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Areas › Low mood and hard feelings › When everything feels flat
Ketamine for depression is the live example. The doses used are far below anaesthetic ones, the nasal form has approval for treatment resistant depression, and the drip form given in private clinics is generally used off licence. Off licence is not the same as wrong, and plenty of good medicine happens there. It does mean the evidence is thinner and the safeguards vary, so the questions about who is watching and what happens afterwards matter more.
He who cures me when I am ill (Quran 26:80). The cure is placed with God, which frees you to ask ordinary careful questions about the treatment in front of you.
الشعراء
وَإِذَا مَرِضۡتُ فَهُوَ يَشۡفِينِ
He who cures me when I am ill
Qur’an 26:80read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
Early evidence deserves to be described as early. A systematic review of behavioural activation for depressed young people concluded that it looks helpful, while stating plainly that the trials were few and small and the conclusion tentative. That is the right tone for anything at this stage, whatever the treatment.
Tindall L, Mikocka-Walus A, McMillan D, Wright B, Hewitt C, Gascoyne S. (2017). Is behavioural activation effective in the treatment of depression in young people? A systematic review and meta-analysis.. Psychology and psychotherapy doi
Strength of evidence: one line of research. A single study, or a theoretical account.
The same substance can be well studied at one dose and route and barely studied at another.
If you are being offered infusions privately, ask about screening, supervision during the session and what the plan is between sessions before agreeing.
The newer thinking about depression is less about topping up a missing chemical and more about connections that have thinned out being rebuilt. Recovery looks more like regrowth than refilling.
Six to eight weeks is what an antidepressant needs before it can be judged. The first fortnight will mostly tell you about side effects.
You can say what an SSRI does in one sentence. It blocks the doorway that carries serotonin back out of the gap between two nerve cells, so more of it stays there for longer and is likelier to be picked up.