"Recreational" drugs may have hugely significant effects in lifting depression.(man)

[DavidS]

according to Scientific American.

Psychedelic Drugs Show Promise as Anti-Depressants: Scientific American

Personally, I don't get depressed, because I meditate regularly and look after my health, and prefer to sort things out that way rather than by taking any drugs at all, but hey, this is a pharmacy forum ...

[sol_adore]

Looks interesting. It's a pity that many promising branches of research into drugs of abuse that may have legitimate medical uses have probably been under-funded and disregarded because of political bulls**t from ignorant bigots.

Personally, I don't get depressed, because I meditate regularly and look after my health, and prefer to sort things out that way rather than by taking any drugs at all

I don't want to start a flame-war or anything but many depressed people need a little more than mediation, exercise and a healthy diet. There is a strict biochemical basis for their depression and all the sunshine and fresh air in the world won't change a thing, but then again Tai Chi may help lots of people I'm sure you weren't suggesting that about depression, but I just thought it needed saying.

Sorry for the off-topic rant. I think I may have missed my last sertraline dose :P

[DavidS]

but many depressed people need a little more than mediation, exercise and a healthy diet.

If you mean meditation, then of course this may be true. What a pity it hasn't been proven. What work on this that has been done (largely by the mantra-meditation crowd) suggests that a huge number of people with depression, the vast majority, would have a very significant and permanent reduction in their symptoms if they meditated regularly.

The neuroscientists are also now saying that meditation can be used as a way of resetting the habitual thought patterns that are behind, say, reactive depression, and even OCD, and providing relief from those symptoms in that way. And they have the brain-scans to prove it (as if there was no other way to measure it, like asking the patient).

Biochemistry, after all, is the interface between thought and the body, and the biochemistry of the brain and body can certainly be altered by meditation: this has been known since Paul Brunton popularised Yoga in this country, between the wars.

In the past few years, mindfulness meditation techniques have been accepted into CBT and are routinely taught within the NHS.

I think we are some way off a flame war on this thread, though! Lets wait and see what Johnep has to say

[johnep]

Not much, except when a Dr said he got very good results through psychotherapy, I asked how much he charged (Was 1961).
20 guineas a session was the reply. Enough to pay for 3-6 months of Librium was my reply. (20 guineas was more than I earned in a week.)
I suggested he could continue to give psychotherapy to his private patients and Librium to the NHS. That way, both groups of pts were getting the best treatment. On my next call he was very enthusiastic and told me that a long standing pt had been able to return to work with Librium.

The next battles I fought were against electro shock therapy and pre frontal lobotomy. Two very popular procedures at the time. When did you last see them used?
Used to enjoy these tussles and seem to have won most of them. Greatest triumph was replacement of amylobarbitone for treatment of anxiety. That was a consultant at the old Grays hospital (Before Basildon was built).
johnep

[johnep]

While we are on the topic of psychotropics, the main neurochemistry I remember from the 60s was concerned with 5HT (serotonin) and GBA (Gamma amino butyric acid). Guess these are old hat now. So what's new in neurochemistry?
johnep

[crit care]

i've seen them use electro convulsive therapy to try nd treat resistant depression and mania, usually this is a last resort after the patient has gone through every medication going with often doses above BNF limits......

[sol_adore]

Isn't ECT supposed to be pretty effective? I mean it sounds horrific, but the patient is under general anaesthetic and surgeons get away with equally horrific stuff.

I see psychological therapy as a means for the patient to influence the physiology of their brain with the mind. If they cannot do so, meds and other techniques can justifiably be used. For example, a deeply ill schizophrenic obviously has strong neural pathways resistant to any form of psychological input, their mind is completely dominated by their biochemistry. Why should it be any different for severely depressed patients?

[Nik]

So what's new in neurochemistry?
johnep

Glutamate and excitatory amino acids in schizophrenia, dopamine in ADHD, orexins in insomnia. Don't know how new these research areas are but they are interesting (at least to me). As an aside, one interesting theory proposed to account for so-called differences between "typical" and "atypical" anti-psychotics is the "hit and run theory", i.e how quickly they dissociate from D2 receptors (presumably "typicals" remain bound for longer, whereas "atypicals" bind for long enough to exert an anti-psychotic effect but without the S/E's of "typicals").

[Nik]

Isn't ECT supposed to be pretty effective? I mean it sounds horrific, but the patient is under general anaesthetic and surgeons get away with equally horrific stuff.

On its own, there's not much benefit - I think relapse rates are quite high unless medication is prescribed post-ECT.

[johnep]

I actually sat in on a session of ECT. They were trying out a new gas from M&B to induce rather than electrodes. Pts had anaesthetic and muscle relaxant but could still see tremors. That was at St Barts.
johnep