[HN Gopher] Study: Electroshock therapy more successful for depr...
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Study: Electroshock therapy more successful for depression than
ketamine
Author : voisin
Score : 44 points
Date : 2022-10-23 20:42 UTC (2 hours ago)
(HTM) web link (today.uconn.edu)
(TXT) w3m dump (today.uconn.edu)
| andy_ppp wrote:
| I absolutely love this talk by Sherwin Nuland, it's beautifully
| told and always worth remembering that someone who seems so put
| together on stage can have had quite extreme troubles...
| electroshock therapy is surprisingly very effective in extreme
| cases.
| https://www.ted.com/talks/sherwin_nuland_how_electroshock_th...
| nvr219 wrote:
| Yeah but ketamine is a lot more fun so I'm gonna stick with that.
| tcj_phx wrote:
| My friend figured out for herself, when she was in her early
| 30's, that she's a poor methylator who can't turn the food
| fortification folic acid into a usable form of Vitamin B-9. She
| once told me that adding L-Methylfolate to her routine was like
| flipping a switch from "depressed" to "not-depressed". But the
| doctors had already decided she was being "stabilized" by the
| anti-psychotic prescriptions they forced on her, so they just
| added this vitamin to their cocktail of prescriptions.
|
| Vitamin B-9 has to do with DNA synthesis... My source for
| physiology told me that even the mutants get enough Vitamin B-9
| from an adequate diet, it's just poor methylators who rely on
| fortified food who are screwed. Deplin is the prescription form
| of Vitamin B-9. It's approved as an add-on therapy, for when
| patients don't respond well to the prescriptions that never work.
|
| Usually 'mental health' diagnoses are manifestations of stress:
| emotional stress is the big one, but malnourishment is often a
| factor too. Stressed brains use more energy thinking about the
| stress all the time.
|
| ECT should be retired from use. I heard once that brain damage
| causes the brain to increase production of the steroid
| allopregnanolone. The beneficial effect of the SSRI's seem to
| also be related to increased allopregnanolone, NOT to boosting
| serotonin levels.
|
| I wonder if my friend's guardian [0] could consent to her getting
| electrocuted.
|
| [0] https://news.ycombinator.com/item?id=33307982
|
| Edit: She remembers being depressed for as far back as her
| memories go. Someone on twitter says food fortification didn't
| really take off until the 1980's. Before then you had to
| explicitly buy "wonder bread" to get fortified flour, now you can
| basically assume white flour is fortified white flour.
| chrsig wrote:
| > But the doctors had already decided she was being
| "stabilized" by the anti-psychotic prescriptions they forced on
| her, so they just added this vitamin to their cocktail of
| prescriptions.
|
| Outside of very specific circumstances during hospitalization,
| doctors can't actually force you to take any medication.
| IIAOPSW wrote:
| Technically, its only electrocution if she dies. Otherwise its
| an electroshock. The consent of your friends guardian to either
| the former, the latter, or both is not within my ability to
| say.
| downrightmike wrote:
| Yeah, but the history of the two are wildly divergent.
| thornjm wrote:
| I found the origin of ECT quite interesting: depressed people
| with epilepsy had dramatic improvement in their symptoms
| following a seizure. They also discovered that the type and
| location of the seizures had varying levels of effect.
| larryliu wrote:
| Ketamine is a prescription medicine that can be taken oral,
| intranasal or IV drip.
|
| ECT is an inpatient procedure that need one anesthesiologist and
| one psychiatrist plus nurses to administer, two to three times
| weekly for three to four weeks.
|
| Who pays for the healthcare, definitely want to try the former
| and use the latter only if the former works poorly.
| RichardCNormos wrote:
| stevenalowe wrote:
| "The side effect profiles of the two treatments differed, with
| ECT more likely to cause headaches, muscle pain and memory loss,
| while ketamine was more likely to cause dissociative symptoms,
| vertigo and double vision."
|
| I'll take milder effects over pain and memory loss, thanks.
|
| No mention of longevity of effect, or specific studies and who
| paid for them.
| Waterluvian wrote:
| Without more information on likeliness, permanence, and
| magnitude, both sets of symptoms sound potentially intolerable.
| arcticbull wrote:
| People do ketamine recreationally; the symptoms really aren't
| intolerably bad, I'm led to believe.
| saxonww wrote:
| And the therapeutic dose in this case seems to be roughly
| 1/2-1/3 of what people do recreationally.
| nibbleshifter wrote:
| The worst side effect recreationally is usually mild
| nausea.
|
| The other "side effects" are generally part of its
| desirable properties ;)
| [deleted]
| fshbbdssbbgdd wrote:
| Anecdotal reports from recreational use (higher doses than
| medical) are that the dissociation, vertigo, and double
| vision only happen while you're high, not after it wears off.
| nibbleshifter wrote:
| I've taken some really, really high doses of ketamine
| recreationally, it all wears off after a few hours at
| worst.
|
| The disassociation is often a desired effect, it can be
| incredibly enjoyable.
| augustuspolius wrote:
| I am also confused by this comparison. Yes, Ketamine might
| cause dissociation... but that's not a side effect, that's
| a catalyst for the actual expected psychological effect.
|
| It's like saying that a side effect of drinking alcohol is
| feeling drunk.
| [deleted]
| JamesBarney wrote:
| By the time you get to ECT for depression you've tried else
| for your more intolerable depression.
| augustuspolius wrote:
| The way this is presented in the article could be
| dangerous. ECT with its potentially life-altering
| horrendous side effects is not an alternative to Ketamine
| with almost non existent negative long term side effects.
| Both treatments are recommended as the last resort (at
| least on paper Ketamine is recommended if anti-depressants
| do not work), with ECT being far more dangerous.
| toss1 wrote:
| Yes, an acquaintance from college went through ECT. The guy was
| previously brilliant. Yes, his illness was part of his later
| problems, but he was wholly convinced that the ECT was a much
| larger problem. So much so that as soon as he got out of the
| institution, he commenced lawsuits against his parents who had
| set up his treatment (as far as I could tell for legit reasons;
| it wasn't one of those horror stories of abusing treatment to
| 'get' someone, just that it went so wrong).
|
| I hadn't thought about that in years, but it was my first
| thought when I saw the headline, I was thinking that was just
| so obsolete. Indeed, longevity of effect, or specific studies
| and who paid for them.
|
| Yikes.
| denzilla8080 wrote:
| The headaches and muscle pain are temporary. But the memory
| loss is severe and while not truly hindering, definitely life
| altering. Years are just blurred together. Some things and
| people just aren't there and it's really hard for me to
| remember on my own. It more changes the relationship you have
| with your memory.
| [deleted]
| leetrout wrote:
| In my experience ketamine makes early memories very vivid and
| makes things easier to recall.
|
| I definitely prefer that over losing memories but I have not
| tried ECT.
| warrenmiller wrote:
| aren't the side effects of ECT quite severe though? "loss of
| creativity, drive and energy. difficulty concentrating. loss of
| emotional responses. difficulty learning new information."
| thrown_22 wrote:
| Those are also the side effects of severe depression so you're
| not missing out on much.
| tru3_power wrote:
| So what are the upsides
| aetherson wrote:
| "Not feeling incredibly depressed."
| andrewflnr wrote:
| If you take away my creativity and ability to learn, you may as
| well just kill me. That sounds like a recipe for depression in
| itself.
| chiefalchemist wrote:
| > All five of the studies independently found that ECT was more
| effective than ketamine at relieving *severe* depression
| symptoms.
|
| A keyword was left from the title / headline.
| rubatuga wrote:
| Definitely a key factor since most psychiatrists reserve ECT
| for severe depression.
| chiefalchemist wrote:
| I think the article mentions that. That said, I would presume
| the Schedule 1 drugs are being approached with a conservative
| mindset. But they still mind have wider application once the
| med profession gets past the stigma. The point being,
| abandoning these new options should be given a fair chance
| even if there are intials findings like this one.
| kingkawn wrote:
| This article completely neglects discussion of side effects.
| Ketamine has almost none, whereas ECT can cause horrible
| degradations to quality of life.
|
| Any discussion of efficacy that doesn't include side effects is
| quackery.
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