A Treatment Update

I've been trying to get out as much as I can because once protocols start, I might not feel up to getting off the ward. "Protocols" mean medication trials and in my case it means an injection a day of ketamine for several weeks. The dosage is low enough that it doesn't foster hallucinations or sedation, but it does make one feel fairly weird for thirty minutes to an hour afterward. Mostly I'm picturing both of my arms turning slightly black and blue and bruised from frequent needle punctures. The visual image that comes to mind is Sylvia Plath's description of her daily injections of insulin while she was hospitalized for depression in the early 1950's---noting her purple-tinged buttocks discolored and sore from months of shots.

One only receives actual relief from the shots for a maximum of one week. One woman here on the ward said that it made an impact on her depression for only three days, then she ceased to feel any effect at all. The neurotransmitter in question here is the amino acid glutamate. Up until this point, neuropathways explored to treat mental illness have been serotonin, dopamine, and norepinephrine. Glutamate has shown some promise and a recent drug trial in Russia which involved a much more aggressive exploration of the pathway worked well enough in stage II trials that I would not be surprised if it were FDA approved within the next few months.

I've been trying to get as much done as I can now, anticipating that once the trial starts I might potentially feel ill from the side effects. Ketamine protocal will take two or three months and then I might qualify to take another drug, Riluzole, which up until this point has been used exclusively to treat ALS, also known as Lou Gehrig's Disease. A correlation between ALS and bipolar has been established, though no one is completely sure how they are related. For example, lithium, which I take as a mood stabilizer, has also showed some promise in treating ALS. If one contemplates and studies much about psychiatry and psychopharmacology, invariably the same conclusions are drawn across the board---we know a little but nowhere near a lot about why medications work.