Ketamine Relieves Depression By Restoring Brain Connections

Discussion in 'Research News' started by Nic B, Oct 5, 2012.

    1. Summers2

      Summers2 Member

      Tinnitus Since:
      2016
      Cause of Tinnitus:
      An outside concert
      I tried ketamine infusion but it didn't work. It did make me less depressed though.
       
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    2. Autumnly
      Wishful

      Autumnly Member Podcast Patron Benefactor Hall of Fame Advocate

      Location:
      Germany
      Tinnitus Since:
      July/August 2013
      Cause of Tinnitus:
      Noise induced
      Ketamine Nasal Sprays For Depression: Unpredictable Side Effects
      "The efficacy and safety of intranasal ketamine for depression is under scrutiny, as a pilot trial is stopped early due to poor side effects in patients.

      Nasal spray devices have been touted as a promising way to deliver ketamine to patients with treatment-resistant depression, with this application easier to use and less invasive than other clinical delivery methods such as injections.

      But new research from the Black Dog Institute and UNSW Sydney reveals the unpredictable nature of intranasal ketamine tolerance from one person to the next. The pilot trial aimed to test the feasibility of repeated doses of ketamine through an intranasal device amongst 10 participants with severe depression, ahead of a larger randomised controlled trial.

      [...]

      However, the pilot study was eventually suspended after testing with five participants due to unexpected problems with tolerability. Side effects included high blood pressure, psychotic-like effects and motor incoordination which left some participants unable to continue to self-administer the spray."

      __________________

      Repeated intranasal ketamine for treatment-resistant depression – the way to go? Results from a pilot randomised controlled trial
      First Published March 15, 2018

      Background
      Ketamine research in depression has mostly used intravenous, weight-based approaches, which are difficult to translate clinically. Intranasal (IN) ketamine is a promising alternative but no controlled data has been published on the feasibility, safety and potential efficacy of repeated IN ketamine treatments.

      Methods
      This randomised, double-blind, placebo-controlled pilot study compared a 4-week course of eight treatments of 100 mg ketamine or 4.5 mg midazolam. Each treatment was given as 10 separate IN sprays, self-administered 5 min apart. The study was stopped early due to poor tolerability after five treatment-resistant depressed participants were included. Feasibility, safety (acute and cumulative), cognitive and efficacy outcomes were assessed. Plasma ketamine and norketamine concentrations were assayed after the first treatment.

      Results
      Significant acute cardiovascular, psychotomimetic and neurological side effects occurred at doses < 100 mg ketamine. No participants were able to self-administer all 10 ketamine sprays due to incoordination; treatment time occasionally had to be extended (>45 min) due to acute side effects. No hepatic, cognitive or urinary changes were observed after the treatment course in either group. There was an approximately two-fold variation in ketamine and norketamine plasma concentrations between ketamine participants. At course end, one participant had remitted in each of the ketamine and midazolam groups.

      Conclusions
      IN ketamine, with the drug formulation and delivery device used, was not a useful treatment approach in this study. Absorption was variable between individuals and acute tolerability was poor, requiring prolonged treatment administration time in some individuals. The drug formulation, the delivery device, the insufflation technique and individual patient factors play an important role in tolerability and efficacy when using IN ketamine for TRD.
       
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    3. jay777

      jay777 Member

      Tinnitus Since:
      10/2017
      Cause of Tinnitus:
      benzo/ headphones
    4. fade2black244
      Inspired

      fade2black244 Member Benefactor

      Location:
      TX
      Tinnitus Since:
      03/24/2017
      Cause of Tinnitus:
      Noise Induced
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    5. Cal18
      Nerdy

      Cal18 Member Benefactor Advocate

      Location:
      San Diego
      Tinnitus Since:
      12/2016
      Cause of Tinnitus:
      2010 / 2016 Both SSRI Withdrawal and Mild Hearing Loss
      My experience: I thought this was a logical approach for trial so I made my own trial out of it since their method was pretty basic.

      I decided to get infused at a local ketamine clinic. I was accepted to receive the infusion ($250). Because I might be sensitive due to prior experiences with medications (mainly an SSRI) I asked for a lower dose. In the study they use 0.5 mg/kg IV of ketamine hydrochloride in saline, this was also clinic's standard dose for depression. Instead, they did .3mg for me to start.

      What it felt like: I pretty much knew what to expect... feeling a bit out of control of your body in a drugged sense. Generally, the thought of this makes me uncomfortable as I'm a little bit of a control freak and do not like being "drugged". I had also gotten panic attacks in the past from pot so I was prepared for the worst. But if it meant the possibility of improving my tinnitus I didn't give a crap. You literally feel it after about 1-2 minutes. The nice thing about an infusion vs an injection, is that it can be stopped at any time - so if you're feeling really horrible, once they stop it, the effects stop within a few minutes. I suddenly felt a weird dizziness and weakness come over me, really like I had been drugged (well, I had been), then you feel a little out of control of your senses. At that 3 min mark, I was ready to stop because it felt pretty weird but I stuck with it and realized, it actually didn't get much stronger/worse than that. It seemed to come in waves where you just feel zonked out but I was able to talk to the physician most of the time. For me, I think I did really well.

      What the tinnitus felt like: Mine fluctuates constantly throughout the day so unless it literally "shut off" measuring it was going to be difficult. I have some pure tones which fluctuate an on my loud days, I have tea kettle tinnitus in additional to "brain" electrical tinnitus. I woke up having a pretty loud day before going to get the infusion. My loud days tend to get louder as the day progresses. During the middle of the infusion, it seemed to get a tiny bit lower but that could have just been a fluctuation for no reason (this also happens when I'm talking so that might have been the case). The infusion lasted 40 min. Afterwards, it was louder but I'm pretty sure it was not due to the infusion itself but to fact that it was later in the day around the time my tinnitus gets louder.

      What changed: In the car on the way home (while wearing ear muffs because I also have hyperacusis) I heard a new beeping sound in my left ear. I got pretty scared but it only happened a couple times then stopped. Since then, I've been waking up with a beeping sound which is annoying but then it stops a few minutes after I get up. But here's the nice part. My left ear had recently gotten worse (months before the infusion) and I was having a stronger pure to that was worse when lying down and was getting more constant throughout the day as the months went by. What I realized is that the beeping was the pure tone BREAKING UP. I had the infusion almost 2 weeks ago and I have not have the loud left ear pure tone since. Just the beeping in the morning for a few minutes when waking - vs the stronger solid pure tone I used to have. I can't tell if the rest of the tinnitus has gotten softer due to the constant fluctuations but it feels slightly less violent at least for time being.

      I'm pretty sure I will go for another infusion soon I wanted to wait a little first just to properly assess the changes that have happened so far to make sure I'm headed in the right direction.

      Did it help with depression? I'm mostly depressed due to the tinnitus but I also have a thalamacortical dysrythmia - look it up and it's association to tinnitus (a possible treatment for this is said to be ketamine) which is another reason why I really wanted to try it. I think it might have helped with the depression a bit. I've been feeling a little more detached from the tinnitus and indifferent, nothing drastic, but I see how it can potentially help other people with "normal" depression.

      Lots of talk on here about Ketamine and it wasn't really a big deal to just go try it. :cool:
       
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    6. leledany

      leledany Member

      Tinnitus Since:
      2016-11-02
      Cause of Tinnitus:
      Acoustic trauma
      @Cal18 maybe for you is more effective a low dosage. Please keep on with this dosage and make us know. Happy for you :)
       
    7. Cal18
      Nerdy

      Cal18 Member Benefactor Advocate

      Location:
      San Diego
      Tinnitus Since:
      12/2016
      Cause of Tinnitus:
      2010 / 2016 Both SSRI Withdrawal and Mild Hearing Loss
      Thanks. For the next infusion, I was going to move up the dose a little. I will keep everyone informed of any changes.
       
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    8. 1MW
      No Mood

      1MW Member

      Tinnitus Since:
      2008 but cured and relapsed from benzos
      Cause of Tinnitus:
      ssnhl/benzos/unknown
      @Cal18 ketamine is ototoxic and I suggest you to avoid it.

      The results are not permanent and it has side effects.

      Check your diet and add vitamins, metals, minerals, certain aminoacids / protein & complex carbs, also good lipids to your diet.

      Sun exposure & sex also very important.

      That's the way to fix depression.
       
    9. ACG
      Studious

      ACG Member Benefactor

      Tinnitus Since:
      2016
      Cause of Tinnitus:
      Not Sure
      Please! This is very exciting. Thanks so much for trying it and taking the time to report back.
       
    10. 3ri0w

      3ri0w Member

      Tinnitus Since:
      2012, H 2016, 12/2018(?)
      Cause of Tinnitus:
      loud noises, ringing came back 12/2018 after 1year of silent
      I've had ketamine infusions many times and I have also had ketamine in hospital (for pain). It was not a tinnitus cure any time :( There are infusion clinics that even list "Tinnitus" as a thing that the infusions could cure. But it didn't cure mine, too bad. I was so excited for AM-101 ;__; I really thought that the NMDA related things would have been THE cure.
       
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    11. fade2black244
      Inspired

      fade2black244 Member Benefactor

      Location:
      TX
      Tinnitus Since:
      03/24/2017
      Cause of Tinnitus:
      Noise Induced
      Does ketamine actually help for depression?

      I see "it helped a little bit" but, is it a $500 per treatment for up to 6 treatments worth it?
       
    12. 3ri0w

      3ri0w Member

      Tinnitus Since:
      2012, H 2016, 12/2018(?)
      Cause of Tinnitus:
      loud noises, ringing came back 12/2018 after 1year of silent
      Helps like 70 % of people I read... I belong to the 30 %... Spent thousands of bucks and it did not cure me.. but it's worth a try if you are really down, because atleast it is not ototoxic like SSRI/SNRI and the other antidepressants, and like even if the other antidepressants are not ototoxic "per se", some of them do cause tinnitus for some people and the ringing does not stop (many cases of SSRI tinnituses on this forum).

      What I don't get about ketamine is that like you have to get "booster shots" every once in a while. And how often, for every person it is different, someone is good for a month, someone for six months etc. But in the US of A you can get ketamine to take at home so you don't have to go to the clinic to take them expensive boosters.
       
    13. fade2black244
      Inspired

      fade2black244 Member Benefactor

      Location:
      TX
      Tinnitus Since:
      03/24/2017
      Cause of Tinnitus:
      Noise Induced
      Also another thing, why is it so darn expensive? I'm pretty sure ketamine is in every major ER/Hospital around as a backup anesthetic.

      It almost seems like they've found a way to make a profit back for a stagnant anesthesia stock.
       
    14. grate_biff
      Alone

      grate_biff Member Benefactor

      Location:
      Oslo, Norway
      Tinnitus Since:
      09/2014
      Cause of Tinnitus:
      Acoustic trauma, benzo/mirtazapine withdrawal, or combo!
      This is similar to how benzos affect my tinnitus and hyperacusis!
       

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