2 posts tagged “depression research”

The benefits of just a bit of exercise (+”forest bathing”?)

Posted June 6th, 2018 by

If frequent, long workouts aren’t in the cards, here’s some good news: A new research analysis based on decades’ of studies shows the potential mental health perks of even just a smidgen of light exercise. Also, see the results of a Japanese study on something called “forest bathing.”

Exercise linked to good vibes

“Even a Little Exercise Might Make Us Happier,” a recent New York Times headline proclaims. It might sound obvious, but it’s still positive news — especially for those who may not be able to meet physical activity guidelines for the general population (30+ minutes of exercise on most days).

“According to a new review of research about good moods and physical activity, people who work out even once a week or for as little as 10 minutes a day tend to be more cheerful than those who never exercise. And any type of exercise may be helpful… The type of exercise did not seem to matter. Some happy people walked or jogged. Others practiced yoga-style posing and stretching.”

For the published review, researchers at the University of Michigan analyzed the results of 23 studies since 1980 that explored the links between physical activity and happiness. The studies were mostly observational (not strict clinical trials) but they involved a total of 500,000 people ranging from adolescents to the very old and from a variety of ethnic and socioeconomic groups.

The Times notes that happiness is a rather “subjective, squishy concept,” and it’s not clear from these studies if working out causes happiness or if the two commonly occur together. But overall, the results are notable because “the amount of exercise needed to influence happiness was slight… In several studies, people who worked out only once or twice a week said they felt much happier than those who never exercised.” Exercising even more frequently may bring even greater happiness, the researchers say.

Talk with your doctor about healthy ways for you to squeeze in physical activity — ideas you’re likely to enjoy and stick with. For some people with Parkinson’s disease, it’s walking to their favorite tunes, and for those living with cancer, it may be chair yoga.

In general, try not to stress about not getting enough exercise — other recent research shows that dwelling on it isn’t good for your health.

What’s “forest bathing”?

Here’s another headline that caught our eye: “Just being outside can improve your psychological health, and maybe your physical health too.”

Quartz summed up about $4 million of Japanese research on the benefits of something called “forest bathing” (essentially, it’s just sitting or standing in the woods).

“Just be with trees. No hiking, no counting steps on a Fitbit. You can sit or meander, but the point is to relax rather than accomplish anything,” Quartz reports. “The Japanese practice of forest bathing is proven to lower heart rate and blood pressure, reduce stress hormone production, boost the immune system, and improve overall feelings of wellbeing.”

Inhaling the essential oils of a forest, generally called phytoncide, appears to give (healthy) people an immune system boost and reduce stress. Even getting a “dose of nature” in an urban park setting can help with stress relief, studies have shown.

Some health conditions may make it difficult to spend time outdoors, such as lupus (which can bring sun sensitivity — check out these photosensitivity tips). Connect with members of your community on PatientsLikeMe or talk with your doctor about ways to safely spend time outside, considering your particular condition.

How do you squeeze in a bit of activity or outdoor time these days? Join PatientsLikeMe today to swap ideas with the community!

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Can ketamine help when antidepressants don’t? A closer look at the off-label drug that’s in the spotlight

Posted May 21st, 2018 by

You may have seen ketamine making headlines recently as a promising drug therapy for treatment-resistant depression, or “TRD.” (What’s TRD? Health care professionals define it as receiving at least two different antidepressants– for at least six weeks in a row, and at an adequate dosage – but experiencing less than a 50% improvement in depressive symptoms.)

So, how does it work and what does the research show so far? Get the facts below — plus find some helpful insight on side effects and more from PatientsLikeMe members who have tried ketamine.

Let’s back up — what is ketamine?

Ketamine has been around since the 1960s, and over the years it has been used as an anesthetic, treatment for some types of pain and a sedative in certain instances. It’s also been abused as a “party drug” due to its hallucinogenic high. But in the 2000s, researchers discovered that ketamine could also have rapid antidepressant effects — in as little as 24 hours — for those with TRD when administered in a small, single dose IV infusion.

A number of clinical trials have since linked the effects of ketamine with improvement in symptoms of major depressive disorder (MDD), as researchers continue to find the optimal dose and the best administration routes (like potentially a nasal spray). Ketamine continues to be studied further in other mood disorders like PTSD and OCD with a focus on its long-term safety.

How does ketamine work?

Researchers are still figuring out the specifics, but the drug seems to affect receptors in the brain, including two called NMDA and AMPA:

  • Ketamine stimulates the AMPA receptor, which increases levels of the protein BDNF (brain-derived neurotrophic factor). This protein helps form new neurons and synapses in the brain, which is thought to improve certain mood conditions such as MDD.
  • Ketamine also blocks the NMDA receptor, which in turn causes an increase in glutamate levels (glutamate is an important neurotransmitter in the brain) and results in a cascade of positive neurobiological changes.
  • Both of these pathways and possibly others that still aren’t fully understood are related to the way ketamine works as an antidepressant.

The research looks promising…

There are currently several ongoing clinical trials involving ketamine and MDD and PTSD — and here’s a breakdown of what other recent research has found:

  • One Cochrane review looked at 25 randomized controlled trials involving ketamine’s effects on brain receptors in people with severe depression. It found that while other antidepressants can take 6 to 8 weeks to become effective, ketamine may offer rapid effects in comparison to a placebo. The authors noted that the initial studies are small and there’s uncertainty about how long ketamine’s effects last.
  • Another 2016 study of 14 patients with TRD found that after 3 weeks of twice-weekly ketamine infusions, 7 (50%) experienced remission from suicidal thoughts. Two of these 7 people maintained remission for 3 months.
  • There isn’t quite as much data about the use of ketamine to treat PTSD, but one trial that has been published showed a significant reduction in PTSD symptoms.

The patient perspective: Real-world reviews of ketamine

  • “I am currently receiving IV racemic ketamine once every 2-2.5 weeks at a 0.5mg/kg dose,” says one PatientsLikeMe member. “I haven’t been successful at spacing treatments further out than once every three weeks and 2-2.5 weeks seems to be the sweet spot for me, and I don’t have significant crashes.”
  • Another member says, “Ketamine has saved my life. After failing so many medication trials and ECT, I thought I had run out of options. I am so lucky to be able to access this treatment.”
  • “I am currently receiving IV ketamine 0.5mg/kg every other week in an outpatient setting,” says one member. “I am feeling very well, probably better than I ever have in my life. Ketamine has been a game changer for me.”

Ketamine’s long-term effectiveness

Despite positive findings on ketamine’s rapid effectiveness, researchers are unsure if the antidepressant effects are sustained beyond two weeks and what the consequences of relapse are. Take one PatientsLikeMe member’s experience:

“I received ketamine as part of a clinical trial. Within 24 hours I felt like ‘myself’ again and was able to experience pleasure and internalize positive experiences. The effects lasted about 9 days and then all my previous symptoms returned.”

Side effects, cost, and other things to consider

Ketamine is currently only FDA-approved for surgical anesthesia, so it must be prescribed off-label (not for its intended use). And because it’s off label, it must be administered by a specialty clinic, which means it may not be covered by insurance and can come with a hefty price tag at $400-$800 per infusion. Learn more about available clinical trials here (and be sure to talk to your doctor before changing anything about your treatment regimen).

And what about side effects? In short, more data and research is needed. But here’s what other members who have tried ketamine for MDD have said:

  • “The worst side effect is nausea, but I receive ondansetron before the infusion and that helps significantly. I have only had one ‘bad trip’ or ‘K-hole’ while getting the infusion, but it quickly subsided.”
  • “I have found that during an infusion, external stimuli intensifies and I can get quickly overwhelmed. To avoid this, I always wear headphones and have music that is very familiar to me playing, and I typically have my eyes closed for much of the time. This also mitigates most of the perceptual disturbances that might occur during an infusion. I am a person who does not like feeling out of control, so I limit my exposure to external stimuli and that helps significantly.”

Have you tried ketamine or been involved in a ketamine clinical study? Join or sign in to PatientsLikeMe to jump in the conversation today.

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