New research may complicate our understanding of ketamine as a potential treatment for depression. Research shows that people with depression who were given saline or ketamine before anesthesia for surgery had similar improvements in their symptoms afterward. The findings suggest that at least some of the therapeutic benefits seen with ketamine may be due to a placebo effect, although more research will be needed to confirm this.
Experiments have found that low doses of ketaminelong used as a sedative and recreational dissociative drug may also help treat depression and other mental health problems, and in a different wayfrom current antidepressants. Some of these studies also included the use of placebo controls for comparison, which is often considered the best method for determining whether a drug or vaccine actually works as intended. no (ideally, neither the patient nor the doctor treating them knows whether they are in danger or not. treatment group or control group).
The problem is that even low doses of ketamine can cause short-term physical symptoms like dissociation or a trip, which makes it pretty easy to tell whether you’re taking it or not, which then undermines any attempt to create a suitable placebo for comparison. So researchers at Stanford University decided to conduct a unique experiment to better rule out the possibility of this happening.
Their study involved 40 people with major depressive disorder scheduled for routine surgery that required the use of general anesthesia. Half were randomized to receive a dose of saline solution, a placebo, immediately before surgery and the other half received a dose of intravenous ketamine. The researchers hypothesized that the act of going down would eliminate the possibility of people taking a typical trip. They then observed the patient for up to three days.
At the end of the study, both groups reported the same average improvement in depressive symptoms. People correctly guessed whether they had received ketamine or placebo less than half the time, or worse, at random, suggesting that the blinding process was indeed effective.
In conclusion, a single dose of intravenous ketamine given during surgical anesthesia is no greater than placebo in acutely reducing the severity of depressive symptoms in adults with major depressive disorder. severe cold. Written in their paper, published this month in the journal Nature Mental Health.
The study’s findings are based on a small sample size of patients and a short follow-up period, meaning any interpretation of it should be viewed with caution until more data is collected. And other researchers have already debated that the results may only suggest that surgery and general anesthesia (which may include ketamine) may be possible provide rapid relief of depression, it is not necessary that ketamine has no therapeutic effect beyond placebo.
The authors say this hypothesis is unlikely to explain the results because other studies have not found a consistent association between surgery and improvement in depression (some even experience worsening or new depression after surgery). But they are careful about the impacts of their work. First, they do not argue that ketamine should only be treated as a placebo when treating depression, or that people with depression are somehow pretending to have it.
Study author Boris Heifets, assistant professor of anesthesiology, said in a statement released by Stanford that saying this was just a placebo is actually a disservice to the placebo. I won’t feel better if I say it enough, and that doesn’t mean the patient doesn’t have a problem.
They hypothesize that people’s positive expectations may be at least part of the reason why ketamine seems to produce these rapid benefits for some people. But even if that were true, that doesn’t mean people don’t experience real and positive physical changes when they take it.
Heifets says there’s definitely a physiological mechanism, something that happens between your ears when you get your hopes up.
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