Depression reduction: Difference between revisions

Depression reduction most commonly occurs with adequate nutritional intake.<ref name="BenderHagan2017">{{cite journal|last1=Bender|first1=Ansley|last2=Hagan|first2=Kelsey E.|last3=Kingston|first3=Neal|title=The association of folate and depression: A meta-analysis|journal=Journal of Psychiatric Research|volume=95|year=2017|pages=9–18|issn=00223956|doi=10.1016/j.jpsychires.2017.07.019}}</ref><ref name="Spedding2014">{{cite journal|last1=Spedding|first1=Simon|title=Vitamin D and Depression: A Systematic Review and  Meta-Analysis Comparing Studies with and without  Biological Flaws|journal=Nutrients|volume=6|issue=4|year=2014|pages=1501–1518|issn=2072-6643|doi=10.3390/nu6041501}}</ref><ref name="SubletteEllis2011">{{cite journal|last1=Sublette|first1=M. Elizabeth|last2=Ellis|first2=Steven P.|last3=Geant|first3=Amy L.|last4=Mann|first4=J. John|title=Meta-Analysis of the Effects of Eicosapentaenoic Acid (EPA) in Clinical Trials in Depression|journal=The Journal of Clinical Psychiatry|volume=72|issue=12|year=2011|pages=1577–1584|issn=0160-6689|doi=10.4088/JCP.10m06634}}</ref><ref name="HuangWang2016">{{cite journal|last1=Huang|first1=Ruixue|last2=Wang|first2=Ke|last3=Hu|first3=Jianan|title=Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials|journal=Nutrients|volume=8|issue=8|year=2016|pages=483|issn=2072-6643|doi=10.3390/nu8080483}}</ref><ref name="NgKoh2017">{{cite journal|last1=Ng|first1=Qin Xiang|last2=Koh|first2=Shawn Shao Hong|last3=Chan|first3=Hwei Wuen|last4=Ho|first4=Collin Yih Xian|title=Clinical Use of Curcumin in Depression: A Meta-Analysis|journal=Journal of the American Medical Directors Association|volume=18|issue=6|year=2017|pages=503–508|issn=15258610|doi=10.1016/j.jamda.2016.12.071}}</ref> Severe depression is effectively reduced with conventional antidepressants; although in mild to moderate depression, SSRI's and tricyclic antidepressants appear (on average) to be either only minimally helpful or completely ineffective.<ref name="FournierDeRubeis2010">{{cite journal|last1=Fournier|first1=Jay C.|last2=DeRubeis|first2=Robert J.|last3=Hollon|first3=Steven D.|last4=Dimidjian|first4=Sona|last5=Amsterdam|first5=Jay D.|last6=Shelton|first6=Richard C.|last7=Fawcett|first7=Jan|title=Antidepressant Drug Effects and Depression Severity|journal=JAMA|volume=303|issue=1|year=2010|pages=47|issn=0098-7484|doi=10.1001/jama.2009.1943}}</ref> However, depression reduction can also occur under the influence of hormone replacement therapies<ref name="ZarroufArtz2009">{{cite journal|last1=Zarrouf|first1=Fahd Aziz|last2=Artz|first2=Steven|last3=Griffith|first3=James|last4=Sirbu|first4=Cristian|last5=Kommor|first5=Martin|title=Testosterone and Depression|journal=Journal of Psychiatric Practice|volume=15|issue=4|year=2009|pages=289–305|issn=1538-1145|doi=10.1097/01.pra.0000358315.88931.fc}}</ref><ref>{{cite journal | vauthors=((Walther, A.)), ((Breidenstein, J.)), ((Miller, R.)) | journal=JAMA Psychiatry | title=Association of Testosterone Treatment With Alleviation of Depressive Symptoms in Men: A Systematic Review and Meta-analysis | volume=76 | issue=1 | pages=31 | date=1 January 2019 | url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/jamapsychiatry.2018.2734 | issn=2168-622X | doi=10.1001/jamapsychiatry.2018.2734 | access-date=29 May 2022}}</ref> and modafinil.<ref name="RockRoiser2013">{{cite journal|last1=Rock|first1=P. L.|last2=Roiser|first2=J. P.|last3=Riedel|first3=W. J.|last4=Blackwell|first4=A. D.|title=Cognitive impairment in depression: a systematic review and meta-analysis|journal=Psychological Medicine|volume=44|issue=10|year=2013|pages=2029–2040|issn=0033-2917|doi=10.1017/S0033291713002535}}</ref>

This is unlikely to be an isolated effect component but rather the result of combining an appropriate environment with other coinciding effects such as [[rejuvenation]], [[introspection]], [[personal bias suppression]], and [[spirituality enhancement]]. It may also stem from the direct neurological changes that occur as a result of a substances’ pharmacological action.

{| class="wikitable"

|Ketamine possesses a strong abuse potential at typical antidepressive doses.<ref name="KokaneArmant2020">{{cite journal|last1=Kokane|first1=Saurabh S.|last2=Armant|first2=Ross J.|last3=Bolaños-Guzmán|first3=Carlos A.|last4=Perrotti|first4=Linda I.|title=Overlap in the neural circuitry and molecular mechanisms underlying ketamine abuse and its use as an antidepressant|journal=Behavioural Brain Research|volume=384|year=2020|pages=112548|issn=01664328|doi=10.1016/j.bbr.2020.112548}}</ref><ref name="BozymskiCrouse2019">{{cite journal|last1=Bozymski|first1=Kevin M.|last2=Crouse|first2=Ericka L.|last3=Titus-Lay|first3=Erika N.|last4=Ott|first4=Carol A.|last5=Nofziger|first5=Jill L.|last6=Kirkwood|first6=Cynthia K.|title=Esketamine: A Novel Option for Treatment-Resistant Depression|journal=Annals of Pharmacotherapy|volume=54|issue=6|year=2019|pages=567–576|issn=1060-0280|doi=10.1177/1060028019892644}}</ref> Ketamine has reported cases of severe bladder and liver injury. Esketamine, a newer nasal spray formulation of Ketamine, does not have any reported cases and is purported to have a better safety profile. However, in recent short-term clinical trials esketamine still more-than-doubled the amount of adverse bladder events when compared to placebo (6-10% vs 1-4%).  Although 2/3 of esketamine incidents resolved themselves either without intervention or through a lowering of dosage, any physiological damage is acute and immediate: in typical dose regimens steady-state concentrations are not reached.

 

Ketamine offers a (dose-dependent) large immediate depression reduction for 30-50% of patients; its effect-sizes become moderate to small by day 7.<ref name="XuHackett2016">{{cite journal|last1=Xu|first1=Ying|last2=Hackett|first2=Maree|last3=Carter|first3=Gregory|last4=Loo|first4=Colleen|last5=Gálvez|first5=Verònica|last6=Glozier|first6=Nick|last7=Glue|first7=Paul|last8=Lapidus|first8=Kyle|last9=McGirr|first9=Alexander|last10=Somogyi|first10=Andrew A.|last11=Mitchell|first11=Philip B.|last12=Rodgers|first12=Anthony|title=Effects of Low-Dose and Very Low-Dose Ketamine among Patients with Major Depression: a Systematic Review and Meta-Analysis|journal=International Journal of Neuropsychopharmacology|volume=19|issue=4|year=2016|pages=pyv124|issn=1461-1457|doi=10.1093/ijnp/pyv124}}</ref><ref name="LeeDella Selva2015">{{cite journal|last1=Lee|first1=Ellen E.|last2=Della Selva|first2=Megan P.|last3=Liu|first3=Anson|last4=Himelhoch|first4=Seth|title=Ketamine as a novel treatment for major depressive disorder and bipolar depression: a systematic review and quantitative meta-analysis|journal=General Hospital Psychiatry|volume=37|issue=2|year=2015|pages=178–184|issn=01638343|doi=10.1016/j.genhosppsych.2015.01.003}}</ref><ref name="PennybakerNiciu2017">{{cite journal|last1=Pennybaker|first1=Steven J.|last2=Niciu|first2=Mark J.|last3=Luckenbaugh|first3=David A.|last4=Zarate|first4=Carlos A.|title=Symptomatology and predictors of antidepressant efficacy in extended responders to a single ketamine infusion|journal=Journal of Affective Disorders|volume=208|year=2017|pages=560–566|issn=01650327|doi=10.1016/j.jad.2016.10.026}}</ref> Weekly to biweekly dosing maintains a statistically significant depression reduction measured at Day 28 and repeated administration has resulted in cases of euthymia.<ref name="RyanMarta2014">{{cite journal|last1=Ryan|first1=Wesley C.|last2=Marta|first2=Cole J.|last3=Koek|first3=Ralph J. |title=Ketamine and Depression: A Review|journal=International Journal of Transpersonal Studies|volume=33|issue=2|year=2014|pages=40–74|issn=13210122|doi=10.24972/ijts.2014.33.2.40}}</ref><ref name="BozymskiCrouse2019">{{cite journal|last1=Bozymski|first1=Kevin M.|last2=Crouse|first2=Ericka L.|last3=Titus-Lay|first3=Erika N.|last4=Ott|first4=Carol A.|last5=Nofziger|first5=Jill L.|last6=Kirkwood|first6=Cynthia K.|title=Esketamine: A Novel Option for Treatment-Resistant Depression|journal=Annals of Pharmacotherapy|volume=54|issue=6|year=2019|pages=567–576|issn=1060-0280|doi=10.1177/1060028019892644}}</ref> A family history of alcohol-use-disorder in a first-degree relative is associated with an improved antidepressive response, and a reduction of adverse mental effects such as [[cognitive dysphoria|dysphoria]]. Its antidepressant properties may also stem more generally from dissociatives' [[novelty enhancement|novelty]] and/or [[immersion enhancement|immersion enhancements]].