Daily Archives: January 4, 2018


What is resilience? It’s the ability to bounce back after an adverse event. Like a rubber band snaps back to its real shape after being stretched to the limit.

We have resilience. Some of us have more, some of us have less. At times we have lots of it, at other times, we have a little bit.

Sometimes we may be seriously resilience challenged and sometimes we may be blessed with lots of it.

Of course, no matter what happens in our lives, what matters is how we react to it. Easy to say. Sometimes we may feel we don’t have any control over our reaction to an event, that the event is so awful that all we can do is break down. But… but we always have control over how we react. Maybe not the initial reaction, but certainly the ensuing reaction, after we think about what has happened and how it affects us. At that point we can decide how to react and push ourselves towards resilience, towards getting over it, towards being strong and tall.

Intranasal formulation of ketamine helps clear treatment-resistant depressive symptoms

There are estimated to be 6 million people are in the US alone who have treatment resistant depression.

The authors of this study have shown that esketamine, a component of the anesthetic ketamine, in the form of a nasal spray, can bring people out of treatment resistant depression! They hope to bring this into clinics soon. This would be a godsend for people with treatment resistant depression!

Ketamine works by binding NMDA receptors, not neurotransmitter receptors like conventional antidepressants do.


A ketamine-based nasal spray produces rapid improvement of depressive symptoms, according to new research published in the scientific journal JAMA Psychiatry.

The double-blind, randomized, placebo-controlled study of 67 adults with a diagnosis of major depressive disorder examined the effects of esketamine, a component of the general anesthetic ketamine.

“Depression is the number one cause of disability worldwide,” remarked study author Ella J. Daly, a researcher at Janssen Pharmaceutical Companies.

“The development of a novel, safe and effective treatment for patients suffering from treatment-resistant depression (TRD) is a recognized significant unmet medical need,” Daly told PsyPost.

“Currently, about one third of patients with major depressive disorder do not respond to treatment with conventional antidepressant medications, leading to continued suffering for patients and their families and significant direct and indirect costs to society. In the US alone, it is estimated that there are approximately 6 million people with treatment resistant depression.”

Previous research had found that ketamine produced an antidepressant effect in patients with treatment-resistant major depressive disorder. Ketamine interacts with NMDA receptors in the brain, meaning it works differently than conventional antidepressant medications that influence serotonin.

The new study, which was a Phase 2 clinical trial, tested disposable nasal spray devices that delivered a dose of esketamine.

“The intranasal formulation that we are studying is less invasive compared to an intravenous formulation, and may facilitate ease of access in outpatient settings,” Daly explained.

In the study, the participants received 28-mg, 56-mg, and 84-mg doses of esketamine twice weekly. All three doses produced an antidepressant effect. The participants were given esketamine in addition to their currently existing antidepressant treatment.

The drug was generally well-tolerated. But four participants experienced adverse effects that led them to drop out of the study. The most common adverse effects were dizziness, headache, and dissociative symptoms.

“Intranasal esketamine is being developed as a treatment for adults with treatment-resistant depression (TRD). Ongoing phase 3 studies are under way to demonstrate safety and efficacy and to better understand the optimal duration of treatment,” Daly said.

“Of note, in a separate program, Janssen is also evaluating intranasal esketamine as a treatment for patients with major depressive disorder and imminent suicidality.”

The study was funded by Janssen Research & Development, which hopes esketamine will become a medically-approved treatment.

“The results of this study reinforce the potential of esketamine as a treatment for patients with treatment-resistant depression and support further clinical research, providing hope for people in need,” Daly said.

“If approved by the FDA, esketamine would be one of the first new approaches to treat refractory major depressive disorder available to patients in the last 50 years.”

The study, “Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression A Randomized Clinical Trial“, was co-authored by Jaskaran B. Singh, Maggie Fedgchin, Kimberly Cooper, Pilar Lim, Richard C. Shelton, Michael E. Thase, Andrew Winokur, Luc Van Nueten, Husseini Manji, and Wayne C. Drevets.

Keeping The Resolutions

So today I talked to my shrink and the insurance company denied my rexulti so we need to press forward and try to get it handled. I hope they do since the med actually helps! I am almost out of pills so my shrink gave me some samples and then I went out to lunch with hubby.  I ate a good lowish carb meal and tried to interact somewhat with the waitress.  Pretty good since I am feeling like crap and didn’t even want to go out. When hubby asked me originally I said no but then I remembered that I want to do the things Dani would have challenged me to do if she were still alive.

That’s about it for today!

Three Strikes, You’re Out!

No, I am not mixed up with my sports terminology! The picture and title don’t match, but you will see the connection soon! The passing of Johnny Bower, the hockey goalie (shown above), brought back memories of my Dad. He was a diehard hockey fan and I became one as well watching it every Saturday night …

House Cleaning

I finally feel better enough to do actual cleaning today.  I got help with it today–Candy and Christy are here now that I have things sorted out and the Christmas stuff down.  So that is a good feeling.

My oldest has a phone interview today for an internship after she finishes school this spring. We will see how it all goes.

Bob is on his way home after putting the middle one in her apartment in Georgia.  He seems to be having an easy trip so far and traveling well.

I switched out purses yesterday and am enjoying my new black one.  I had to go through all the junk in it and throw stuff away.  That was fun.  But it needed to be done with a  New Year and getting out all my tax stuff.

My mood is steadily improving.  I am so glad to not be sick any more. But I am still tired somewhat.  It is so cold here it is so tempting to just get back in bed to stay warm in the house.  But I am working to avoid that.   We will see what happens.

Hope everyone has a good day and a good rest of the week.


Penny Positive #44

From An Optimist’s Calendar

Bipolar,Unemployed & Lost

what a blog.

what a cool tool for myself and people out there to read and relate. I still get emails asking me to help spread the word and bring people to resources and help and hope.


where did the time go?

I don’t want to let anyone down but would I be right to say I don’t have the time to continue this blog? Would I be wrong to say I can’t?