Ketamine for Bipolar Disorder

Ketamine Helps Patients With Bipolar Disorder – All you need to know about Ketamines?

Ketamine is an anesthetic and if it is used in higher doses it can also relieve depression within hours when taken intravenously. According to a research by Morteza Jafarinia and colleagues in the Journal of Affective Disorders, oral ketamine can help in treatment of mild to moderate depression in people with severe pain.

In this study the scientists compared 150mg daily doses of oral ketamine to 150mg daily doses of the anti-inflammatory pain reliever Diclofenac over 6 weeks. The subjects were interviewed after week 3 and week 6 and the ketamine group reported fewer symptoms of depression than the Diclofenac group.

This effect of Ketamine is the result of the blockade of a particular receptor for the neurotransmitter glutamate (the NMDA glutamate receptor). Researchers originally thought that the NMDA blockade was linked to ketamine’s antidepressant effects, but this appears not to be the case.

How Ketamines works?

Ketamine are strange substance and they works in a completely different way from other medicines you have ever taken for depression, bipolar, PTSD, or anxiety. Most of the medicines work by manipulating the quantity of certain neurotransmitters in your brain, which can have miserable side effects. Ketamine works differently since it briefly blocks a certain type of receptor in the brain from being triggered. Ketamine is not a one-time, permanent cure but it has the potential for lasting relief.

In general, a series of multiple injections gives longer, faster and lasting relief than a single infusion, and younger patients tend to get longer relief than older ones. For patients who relapse, getting additional infusions can often restore the relief.

Further use of Ketamines

According to a study, adding two more existing drugs to Ketamines, prolongs the effect of Ketamine which otherwise has very short lived effects. They after the addition effectively reduce symptoms of depression and suicide in patients with bipolar depression.

Stopping Meds Leads To Relapse

Caution for Stopping Psychiatric Medication Abruptly – All you need to know about Relapse

Why people decide to stop taking medicines? Do they know it can cause more harm than benefit?

Well the answer according to the study conducted by Dr. Banov, lies in the thought of people that they might feel better by stopping medicines and thinks they don’t need them anymore. Their family might be pressuring them to stop when they read some nasty feedback or side effect of the medicine.  Many a times, people stop taking medicines when they are experiencing a major change in life like change of job, divorce, changing house, etc. According to psychologists, this is the worst time to stop taking medicines.

There are many other mental health conditions which need the medicines to be taken perpetually. There would be a disaster if they are stopped in between.

Depending on the type of medicine, stopping them suddenly can create many reactions which can range from mild to moderate during early days of discontinuation to even life threatening seizures in some cases in the later phases when the disease relapses with much more severity.

Remember – You should always consult your doctor before stopping any medicine. Do not ever attempt to do it you’re your own thoughts and decision.

Stopping medication is not a quick process

Safe and slow process of drug discontinuation lasts for more than many weeks or months rather than many days. Drugs like antidepressants, takes weeks to show their results; similarly their withdrawal is also spread over several weeks.

Causes and Trigger of Relapses

The environmental cues like people, places, sights and sounds experienced by an addict are among the primary triggers of any kind of relapses which happens to a person.

First we need to understand the triggers. These can be a person, a place, events, or unresolved psychiatric issues, such as depression. While undergoing a treatment for drug addiction, doctors tell the patients to stay away from triggers such as old friends who are still on drugs, stressful situations, etc.

Does relapse to drug abuse mean treatment has failed?

Relapse rates for people with addiction and other substance abuse disorders are similar to rates for other medical illnesses such as diabetes, hypertension, etc. Treatment of these chronic diseases has many changes in behavior and personality. When relapse occurs, it cannot be concluded that the treatment has failed. It just suggests that the treatment needs to be reinstated or adjusted, rather than suggesting the failure of treatment.

How quickly do antidepressants work?

Most treatment guidelines suggest that antidepressants may take many weeks to work. It is argued that even if the current treatment seems ineffective, it should be persisted with for several weeks or even months. The Mood Disorders Unit interprets the evidence differently.
If medication is likely to be effective, evidence of at least some improvement should appear in the first ten days or so, whether it is an improvement in mood, sleep, or other features. For melancholic and psychotic depression, the rate of improvement is generally slower (but relatively constant). It may, in fact, appear painfully slow.
If no improvement is noted in the first two weeks after commencing an antidepressant, the dose of that drug may need to be increased, a change to another class of antidepressant may be required, or ‘augmenting’ strategies (the addition of quite differing drugs) may need to be introduced. Unfortunately, when changing from one drug to another, days to weeks may pass before success can be established. It might also be the case that non-drug strategies will be more effective in bringing the depression to an end.

Augmentation of antidepressant drugs
The effectiveness of some antidepressants can be increased by the use of adjunctive or augmentation drugs, for example, thyroid hormones or lithium.
There is increasing evidence to suggest that the new ‘atypical’ antipsychotic drugs may also have augmenting effects on antidepressants, often working rapidly and also being able to be ceased rapidly in many instances. While not investigated formally, the benefits of such augmenting drugs may only be relevant to melancholic and psychotic depression.

SSRI Pregnancy Concerns

SSRIs (antidepressants) have had somewhat of a panacea status with physicians prescribing the meds for all sorts of off label usage, particularly during the boom of the drugs existence over the past half decade. However, there has been a steady reporting of concerns related to the drugs as time progresses. Most people have heard about the adolescent suicide risk associated with the medication, and a new study is reporting that mothers taking the drugs put their newborns at risk for being under-weight and having respiratory problems.

”There was a significantly greater incidence of respiratory distress (13.9% vs. 7.8%) and longer hospital stays for infants born to depressed mothers on SSRIs than those born to untreated depressed mothers, the team reports in the Archives of General Psychiatry.”

Obviously, people should consult with their psychiatrists or health care providers for specific treatment information. I think the overall effect of some of these stories is going to be that people are more cautious about taking the drugs, and asking more pointed questions about their treatment.

What to Do About Antidepressants If You Are Nursing

There is no evidence to support fears that taking an antidepressant while nursing I harmful to the infant. Dr. Cynthia Neill Epperson of Yale University is one of the many researchers who have put this to the test. She recruited infants of depressed mothers, some breast-fed and others not, and then measured the level of antidepressant (in her work, Zoloft, which targets   serotonin) and of serotonin in the infants’ blood. Reporting on her work, Epperson states that she detected no Zoloft in their bloodstreams and that there was no change in the level of serotonin in most of the infants. She concluded, with the scientist’s reserve, that “it does not appear that the administration of Zoloft in breast-feeding women is likely to have a physiologic effect on their children.”
 Many depressed women derive much-needed joy from breast-feeding and become even more upset when deprived of the opportunity. Physicians who still caution against combining antidepressants with feeding except when the illness is severe recommend substituting a bottle once or twice a day to further reduce any possible risk. As always with depression, each sufferer should take into consideration all the known facts and with the of her doctor   make an informed decision. What is right for one person may be wrong for another.

Depression Medication

Antidepressants or depression medication are drugs specially designed to overcome the problems in brain chemistry that cause depression.
Antidepressants are much more specific than painkillers. The SSRI drugs (marketed as Prozac, Seroxat, Lustral, etc) work specially to raise the levels of serotonin in the brain. Others raise the levels of noradrenalin. Lack of these mood-enhancing substances can cause depression. Raising their levels, a process that usually takes about 10 days, is usually very helpful.
There are side effects but they are often mild, short-lived and pale into insignificance as the depression improves.