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Monday, October 13, 2014


Zarate, Carlos (NIH/NIMH) [E]

Dear Mr. Reed—
I appreciate your concern about ketamine not being widely available at this time. There are many research efforts under way to attempt to achieve FDA approval of ketamine for treatment-resistant depression including multicenter trials around the country. For now, we need to wait for the efficacy and safety results of these trials before the treatment can be given as an approved standard of care for treatment-resistant depression. On our end, we continue with research to better understand how ketamine works and to develop safer alternatives than ketamine.


Carlos A. Zarate, Jr., M.D.
Chief Experimental Therapeutics & Pathophysiology Branch &
Section Neurobiology and Treatment of Mood Disorders
Division of Intramural Research Program
National Institute of Mental Health

Transforming the understanding
and treatment of mental illnesses.


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The Experimental Therapeutics and Pathophysiology Branch (ETPB) is part of the National Institute of Mental Health (NIMH), a major research component of the National Institutes of Health (NIH). The ETPB conducts clinical research studies on mood disorders (including: major depressive disorder and bipolar disorder) with the goal of creating better ways to prevent, diagnose, and treat mental illness.

Researchers at NIMH that specialize in Mood Disorders seek through RESEARCH STUDIES to:
DEVELOP medications that rapidly decrease symptoms of depression
IDENTIFY biological characteristics (biomarkers)
Better PREDICT with biomarkers who might respond to medications and treatments
UNDERSTAND the mechanisms in the brain that are causing depression and response to treatments

At NIMH, research studies on mood disorders investigate how the depressed brain works, with a primary focus on the glutamate and cholinergic systems. Understanding how experimental medications may work to quickly lift severe and hard-to-treat depressive symptoms may lead to development of new, faster-acting treatments. Researchers at the ETPB also seek to understand what makes some people more likely to develop mood disorders.

Robin Hood, "Man" Marion; Interpretor for Redgrave, Redistributing Time Bandit's Loot to the Poor

NY Times: The Opinion Pages | Op-Ed Columnist - Revenge of the Unforgiven; How Righteousness Killed the World Economy by Paul Krugman

The Opinion Pages | Op-Ed Columnist
Revenge of the Unforgiven
How Righteousness Killed the World Economy

OCT. 12, 2014
Continue reading the main story
"Response to poor economic performance has essentially been that the beatings will continue until morale improves." Paul Krugman

Continue reading the main story

Stop me if you’ve heard this before: The world economy appears to be stumbling. For a while, things seemed to be looking up, and there was talk about green shoots of recovery. But now growth is stalling, and the specter of deflation looms.

If this story sounds familiar, it should; it has played out repeatedly since 2008. As in previous episodes, the worst news is coming from Europe, but this time there is also a clear slowdown in emerging markets — and there are even warning signs in the United States, despite pretty good job growth at the moment.

Why does this keep happening? After all, the events that brought on the Great Recession — the housing bust, the banking crisis — took place a long time ago. Why can’t we escape their legacy?

The proximate answer lies in a series of policy mistakes: Austerity when economies needed stimulus, paranoia about inflation when the real risk is deflation, and so on. But why do governments keep making these mistakes? In particular, why do they keep making the same mistakes, year after year?

The answer, I’d suggest, is an excess of virtue. Righteousness is killing the world economy.

What, after all, is our fundamental economic problem? A simplified but broadly correct account of what went wrong goes like this: In the years leading up to the Great Recession, we had an explosion of credit (mainly to the private sector). Old notions of prudence, for both lenders and borrowers, were cast aside; debt levels that would once have been considered deeply unsound became the norm.

Then the music stopped, the money stopped flowing, and everyone began trying to “deleverage,” to reduce the level of debt. For each individual, this was prudent. But my spending is your income and your spending is my income, so when everyone tries to pay down debt at the same time, you get a depressed economy.

So what can be done? Historically, the solution to high levels of debt has often involved writing off and forgiving much of that debt. Sometimes this happens explicitly: In the 1930s F.D.R. helped borrowers refinance with much cheaper mortgages, while in this crisis Iceland is outright canceling a significant part of the debt households ran up during the bubble years. More often, debt relief takes place implicitly, through “financial repression”: government policies hold interest rates down, while inflation erodes the real value of debt.

What’s striking about the past few years, however, is how little debt relief has actually taken place. Yes, there’s Iceland — but it’s tiny. Yes, Greek creditors took a significant “haircut” — but Greece is still a small player (and still hopelessly in debt). In major economies, very few debtors have received a break. And far from being inflated away, the burden of debt has been aggravated by falling inflation, which is running well below target in America and near zero in Europe. Continue reading the main story

Why are debtors receiving so little relief? As I said, it’s about righteousness — the sense that any kind of debt forgiveness would involve rewarding bad behavior. In America, the famous Rick Santelli rant that gave birth to the Tea Party wasn’t about taxes or spending — it was a furious denunciation of proposals to help troubled homeowners. In Europe, austerity policies have been driven less by economic analysis than by Germany’s moral indignation over the notion that irresponsible borrowers might not face the full consequences of their actions.

So the policy response to a crisis of excessive debt has, in effect, been a demand that debtors pay off their debts in full. What does history say about that strategy? That’s easy: It doesn’t work. Whatever progress debtors make through suffering and saving is more than offset through depression and deflation. That is, for example, what happened to Britain after World War I, when it tried to pay off its debt with huge budget surpluses while returning to the gold standard: Despite years of sacrifice, it made almost no progress in bringing down the ratio of debt to G.D.P.

And that’s what is happening now. A recent comprehensive report on debt is titled “Deleveraging, what deleveraging?”; despite private cutbacks and public austerity, debt levels are rising thanks to poor economic performance. And we are arguably no closer to escaping our debt trap than we were five years ago.

But it has been very hard to get either the policy elite or the public to understand that sometimes debt relief is in everyone’s interest. Instead, the response to poor economic performance has essentially been that the beatings will continue until morale improves.

Maybe, just maybe, bad news — say, a recession in Germany — will finally bring an end to this destructive reign of virtue. But don’t count on it.

Charles M. Blow is off today.

A version of this op-ed appears in print on October 13, 2014, on page A21 of the New York edition with the headline: Revenge of the Unforgiven. Order Reprints|Today's Paper|Subscribe