The two papers read for this week, Li et al and Pollak et al, were related to treatment of depression but Li et al focused on using pharmacology while Pollak used behavioral intervention.   I found incredibly interesting all of Pollak et al results but did not like how they approached several issues. To begin with they did not truly support the reason for using learned safety as a measure to treat depression.  Nonetheless, their findings on the decrease of depressive behavior with behavioral training such as learned safety was incredible.  I wonder how we can apply this to humans, and even more so because of the fact that they stated the second test that a true conditioned inhibitor needs to pass is retardation and they showed how after 1 day of training they still reacted as feeling safe under stimulus that was now presented as fear stimulus.  However, after two days of training with CS as fear training, they froze more.  If we think of PTSD or phobias, then I would believe this kind of training could be incorporated as a therapy session or tasks where they learn to associate certain situations with safety.  However, I feel the stimulus couldn’t meet this retardation tests as are met by controlled animals studies.  It is practically impossible to control what happens outside of the clinical area, and thus difficult to control if the stimulus are affected otherwise. Even though I do not believe this is very applicable to depression in humans, I believe we can manipulate the idea of the behavioral intervention and safety measures to treat depression and maybe anxiety with something as simple as a rosary. 

            When considering the findings of Li et al and the rapid antidepressants effects of Ketamine in rats under CUS, I would highly recommend this as an antidepressant treatment.  However, being aware of the multiple side effects such as the possibility of feeling in a dream like state or hallucinations due to its anesthetic effects then I consider that the risk should be taken for those patients with chronic MDD that aren’t reactive to other treatment.  The fact that we have knowledge on how it works in the brain by having studied mTOR pathways and imaging is great as to better understand if something is encountered when administered and what to do in that case.  Moreover, only 12% of the patients that are treated with Ketamine undergo these unfortunate side effects which thus supports the fact that there is more good than bad done by this drug overall. The fact that it is an injection rather than pills is a pro, since trusting a patient with a chronic mental disorder to administer its own drugs is not the best idea.  Since the first feelings of Ketamine administration could include anesthetics effect than it would be beneficial for the patient to stay an hour or so under clinical surveillance the first few times in order to assure he or she is reacting in a healthy manner.  Also, the side effects can be reduced by given the drug intramuscularly and the incidence is reduced as experience with the drug is gained.  Therefore, the patient can react better to this with time.  Since using lower recommended dosages can also reduce the side effects then one might start by applying very small dosages and then increasing it.  Overall, there is a lot to discuss and say about both papers, however I understand their findings are incredible as to expand on them and find great alternative methods to treat such complex mental disorders.