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Dr. Bob is Robert Hsiung, MD,
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Posted by poser938 on July 2, 2013, at 18:22:32
In reply to ECT In Kids, Safe,Effective But Under utilizied, posted by Phillipa on July 2, 2013, at 17:29:43
Why is it that mental health "professionals" are about a 1000% more likely to praise ECT than the ones who are actually having the volts sent through their brain?
This is a bit like when they used to say Insulin Coma treatment "gets rid of bad brain cells".What is underutilized is Magnetic Seizure Therapy.
What ECT is good at is reducing symptoms of being alive.
Posted by Jeroen on July 2, 2013, at 18:44:02
In reply to ECT In Kids, Safe,Effective But Under utilizied, posted by Phillipa on July 2, 2013, at 17:29:43
hey why not take a needle and stick. it up your nose til it reaches the brain and lets say its good for the future of our children ;S
Posted by poser938 on July 2, 2013, at 19:08:49
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied, posted by poser938 on July 2, 2013, at 18:22:32
> Why is it that mental health "professionals" are about a 1000% more likely to praise ECT than the ones who are actually having the volts sent through their brain?
> This is a bit like when they used to say Insulin Coma treatment "gets rid of bad brain cells".
>
> What is underutilized is Magnetic Seizure Therapy.
>
> What ECT is good at is reducing symptoms of being alive.And the less life detected, the less depression can be detected as well.
The past few days I've had much fewer suicidal thoughts cross my mind than in quite some time. But this is because I have fewer thoughts in general, because I'm so unemotional. It is getting difficult to post my thoughts on here because they are barely accessible and before long I won't have any accessible thoughts to post on here or be able to talk about how bad I feel. Thanks to Mirapex and the lessening of the great effects Cyproheptadine had on digging me out of the hole Mirapex put me in.
But, since I won't be complaining, I'm certain the psychiatrists that did this study would mark this down as "improvement" in my condition.
Posted by linkadge on July 2, 2013, at 19:27:02
In reply to ECT In Kids, Safe,Effective But Under utilizied, posted by Phillipa on July 2, 2013, at 17:29:43
It makes me want to vomit.
Why can they start using ketamine before such considerations
Linkadge
Posted by poser938 on July 2, 2013, at 19:38:02
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied, posted by linkadge on July 2, 2013, at 19:27:02
But they do the same thing with other treatments as well. The treatments that come in pill form. Though though they may be much safer, when someones mental health situation becomes much worse after a round of meds had their way with someones brain, this is viewed in the mental health community as just a worsening of depression.. and that its nothing related to the chemicals (medicine) that passed through the patients blood-brain barrier.
Posted by Phillipa on July 2, 2013, at 20:25:43
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied, posted by poser938 on July 2, 2013, at 19:38:02
After personally watching it performed and then with the patient before & after I cried for real as he didn't remember a thing. Phillipa
Posted by poser938 on July 2, 2013, at 20:51:33
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » poser938, posted by Phillipa on July 2, 2013, at 20:25:43
> After personally watching it performed and then with the patient before & after I cried for real as he didn't remember a thing. Phillipa
:(
Posted by Bob on July 2, 2013, at 22:16:29
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied, posted by linkadge on July 2, 2013, at 19:27:02
> It makes me want to vomit.
>
> Why can they start using ketamine before such considerations
>
> Linkadge
I am so tired of seeing article after article being published about how promising Ketamine is as a treatment for depression but it never seems to be getting any closer to actually being a real, viable treatment for anyone outside of a study.Bob
Posted by SLS on July 3, 2013, at 5:12:02
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » linkadge, posted by Bob on July 2, 2013, at 22:16:29
> > It makes me want to vomit.
> >
> > Why can they start using ketamine before such considerations
> >
> > Linkadge
>
>
> I am so tired of seeing article after article being published about how promising Ketamine is as a treatment for depression but it never seems to be getting any closer to actually being a real, viable treatment for anyone outside of a study.
>
> Bob
Don't be too frustrated. The discovery regarding ketamine and depression initiated a fury of investigation into new drugs that work on the NMDA receptor. One of these is an orally-delivered compound that works on a different part of the receptor and is devoid of psychotomimetic side effects.
- Scott
Posted by SLS on July 3, 2013, at 5:18:01
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » Bob, posted by SLS on July 3, 2013, at 5:12:02
> > > It makes me want to vomit.
> > >
> > > Why can they start using ketamine before such considerations> > I am so tired of seeing article after article being published about how promising Ketamine is as a treatment for depression but it never seems to be getting any closer to actually being a real, viable treatment for anyone outside of a study.
> Don't be too frustrated. The discovery regarding ketamine and depression initiated a fury of investigation into new drugs that work on the NMDA receptor. One of these is an orally-delivered compound that works on a different part of the receptor and is devoid of psychotomimetic side effects.
- Scott
Posted by linkadge on July 3, 2013, at 7:22:09
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » linkadge, posted by Bob on July 2, 2013, at 22:16:29
>I am so tired of seeing article after article >being published about how promising Ketamine is >as a treatment for depression but it never seems >to be getting any closer to actually being a >real, viable treatment for anyone outside of a >study.
It seems that certain treatments need to be made available to the most desperate patients.
When they safe ect is 'safe' in kids, this just means that the kid doesn't die in the 6 months follow up.
They should make a commercial for ECT like they do cymbalta. Can you imagine the list of side effects and disclaimers?
Posted by linkadge on July 3, 2013, at 7:23:46
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » Bob, posted by SLS on July 3, 2013, at 5:12:02
No, but what is wrong with just ketamine?
In all the clinical trials I have read, patients do not develop any significant 'psychotic' reactions.
These companies likely want $$.
Linkadge
Posted by SLS on July 3, 2013, at 10:09:45
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » SLS, posted by linkadge on July 3, 2013, at 7:23:46
> No, but what is wrong with just ketamine?
>
> In all the clinical trials I have read, patients do not develop any significant 'psychotic' reactions.
>
> These companies likely want $$.
>
> Linkadge
These Naurex drugs are partial agonists at the glycine site of the NMDA receptor rather than being complete channel blockers like ketamine. I doubt there is a narrow therapeutic window to worry about. If you take even a little too much ketamine, you forfeit the antidepressant effect. Of course, taking a pill is more convenient than administering an i.v. drip. As an aside, i.v. administration of ketamine is probably necessary to deliver such a precise dose. Injections and nasal sprays can't do this, and I doubt these methods can hit the narrow window necessary to promote an antidepressant response.I don't care if they want $$. Just give me my drugs.
- Scott
Posted by linkadge on July 3, 2013, at 16:47:42
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » linkadge, posted by SLS on July 3, 2013, at 10:09:45
I don't think the mechanism (or therapeutic window) has been fully uncovered yet.
For instance, there has been desire for decades to replicate the efficacy of clozapine without the side effects on blood cells. We really haven't done that.
I think using ketamine right here right now in its present form would be perfectly acceptable. However, the greatest concern (of some) is likely abuse.
Linkadge
Posted by SLS on July 3, 2013, at 17:08:44
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied, posted by linkadge on July 3, 2013, at 16:47:42
> I don't think the mechanism (or therapeutic window) has been fully uncovered yet.
That a mechanism for an observed phenomenon has not yet been fully uncovered does not make the observation fictitious.
- Scott
Posted by Bob on July 3, 2013, at 17:28:41
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied, posted by linkadge on July 3, 2013, at 7:22:09
> >I am so tired of seeing article after article >being published about how promising Ketamine is >as a treatment for depression but it never seems >to be getting any closer to actually being a >real, viable treatment for anyone outside of a >study.
>
> It seems that certain treatments need to be made available to the most desperate patients.
>Agreed!
Posted by Phillipa on July 3, 2013, at 19:53:22
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » Bob, posted by SLS on July 3, 2013, at 5:12:02
Scott Byrn received IM injections I think it was a week of ketamine and this was in the city? So it is being used in forms other than IV. Plus a few other posters have had the IV treatment. Wasn't it in CA? Phillipa
Posted by Trevpr on July 4, 2013, at 1:04:00
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » SLS, posted by Phillipa on July 3, 2013, at 19:53:22
They are doing studies with other NMDA antagonists as well.
Also, I had no memory loss or cognitive difficulties even after 11 bilateral ECTs.
Posted by europerep on July 4, 2013, at 6:55:52
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » linkadge, posted by SLS on July 3, 2013, at 10:09:45
> If you take even a little too much ketamine, you forfeit the antidepressant effect.
Where did you read that? I've read reports from people who were suffering from depression and took recreational doses of ketamine, and got a strong antidepressant effect lasting for several days. And, at the time of using, these people didn't even know that ketamine was studied for potential antidepressant properties.
I think that the question of getting the right dose of ketamine is mostly, if not entirely, related to the psychedelic effects it produces at high(er) doses. After all, the pretty much universally used dosage of 0.5mg/kg, administered over 40 min. via IV infusion, has, at least as far as I know, not been "developed" or elaborated in any kind of way. It's just the dosage the first guys who studied ketamine in TRD came up with, and they sticked with it because it worked. It would be quite a coincidence if they had just accidentally found a "narrow therapeutic window."
Posted by SLS on July 4, 2013, at 7:05:06
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » SLS, posted by europerep on July 4, 2013, at 6:55:52
> > If you take even a little too much ketamine, you forfeit the antidepressant effect.
>
> Where did you read that?I'll see if I can find the lecture online.
- Scott
Posted by SLS on July 4, 2013, at 10:29:55
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » SLS, posted by europerep on July 4, 2013, at 6:55:52
> I think that the question of getting the right dose of ketamine is mostly, if not entirely, related to the psychedelic effects it produces at high(er) doses. After all, the pretty much universally used dosage of 0.5mg/kg, administered over 40 min. via IV infusion, has, at least as far as I know, not been "developed" or elaborated in any kind of way. It's just the dosage the first guys who studied ketamine in TRD came up with, and they sticked with it because it worked. It would be quite a coincidence if they had just accidentally found a "narrow therapeutic window."
You may be right. Perhaps I am mistaken in my recollection. Nevertheless, NMDA receptor partial agonism seems to be a more desirable mode of modulating glutamatergic neural activity than ketamine is. The risk of triggering psychosis is much reduced and oral agents now exist. The therapeutic indexes (safety / toxicity) of these drugs is quite a bit wider than that of ketamine.
- Scott
Posted by poser938 on July 4, 2013, at 17:26:18
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » europerep, posted by SLS on July 4, 2013, at 10:29:55
If Ketamine in IV form is not practical, why not intranasal Ketamine for take home use? That's how a psychiatrist prescribed it to me.
Posted by SLS on July 5, 2013, at 0:16:14
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » SLS, posted by europerep on July 4, 2013, at 6:55:52
> > > If you take even a little too much ketamine, you forfeit the antidepressant effect.
> >
> > Where did you read that?
>
> I'll see if I can find the lecture online.
>
>
> - Scotthttp://mediasite.video.ufl.edu/Mediasite/Play/4a46e8f9a6f84560aadacc408f77f6b51d
Pay attention to the comments at the end of the lecture regarding the opposite actions on glutamate release of varying concentrations of ketamine (time - 00:59:00). I'd be curious to know how you interpret them.
- Scott
Posted by SLS on July 6, 2013, at 13:55:00
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied, posted by poser938 on July 4, 2013, at 17:26:18
> If Ketamine in IV form is not practical, why not intranasal Ketamine for take home use? That's how a psychiatrist prescribed it to me.
Based upon the data currently available, my guess is that one would have to meter the delivery of ketamine rather precisely. You might need to administer many very low intranasal doses over the course of 40 minutes. Perhaps a transdermal patch would work. I don't know.
- Scott
Posted by SLS on July 6, 2013, at 14:02:55
In reply to Re: ECT In Kids, Safe,Effective But Under utilizied » europerep, posted by SLS on July 5, 2013, at 0:16:14
I forgot to mention that one study indicated that ketamine was effective in people who failed to respond to ECT.
http://www.ncbi.nlm.nih.gov/pubmed/21466832
It is intriguing that there are a growing number of studies testing the use of ketamine during ECT treatment.
- Scott
This is the end of the thread.
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