Depression

[gw_leics772]

3 hours ago, Buce said:

Ketamine-related drug could be ‘watershed’ in treating depression

 

Experts are cautiously optimistic a drug related to ketamine, recently approved by the US Food and Drug Administration, could be a “watershed” moment in the treatment of depression, and one of the first drugs to be a “rapid-acting” medicine to treat the chronic disease.

The drug, called esketamine, will be sold under the brand name Spravato, and was approved to treat people with depression who don’t respond to traditional psychiatric drugs.

“For a long time, all our standard antidepressants have been ‘me too’ drugs,” said Dr Walter S Dunn, a professor of psychiatry at the University of California Los Angeles, and a member of the FDA advisory committee which recommended the drug be approved.

 

“As much as the companies like to say our drug is better than the next, they were pretty much all the same,” said Dunn, referring to brand name drugs which work on similar pathways in the brain, such as selective serotonin re-uptake inhibitors like Prozac.

The newly approved drug builds on years of research into ketamine as a treatment for major depression. Ketamine has long been seen as a safe drug for anesthesia, and has recently developed as a treatment for depression.

“All the medicines have been operating under the same mechanisms so it was time to explore some of these other compounds that, yes, have been associated with recreation and abuse as potential pathways or compounds to treat depression,” said Dunn.

The drug’s approval, while greeted favorably within the psychiatry community, has raised a host of new questions about accessibility for US patients.

How would the new treatment work?

Psychiatrists such as Dunn believe the drug could be the first in a class of so-called rapid acting depression treatments, because their effects would be felt within hours or days, not weeks like traditional depression treatments.

Although the mechanism at work in the brain is not clearly understood, ketamine, which is typically used as an anesthetic, has been used in clinics intravenously to treat depression since the early 2000s. However, it still has the potential for abuse, once known as a party drug nicknamed Special K, since it can cause what psychiatrists call a “dissociative” or out-of-body experience.

For that reason, patients will not be able to take the drug home. Esketamine will have to be administered in an approved clinic, and patients will be required to stay there for at least two hours, and not allowed to drive until after a night of rest. The FDA advisory committee hopes this will also prevent the drug from entering the black market.

Will it be widely available?

There are a number of possible barriers to widespread use of the drug, including the need for it to be administered in a clinical setting. Patients will need to stay at a clinic for two hours, twice a week, with possible boosters of the drug.

The time commitment could be a logistical challenge for doctors and patients alike, who would need to set aside a significant amount of time to be treated. As well, it’s unclear how widely insurance companies will cover the drug, which is expensive at between $4,720 and $6,785 in the first month.

While studies for esketamine included patients who did not respond to two traditional antidepressant treatments, it’s possible insurance companies could further restrict the group of people who have payment approved for the drug. For example, they could require patients fail to respond to four traditional antidepressants.

If ketamine is generic, why not use that?

Economics thwarted ketamine’s widespread use. Without an FDA-approved use for ketamine as a depression treatment, insurance companies did not cover the drug. And because it had long been generic, drug companies did not see it as a way to make money, and did not fund the clinical trials necessary to have it approved specifically to treat depression.

Therefore, without any drug companies applying to sell the drug, it was relegated to a relatively small number of clinics running cash operations, and delivering ketamine intravenously.

However, Dunn said it is possible ketamine could become a more broadly accepted treatment for depression because of the approval of esketamine. Doctors may see data about esketamine, and work with compounding pharmacies to make a ketamine nasal spray much like the delivery system for esketamine developed by Janssen Pharmaceuticals, an arm of Johnson & Johnson, Dunn said.

What does this mean for the treatment of depression?

With other new rapid-acting drugs to treat depression in development, Dunn believes esketamine could be seen as paving the way for a new class of drugs for depression treatment.

“This is really the first, and there are several in various phases of development, and over the next couple years you will see more coming out on the market,” said Dunn.

The biggest challenge psychiatrists will face, Dunn said, is much the same as the one they face now: keeping patients in treatment.

“The challenge we’ve all faced in psychiatry is keeping people on their medications,” he said. “Patients have gotten better, they don’t have symptoms anymore, so why take the medication?”

“The more barriers, or difficult it is to take a medication in the maintenance period, the less likely they’re going to take it,” he said. “The barrier is going to be coming in, taking two hours out of your day. That we might see as more of a problem.”

Back to the ketamine laced e's then? Happy happy days ?

[Wymsey]

Justin Bieber reveals that he's currently struggling.

https://news.sky.com/story/amp/justin-bieber-to-fans-pray-for-me-im-struggling-11661348

[TheLittleBigMan]

On 12/03/2019 at 10:25, Wymeswold fox said:

Justin Bieber reveals that he's currently struggling.

https://news.sky.com/story/amp/justin-bieber-to-fans-pray-for-me-im-struggling-11661348

I've been struggling with him for years.

[Grebfromgrebland]

On 08/03/2019 at 16:28, Buce said:

Ketamine-related drug could be ‘watershed’ in treating depression

 

Experts are cautiously optimistic a drug related to ketamine, recently approved by the US Food and Drug Administration, could be a “watershed” moment in the treatment of depression, and one of the first drugs to be a “rapid-acting” medicine to treat the chronic disease.

The drug, called esketamine, will be sold under the brand name Spravato, and was approved to treat people with depression who don’t respond to traditional psychiatric drugs.

“For a long time, all our standard antidepressants have been ‘me too’ drugs,” said Dr Walter S Dunn, a professor of psychiatry at the University of California Los Angeles, and a member of the FDA advisory committee which recommended the drug be approved.

 

“As much as the companies like to say our drug is better than the next, they were pretty much all the same,” said Dunn, referring to brand name drugs which work on similar pathways in the brain, such as selective serotonin re-uptake inhibitors like Prozac.

The newly approved drug builds on years of research into ketamine as a treatment for major depression. Ketamine has long been seen as a safe drug for anesthesia, and has recently developed as a treatment for depression.

“All the medicines have been operating under the same mechanisms so it was time to explore some of these other compounds that, yes, have been associated with recreation and abuse as potential pathways or compounds to treat depression,” said Dunn.

The drug’s approval, while greeted favorably within the psychiatry community, has raised a host of new questions about accessibility for US patients.

How would the new treatment work?

Psychiatrists such as Dunn believe the drug could be the first in a class of so-called rapid acting depression treatments, because their effects would be felt within hours or days, not weeks like traditional depression treatments.

Although the mechanism at work in the brain is not clearly understood, ketamine, which is typically used as an anesthetic, has been used in clinics intravenously to treat depression since the early 2000s. However, it still has the potential for abuse, once known as a party drug nicknamed Special K, since it can cause what psychiatrists call a “dissociative” or out-of-body experience.

For that reason, patients will not be able to take the drug home. Esketamine will have to be administered in an approved clinic, and patients will be required to stay there for at least two hours, and not allowed to drive until after a night of rest. The FDA advisory committee hopes this will also prevent the drug from entering the black market.

Will it be widely available?

There are a number of possible barriers to widespread use of the drug, including the need for it to be administered in a clinical setting. Patients will need to stay at a clinic for two hours, twice a week, with possible boosters of the drug.

The time commitment could be a logistical challenge for doctors and patients alike, who would need to set aside a significant amount of time to be treated. As well, it’s unclear how widely insurance companies will cover the drug, which is expensive at between $4,720 and $6,785 in the first month.

While studies for esketamine included patients who did not respond to two traditional antidepressant treatments, it’s possible insurance companies could further restrict the group of people who have payment approved for the drug. For example, they could require patients fail to respond to four traditional antidepressants.

If ketamine is generic, why not use that?

Economics thwarted ketamine’s widespread use. Without an FDA-approved use for ketamine as a depression treatment, insurance companies did not cover the drug. And because it had long been generic, drug companies did not see it as a way to make money, and did not fund the clinical trials necessary to have it approved specifically to treat depression.

Therefore, without any drug companies applying to sell the drug, it was relegated to a relatively small number of clinics running cash operations, and delivering ketamine intravenously.

However, Dunn said it is possible ketamine could become a more broadly accepted treatment for depression because of the approval of esketamine. Doctors may see data about esketamine, and work with compounding pharmacies to make a ketamine nasal spray much like the delivery system for esketamine developed by Janssen Pharmaceuticals, an arm of Johnson & Johnson, Dunn said.

What does this mean for the treatment of depression?

With other new rapid-acting drugs to treat depression in development, Dunn believes esketamine could be seen as paving the way for a new class of drugs for depression treatment.

“This is really the first, and there are several in various phases of development, and over the next couple years you will see more coming out on the market,” said Dunn.

The biggest challenge psychiatrists will face, Dunn said, is much the same as the one they face now: keeping patients in treatment.

“The challenge we’ve all faced in psychiatry is keeping people on their medications,” he said. “Patients have gotten better, they don’t have symptoms anymore, so why take the medication?”

“The more barriers, or difficult it is to take a medication in the maintenance period, the less likely they’re going to take it,” he said. “The barrier is going to be coming in, taking two hours out of your day. That we might see as more of a problem.”

In all seriousness doing mushrooms or Ket can lift the mood for weeks after taking them.

[Rain King]

Still struggling at the minute. I was booked onto a 7 week Lets Talk Well Being course by the GP which I have found pretty useless to be honest. I find it hard to relate my scenario to the scenarios they talk about. My low mood and anxiety comes from constant worry about my kids rather than myself. I'm ok in myself but when it comes to them I am constantly on edge, always convinced something bad is going to happen. Ridiculous but I can't seem to shake it.

 

I always convince myself they are struggling at school or playing on their own when there is little evidence to back this up.

When there isn't evidence there I look for it. It's driving me insane. I talk to them when they come home and realise I am almost interrogating them to make sure everything is ok.

 

I dread half 3 every day when I speak to the Mrs after she has picked them up, my stomach churns and I'm convinced they've had a bad day.

 

I know the above sounds ridiculous.

 

I'm not sure why or where it stems from, the only thing I can point to is they were both born very prematurely and had to spend a lot of time in hospital when they were young which makes me over the top protective. I need to stop it as it isn't good for me or them.

[Izzy]

1 hour ago, pds said:

Still struggling at the minute. I was booked onto a 7 week Lets Talk Well Being course by the GP which I have found pretty useless to be honest. I find it hard to relate my scenario to the scenarios they talk about. My low mood and anxiety comes from constant worry about my kids rather than myself. I'm ok in myself but when it comes to them I am constantly on edge, always convinced something bad is going to happen. Ridiculous but I can't seem to shake it.

 

I always convince myself they are struggling at school or playing on their own when there is little evidence to back this up.

When there isn't evidence there I look for it. It's driving me insane. I talk to them when they come home and realise I am almost interrogating them to make sure everything is ok.

 

I dread half 3 every day when I speak to the Mrs after she has picked them up, my stomach churns and I'm convinced they've had a bad day.

 

I know the above sounds ridiculous.

 

I'm not sure why or where it stems from, the only thing I can point to is they were both born very prematurely and had to spend a lot of time in hospital when they were young which makes me over the top protective. I need to stop it as it isn't good for me or them.

Doesn't sound ridiculous at all mate. Sounds like you love your kids with all your heart and care deeply about their welfare and well-being.

 

Although you say that you don't know where this over-protectiveness comes from, you then describe a very plausible reason why it might be so. I think it's perfectly natural for us to want to be in control of our kids growing up, and I too struggle to 'let go' and trust that mine will be O.K.

 

I was going to ask if there was anything in your own childhood that might have a bearing on this, but I'm no shrink. I would seriously consider speaking to a Councillor though as it sounds like Well Being course isn't doing it for you.

 

And of course it's all your 'thinking' as I've said many times on this thread. Those constant "What if...?" thoughts that send us down make believe rabbit holes where we end up catastrophising and making stuff up really bad. 

 

Btw, you can stop it if you 'catch' your thinking and notice that it's not your reality. Our thoughts are not always to be trusted - especially when our mood is low.

 

Here's a book I read and it helped me enormously. If you like reading I'd thoroughly recommend it:

 

 

Finally, someone gave me this poem a while ago and it really made me think. Our kids are only ever 'on loan' to us...

 

 

Best of luck and keep posting on here mate 

[gw_leics772]

5 hours ago, pds said:

Still struggling at the minute. I was booked onto a 7 week Lets Talk Well Being course by the GP which I have found pretty useless to be honest. I find it hard to relate my scenario to the scenarios they talk about. My low mood and anxiety comes from constant worry about my kids rather than myself. I'm ok in myself but when it comes to them I am constantly on edge, always convinced something bad is going to happen. Ridiculous but I can't seem to shake it.

 

I always convince myself they are struggling at school or playing on their own when there is little evidence to back this up.

When there isn't evidence there I look for it. It's driving me insane. I talk to them when they come home and realise I am almost interrogating them to make sure everything is ok.

 

I dread half 3 every day when I speak to the Mrs after she has picked them up, my stomach churns and I'm convinced they've had a bad day.

 

I know the above sounds ridiculous.

 

I'm not sure why or where it stems from, the only thing I can point to is they were both born very prematurely and had to spend a lot of time in hospital when they were young which makes me over the top protective. I need to stop it as it isn't good for me or them.

I am surprised that the 7 week wellbeing course is not working for you.

I also went on this and found it very helpful. 

There were areas that were less relevant to me that seem potentially very relevant to what you are saying.

I recommend you speak to the counsellor to help you to relate it to your particular circumstances as i felt i took some coping mechanisms from almost all of them.

Yours sounds relatable to the people who carry something round with them like a first aid kit, as a crutch for them emotionally. It sounds to me like you interrogating your children can be related to that. Ie. Practice not interrogating them, not even asking them for a while as it sounds bad for you and cant be much fun for them either. Like the people who carried the first aid kit. How many times did they need it. = how many times were your interrogations worthwhile? What would happen if you dont do it. Highly likely nothing bad will happen, abd you will all feel better for it.

There is also the worrying module where you plan how to interact and look at worst case scenarios and how likely they are to happen.

I also worried about my children with potential bullying and also overthinking. Once i was able to accept it was my issue and that they were not being bullied it felt great.

Also with another son, i worried about him worrying, and it was great to see that he just isn't a worrier. The type of shit that would eat me up inside is like water off a ducks back to my little superstar, and made me very proud of him.

Ask for manisha if you are not already assigned to her. They are busy and like anyone else, will take the path of least resistance but if you stay behind to talk to them, and arrange a telephone appointment if necessary, they can be very good. Its all about finding the right tools to tackle the problem.

Another possibility that hits me is that you could be too down currently to find any use in it. This is a relatively new thing with them that i didnt get from them first time i used them years ago, and in truth, until i had tackled a lot with medication first, i probably wouldn't have been "ready"

1 - if you are too low, see your gp to get medication right first.

2 - persevere with the course. It can be great. Not all of it, but i took a few coping mechanisms that resonated with me and they were worth their weight in gold. Ask for help from the people who run it. They know what they are talking about.

[ozleicester]

On 25/03/2019 at 23:32, pds said:

Still struggling at the minute. I was booked onto a 7 week Lets Talk Well Being course by the GP which I have found pretty useless to be honest. I find it hard to relate my scenario to the scenarios they talk about. My low mood and anxiety comes from constant worry about my kids rather than myself. I'm ok in myself but when it comes to them I am constantly on edge, always convinced something bad is going to happen. Ridiculous but I can't seem to shake it.

 

I always convince myself they are struggling at school or playing on their own when there is little evidence to back this up.

When there isn't evidence there I look for it. It's driving me insane. I talk to them when they come home and realise I am almost interrogating them to make sure everything is ok.

 

I dread half 3 every day when I speak to the Mrs after she has picked them up, my stomach churns and I'm convinced they've had a bad day.

 

I know the above sounds ridiculous.

 

I'm not sure why or where it stems from, the only thing I can point to is they were both born very prematurely and had to spend a lot of time in hospital when they were young which makes me over the top protective. I need to stop it as it isn't good for me or them.

That sounds so tough, i feel for you and can appreciate where you are coming from... kids eh, a blessing and a curse

 

Please dont give up with the Doc, maybe go back and get a different recommendation, keep trying until you find the one that fits.. it is there, it just takes a while to find.

[urban.spaceman]

Me, today:

 

 

[urban.spaceman]

Transitioning to new meds which I start on Monday so having to have a “whiteout” for a week. Not pleasant! Anyone got any experience with Prozac?!

[egg_fried_rice]

2 hours ago, urban.spaceman said:

Transitioning to new meds which I start on Monday so having to have a “whiteout” for a week. Not pleasant! Anyone got any experience with Prozac?!

Yes - it gave me night sweats and an inability to cum 

 

Apparently it can be very hit and miss and it was certainly a miss for me.

[Buce]

3 hours ago, urban.spaceman said:

Transitioning to new meds which I start on Monday so having to have a “whiteout” for a week. Not pleasant! Anyone got any experience with Prozac?!

 

Not personally, but I know enough people who have to know that I wouldn't take it.

[shilton_fox]

7 hours ago, urban.spaceman said:

Transitioning to new meds which I start on Monday so having to have a “whiteout” for a week. Not pleasant! Anyone got any experience with Prozac?!

Worked for me when I needed it, didn’t have any negative side effects. We all react differently to different anti-d’s

[gw_leics772]

7 hours ago, urban.spaceman said:

Transitioning to new meds which I start on Monday so having to have a “whiteout” for a week. Not pleasant! Anyone got any experience with Prozac?!

And finally some good news.

 

I know my mum took it and just checked the non branded name which is fluoxetine and know that my mum and brother have been on it for years (we're "that" kind of family ?) so worked for them long term.

 

Im on paroxetine and that has worked for me for years. Its horses for courses so be prepared to give it a few weeks but if you feel no better, or even worse, make sure you tell your gp as there are plenty of alternatives.

 

Happy to announce that i have no idea how it affected either of their sex lives ?????

Edited 3 April 2019 by gw_leics772

[Costock_Fox]

2 hours ago, gw_leics772 said:

And finally some good news.

 

I know my mum took it and just checked the non branded name which is fluoxetine and know that my mum and brother have been on it for years (we're "that" kind of family ?) so worked for them long term.

 

Im on paroxetine and that has worked for me for years. Its horses for courses so be prepared to give it a few weeks but if you feel no better, or even worse, make sure you tell your gp as there are plenty of alternatives.

 

Happy to announce that i have no idea how it affected either of their sex lives ?????

I’m really glad you said lives there but I guess that’s where the Edit came in.

[gw_leics772]

[Bellend Sebastian]

11 hours ago, urban.spaceman said:

Transitioning to new meds which I start on Monday so having to have a “whiteout” for a week. Not pleasant! Anyone got any experience with Prozac?!

I'm sure I've said this on here before but it worked so well for me I'd put it in the water supply.

 

8 hours ago, egg_fried_rice said:

Yes - it gave me night sweats and an inability to cum 

 

Apparently it can be very hit and miss and it was certainly a miss for me.

I missed out on the night sweats, but not the latter.

 

It didn't stop it completely, it just took a LOT more effort to, erm get where I needed to.

 

Worth it though BOOM

[urban.spaceman]

On 03/04/2019 at 14:51, egg_fried_rice said:

Yes - it gave me night sweats and an inability to cum 

 

Apparently it can be very hit and miss and it was certainly a miss for me.

 

On 03/04/2019 at 15:45, Buce said:

 

Not personally, but I know enough people who have to know that I wouldn't take it.

 

On 03/04/2019 at 19:50, shilton_fox said:

Worked for me when I needed it, didn’t have any negative side effects. We all react differently to different anti-d’s

 

On 03/04/2019 at 20:05, gw_leics772 said:

And finally some good news.

 

I know my mum took it and just checked the non branded name which is fluoxetine and know that my mum and brother have been on it for years (we're "that" kind of family ?) so worked for them long term.

 

Im on paroxetine and that has worked for me for years. Its horses for courses so be prepared to give it a few weeks but if you feel no better, or even worse, make sure you tell your gp as there are plenty of alternatives.

 

Happy to announce that i have no idea how it affected either of their sex lives ?????

 

On 03/04/2019 at 23:27, Bellend Sebastian said:

I'm sure I've said this on here before but it worked so well for me I'd put it in the water supply.

 

I missed out on the night sweats, but not the latter.

 

It didn't stop it completely, it just took a LOT more effort to, erm get where I needed to.

 

Worth it though BOOM

Some er, useful messages there, thanks! Starting tomorrow, been absurdly skittish the whole week so I’m hoping it will help. 

[Finnegan]

Hmm. 

[Finnegan]

On 03/04/2019 at 12:16, urban.spaceman said:

Transitioning to new meds which I start on Monday so having to have a “whiteout” for a week. Not pleasant! Anyone got any experience with Prozac?!

 

Yeah fluoextine was the least offensive SSRI I've been on (citalopram and sertraline.)

 

If you've been on SSRIs already then you basically know what to expect, other than different ones trigger slightly different side effects in people they're all fairly similar. Citalopram, for example, made it difficult for me to start a flow when trying to piss where as fluoextine didn't, others might have experienced the opposite. 

 

Only noticeable side effect for me with fluoextine was a drop in sensitivity in my penis and a likely linked difficulty in achieving orgasm. Sounds like it might have practical uses at first, hammering away forever like a porn star, but really it just became stressful and distracting. 

 

The problem I have with all SSRIs though is that, in my experience, they're great for anxiety and just shit for depression. I find I feel slow, tired, sluggish and just deadened a lot of the time. That's fine when I need peeling off the ceiling from some hyperaroused state of extreme anxiety or patterns of obsessive compulsive behaviour but less so helpful when I need dragging out of a hypoaroused state of depression. 

 

Other people will experience it differently though. 

Edited 8 April 2019 by Finnegan

[egg_fried_rice]

I wonder if anyone has any insight on this.

 

I know intellectually/conceptually that I cannot control how other people feel. But to me it seems unarguable that your words and actions have an effect on other people. Now normally this is fine when it comes to strangers, colleagues, even friends. I know my boundaries and can uphold them pretty well without much fear of upsetting others. I don't go about trying to be an arsehole so if I say something that upsets - well, that's regrettable, but there isn't much I can do about it.

 

But when it comes to prospective partners, I find it much more difficult. The fact that I can influence things for the worse, and even for the better feels like a great deal of responsibility - especially if that person also experiences many of the issues mentioned in this thread. This,combined with an occasionally overwhelming feeling of compassion and empathy for the traumatic experiences of that person, and the other strong emotions you feel when exploring romantic interests (fnarr fnarr), makes my mind feel like a confusing, mushy mess. How much of my interest relates to making the other person feel good? How much of my interest relates to their character () and personality? What am I getting out of this relationship? I can't seem to separate these, and many other, questions.

 

At times, I get lost in all that worry and concern. More so than from any other sort of trigger. I might meditate for a bit and settle my mind, but it soon pops back in with a vengeance. It feels inescapable. Typing this out, it appears like I'm putting a lot of pressure on myself but quite honestly I don't know how to alleviate myself of that. You might ask why I feel such responsibility for others - truthfully I'm not really sure, but I think if we can make the lives of those we hold dearest a little more pleasant and easeful, then shouldn't we at least try?

Edited 9 April 2019 by egg_fried_rice

[lifted*fox]

Travelled, saw amazing things, met an amazing person. ****ed up. Got insane amounts of valium and xanax in Cambodia, using them to numb everything. Literally couldn't give a **** if I wake up tomorrow. What a mess.

[Manini]

48 minutes ago, lifted*fox said:

Travelled, saw amazing things, met an amazing person. ****ed up. Got insane amounts of valium and xanax in Cambodia, using them to numb everything. Literally couldn't give a **** if I wake up tomorrow. What a mess.

Thinking of you, mate. Same goes for anybody else struggling, I know words sort of pale in to insignificance...but, You got this. 

[ozleicester]

2 hours ago, lifted*fox said:

Travelled, saw amazing things, met an amazing person. ****ed up. Got insane amounts of valium and xanax in Cambodia, using them to numb everything. Literally couldn't give a **** if I wake up tomorrow. What a mess.

Hope we see you tomorrow and every day thereafter. 

 

Dont let it go, you have value to many. 

[urban.spaceman]

5 hours ago, lifted*fox said:

Travelled, saw amazing things, met an amazing person. ****ed up. Got insane amounts of valium and xanax in Cambodia, using them to numb everything. Literally couldn't give a **** if I wake up tomorrow. What a mess.

Please wake up tomorrow. Come and tell us anything you want - we're all here to listen and won’t judge. Like Oz said, you ARE valued.