New research may complicate our understanding of ketamine as a potential treatment for depression. The study found that depressed patients who were given saline or ketamine before receiving anesthesia for surgery experienced similar improvement in symptoms afterwards. The results of this study suggest that at least some of the therapeutic effects seen with ketamine may be due to a placebo effect, but further research is needed to confirm this.
lots of research Researchers have found that low doses of ketamine, which has been used for years as a dissociative sedative and recreational drug, may also be useful in treating depression and other mental health issues. in a different sense From current antidepressants. Some of these studies also include the use of a placebo control for comparison, often considered the best way to determine whether a drug or vaccine really works as intended. (Ideally, both patients and the doctors treating them cannot know whether they are effective in the treatment or control group).
The problem is that even low doses of ketamine can cause short-term physical symptoms, such as dissociation or “trips,” which make it very easy to tell if you’re on ketamine and, therefore, suitable for ketamine. This weakens any attempt to create a placebo. comparison. So researchers at Stanford University decided to conduct a unique experiment to further eliminate the possibility of this happening.
Their study involved 40 patients with major depressive disorder scheduled to undergo routine surgery requiring the use of general anesthesia. Half were randomized to receive a single dose of saline and a placebo immediately before surgery, and the other half were randomized to receive a single dose of intravenous ketamine. The researchers theorized that the act of going down would make people less likely to go on regular trips. Patients were then observed for up to 3 days.
By the end of the study, both groups reported similar improvements in depression symptoms, on average. People guessed correctly whether they had taken ketamine or a placebo less than half the time, or worse than chance, showing that the blinding process really worked.
“In conclusion, a single dose of intravenous ketamine administered during surgical anesthesia is no more effective than a placebo in acutely reducing the severity of depressive symptoms in adults with major depressive disorder. “, the authors said. I have written They write in a paper published this month in Nature Mental Health.
The results of this study are based on a small patient sample and short-term follow-up, meaning that interpretation of this study should be considered with caution until more data are collected. And other researchers already discussed The results show that surgery and general anesthesia (which may include ketamine) provide Although it provides rapid relief from depression, this does not necessarily mean that ketamine has no more therapeutic effect than a placebo.
The authors say this hypothesis is unlikely to explain their results because other studies have not found a consistent association between surgery and improvement in depression (some people experience worsening or new depression after surgery). But they are careful about the impact of their work. First, they are not arguing that ketamine should be viewed as just a placebo when it comes to treating depression, or that depressed patients are somehow faking their illness.
“Saying, ‘It’s just a placebo’ really desecrates the essence of a placebo,” study author Boris Heifetz, an assistant professor of anesthesiology, said in a statement released by Stanford University. “This is not a ‘if you say it enough times you’ll feel better’ kind of thing, and it doesn’t mean there’s nothing wrong with the patient.”
They theorize that at least part of the reason ketamine appears to have such rapid effects in some people may be people’s positive expectations. But even if that’s true, it doesn’t mean people don’t experience real positive physical changes when taking it.
“There’s definitely a physiological mechanism where when you create hope, something happens between your ears,” Heifetz says.
