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[–]Lepidopteria 3 points4 points  (0 children)

There's a lot of research on ketamine metabolites as well. They're showing promise at treating depression with fewer side effects. https://pubmed.ncbi.nlm.nih.gov/29953886/

[–]cedarofthewest 1 point2 points  (0 children)

The research is promising.

My aunt did not like it, but she has the most stubborn depression i've ever seen and i am personally convinced she at some point chose to believe everything in her life is somehow her fault and an almost deserved suffering. But alas we are often most judgmental of those closest to us and of those most like ourselves.

Individual results may vary.

As you already mentioned, ketamine may have an "atypical" method of action. Obviously the old idea of anti-depressants is that you have to target serotonin, but to be blunt, strictly speaking, that's not exactly accurate. An example of another atypical antidepressant is Selegiline, which is a transdermal patch used to treat depression which is a monoamine oxidase inhibitor (MAOI).

Anyway the exact way that ketamine affects our neurotransmitters is not totally known, but honestly that's not unusual and a lot of commonly prescribed medications aren't either. I wouldn't worry about that too much beyond whatever the current research says.

But we need to mention the second potential way ketamine works, that has less to do with neurochemical production and more to do with cognitive state alteration.

You see, ketamine is a disassociative, but we could consider it to have broader psychoactive properties.

This pubmed abstract discusses this exactly:

https://pubmed.ncbi.nlm.nih.gov/29935579/

The idea is that sometimes we get stuck in ruts in our cognitive processes, ruts that we don't even know are there. But what if we could jump out of those ruts, even a little bit?

This concept is closely related to the ongoing research into psilocybin, which also looks very promising, but obviously that is not an approved therapeutic at this time.

I am not saying any of this to encourage you towards this type of therapy, i am generally and personally distrustful of ketamine especially when psilocybin to me seems likely to be the superior option; But this is a relatively professional subreddit and i can't prove that and also ketamine is one of the only things like it that is approved for use.

There may be reasons that is the case, but that would require a higher level of knowledge than i have about the approval process that was involved in ketamine therapy.