from Hacker News

Listening to Ketamine

by pmcpinto on 3/30/19, 11:31 PM with 68 comments

• by freedomben on 3/31/19, 12:56 AM

  > Recent approval of a nasal spray promises to expand access, but much remains unknown about long-term use and the potential for abuse.

  This might surprise everybody, but if it's possible to "abuse" it, somebody will (turns out some humans will do that). I wish we'd stop restricting access to things that could help and improve people's lives because we're worried that somebody might do something with their body that we find morally objectionable.

• by bitforger on 3/31/19, 1:27 AM

  Coincidentally, I was talking to my neighbor this afternoon about how much ketamine has helped his depression. Apparently he loves the stuff, and each treatment lasts several months.

  He did mention, though, that every time you get a dose you basically hallucinate for an hour. But maybe that's fine, if you're into it.

• by tmp192489 on 3/31/19, 7:05 AM

  I've done ketamine recreationally and haven't been that impressed. Not sure if it's the dosage or my personal reaction to the drug, but it's like a very temporary (30 min max) feeling that is similar to being drunk.

  There are better highs IMO.

• by neom on 3/31/19, 4:37 AM

  Folks say really really positive things about Ketamine. I wouldn't say I'm an inexperienced psychonaut, yet ketamine scares me. Two close friends told me they have problems "abusing" ketamine. If anyone is able to help shed some light what abusing ket looks like, I'd appreciate it.

• by no_identd on 4/3/19, 6:08 PM

  Pah. The Ketamine Fast Track approval feels a bit like a bad joke. See Scott Alexander's recent blog post here:

  https://slatestarcodex.com/2019/03/11/ketamine-now-by-prescr...

  Really wish they'd have gone for Arketamine. To quote in part from above:

  "Another possibility is that everyone made a huge mistake in using left-handed ketamine, and it’s right-handed ketamine that holds the magic. Most previous research was done on a racemic mixture (an equal mix of left-handed and right-handed molecules), and at least one study suggests it was the right-handed ketamine that was driving the results. Pharma decided to pursue left-handed ketamine because it was known to have a stronger effect on NMDA receptors, but – surprise! – ketamine probably doesn’t work through NMDA after all. So there’s a chance that this is just the wrong kind of ketamine – though usually I expect big pharma to be smarter than that, and I would be surprised if this turned out to be it. I don’t know if anybody has a right-handed ketamine patent yet."

  I don't think that quite covers it, tho. Personally, I suspect Esketamine, as the part of racemic Ketamine that causes hallucinations exhibits an 'antidepressant' effect similar to the one weakly associated with psychedelics, i.e. more by granting new high level psychological insight than via some low level neurological effect - whereas I'd speculate Arketamine causes the documented 'magic' and RAPID next-day antidepressive effect of racemic Ketamine.

  Which makes me suspect we'd probably do well doing the same thing done with some other stereoisomeric medications such as for example in the case of Adderall, which has a ratio of Dexamphetamine to Levo Amphetamine of 3:1(viz., 75% Dex, 25% Levo):

  Figure out the optimal ratio of the two stereoisomers (to each other) for depression treatment.

• by atomical on 3/31/19, 4:02 AM

  > Zarate and others are still thrilled to see big pharma investing in ketamine, after decades of stalled efforts to find new psychiatric drugs. “As esketamine hits the market, venture capitalists will come up with better versions and move the field forward,” Zarate says.

  My doctor prescribes me sublingual ketamine for use at home. What we have now is good enough.

  We need doctors like mine that have the courage to prescribe off label.

• by skilled on 3/31/19, 12:55 AM

  I can't be the only one thinking that solving 'drug problems' with drugs is not the way to go?

  Meditation and yoga offer plenty of support for managing stress and in fact depression. But most people want a quick antidote, something that 'burns' the edge off and not fixes it for good.