Party Drug That Treats DEPRESSION? | Wednesday Checkup #22


– Can a party drug really
be used to treat depression? That’s what we’re talking about on this week’s Wednesday Checkup. (squeaks) (upbeat music) (static surges) I wanna talk to you guys
about last week’s keto video. I know many of you dropped
to the comment section that you wanted me to watch some video about a one-star hospital
where someone went to get their ringworm treated. And you wanted me to react to that video. I started my (laughs)
reaction to that video, and I had to stop it, because I didn’t think there
was enough useful information. Let’s just say it didn’t
have enough educational value for me (laughs) to continue and give you my honest feedback on it. I respect all creators out there that are trying to do their own thing, but this channel is
about having a good time and learning something in the process. And I don’t think we
could have used that video for that purpose. (upbeat music) Okay, okay, so ketamine nasal spray. Ketamine to many people is
just known as a party drug. This is because in the
1990s, it rose to popularity in the rave culture, using
it as a way to get high. Enter what’s known as the K-hole. People have even used it
to mitigate the effects of a come down from using MDMA or ecstasy. But ketamine actually has
legitimate medical uses. We’ve been using it for some
time now as an anesthetic, as a way to control pain, as
a way to maintain anesthesia. Veterinarians also use ketamine
to do the same with animals. But recently, headlines have been made where ketamine may be
soon approved by the FDA as a way to treat depression. Before everybody gets very
excited and starts saying, “Wow, we’re gonna be using
a party drug for depression? “How is that beneficial?” Or, “Should I stop taking my medications “that my doctor prescribed
me and ask about this?” As with most stories that
run amok in the media, there’s some truth to this, and there’s also some
things that are overblown. And that’s what I wanna cover today. (upbeat music) Within the last 10 or 20 years, there’s been mounting anecdotal evidence that ketamine can be used as
a treatment for depression. Basically, stories or case
reports or case studies from doctors successfully using ketamine as a way to treat depression. Based on this successful
anecdotal evidence, Johnson and Johnson has
actually pursued clinical trials to find out whether or not
ketamine can successfully be used to treat depression. And what we’re finding is that in cases where we have a very, very
specific subtype of depression, treatment-resistant depression, which means that traditional medications that we have a lot of
success with don’t work on this patient. In those very specific
subsets of patients, we see success with ketamine, from this preliminary research. (upbeat music) Let’s talk about why there’s so much hype about this ketamine nasal spray. First, there hasn’t been a
breakthrough in the treatment of depression with the
pharmaceutical in a really long time. Obviously, that alone
is gonna get headlines, gonna get doctors excited. The real reason why I think
doctors are excited is because of how fast ketamine works. Traditional meds that we
use for depression can take up to six weeks to see a proper result, and for someone who’s
actively, severely suicidal, that may not be a sufficient treatment. But what these preliminary studies done by Johnson and Johnson have shown is that ketamine acts very quickly, sometimes as early as
four hours into taking it. So you can see why doctors may
get excited by a medication that can rapidly reduce the amount of suicidal ideations a person may have. Also, since this medication
ideally is gonna be used for those who suffer from
treatment-resistant depression, that provides hope for these people. And that can sometimes bring a lot of hype to a medication on its own. Also, I think it’s really
important to mention this here. Just because I’m talking
about pharmaceuticals for depression, that’s not because I think that pharmaceuticals are the only or best way to treat depression. In fact, what we’ve seen is that therapy, specifically cognitive-behavioral
therapy, can be as good or even at times better
at treating depression and decreasing the likelihood that it will return in the future. (upbeat music) I think it’s important to
sort of touch on the subject of the over-prescription of
antidepressant medications, because I do think that’s a problem. And folks are quick to blame doctors and pharmaceutical companies
for pushing the medications, and while I do think that
pharmaceutical companies with their direct-to-consumer advertising, which I’m not a fan of, are certainly part of the problem, doctors sometimes can
be part of the problem, ’cause they may not be totally educated on the risks, benefits,
the timing schedules. But there’s also this other side that’s not discussed enough, where A, patients are directly
requesting a quick solution in terms of a medication
to solve their problem, despite a doctor’s
initial recommendations. And two, the lack of access to quality mental health
professionals is truly disturbing within our healthcare system. Sometimes, I meet a patient, and I think they’re gonna
be perfect candidate for cognitive-behavioral therapy. I think that medications are not ideal in their given scenario, but when they go and try to make an appointment
with either a therapist, a counselor, a psychiatrist,
psychologist, whatever it is, they have so many barriers
that they need to go through. They need to call 10 different doctors, see who’s taking new patients, whether they need to
pay a huge deductible, and all of these things prevent folks from getting the quality
services that they need. And as a result, they’re
forced to take the medication and hope it works out with
just a pharmaceutical. (upbeat music) My bottom line when it comes
to this new intranasal spray. I wanna make sure that the quality studies
here are concluded. We get a medication quickly and
safely to those who need it, especially if you’re actively suicidal. You’re receiving treatment for depression, and it’s not working. And you finally have hope that
there’s this other medication on the horizon, but you have to understand that doctors still have a lot of questions when it comes to ketamine. How long patients should
be taking this medication? How feasible is this? Is this gonna be too expensive for the majority of my
patients to acquire this? Ketamine is not gonna be just prescribed to you and you take it home. This is gonna be a medication
where you’re gonna need to go to a healthcare professional’s
office or hospital setting. They’re gonna administer
it to you once a week, and then you keep coming
back for treatments as long as it’s prescribed to you. This alone can be a barrier. Think about transportation,
cost, all of these things. Yes, there’s new hope, but
there’s also a responsibility that both Johnson and Johnson
and doctors like myself have to you as a patient in order to make sure that I’m giving you a medication
that has more benefits than harms, that it’s well studied. I know how to dose it properly. I know what adverse effects exist. I know how to change the therapy. All of these things don’t quite
have the answers just yet, but I remain optimistic. I remain hopeful that we
can find out these answers, find the perfect instance when
this medication can be used, and as a result, we can get patients who are suffering some proper help. On a lighter note, if you
haven’t watched my 30 days of keto video, click here. And as always, stay happy and healthy. (upbeat music)

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Comments

  1. They used Ketamine for my C-Section in 1998. I have Scoliosis and they couldn't get my epidural to take. I heard everything going on. I was even hallucinating psychedelic colors. If I felt the pain, I don't remember but I know I would say "Owww" in slow motion. Afterwards, when I was trying to wake up, I couldn't speak at all so I shook my head "no" and the nurse or whatever had to stop my head from moving. It was awful.

  2. I’m a huge fan of Ketamine, it is a great Medicine. I love that it has been used to treat depression, but it can be used to treat pain too. I had hip surgery two years ago. Core decompressions and bone grafts on each hip. I had each hip done two months apart. The first surgery was rough and I was in so much pain they ended admitting me to the hospital after maxing out of medication in PACU. It was so bad they ended putting me on a PCA pump on the Orthopedic surgery floor. The next surgery the anesthesiologist saw how hard the surgery was last time and said he would like to try and use Ketamine, he said it might help a little it might help a lot, but that he’s has success with Ketamine with painful surgeries and said it was worth a try. I woke up in recovery and felt really weird, like room spinning, a little out of it seeing colors, but was not in nearly as much pain. It was amazing, and I learned latter on they ended up doing a lot more surgery on the second hip and the operation took over an hour longer, but I woke up in a fraction of the pain. I used less than half of the pain medication in PACU compared to the first surgery and was able to go home after surgery and didn’t have to spend almost three days in the hospital like the first surgery. The truly crazy thing is I used almost 40% less pain medication outpatient on the second surgery, so the effects lasted the days and weeks after surgery too or at least l didn’t start out in a ton of pain and was behind the 8 ball trying to control the pain. It was amazing to that even having a larger surgery that took longer, that because of Ketamine I didn’t have to stay in the hospital and I didn’t need nearly as much medication right after surgery or during my recovery and Physical therapy the weeks after surgery. I am a huge fan of Ketamine, it saved me so much suffering!

  3. Oh please please please Do a video with The Try Guys! Some suggested this and it’s the best idea ever!!! Zach one of the Try Guys has Ankylosing Spondylitis, a condition that I have also. I would love to see Dr. Mike give them physicals and answer Medical questions for them (Try Guys) and their wives/girlfriends. Please #Tryguys and #DrMike make this happen!!!!

  4. My doctor thinks that this Esketamine is one of the only things that will help my depression. Unfortunately my work can't give me the days off that I would need to go to the hospital once a week to get the medicine. Thus I remain severely depressed. Nothing works and there are no doctors for any kind of therapy within an hour drive distance of my location that take my insurance and that's accepting me patience.

  5. yo, i love CBT. ive taken meds before and i just became dull. CBT has changed my life! Only therapy thats worked on me

  6. The barriers to reaching a psychiatric providers are getting more ridiculous as time goes by. I know more psych practitioners nowadays that no longer accept insurance because of all the pain insurance companies give them. Health Insurance companies should really be restricted in how much they can decide a person's treatment.

  7. I really enjoyed this video and learned a lot! I see a therapist and do CBT and have major depression, PTSD, panic disorder and an eating disorder. I have been in a lot of situations where I was extremely suicidal and my medicines weren't helpful for those extremely hard moments, so the prospect of medicines like this being explored is very exciting!! Love your videos!

  8. I am certainly going to be keeping my eye on ketamine, as I have both severe chronic pain, and have been dealing with depression for most of my life. However, it is always worth being cautious. I have had experience with it before, as i was on it after surgery. I had a unusual and oddly specific side effect of turning everything green. My entire vision was like looking through a green filter, and i saw very little of any other color. But the dosage for depression is obviously going to be a lot lower than what they give you for the first week after major surgery. The possibility of it reducing my pain and depression make it an exciting possibility. But the thing that you need to be careful about drugs, and particularly antidepressants is that they don't necessarily make you happy. They just numb the depression a bit, which can sometimes dull all of your emotions and generally make you feel like a zombie. If a drug relieves symptims, but as a consequence barely leaves anybody home to experience said reducion in symptoms, it isn't always a bright idea.

  9. I'm calling a SPRAVATO center tomorrow.
    This video helped to push me over the edge and try it instead of staying the way I am.

  10. I heard that as long as you test your lsd to make sure it's legit, have a trip sitter to calm you down in case you panic, and make sure to control your doses and also not use it often, that LSD is super beneficial

  11. Isn’t that one of the date rape drugs I remember learning about it in health class because the teacher always said
    Girls, if your drink tastes salty
    SPIT

  12. I get ketamine infusions. I have treatment resistant bipolar and ptsd. My psychiatrist suggested I try it for 3 months. Been doing it for 18 months. An anesthesiologist puts it through my already placed Power Port (it’s not there just for this purpose) n I have weekly talk therapy sessions. It’s helped my chronic pain significantly too which was a cool thing. The infusions get further apart as you feel better. It was one of my last options. But it has helped me a lot. Wouldn’t recommend for everyone. At all. But it works for me

  13. As a veterinary medicine professional, it’s super cool to see Ketamine losing it’s bad rap in human medicine. I’ve seen that it’s being introduced as pain control for pre-hospital care in the UK (under limited circumstances) and now this, it’s awesome. In Vet Med, it’s great for cats and horses because it doesn’t compromise the airway and controls pain very well- I believe it’s mixed with something else in humans because it interacts with the brain differently (?) And can cause hallucinations and paranoia.

  14. I think another thing that should be discussed is that there are many different types of "suicidal." For example, thinking the world would be better off without you or just "thinking" about "what if" I just veered my car off into that tree but never having an intention of following through, that is STILL suicidal thoughts/ideation. There are many things at play when someone asks you if you have had any suicidal thoughts. Just something I learned in therapy myself that I think could truly help someone before it is too late.

  15. I can speak from personal experience that after 6 ketamine infusions had my depression gone. Like the veil was lifted. All suicidal tendencies disappeared. For the first time in my life. I have such a better understanding between my depressed brain and non-depressed brain. A day not thinking I'm worthless and wanting to die was just…amazing really. Unfortunately, infusions are quite costly and after the first 6, as needed visits are required and they can range between every so weeks to every month @ 250 dollars an infusion. Insurance does not cover it.

    I've been trying to find a progressive doctor to write me a script for the nasal spray. It's 50 dollars for the standard dosage. I know what would work with me based on the infusions. I disagree completely that you need to go anywhere to do the spray. The dosage for the spray is relatively established. You just take it before you go to sleep and ensure a safe environment; not unlike being on valium.

    I personally found no addictive qualities to ketamine and I do have an addictive personality.

    This video just struck me as another doctor resistant to a real solution for those suffering treatment-resistant depression. All love Doctor Mike, just not on the same page with you on this subject.

  16. Just make your own spray, easy 10ml spray bottle 1g K in warm distilled water, shake and spray. about 10mg per spray. GL 😛

  17. Dr Mike, why is it that the side effects of some of the depression medication are the same as the actual symptoms?

  18. A little disappointed in how generalized you made that statement about CBT at 4:15. Those studies have found that CBT is equitable to medication in MILD/MODERATE symptoms. In moderate/severe depression, medication is absolutely necessary to manage symptoms for that individual.

  19. I can’t concentrate. I just keep wondering what that shirt is made of to fit like that. There has to be a certain amount of spandex in that baby.

  20. Doctor Mike. In the USA we have got to change how we deal with drugs and addiction. We need to stop imprisonment for use and possession of controlled substances. We should legalize these drugs or at leased decriminalize them. Locking people in cages for long periods of time for use and possession of drugs is the worst way to treat addiction. Addicts need connections and support. Not more adversity and hardship. Manufacturing and dealing these drugs should be a criminal offense but not depression.

  21. Have you heard about using psilocybin as a experimental treatment for depression? Supposedly, a very small exposure works to positively adjust neural pathways for months.

  22. You have some lump on your neck, Doc. Not your thyroid but much lower to your left. It could be just large veins popping out. I hope it’s just nothing.

  23. This video is very helpful because my little brother has become very aggravated by depression ever since his 5 years relationship with his girlfriend ended (by her request) a few months ago.
    My only problem is that doctor Mike's explanation is very analytical and too elaborate for him 🙁 I don't know how to explain this to a 20 years old man who went on to do drugs seriously to alleviate his mental pain. He might not want to sit through this. Can anyone advise me on how to break down the video message into precise messages? Thank you very much! 🙏🏻

  24. Could you comment on the use of Adderall to treat depression? I take it for my ADD but I have noticed significant immediate improvement in my depressive symptoms as well and Googling it reveals similar feelings. How legitimate is this? Love your videos, thanks!

  25. There's a ketamine research clinic a few miles north of my city. They administer it by IV once a month, and they seem to be getting good results from their patient testimony

  26. God damn. I wish you could be my doctor. I cannot take SSRIs and other anti depressants. They make me incredibly suicidal and increase my ideation to action. My last therapist prescribed me medication and sent me to a counselor for "trauma" therapy and refused to see me further because I'd been raped but was ok still prescribing the pills even though I told them I was having bad reactions.

  27. My ex was a ketamine addict and seeing the state it put him in I cannot believe it's even being considered. Evil drug, just as bad as heroin. Are we gonna start prescribing heroin for depression too??

  28. CBT is $120 an hour. Out of pocket costs for most older anti-depressant medications is less than $20 per month with no insurance. Regardless of what the best choice is, there's the choice that I personally can afford. Another example is I know that CBD oil works for me for my anxiety… it costs around $125 a month. My Valium prescription is $1.28 a month private pay. As someone with CPTSD / autism who has been on and off medications for about 30 years, ketamine has given me new hope. I have a prescriber who monitors me regularly and have been using it for about 2 years in both nasal form and troche. It's not a miracle drug, but it has definitely helped me without any of the side effects that plague with with the SSRIs, NSRIs, MAOIs, and tricyclics. It's a nice supplement to my Trazodone when I'm having a sensory meltdown and I only take it as needed. So many people have shamed me for taking it and have strong opinions with no medical backgrounds. Thank you for this video.

  29. I was in the hospital with SVT, heart tachycardia, they gave me this to put a central line and A – line. Worst experience in my life. DO NOT do Ketamine it SUCKS. I recommend that you ask for a numb instead. I can’t describe what I been through because of how much happened. I remember waking up looking at the clock and just like in the movies the thing was copy and pasting like in the time traveling senses (clock hands weren’t moving back of course) but please. Be extremely careful if you are thinking of doing Ketamine. (I am aware this was different than what it would be for anti depression but this IS WHAT this drug does)

  30. I wish you knew as much about THC/CBD as you do all these high risk drugs like Ketamine, Xanax, Oxymorphone etc etc.

  31. Nothing so far including 5 different anti depressants has helped mine. It's probably because I have been on Suboxone for almost 7 years…I dont know what to do at this point other than wean off the suboxone and hope for the best?..

  32. The university that treats my depression actually has this and thought about using it on me when I didn't respond to any medication after two years of treatment. They have a ton of really extreme measures, including medically-induced seizures and (experimental) deep brain stimulation. I ended up going the TMS route instead, which was probably for the best. They might put me on ketamine if I have a severe relapse, tho.

  33. Depression: Get a brain SPECT scan. Depression is different person to person. TCM works for refractory depression many cases… get a scan first. See a psychiatrist who uses Spect Scan. Mental and behavioral health is terrible in the US unless you have a lot of money, but if you get it right…It can save lives. Dr. Mike check out what they do at Amen Clinics.

  34. Last epi of season 2 or 1st epi of season three of house, house is shot and has to go through surgery and asks to be put in a ketamine coma and when he comes out, his leg no longer hurts and he can walk normally and even run. And hes somewhat less of an asshole. Doesnt stick but it did something. Its also a tv show but the concept was based on studies. It is interesting.

  35. Doesn’t emotional and physical pain both go to the same place in the brain? So, if Ketamine is already used for physical pain and anesthesia etc. doesn’t it seem like it could be blocking the person’s pain signals by some other way than just binding to opioid receptors and therefore it’s able to work better on depression and suicidal thoughts etc. than drugs like oxycodone or hydrocodone etc.
    Kinda a question and a statement lol

  36. I go to festivals, an see a lot of people using this and other drugs recreationally. I'm sure they are quite happy but those I see with keys tend look like zombies in bucket hats. No judgement on other peoples life choices, but we have lovingly named them D*ckheads on donkey dust.
    I know there is research being done on micro dosing with recreational drugs, I think anything that can help alleviate suffering physically or mentally is obviously I great thing, but hopefully no one uses this study as an excuses to use drugs. Anything used in a trial would be very diffrent than anything paid for by the loos of a festival.
    Recreational drugs will always be dangerous, as you really dont know what you are putting in your body.
    Education, and risk assessment drug use has come along way, with amazing charties like The Loop making huge waves here in the UK.
    If you dont know who they are check them out, they are a non profit organisation that have saved lives every year with their facilities.

  37. Not only Ketamine, but any NMDA antagonist is likely a good target and have had success.
    They also have promise in resetting tolerance (adaptation) to stimulants and opiods. Preventing doses from going too high, rebound effects, and higher sensitivity to pain.

    People who have done them for depression (a few anecdotal reports, but consistent), however, tend to regress after 3 months or so and need another dose.

    Some have also responded very well to psychedelics.

    It's a promising future, as long as we drop the stigma of the drug war. When only one organization (MAPS) is bothering with this research, it is a problem.

  38. I'm sure you know this, but our bodies release ketamine just prior to death, so it's naturally occurring in our bodies. So how can it be (ketamine), is it, so how do they produce this stuff when it occurs inside our bodies?

  39. My sister is a palliative care physician, so she sometimes uses it with patients that are anxious about dying (and really, who WOULDN'T be anxious about that)

  40. Dr Mike, please clarify that the dosage of ketamine used in the Esketamine nasal spray and IV infusions are MUCH lower than the street drugs. Don’t try street drugs for TRD! Maybe explain the different between the IV and nasal spray ketamine. Perhaps do a video with a psychiatrist to answer everyone’s questions? 🙂

  41. What do you think of big pharmaceutical companies being held responsible for opioid addiction? For example, the latest case with Johnson & Johnson…

  42. I love your videos! Could you do a video discussing psychiatry and mental illness, like schizophrenia or bipolar? I feel like those illnesses don't get enough coverage and I'd love to see your perspectives on psychiatry and mental health! 🙂

  43. This might be controversial but I strongly think DMT should be researched on the effects of depression and anxiety , the history behind is is quite astounding

  44. Ketamine is pretty awesome because it doesn't cause physical addiction and you can't OD on it.
    It can destroy your kidneys in the long run, though.

  45. I don't think that shirt would be appropriate while working with patients. Yes his an attractive man, but there is a time and place to show that.

  46. As someone with treatment resistant depression, I am very hopeful about ketamine and the help it can give. Ive even argued about this with a family member who used it as a street drug.

    Also, thank you, Dr Mike for hitting the mental health care nail right on the head. The only reason I have access to my therapist is that my church paid for it in the beginning. Now I pay out of pocket rather than having to jump through insurance hoops.

    Thankfully they have a sliding scale for the fees.

  47. I'm super sad about the over prescribing of medication. I had this happen to me, but it wasn't my choice. My mom had my brothers and I over medicated so that she wouldn't have to deal with us. We were put on 7 different medications at once, one of them being lithium. I was six years old. What licensed doctor in his right mind would prescribe a 6 year old lithium???? There were several different antidepressants I was on as well. But still, lithium, really? Lithium is used in batteries. Ok rant over.

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