Why do you "sigh" Captain.Heroin? Honest question.
This seems like a really positive step forward in treatment for depression, and will be much cheaper than IV infusions. While Ketamine is, imo, unlikely to provide lasting benefits past 6 months or a year in most patients, at least it'll likely do that! And often that's all that is needed! It will really stand out in patients admitted for suicide attempts, where even giving them a few hours free from depression can help them past a crisis, and reduce the chance of another suicide significantly, and hopefully further healing.
Patients will be required to stay in a clinic for at least two hours, until they can safely get home and aren't tripping anymore. Sad for those of us, (me included,) who wanted to take it home and enjoy some fun at our own whim, but for the average patient it is the right call, since while it wouldn't be anything like the opioid crisis, giving a powerful dissociative to people who don't even smoke weed, and don't understand drugs the way those in this forum do, would lead to lots of stories of people flipping out, ending up in the hospital or dead somehow, and getting the drug pulled from the market and demonized once more. Just like, no patient should just be prescribed LSD. LSD should be available for recreation and for addiction/depression/etc. but just giving it out with 5 minutes of instruction would lead to disaster for lot's of people who don't understand the drug. Ketamine is safer in that respect, but for people who don't understand drugs, (most people) it would lead to some really bad reactions if now watched over. Hopefully restrictions can be loosened after you've proven to the Dr you know what you're doing, but that won't be for a while if ever.
The part of the protocol that I hate is that patient's are required to also be taking a traditional antidepressant... Even though study after study shows no more than a tiny improvement in a tiny % of the depressed population from SSRI's, tricyclics, MAOI's, etc. And funny enough, a study just came out, (sorry I don't have the link or study access right now, but there's a New York Times Article about it today titled "How to quit antidepressants: Very Slowly Doctors say" for anyone interested,) that address what patients and (some) scientists have known for at least 15 years (at least that's how long I've known it,) about how doctors taper people off their ADs in a month (at first they didn't taper patients at all,) when it should be anywhere from 6 - 18 months or more for most patients (excluding short term users,) with long term consequences for those who taper too quickly.
Patient's have known this for at least 15 years as I said, the medical system seems to finally JUST NOW be admitting that AD withdrawal is both real AND severe, and not just a bunch of whiny patients (I've literally had a doctor tell me to stop whining, when I requested a slower taper schedule because of the moderate/severe withdrawal effects I was having. I ended up agreeing to "go back on AD's", so he'd give me what I needed to do a proper taper I needed.) Anyway, the point of this tangent is that it'll only be prescribed for "treatment resistant patients," so why should they be required to be on a drug with major side effects, that isn't working, and is causing major dependence, to get the Ketamine? That's the dumbest part to me, hopefully they won't drug test, and people like me, who are only damaged and worse off from traditional AD's, can just pretend to be taking a SSRI and still get the Ketamine, and maybe some real help for the first time. One of the great things about trying Ketamine (for medical usage, not daily (ab)use,) is that if it doesn't work, you can just stop, not be forced to taper (or suffer severe withdrawal) for 6 months from something that did nothing but cause problems.
Anyway, sorry for the tangents. As to the OP's question regarding bladder problems that's outside my knowledge, but I do know it isn't intended as a daily medication, the protocol is something like a few times a week for a few weeks and then only twice a week and then once or something to that effect, I don't know the actual protocol. Is ketamine something that can cause bladder problems quickly (in otherwise healthy people)? I've always assumed it only occurred from chronic use, but I realize I've never actually looked that up. Anyway, this isn't perfect, but to me it is a HUGE step forward to for the government to even admit that a "street drug" can have beneficial effects. If successful, it could further change minds towards MDMA for therapy, which has been proven effective but still is FAR from happening, and LSD/psilocin for addictions, depression, and whatever else they may help, and hopefully towards the realization by the population, that a drug can be good or bad, depending on how it's used, and most should be available for those who want to use them, once given the proper knowledge (at least that's my belief.)
Sorry for the tangents (again,) this just excites me, in some sense this is the first REAL advancement in depression medications since MAOI's and Tricyclics produced in the 50s.
Peace
