posts such as
      https://www.psychologytoday.com/blog/evolutionary-psychiatry/201104/your-brain-ketones
      http://evolutionarypsychiatry.blogspot.com/2010/08/your-brain-on-ketones.html
      by Dr. Emily Dean interesting.

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