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Talking Ketamine Podcast

Talking Ketamine Podcast

De: Talking Ketamine
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Explore the cutting-edge science and therapeutic potential of ketamine. Talking Ketamine offers evidence-based discussions to demystify its role in mental health and beyond, providing informed insights into this powerful compound.© 2025 Talking Ketamine Ciencia Ciencias Biológicas Higiene y Vida Saludable Medicina Alternativa y Complementaria Psicología Psicología y Salud Mental
Episodios
  • Ketamine and Sickle Cell Disease - Timing is Everything

    Ketamine and Sickle Cell Disease - Timing is Everything
    Dec 12 2025
    Sickle Cell Disease (SCD) pain crises are the leading cause of hospitalization for affected children, causing excruciating vaso-occlusive episodes where misshapen blood cells block oxygen flow to tissues. For decades, the standard treatment has been high-dose opioids, but this often leads to tolerance, inadequate relief, and the dangerous paradox of opioid-induced hyperalgesia—where the treatment actually makes the nervous system more sensitive to pain. In this episode, we analyze a massive cross-sectional study from 44 U.S. children’s hospitals involving over 74,000 admissions. The study asks a critical question: Can ketamine, an NMDA receptor antagonist that "turns down the volume" on central sensitization, break the cycle of pain where opioids fail? The findings reveal a slow but steady rise in ketamine use (doubling from 2.3% in 2016 to 5.7% in 2023), mostly reserved for older children with severe disease markers like chronic pain or hydroxyurea use. But the most stunning insight is about timing. The study found that when ketamine was administered early (within the first 3 days of admission), it cut the median hospital Length of Stay (LOS) in half—from 12 days to just 6 days—and drastically reduced the days patients needed IV opioids. Despite these compelling results, huge gaps in care remain, with some hospitals using ketamine in 20% of cases and others in 0%. We discuss the institutional barriers, stigma, and red tape that prevent clinicians from using this powerful tool when it matters most: early in the crisis. Reference: Jenkins, A. M., Hendry, E., Power-Hays, A., Valentino, M., Hall, M., Kyler, K. E., Antoon, J. W., Tang Girdwood, S., Goldman, J. L., Morel, A. N., Savage, T. J., Orth, L. E., & Archer, N. M. (2025). Increasing ketamine administration in children's hospitals for youth with sickle cell disease. Blood Advances. https://doi.org/10.1182/bloodadvances.2025016826
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    10 m
  • Will Ketamine Work for Me?

    Will Ketamine Work for Me?
    Dec 5 2025
    "Will this actually work for me?" It is the most critical question patients ask before investing time, money, and hope into ketamine therapy. In this episode, we analyze a massive body of research—including a systematic review of 112 studies and a real-world analysis of 77 patients —to find actionable predictors of success. The results are reassuringly broad: factors like age, sex, depression severity, trauma history, and even the intensity of dissociation do not predict whether ketamine will work. However, the data reveals two powerful signals that every patient should know: The "Line in the Sand": The strongest negative predictor is pharmacological resistance. Patients who have failed more than six previous antidepressant trials were significantly less likely to respond to ketamine. The "Perfect" Positive Signal: Researchers identified an early marker of success after just the second infusion. A tiny symptom reduction of just 4.1% on the PHQ-9 scale carried a Positive Predictive Value of 1.0—meaning 100% of patients who hit this mark went on to achieve a clinical response. Crucially, we explain why early non-improvement does not mean failure, as nearly half of patients who showed zero improvement after dose two still achieved a response by the end of treatment. Join us to learn why ketamine might need to be considered earlier in the treatment timeline, before pharmacological resistance sets in. Reference: Syed, O. A. (2025). Predictors of the antidepressant effects of ketamine and psychedelic substances [Master's thesis, University of Toronto]. TSpace Repository.
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    10 m
  • Ketamine, Sleep, and Oral Bacteria – A Microbial Mystery

    Ketamine, Sleep, and Oral Bacteria – A Microbial Mystery
    Nov 30 2025
    Surgery is a trauma that wrecks sleep, and for vulnerable patients, Post-Operative Sleep Disturbance (PSD) is a serious complication linked to delirium, increased pain, and slowed recovery. In this episode, we dive into a fascinating study that connects three seemingly unrelated dots: ketamine, sleep, and the oral microbiome. Researchers treated 130 high-risk surgical patients with a continuous low-dose infusion of esketamine. The clinical results were striking: the rate of PSD dropped from 65% in the control group to just 43% in the esketamine group. Patients reported significantly better sleep quality and required far fewer opioids like hydromorphone. But the real surprise was found in their saliva. The study revealed that esketamine treatment actively reshaped the oral microbial community—boosting beneficial bacteria like Streptococcus while suppressing groups like Bacteroidota that were linked to poor sleep. Why would an IV anesthetic change mouth bacteria? We explore the leading theories: Systemic Anti-Inflammation: Surgery floods the body with pro-inflammatory cytokines (a "systemic fire"). Ketamine’s powerful anti-inflammatory properties may calm this environment, making the host less hospitable to stress-related microbes. The Gut-Oral Axis: Ketamine may influence the gut microbiome, with effects rippling up to the mouth to stabilize the body's entire ecosystem. This research challenges us to rethink how psychiatric drugs work—not just by hitting receptors in the brain, but by restoring ecological balance to the nerves, immune system, and the trillions of microbes that live within us. Reference: Li, X.-Y., Qiu, D., Du, N., Hashimoto, K., Wang, X.-M., & Yang, J.-J. (2025). Esketamine prevents postoperative sleep disturbance in patients with preoperative sleep disorders: A role for oral microbiota. Translational Psychiatry, 15(1), 501. https://doi.org/10.1038/s41398-025-03705-9
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    8 m
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