Separately, other studies have shown that it works as an antidepressant. My follow-up comment was pointing out that it also works in a way that should be expected to have a longer-term effect than other antidepressants. It hasn’t been studied much for that use, though, so we don’t know for sure, but repairing damage as opposed to the symptoms of the damage seems like a promising result.
For any given antidepressant there are a few studies that show that they work. Even for homeopathy there are studies that it works.
You said that it’s off-label to use the drug as antidepressant. That probably means that the FDA thinks that the studies that exist don’t provide enough evidence for it being a good antidepressant.
It hasn’t been studied much for that use, though, so we don’t know for sure, but repairing damage as opposed to the symptoms of the damage seems like a promising result.
How do you know that rebuilding the specific synaptic connections they studied isn’t treating symptoms but causes?
Different people are depressed for different reasons. People who get serious head insuries are more likely to develop depression. If you have a way to address the causes of depression within one person, you don’t necessarily have a way to address it for the next person.
“How do you know that rebuilding the specific synaptic connections they studied isn’t treating symptoms but causes?”
I don’t know that, which is why I suggested discussing it with a qualified medical practitioner, rather than, for example, just buying some from an illegal dealer, and said it was definitely not a recommendation, capitalising those words. The little I know about the subject suggests it might be a promising line of enquiry, but I am not making any claims about its efficacy.
I don’t know that, which is why I suggested discussing it with a qualified medical practitioner, rather than, for example, just buying some from an illegal dealer, and said it was definitely not a recommendation, capitalising those words.
Lesswrong isn’t a place where you would tell someone directly: “Go buy illegal drugs.” It’s a public forum in which you participate with your real name.
Saying “this is not a recommendation” is likely be read be some adventurous people as: “I don’t want to held accountable in any way for the recommendation I’m making, but in case you are interested...”
I can certainly see that, but I would also hope that if someone is, as the OP claims to be, wanting to be truly rational, possibly the very first point in a list of ‘how to be rational’ rules would be “Don’t buy illegal brain-altering chemicals based solely on a remark made by a total stranger on the internet.”
Were someone to not be following that rule already, I suspect any other advice any of us could give them would be useless.
(Incidentally, I’m not one of the people who downvoted that comment. It seems reasonable to at least raise the issue.)
The existence of gwern, of Crazy Meds, and of the subset of the trans community unable to get treatment through official channels suggests that this rule isn’t actually all that good.
“Drug restored damaged synaptic connections” → “Drug is good” is a quite seductive argument that bears the danger of being accepted by smart people. The person might focus his fact check whether the claim about restoring damaged synaptic connections is true.
Given the failure of antidepressants in which companies invested a lot of money, it’s rational to choose the prior “a new antidepressent isn’t likely to create big positive effects” when evaluating a new candidate. Picking the right reference class is valuable.
According to Wikipedia there are small studies that seem to show a short-term antidepressant effect, but their size and methodological quality appears to be insufficient to consider them conclusive evidence. There seems to be nothing on long-term effects.
the FDA thinks that the studies that exist don’t provide enough evidence for it being a good antidepressant
I was going to say the FDA is a bunch of cowardly windbags who won’t approve anything that looks remotely scary or new, but turns out I can’t find a neutral source on that, just libertarian journals and lizard-conspiracy guy.
As handoflixue said, potential for recreational use. (This even scares them about freaking bupropion, which doesn’t actually have any.) Long-term effects not well known, because horses rarely take the Beck depression inventory. Just plain bizarre effects given current model—depression does not normally goes away in an hour, and if it goes away in less than a week you panic, lock the patient up, and watch for signs of mania.
Cannabis is a Schedule I (1) drug, the most severe rank a drug can have. Requirements for Schedule I:
1 - The drug or other substance has a high potential for abuse. 2 - The drug or other substance has no currently accepted medical use in treatment in the United States. 3 - There is a lack of accepted safety for use of the drug or other substance under medical supervision.
There have been some theories about a “war against recreational drugs”, and proponents of this theory suggest that drugs with strong recreational properties may meet with excessive bureaucratic regulation.
Further theories along the same vein suggest the ocean may in fact be slightly damp, and that Hand Of Lixue may be prone to the occasional understatement.
″ That probably means that the FDA thinks that the studies that exist don’t provide enough evidence for it being a good antidepressant.”
The previous comment of mine was an example of a controversial move by the FDA, which illustrates that they may have reasons to deny approval to certain drugs deemed to have excessive “recreational” potential. I’m hoping you can see why this is relevant to a conversation about why the FDA might opt not to approve a drug.…
Why do you focus on the FDA? Almost all countries have drug regulation agencies, and various of them approve cannabis or cannabinoids for therapeutic uses, but, as far as I know, none of them approves ketamine for use as an antidepressant.
Because the thread was about the FDA. I have no clue whether the claim about ketamine is valid or not, but I do strongly suspect that “The FDA has not approved this” is not relevant (since they have a clear motive to oppose the substance even if it is an antidepressant.)
If no place else has approved it, then that is much more useful evidence against ketamine, and I’m glad to encounter such :)
Separately, other studies have shown that it works as an antidepressant. My follow-up comment was pointing out that it also works in a way that should be expected to have a longer-term effect than other antidepressants. It hasn’t been studied much for that use, though, so we don’t know for sure, but repairing damage as opposed to the symptoms of the damage seems like a promising result.
For any given antidepressant there are a few studies that show that they work. Even for homeopathy there are studies that it works.
You said that it’s off-label to use the drug as antidepressant. That probably means that the FDA thinks that the studies that exist don’t provide enough evidence for it being a good antidepressant.
How do you know that rebuilding the specific synaptic connections they studied isn’t treating symptoms but causes?
Different people are depressed for different reasons. People who get serious head insuries are more likely to develop depression. If you have a way to address the causes of depression within one person, you don’t necessarily have a way to address it for the next person.
“How do you know that rebuilding the specific synaptic connections they studied isn’t treating symptoms but causes?”
I don’t know that, which is why I suggested discussing it with a qualified medical practitioner, rather than, for example, just buying some from an illegal dealer, and said it was definitely not a recommendation, capitalising those words. The little I know about the subject suggests it might be a promising line of enquiry, but I am not making any claims about its efficacy.
Lesswrong isn’t a place where you would tell someone directly: “Go buy illegal drugs.” It’s a public forum in which you participate with your real name. Saying “this is not a recommendation” is likely be read be some adventurous people as: “I don’t want to held accountable in any way for the recommendation I’m making, but in case you are interested...”
I can certainly see that, but I would also hope that if someone is, as the OP claims to be, wanting to be truly rational, possibly the very first point in a list of ‘how to be rational’ rules would be “Don’t buy illegal brain-altering chemicals based solely on a remark made by a total stranger on the internet.”
Were someone to not be following that rule already, I suspect any other advice any of us could give them would be useless.
(Incidentally, I’m not one of the people who downvoted that comment. It seems reasonable to at least raise the issue.)
The existence of gwern, of Crazy Meds, and of the subset of the trans community unable to get treatment through official channels suggests that this rule isn’t actually all that good.
I don’t know about that. After all it seems like they are the kind of person to take the advice of strangers on the internet...
“Drug restored damaged synaptic connections” → “Drug is good” is a quite seductive argument that bears the danger of being accepted by smart people. The person might focus his fact check whether the claim about restoring damaged synaptic connections is true.
Given the failure of antidepressants in which companies invested a lot of money, it’s rational to choose the prior “a new antidepressent isn’t likely to create big positive effects” when evaluating a new candidate. Picking the right reference class is valuable.
According to Wikipedia there are small studies that seem to show a short-term antidepressant effect, but their size and methodological quality appears to be insufficient to consider them conclusive evidence. There seems to be nothing on long-term effects.
I was going to say the FDA is a bunch of cowardly windbags who won’t approve anything that looks remotely scary or new, but turns out I can’t find a neutral source on that, just libertarian journals and lizard-conspiracy guy.
In what way is Ketamine more scary and new than the antidepressant that the FDA approved?
As handoflixue said, potential for recreational use. (This even scares them about freaking bupropion, which doesn’t actually have any.) Long-term effects not well known, because horses rarely take the Beck depression inventory. Just plain bizarre effects given current model—depression does not normally goes away in an hour, and if it goes away in less than a week you panic, lock the patient up, and watch for signs of mania.
Cannabis is a Schedule I (1) drug, the most severe rank a drug can have. Requirements for Schedule I:
1 - The drug or other substance has a high potential for abuse. 2 - The drug or other substance has no currently accepted medical use in treatment in the United States. 3 - There is a lack of accepted safety for use of the drug or other substance under medical supervision.
There have been some theories about a “war against recreational drugs”, and proponents of this theory suggest that drugs with strong recreational properties may meet with excessive bureaucratic regulation.
Further theories along the same vein suggest the ocean may in fact be slightly damp, and that Hand Of Lixue may be prone to the occasional understatement.
Cannabis is schedule I, ketamine isn’t. I therefore don’t see the point of bringing up cannabis.
The previous comment of mine was an example of a controversial move by the FDA, which illustrates that they may have reasons to deny approval to certain drugs deemed to have excessive “recreational” potential. I’m hoping you can see why this is relevant to a conversation about why the FDA might opt not to approve a drug.…
Why do you focus on the FDA? Almost all countries have drug regulation agencies, and various of them approve cannabis or cannabinoids for therapeutic uses, but, as far as I know, none of them approves ketamine for use as an antidepressant.
Because the thread was about the FDA. I have no clue whether the claim about ketamine is valid or not, but I do strongly suspect that “The FDA has not approved this” is not relevant (since they have a clear motive to oppose the substance even if it is an antidepressant.)
If no place else has approved it, then that is much more useful evidence against ketamine, and I’m glad to encounter such :)