Monday, June 22, 2020

Reading the Research: Keeping Tabs on Ketamine

Welcome back to Reading the Research, where I trawl the Internet to find noteworthy research on autism and related subjects, then discuss it in brief with bits from my own life, research, and observations.

Today's article is another step forward in getting better, faster treatments for depression to the people that need them.   Autistic people are chief among those, as we tend to suffer higher rates of depression and anxiety than the general population.  Now, in the current circumstances with coronavirus isolation looming large, depression rates are up, and the need is greater than ever for fast, effective treatments.  

I've always been kind of horrified by the common strains of anti-depessants.  They take a month to kick in, typically come with side effects that are almost as bad as the thing they're treating, and your chances of getting one that works for you the first time are minimal, even with a competent doctor.  You can go through a dozen anti-depressants before finding one that works.  Or you might never find one, because our current anti-depessants simply don't work for everyone.  We have theories about how depression works and how to treat it.  Compared to the very sure, known treatment for things like influenza and chicken pox, it's vastly disheartening.  

So when something that works fast for depression comes up, I really have to wonder why people didn't fast-track it and get more and better tests done.  When this drug, ketamine, works so quickly that you can use it in the ER to help suicidal people stop being a risk to themselves...  why would you wait years to explore it?  

It's probably money.  At least in the US, that's usually what it is.  In any case, this study advances the understanding of how ketamine acts so quickly.  The researchers make noises about ketamine's drug ranking, which would hold a lot more weight with me if marijuana wasn't ranked as a Schedule I (dangerous; high potential for abuse) drug.  Also, admittedly, it would mean more to me if I didn't know that in the right quantities, poison becomes medicine and vice versa.  Also also, that literally anything can be addictive, from food to TV to exercise.

I'll be interested to see if they do manage to synthesize a new class of drugs based on how ketamine works.  But in all honesty, this is not where I see the future of treatments for depressive disorders going.  I strongly suspect the data will show that neurofeedback and other forms of brain stimulation like TMS are far more cost-efficient for the patient, as well as having long-lasting effects.  Combined with effective therapy, like Cognitive Behavioral Therapy and other data-proven schools of thought, the person would be given the best possible chance to improve.  

I do see ketamine or similar drugs having a place in the future, though.  Acutely suicidal people, people who go to the ER or to mental healthcare in order to get help could use this fast-acting relief.  If you keep the person from harming or killing themself, they can get their feet under them, get into therapy, and get set up with brain scans and brain stimulation.  All that would put them on the path to recovery and a better life, which is what any decent person would want for others in that situation.  

(Pst! If you like seeing the latest autism-relevant research, visit my Twitter, which has links and brief comments on studies that were interesting, but didn't get a whole Reading the Research article about them.)

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