I don’t know about oxygen. There were mindful of nitrous: anesthesiologists were asked to minimize use of nitrous oxide and they conducted a sensitivity analysis in which they excluded ppl who received nitrous.
If I recall correctly there's some (early) evidence for antidepressant effects from anaesthetics like propofol or sevflurane? Which could explain the unusually high "placebo" response - "Agents used for anesthetic maintenance included intravenous propofol and inhaled sevoflurane or isoflurane" in the "Trial of Ketamine Masked by Surgical Anesthesia in Depressed Patients" paper.
Possibly it's just that the other anaesthetics were also effective antidepressants!
You lay out the pros and cons of the research quite well. One crucial issue is the nature of depression. If you think depression is the result of relentless emotional abuse by an angry mother, or shame after childhood sexual abuse, then the effects of ketamine are nothing more than expectancy effects created from elaborate rituals. If you think depression is an abnormality of physiology from genes or chemical imbalances or whatever else, then the lack of separation from placebo is very difficult to accept. A somatic intervention should result in cure. However, after 35,000 hours of doing psychotherapy, roughly 99% of depressed people are in my office because of the emotional abuse, physical neglect, bullying, and other serious psychological injuries.
"If you think depression is the result of relentless emotional abuse by an angry mother, or shame after childhood sexual abuse, then the effects of ketamine are nothing more than expectancy effects created from elaborate rituals."
I don't get how you go from premise to conclusion here.
Because ingesting a chemical does not make the abuse have not happened.
I think Eric is dividing depression causes roughly into "mental" and "physiological", and saying that he expects ketamine to aid in the latter but not the former.
Of course not, but NO treatment can go back in time to erase past events from your life and make it the case that they never happened. That goes for talk therapy as well as for ingesting chemicals.
I'm not saying this because I'm against talk therapy and thinks drugs are generally better. I think present-day psychiatry tends to be way too drug-oriented and way too biology-focused.
But there's no reason why chemicals couldn't make you feel better regardless of why you got depressed in the first place, just like there's no reason why talk therapy couldn't help regardless of why you got depressed (even if you didn't have past abuse to talk about, you might be helped in other ways by talking and coming up with mental strategies). It's a mistake to conclude from the fact that some treatment helped you, that the ultimate cause of your problem must be of "the same kind" as the treatment.
Were they on oxygen under anesthesia? Oxygen at somewhat higher than RA % has shown antidepressant effects. So has nitrous oxide.
I don’t know about oxygen. There were mindful of nitrous: anesthesiologists were asked to minimize use of nitrous oxide and they conducted a sensitivity analysis in which they excluded ppl who received nitrous.
If I recall correctly there's some (early) evidence for antidepressant effects from anaesthetics like propofol or sevflurane? Which could explain the unusually high "placebo" response - "Agents used for anesthetic maintenance included intravenous propofol and inhaled sevoflurane or isoflurane" in the "Trial of Ketamine Masked by Surgical Anesthesia in Depressed Patients" paper.
Possibly it's just that the other anaesthetics were also effective antidepressants!
You lay out the pros and cons of the research quite well. One crucial issue is the nature of depression. If you think depression is the result of relentless emotional abuse by an angry mother, or shame after childhood sexual abuse, then the effects of ketamine are nothing more than expectancy effects created from elaborate rituals. If you think depression is an abnormality of physiology from genes or chemical imbalances or whatever else, then the lack of separation from placebo is very difficult to accept. A somatic intervention should result in cure. However, after 35,000 hours of doing psychotherapy, roughly 99% of depressed people are in my office because of the emotional abuse, physical neglect, bullying, and other serious psychological injuries.
"If you think depression is the result of relentless emotional abuse by an angry mother, or shame after childhood sexual abuse, then the effects of ketamine are nothing more than expectancy effects created from elaborate rituals."
I don't get how you go from premise to conclusion here.
Because ingesting a chemical does not make the abuse have not happened.
I think Eric is dividing depression causes roughly into "mental" and "physiological", and saying that he expects ketamine to aid in the latter but not the former.
Of course not, but NO treatment can go back in time to erase past events from your life and make it the case that they never happened. That goes for talk therapy as well as for ingesting chemicals.
I'm not saying this because I'm against talk therapy and thinks drugs are generally better. I think present-day psychiatry tends to be way too drug-oriented and way too biology-focused.
But there's no reason why chemicals couldn't make you feel better regardless of why you got depressed in the first place, just like there's no reason why talk therapy couldn't help regardless of why you got depressed (even if you didn't have past abuse to talk about, you might be helped in other ways by talking and coming up with mental strategies). It's a mistake to conclude from the fact that some treatment helped you, that the ultimate cause of your problem must be of "the same kind" as the treatment.
I mostly agree with you, unfortunately it doesn't seem like Eric is coming back to justify what he wrote.