All aboard the ketamine express

Is this at-home therapy safe?

IN a nutshell Hi, friends! I want to start by congratulating Miss Argentina and Miss Puerto Rico who recently got hitched. Mariana Varela and Fabiola Valentín, if you're reading this, we wish you the best! Now onto a completely unrelated subject and the focus of today's newsletter: How safe is it to get an online prescription for ketamine to treat depression? For many people with depression, the drug has helped when no other medication could. But experts are worried about the risks of taking it without the guidance of a healthcare professional. We get into the details below. We'll also be talking about: • a system for keeping tabs on your mental health • a good reason to plunge your face into cold water • why people care about Mars retrograde • more health stories you need Stay sharp, Ginger Wojcik Newsletter Editor, Healthline

Written by Ginger Wojcik November 9, 2022 • 7 min read

what's got us buzzing Ketamine may help depression, but doing it at home may come with risks It's easier than ever to receive a ketamine prescription in the mail, thanks in part to the rise of online mental health care. But experts are concerned that companies offering at-home ketamine therapy — which hasn't been officially approved by the Food and Drug Administration (FDA) — are jumping the gun. "While there is absolutely merit in using ketamine off-label for treatment-resistant depression, it's still in the earlier stages of research so it's quite bold to be sending it out via telehealth," said Audrey Amos, PharmD. Ketamine is a short-acting anesthetic that's been used for decades for sedation and pain management. It's also a popular club drug, known to cause euphoria, hallucinations, and dissociative feelings. Recently, there's been a boom in research around ketamine as a mental health treatment. Studies have shown it can reduce thoughts of suicide, help people with alcohol use disorder stay sober, and improve symptoms of treatment-resistant depression. Results were so positive, in fact, that the FDA approved esketamine — a chemical almost identical to ketamine — as a treatment for treatment-resistant depression. So why all the fuss about at-home therapy treatment? Ketamine includes a laundry list of side effects, which could be dangerous without the supervision of a healthcare professional. "High doses of ketamine can result in more severe adverse effects and even ketamine toxicity," said Amos. "This includes muscle spasms, weakness, dizziness, balancing difficulties, slurred speech, nausea, vomiting, tachycardia, and hypertension." Two studies from this year — one from September and one from October — did find that at-home ketamine therapy (without the supervision of a healthcare professional) was safe and effective. But it's hard to know how much stock to put into these studies because they were both published with heavy involvement from telehealth companies that sell at-home ketamine therapy. With the global ketamine treatment market projected to grow by over 75% in the next 4 years, there's quite an incentive for companies to get into the market early and establish their brands. But as The Journal of Clinical Psychiatry puts it, "until studies of a sufficiently high quality become available, the use of oral ketamine to treat depression must be considered experimental." tl;dr: A boom in telehealth companies offering online ketamine prescriptions for depression has experts worried about the potential risks of taking the drug without the supervision of a healthcare professional. Early research shows ketamine may effectively treat depression, suicidal ideation, and other mental health symptoms. But experts say more research is needed regarding its safety.

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say what   Look who's talking "back for a minute. i'm bi. congrats for forcing an 18 year old to out himself. i think some of you missed the point of the show. bye" – Kit Connor, star of ''Heartstopper''     After months of being taunted on social media for "queerbaiting," Connor came out as bisexual to his 1 million Twitter followers. Queerbaiting is a criticism used against artists who perform queerness in order to appeal to queer audiences (Connor had recently been seen holding hands with a female costar, despite playing a queer character in the show). While queerbaiting is a real issue in Hollywood, many argue that the internet has weaponized the term to bully a teenager into publicly disclosing his sexuality.

Wednesday Kick Start Don't think, just put your face in this bowl of cold water You run into your ex while wearing sweats, you're hit with a surprise vet bill and a surprise car bill in the same week, you forget to buy milk — stress is an unavoidable part of life. But you don't have to let yourself simmer in a pot of cortisol soup until the brain fog rolls in and there's no way to reclaim the day. You can hack your body back to a resting state. And one way to do this is by submerging yourself — or a part of yourself — into very cold water. Why does it help? Immersion in cold water stimulates the vagus nerve, which activates the parasympathetic nervous system, aka your "rest and digest" state. This brings your heart rate down and helps your breathing become even. It also may get the dopamine flowing, giving you feelings of pleasure. For the full effect, it's best to submerge your whole body in cold water. But if you don't have a lake on hand or you need relief ASAP before your next Zoom meeting, dunking your face into a bowl of cold water can do the trick. How cold should the water be? Advocates of the Wim Hoff method would say the colder the better, but water that's in the 50 to 59°F (10 to 15°C) range can still effectively stimulate vagal activity. (And if you have a history of heart problems, please talk with a doctor before you start dabbling in the world of cold water plunges.)

health stories you need What we're reading next How rejection sensitivity makes it feel like rejection is everywhere. When you're sensitive to rejection, you may see it even when it's not there. We look into ways to have a more balanced perspective. A handful of almonds a day may keep gut health imbalances away. A new study finds that eating around 46 almonds a day can improve gut health by increasing levels of a key fatty acid. Essential gifts for people who are always on the go. Our editors rounded up the best products for that friend who always has somewhere to be.

you're up Last week, we entered Mars retrograde. You either already knew this or now you're madly looking for the unsubscribe button. But before you sever ties, know that I'm not here to endorse, criticize, or otherwise pass judgment on anyone's astrological beliefs. In the culture war over astrology, consider me Switzerland. Mars retrograde is a period of time when the planet appears to spin backward in the sky because of where it's positioned relative to Earth. All planets go into retrograde, but they do so at different intervals. Mars is the longest, with 26 months in between retrogrades. This one will last from Oct. 30, 2022 to Jan. 12, 2023. According to astrology.com, "Typically, any plans initiated under Mars retrograde go nowhere, slowly. Well-intended schemes fizzle out before our eyes, while alluring would-be lovers that got our hearts racing at the start of Mars retrograde peter out and lose their charge." Looks like I'll be tabling all my well-intended schemes until January. We want to know: Do you believe in astrology? If yes, what benefits do you get out of it? Let us know at wellnesswire@healthline.com.

Thanks for reading! I hope you know how much it means to me and all of us that you read our newsletter. We're truly honored. We'll be back on Friday with more health nuggets you didn't know you needed.

Until next time, Take care of yourself, and we'll see you again soon!     This edition was powered by that feeling of relief when the rivers start flowing again.   View in browser Did a friend send you this email? Subscribe here. To see all newsletters, click here. Privacy    |    Unsubscribe © 2022 Healthline Media 1423 Red Ventures Drive, Fort Mill, SC 29707