Still Thisclose

Rave drug holds promise for treating depression fast Companies and clinicians turn to ketamine to treat mental-health disorder as pipeline of new drugs dries up.

Today’s most common antidepressants target the brain’s serotonin or noradrenaline pathways (some target both). Ketamine blocks the signalling molecule NMDA, a component of the glutamate pathway, which is involved in memory and cognition. Before ketamine was studied, no one even knew that the pathway was involved in depression, Murrough says.
In 2013, his group published the largest trial of off-label ketamine carried out so far, with 73 participants. The trial found that the drug reduced depression 24 hours after treatment in 64% of patients who had tried three or more other medications with unsuccessful results. A second group received the sedative midazolam; in that case, the reduction was 28% . Murrough’s group is now imaging the brains of patients receiving ketamine treatment to try to dissect just how the drug works.

  Well, that probably won't help very much since it works in the periphery...

Ketamine’s fast action is particularly promising for suicide prevention, says Carlos Zarate of the NIMH. Instead of being committed to institutions for weeks of treatment, people who have just attempted suicide might be treated with ketamine and released in days or even hours. Zarate has found that ketamine seems specifically to affect the desire to attempt suicide, whether a person is clinically depressed or not (ref). That observation suggests that suicidal behaviour might be distinct from depression.

 This is because Ketamine reverses the cascade of sepsis.   Septic delirium is a trigger for suicidal ideation.

In vitro investigation of the antibacterial effect of ketamine.
Large dose ketamine inhibits lipopolysaccharide-induced acute lung injury in rats. 
Ketamine suppresses endotoxin-induced NF-kappaB activation and cytokines production in the intestine.
Mechanisms of ketamine-induced immunosuppression.
Glutamate metabolism in malnutrition and sepsis in man.

I like this a lot.   I like that it works.  I like that it makes sense.
I do not like that- once again- they are going to sell the living shit out of it before they understand what the hell they're doing ...

Same as it ever was.