tag:blogger.com,1999:blog-6886575137375451769.post7456574482258802857..comments2023-08-08T00:53:58.434-07:00Comments on Garth Kroeker: Ketamine in PsychiatryGKhttp://www.blogger.com/profile/14714377295981745087noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-6886575137375451769.post-84315448910850734812013-12-04T17:59:39.849-08:002013-12-04T17:59:39.849-08:00I'm hoping to add some more posts before the e...I'm hoping to add some more posts before the end of 2013. <br />GKhttps://www.blogger.com/profile/14714377295981745087noreply@blogger.comtag:blogger.com,1999:blog-6886575137375451769.post-54013153644185897722013-11-29T23:23:34.646-08:002013-11-29T23:23:34.646-08:00Looking forward to another blog post on another to...Looking forward to another blog post on another topic. I enjoy your blogAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-6886575137375451769.post-67506188910510322802013-07-12T11:07:46.784-07:002013-07-12T11:07:46.784-07:00At Depression Recovery Centers in Scottsdale, AZ w...At Depression Recovery Centers in Scottsdale, AZ we have experimented with intranasal, IM, and oral dosing. I agree IV is less convenient for patients and most office practices, but we found the results far surpass other administrations. Some of our patients had unwanted side effects such as loss of smell (temporary) with intranasal, and others just did not receive the same benefit as they had with IV. <br />Anonymoushttps://www.blogger.com/profile/10728366083782023082noreply@blogger.comtag:blogger.com,1999:blog-6886575137375451769.post-31210513998595625572013-07-10T17:03:09.088-07:002013-07-10T17:03:09.088-07:00Thanks a lot! What a great informative comment!
...Thanks a lot! What a great informative comment! <br /><br />I find that oral dosing is simple and convenient for the patient and for office setup. But I am planning to explore the possibility of IM dosing as possibly more effective for some people. <br />GKhttps://www.blogger.com/profile/14714377295981745087noreply@blogger.comtag:blogger.com,1999:blog-6886575137375451769.post-36245007909929213752013-07-10T14:42:56.648-07:002013-07-10T14:42:56.648-07:00I work with a Ketamine treatment clinic in AZ. As...I work with a Ketamine treatment clinic in AZ. As a clinical psychologist with almost 30 years experience treating mood disorders, I can honestly tell you the results of Ketamine treatment are dramatic and impressive. I would also like to respond to the questions you have posed.<br />1. Ketamine is generally not recommended with persons who are actively psychotic. We have utilized the treatment with people who have had limited history of psychosis, including personality disorders which often have a greater predisposition for psychosis, without difficulty or change in efficacy. That is however, something that should be monitored closely before and during treatment. Other clinics have reported episodes where people have had “bad trips”, but that has not been our experience.<br />2. We believe the environment plays an important support role. Beyond the setting in which the drug is administered, we utilize CBT to help structure the person’s internal environs or thought process to maximize the benefit of the infusion experience. Clearly, the drug reduces “ego boundaries”, so providing a safe, calm environment allows for the person to relax and take in both the drugs benefit and therapeutic ideas previously given.<br />3. Best dosing protocols are still being explored. What is generally agreed upon, is the benefit is initially short-term, with the need to reinforce (through further treatments) in a few days. Over the course of the first few treatments, effect seems to be “built up”, with gains being retained longer. Our patients receive twice weekly treatments for the first 2-3 weeks. This is followed by weekly treatments for another 2-3 weeks. For some individuals, this is all they need. Other people may require regular treatments every 3-4 weeks.<br />While some people may no longer feel the need to maintain any other psychiatric medications, many of our patients continue to take mood stabilizers without any lessening of ketamine benefit. Other medications, including narcotics and benzodiazepines may affect the treatment benefit.<br />4. Unfortunately, there is little long-term information.<br />5. There is a substantial amount of research. I agree a large research project would help clarify some of the questions raised. Unfortunately, this may have to be left to drug companies who are attempting to repackage the drug in a manner that will allow them to recoup their investment, and place their version of the drug on patent.<br />6. We have treated persons with mild depression, as well as those for whom this is a first-line treatment. Both groups benefitted from this, but the costs and the intravenous protocol is likely to make this less desirable.<br />7. We have treated persons suffering from concurrent PTSD, which Ketamine seems to offer some relief. We have not utilized it for treatment of impulse control disorders<br />8. We are utilizing psychotherapy specifically for depression with ketamine treatment. Patients report that despite having heard some of the same things before in previous therapies, they were able to absorb it in a manner that allowed them to utilize it in their daily life. Think about clinical hypnotherapy. The suggestions are not unique, but the context in which the individual receives the information allows for better utilization. We believe the same thing occurs with Ketamine assisted therapy , in addition to actual changes from the medication itself. Alleviating the burden of depression allows the individual to be able to focus on other therapeutic issues or life goals with current providers.<br />Anonymoushttps://www.blogger.com/profile/10728366083782023082noreply@blogger.comtag:blogger.com,1999:blog-6886575137375451769.post-23762676588192755402013-04-11T10:46:46.808-07:002013-04-11T10:46:46.808-07:00Thanks. The article supports further research, but...Thanks. The article supports further research, but I find the authors quite lukewarm about data which appear far more exciting and promising to me. They are quite negatively toned even about such very simple issues such as mode of administration. I think it is completely unnecessary, for example, for ketamine to be given as an IV infusion!<br /><br />Also, as is unfortunately typical and expected in a paper from Biological Psychiatry, there was no discussion of the psychotherapeutic or environmental milieu in place during administration of the ketamine (e.g. during the administration, presence of a trusted therapist, physical comfort, music, etc. rather than simply administration alone on a hospital stretcher with beeping monitors, etc.). So there was no discussion of its possible effect as a potent augmenting agent for psychotherapeutic change.<br />Even the best augmenting agents only work well in conjunction with something else happening at the same time. <br /><br />So it is quite a limited and narrow review. GKhttps://www.blogger.com/profile/14714377295981745087noreply@blogger.comtag:blogger.com,1999:blog-6886575137375451769.post-46259785795724147902013-04-08T23:42:30.948-07:002013-04-08T23:42:30.948-07:00Thank you for the post.
I highly recommend this r...Thank you for the post. <br />I highly recommend this review http://www.ncbi.nlm.nih.gov/pubmed/22705040 if you haven't seen it yet. It's a systematic review of all available published data on the antidepressant effects of ketamine, including completed, ongoing and planned studies. Anonymousnoreply@blogger.com