New research on ketamine explores its efficacy compared to ECT and antipsychotics, placebo effects, and the effectiveness of ketamine versus esketamine. The podcast also discusses sustaining the benefits of ketamine, incorporating psychotherapy, and using subliminal messages during treatment. Additionally, conflicts of interest in a psychotherapy study and the belief of weight gain on lithium are analyzed in this informative episode.
Ketamine generally has larger effect sizes compared to esketamine, but direct head-to-head comparisons have shown both treatments to be equally effective.
To sustain the benefits of ketamine or esketamine, long-term maintenance therapy is usually recommended, and combining psychotherapy with ketamine treatment can enhance its effectiveness.
Deep dives
Effectiveness Comparison: Ketamine vs. Eskeetamine
Ketamine and eskeetamine are two drugs used in the treatment of depression, but their effectiveness is still a topic of debate. Animal studies suggest that the R ketamine may have stronger antidepressant effects, while clinical data from meta-analyses indicate that ketamine generally has larger effect sizes compared to eskeetamine. However, direct head-to-head comparisons have shown both treatments to be equally effective. Ketamine requires IV delivery, while eskeetamine is more expensive and only available as a brand-only product.
Sustaining the Benefits and Psychotherapy
To sustain the benefits of ketamine or eskeetamine, long-term maintenance therapy is usually recommended. Studies have shown that continuing esketamine treatment at a reduced frequency or switching to placebo can help maintain the therapeutic effects. However, the use of psychotherapy alongside ketamine treatment may also contribute to sustaining the benefits. A small trial combining traditional CBT with ketamine showed some positive results, suggesting that ketamine-induced neuroplasticity can enhance the effectiveness of therapy. Another study used subliminal positive association training alongside ketamine infusion, although its benefits were only seen after a month.
Weight Gain and Lithium
Contrary to popular belief, recent studies have challenged the notion that lithium causes significant weight gain. Meta-analyses have shown no significant weight gain on average when comparing lithium to placebo, although a slight trend towards weight gain was observed. A study analyzing severe weight gain reports on psychotropic medications found that lithium-induced weight gain was not statistically different from another mood stabilizer called Lamotrigine. These findings suggest that weight gain on lithium is rare and often exaggerated, and that untreated mood disorders may have a greater impact on metabolism.
New research brings clarity to the big ketamine questions. How does it compare to ECT and antipsychotics? How much of it is placebo? Which is more effective – ketamine or esketamine? How do you sustain the benefits? Does it work better with psychotherapy?
Chris Aiken, MD, and Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Get the Snipd podcast app
Unlock the knowledge in podcasts with the podcast player of the future.
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode
Save any moment
Hear something you like? Tap your headphones to save it with AI-generated key takeaways
Share & Export
Send highlights to Twitter, WhatsApp or export them to Notion, Readwise & more
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode