Talk:Ketamine/Archive 3

Archive 1

Archive 2

Archive 3

Depression

User:A Real Journalist, about this (which had edit note "updated scientific data") and then this which had edit note "correct citation".

first version

Over the last 15 years, ketamine has been found to be very effective as an antidepressant when administered intravenously in sub-anaesthetic doses. Over 100 independent clinical trials at leading institutions such as The National Institute of Mental Health, The Cleveland Clinic, Mt. Sinai Hospital, Yale University, Stanford University, UCLA, USC, and NYU, have been conducted. Average response rate to Ketamine Infusion Therapy among participants across all the studies is about 70%. In the last 5 years, there has been a significant increase in the number of ketamine clinics in the United States offering the treatment to the general public.

second version

However advancements over the last 15 years show that ketamine has been found to be very effective as an antidepressant when administered intravenously in sub-anaesthetic doses. Over 100 independent clinical trials at leading institutions such as The National Institute of Mental Health, The Cleveland Clinic, Mt. Sinai Hospital, Yale University, Stanford University, UCLA, USC, and NYU, have been conducted. Average response rate to Ketamine Infusion Therapy among participants across all the studies is about 70%. In the last 5 years, there has been a significant increase in the number of ketamine clinics in the United States offering the treatment to the general public.

References

The section of the article where you put this content is "medical use". Content that goes into this section needs to describe medical use, and be sourced per WP:MEDRS, which briefly means a fairly recent literature review published in the biomedical literature, or a statement by a major medical medical or scientific body. The content in that section already describes medical use and the evidence for it, and is sourced to a fairly recent review.

The first source is an interview in NY Magazine and is not MEDRS. The second source is a news piece by the NIH, which is also not a MEDRS source.

The content is also very promotional, and obviously so, and really importantly, not supported by either source. Jytdog (talk) 00:14, 25 March 2017 (UTC)

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Changes to lead

User:Irapliss, you are making changes only to the WP:LEAD and are using poor refs. Please see the note on your talk page at User_talk:Irapliss#Welcome and the other messages there as well. Jytdog (talk) 19:50, 4 March 2018 (UTC)

Further reading

• Lener MS, Kadriu B, Zarate CA (March 2017). "Ketamine and Beyond: Investigations into the Potential of Glutamatergic Agents to Treat Depression". Drugs. 77 (4): 381–401. doi:10.1007/s40265-017-0702-8. PMC 5342919. PMID 28194724.
• Zanos P, Thompson SM, Duman RS, Zarate CA, Gould TD (March 2018). "Convergent Mechanisms Underlying Rapid Antidepressant Action". CNS Drugs. doi:10.1007/s40263-018-0492-x. PMID 29516301.
• Zanos P, Gould TD (March 2018). "Mechanisms of ketamine action as an antidepressant". Mol. Psychiatry. doi:10.1038/mp.2017.255. PMID 29532791.

These could be used as references potentially? Doc James (talk · contribs · email) 05:00, 22 March 2018 (UTC)

I don't understand why an article from Frontiers in Human Neuroscience has been excluded from this Further reading list. While the quality of articles in Frontiers journals is of course fluctuating (like in other journals), Frontiers in Human Neuroscience articles are reviewed, the journal has several well established scientists on the editorial board and Frontiers articles are regularly cited in other papers. Frontiers in Human Neuroscience has an IF of 3.2 and an SJR - which takes the prestige of citing journal into account - of 1.7 which is similar to the SJR of Drugs (1.5) and CNS Drugs (1.8), two of the journals used in the above list. I therefore see no basis on which articles from this journal are be categorically excluded. A different issue is of course if someone thinks there is something wrong with the specific article that was suggested for this list; then I'd be happy to know. THanksLucleon (talk) 11:01, 22 March 2018 (UTC)

Because Frontiers is a dodgy, maybe a predatory publisher. We need reputable sources. Alexbrn (talk) 11:28, 22 March 2018 (UTC)

Do you have any support for this claim please?Lucleon (talk) 11:34, 22 March 2018 (UTC)

See Frontiers Media. Alexbrn (talk) 11:40, 22 March 2018 (UTC)

Against that you have the SJR, which measures the reputation of a journal and which is similar or even higher for Frontiers in Human Neuroscience as for other journals used here (e.g. CNS Drugs and Drugs, two of the journals used in the above list). In addition the page you link to mainly refers to what happened at Frontiers in Medicine and Frontiers in Cardiovascular Medicine, some individual papers in Frontiers journals and the opinion of an individual (Beal). While I agree that this means articles should be critically reviewed, I see no basis to exclude articles from this journal categorically. You wouldn't categorically ban articles from Science, Cell, Nature just because they have higher retraction rates (http://iai.asm.org/content/79/10/3855.full.pdf+html)Lucleon (talk) 11:50, 22 March 2018 (UTC)

It's a - at best - controversial journal eschewed by MEDLINE. We don't use such sources for any non-trivial medical claims, particularly about treatment efficacy. If you want overturn the consensus on this we'd need to change WP:MEDRS and WP:REDFLAG. Better just to find properly reputable sources and summarize them. Why on earth would we do otherwise? Alexbrn (talk) 12:13, 22 March 2018 (UTC)

Frontiers in Human Neuroscience is MEDLINE listed, like many other Frontiers journals. Maybe I overlooked something but I couldn't find anything against Frontiers journals in general in WP:MEDRS and WP:REDFLAG, which would not also apply to the journals Drugs or CNS Drugs (both used in the above list). Claiming that an article from Drugs or CNS Drugs is "properly reputable" while an article from Frontiers in Human Neuroscience is not, seems rather subjective to me. Unfortunately even the highest ranked journals have problems with regard to quality and there is quantitative support for that claim (see below for some examples) while the evidence against Frontiers journals is rather little an in parts subjective (as described in the link you provided, Frontiers Media).

-lowered powered (=less reliable) studies in high IF journals http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.2000797

- more bias in high IF journals https://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&Cmd=ShowDetailView&TermToSearch=19156153

-lowest quality work in crystallography in high IF journals: https://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17704562

-higher retraction rates in high IF journals (http://iai.asm.org/content/79/10/3855.full.pdf+html)Lucleon (talk) 13:49, 22 March 2018 (UTC)

The NLM say it is not MEDLINE-indexed.[1]. As I say, if you want to overturn the WP:PAGs this is not the place. Alexbrn (talk) 13:55, 22 March 2018 (UTC)

My bad and you are correct Frontiers in Human Neuroscience is not MEDLINE indexed but it's PUBMED indexed (+ Scopus, Web of Science etc.) like many Frontiers journals. Moreover, some Frontiers journals, like Frontiers in Neural Circuits for example, are MEDLINE indexed. I don't think there is any need to change any policy because I can't find anything in these policies on which basis articles from Frontiers journals must be categorically excluded (which wouldn't apply to journals like Drugs/CNS Drugs etc). Lucleon (talk) 14:24, 22 March 2018 (UTC)

WP:MEDRS cautions against non-MEDLINE-indexed sources. It depends on the claim being made. For any exceptional claim (into which category any claim of treatment efficacy usually falls) a very solid source is needed. And something published in a Frontiers journal probably won't be it. Our usual experience of Frontiers journals here is from woo advocates arguing for their use to promote some or other health scam. Alexbrn (talk) 14:49, 22 March 2018 (UTC)

I completely agree with rejecting health scams of course and I do understand your worries as a longstanding editor after seeing how these pages are edited and misused by some people. I also agree with being cautious about recent articles in Frontiers journals after their history in the last few years. I do, however, know good articles in Frontiers journals. Moreover, the editorial boards of some Frontiers journals are composed of scientists with a very high reputation in their respective fields. Therefore I don't think it's fair to categorically exclude articles from this series.

In the present case someone (IP user) simply added a Frontiers article to the Further reading list without any claim. The article is a historical summary which I found quite interesting to read and which looked ok to me. I am, however, not an expert in research or application of Ketamine and maybe this article is not so important after all.Lucleon (talk) 15:13, 22 March 2018 (UTC)

Rapid acting antidepressant

Ketamine is not approved for this. Wired is not a good source to support Velasquez-Manoff, Moises (2018-05-08). "Ketamine Stirs Up Hope—and Controversy—as a Depression Drug". Wired. ISSN 1059-1028. Retrieved 2019-04-03.

We have a whole section in the body Ketamine#Depression Doc James (talk · contribs · email) 20:50, 3 April 2019 (UTC)

Okay added to the lead with a better source. Doc James (talk · contribs · email) 20:57, 3 April 2019 (UTC)

Cleanup

This article is a little messy and could do with some rearranging. The medicinal uses part needs some subsections, and some thought might be given to partial merge with the medical research section. — Preceding unsigned comment added by Testem (talk • contribs) 10:28, 15 January 2014

In the structure subsection of the chemistry section, there is a table which includes axial and equatorial forms of ketamine, equating them to the salt and the free base forms. While chemically this may be true, the ball and stick structures do not show the nitrogen atom with the correct number of hydrogen atoms in covalent linkage. 24.12.7.29 (talk) 00:37, 9 May 2019 (UTC)

I have already pinged the editor who created that image to see about getting the ball-and-stick actual salt form for this context. DMacks (talk) 03:06, 9 May 2019 (UTC)

Immense profit potential means media bias and Government approval? Maybe. More information on ketamine please

The media (Washington Post, Cosmopolitan, et al) have delivered glowing reviews (repeatedly in the case of the Washington Post) of this drug for depression. These are anecdotal stories of one or more individuals who have a story of remarkable success apparently related to their use of the drug.

However, the following link shows flimsy evidence was used by the FDA to approve this drug for depression:

Moncrieff, J., & Horowitz, M. (2019). Esketamine for treatment-resistant depression. BMJ, 366. DOI: https://doi.org/10.1136/bmj.l5572 (Link)

Also Ketamine is known to be addictive. Here's this:

https://www.independent.co.uk/topic/ketamine

Side effects seem to include depression itself:

Short, B., Fong, J., Galvez, V., Shelker, W., & Loo, C. K. (2017). Side-effects associated with ketamine use in depression: A systematic review. Lancet Psychiatry. http://dx.doi.org/10.1016/ S2215-0366(17)30272-9 — Preceding unsigned comment added by 173.153.152.32 (talk) 23:40, 29 November 2019 (UTC)

Trace like versus dream like

Ref says "The resulting trancelike cataleptic state of “sensory isolation" not dream like. Propofol gives one the nice dreams. Doc James (talk · contribs · email) 21:50, 11 April 2020 (UTC)

Table of biological targets

I suggest removing all targets with Ki > 10 mkM from the table. These targets are too weak to lead to any noticeable biological effect, and they make the Table confusing. The same goes about the text on the left from the Table: what is your opinion about removing all references to the targets inhibited with K more that 10 μM ?

The Sceptical Chymist (talk) 18:12, 26 November 2020 (UTC)

more cleanup

The "Recreational use" section is now duplicated in Ketamine in society and culture, so it should be just summarized here with a "main article" link. MB 01:37, 13 December 2020 (UTC)

Done. The Sceptical Chymist (talk) 12:58, 13 December 2020 (UTC)

"recreational use"

It is an incorrect term. It's not "use", it's recreational "abuse" as is misuse of all Rx medications, especially Scheduled ones. 2603:6000:D70A:BC00:1C69:20E9:6115:D11D (talk) 14:52, 19 July 2022 (UTC)

This seems to be primarily a question of morality, rather than fact. The word "use" captures things quite accurately from what I can tell. 153.92.159.205 (talk) 22:05, 10 October 2022 (UTC)

Date Rape mention

More info on ketamine’s use as a date rape drug would be useful, and it likely shouldn’t be included under Recreational Use? 69.42.137.164 (talk) 00:24, 19 November 2021 (UTC)

@69.42.137.164

A novel trimodal system on a paper-based microfluidic device for on-site detection of the date rape drug “ketamine”

https://doi.org/10.1016/J.ACA.2020.01.002 2603:6000:D70A:BC00:1C69:20E9:6115:D11D (talk) 16:15, 19 July 2022 (UTC)

What kind of information do you feel is missing? The article already mentions that it has (sadly) been used in that way. Any drug which induces loss of consciousness or inhibition can and likely has been abused in such a way, by far the most common being alcohol. 153.92.159.205 (talk) 22:10, 10 October 2022 (UTC)

Transient effect

The article mentions "Ketamine is a robust and rapid-acting antidepressant, although its effect is transient". I am not aware of any antidepressant whose effect is not transient, yet similar mentions are not included in articles on other antidepressants such as SSRIs. Should we consider removing this mention, or adding similar to other articles about antidepressants? 153.92.159.205 (talk) 22:08, 10 October 2022 (UTC)

I found this strange too, and later parts of the article talk about it only lasting a week or so but doesn’t really explain why this is significant - as you say, most drugs require repeated doses. EAi (talk) 23:40, 12 January 2023 (UTC)