Savouring the flax flowers

Another light day at the Centre. Enough time to read and then summarise and reflect on a paper about the use of ketamine in treating what the investigators called treatment resistant depression. Defined very loosely as failure to respond to at least two "adequate" trials of treatment.

The problem I have with these vague definitions is that someone who has had three different types of antidepressant, and augmentation with lithium is very different to someone who has failed to respond to two SSRIs. An additional issue in this study is that they did not describe the diagnostic process; just that the patients met criteria for a major depressive episode. That could mean someone with the right number of symptoms as a result of socio economic stress or someone with what we once called an endogenous depression. Their results demonstrated symptom resolution but only as long as the ketamine continues and only for not quite a fifth of those treated.

Evidence from past research suggested that 60% of depressed patient who received lithium added to the antidepressant would recover

I left work early enough to have a walk at Te Wai Orea (Western Springs Lake), which is wher I got this lovely image of a Tui