The David Pakman Show - 11/29/22: Arizona Loses Its Mind, Twitter Bails on Disinfo Policy

Episode Date: November 29, 2022

-- On the Show: -- Doctor John Krystal, psychiatrist and Yale University Professor best known for the discovery of the rapid antidepressant effects of ketamine, joins David to discuss depression, SSRI's, treatment with ketamine, and much more -- Absolutely insane Arizona hearing about the 2022 election goes completely off the rails -- Cochise County in Arizona is refusing to certify its election -- Under Elon Musk's leadership, Twitter is no longer enforcing its COVID disinformation policy -- Failed former President Donald Trump explodes at 2:30am, demanding that Kari Lake, who lost the Arizona gubernatorial election, be "installed" as governor -- Donald Trump's presence has become so toxic to Republican candidates that he isn't being allowed anywhere near Georgia Republican Senate candidate Herschel Walker's campaign events -- Georgia Republican Senate candidate Herschel Walker says that people who protest should be arrested if they continue protesting after 5pm -- MyPillow CEO and founder Mike Lindell says he is running for Republican Chairman, challenging Ronna McDaniel -- Voicemail caller seems to think David is still talking about Bernie Sanders -- On the Bonus Show: Pitch invader with rainbow flag invades World Cup Match, San Francisco considers allowing law enforcement robots to use lethal force, Florida woman sues Velveeta over macaroni cooking time, much more... ⚠️ You can use Ground News for FREE at http://ground.news/pakman ❄️ ChiliSleep by SleepMe: Get 25% OFF your bed-cooling system at https://chilisleep.com/pakman 🌰 Munk Pack: Code PAKMAN saves you 20% at https://thld.co/munkpack_pakman_1122 🧻 Reel Paper: Use code PAKMAN for 30% OFF + free shipping at https://reelpaper.com/lemur -- Become a Supporter: http://www.davidpakman.com/membership -- Subscribe on YouTube: http://www.youtube.com/thedavidpakmanshow -- Subscribe to Pakman Live: https://www.youtube.com/pakmanlive -- Subscribe to Pakman Finance: https://www.youtube.com/pakmanfinance -- Follow us on Twitter: http://twitter.com/davidpakmanshow -- Like us on Facebook: http://www.facebook.com/davidpakmanshow -- Leave us a message at The David Pakman Show Voicemail Line (219)-2DAVIDP

Speaker 1 Speaker 1 Ladies and gentlemen, welcome inside the new studio. I know it looks very much the same, but it is very much different. And I know it will probably sound a little different for a couple of days dealing with an echo. You don't need to email me about the echo we're dealing with. It's still treating the room. Please bear with me as we work through some technical elements here. And I know it looks like I have a wire coming out of my right arm and I do. It's been implanted to connect directly to the studio. No, I'm kidding. Let's get right into it, because there is so much to talk about. It is not yet over in Arizona in a number of different ways.

And of course, it is completely over in Arizona in terms of Kerry Lake is not going to be the next governor from Arizona. So let's take it step by step in Maricopa County. They they held. And by they, I mean the county authorities and people who believe Carrie Lake actually won. They held a hearing and the hearing was so insane and so depraved and so outrageous that within just moments it went bad. I want to look at a couple of these moments with you again as a reminder that these people will go for years. You know how sometimes you look at a little puppy dog or a toddler and they seem to have endless energy and you say, well, I've already thrown the ball 100 times. I've already picked up the spoon 500 times.

And it's still interesting and you still want to do it again. And the answer is they will go for years. They are still not over the results of the 2020 election. And now they are getting going with 2022. Here is a woman who says she is there somehow related to wanting a new election. And also her children were once taken away from her, which is certainly odd. Take a listen to this. I'm questioning why is nobody talking about us over the media? I'm nobody like I'm just like mother trying to save my family because my kids were taken from me when they were little because I fought for them medical freedom because.

So it sounds like the children were taken away for reasons of neglect. And this is the person who knows we should have a new election. Speaker 4 I don't go there. OK, but I want to tell you this, guys. I feel this like a joke, but please, Arizona, I love Arizona. I love all of you. I love you, Stephen. I voted for you. OK, this is not about hate, love and hate. You know what? Love is to say no to wrongdoing, you know, and and please try to understand those people how upset they are. Yeah, everybody's very upset because their candidate lost. And yet they want a new election because of that.

If we won, it was fair. If we lost, it was rigged. Here is another woman who believes there were hundreds of thousands of people in Arizona who could not vote. There's a statistician online that's already done statistics on the guys. It's a statistician who's done statistics. What else do you need? Disenfranchisement based on Richard's numbers and how he calculated people waiting in line. It's over hundreds of thousands of people that were not able to vote, that they disenfranchised. The second thing is everybody

that's been paying attention for way years before 2020, and then when 2020 came along, and they've been paying attention since then, do not trust these machines. There have been investigations going on. Mike Pillow is one of those guys. For two years, the evidence is in. They've got it all. They're going to it's going to bubble up to the top. If we had journalists that were doing their job and asking questions, people would know this by now, but they don't. So here's my next point. It's going to bubble up. This is a fork in the road right now. Today. Now, by bubble up, it sort of sounds like she's increasingly saying that this might lead to violence.

And again, think of it. Two point four million people voted in Arizona a few weeks ago. She says hundreds of thousands were disenfranchised. That sort of means like a third of the electorate or at least 10, 15, 20 percent. It's bonkers. Now, then came another woman who was even more dire and apocalyptic in her concerns. She says if this election gets certified, it's going to get very bad very quickly. Justice, you high and mighty politicians don't even know the meaning of the word fairness. Which of you has any left?

Not one. All your dealings are crooked. You give justice in exchange for bribes. These men are born sinners, lying from their earliest words. They are poisonous, deadly snakes, cobras that close their ears to the most expert of charmers. So this is this is like biblical stuff, right? Oh, God, break off their fangs. Tear out the teeth of these young lions.

Lord, let them disappear like water into thirsty ground. Make their weapons useless in their hands. Let them be a snail that dissolve into slime. OK, I think you basically get it. Just crazy apocalyptic stuff. Here is another woman who came forward and said that the board of electors in Maricopa County are traitors. I came here today to get an up close and personal look at the seven traitors to the United States Constitution. Again, please. Sitting at that desk.

You were set to receive a subpoena this morning at 930. What did you do? You called your meeting for 8 a.m. What are you hiding? Right. We all know nothing good happens at eight in the morning. If you hold an 8 a.m. meeting, it must be for some kind of subterfuge. And then lastly, here's a guy again with just more like apocalyptic Bible type stuff. And then he throws in some Klaus Schaub World Economic Forum conspiracy theories. Imagine getting out of bed for this. Some people traveled from other states, which, by the way, what stake do they

have in Arizona? That's a whole other question. The wicked flee when no one is chasing them, but the godly are bold and lion. You see any bold people who are lions here? I see bald people. They're committed to this thing. So am I. When there is moral rot within a nation, its government topples easily. But with honest and sensible leaders, there is stability. I want you to feel. So there is this guy and they are going to achieve nothing. They continue to be convinced that they are right, that they actually won, despite there being no evidence whatsoever. Kerry Lake is playing along with these people.

Kerry Lake continues to say, oh, it's not over. It's this that the other thing it is over. And there is one Arizona county who refuses to accept it. Let's talk about that next. There is a Republican controlled county in Arizona that is Cochise County, or it may be pronounced goat cheese. It's not completely clear to me. And they are refusing to certify the election.

As the Associated Press is reporting, Republican officials in a rural Arizona county refused yesterday to certify the 2022 election. Here we go again. It's the same stuff. This is the sequel, my friends, a decision that was quickly challenged in court by the state's top election official. Now, I want to make an important distinction here. Steve Bannon and some others, when it comes to 2020, continue to talk about decertification. We have to decertify the election. There is no such process. There's just it doesn't exist. This here is a different situation where they are saying, let's not certify. Certification is indeed a process. And the secretary of state, Katie Hobbs,

is the Democratic candidate who won and will be the governor. She has asked a judge to order county officials to canvas the election, which she said is an obligation under the law. So there's a couple of different things going on here. And of course, no matter what is going on, these right wingers will come up with some reason why they are actually correct and everything is absolutely right that they want to do when they want to do it. But any time there's a different perspective, then it must be somebody who's doing something wrong. It's fraud. It's whatever the case is going to be. The practice that they are

getting here is to refuse to certify a federal election. It's important to understand that these are always trial balloons for the next thing and refusing to certify a state election at the county level is a trial for a state refusing to certify a federal election at the state level. If this were to happen or in any way, even a fraction of it were to happen, they would use it as precedent for the future. That's number one. Secondly, this isn't legal. OK, it is absolutely correct to go to court to try to force certification.

And these are folks who have been given a duty, a task. An election has taken place. The ballots have been counted. Now you have to certify. There is no analogy to Bannon saying, well, there is a duty to decertify. Decertification isn't a thing. These elected officials have no duty to decertify elections. You're you're put in a certain position, county board of elections. You have to certify. They're not doing it. It's a legal issue. That's why they're going to court. Now, I know where they are going to ultimately find the certificate. And it's going to be, of course, in Hunter Biden's laptop or on Hillary hard drives emails. Right. No, I believe that the grounds here that they are claiming are, of course, completely imaginary.

This is going to be certified. And then they are going to say this is proof. That they stole it because they came in and forced us to certify something that shouldn't have been certified. Of course, it's simply their job to certify. This is still potentially very dangerous because almost no matter what ultimately happens with this attempt not to certify, they are going to say, well, here's the next thing that now we have to do at the next election, which happens to be 2024 presidential, where Arizona, along with a handful of other states, could determine who's the next president of the United States. Very scary stuff. I don't think this will come as a surprise to many of you, but under Elon Musk's stewardship, for lack of a better term,

Twitter is no longer enforcing its covid misinformation policy. CNN has an article about this where they write. Twitter said it will no longer enforce its longstanding covid misinformation policy. Yet another sign of how Elon Musk plans to transform the company he bought a month ago. CNN writes that in 2020, Twitter developed this set of rules that prohibits or seeks to prohibit, quote, harmful misinformation about covid and the vaccines. And we all know, as CNN summarizes, that between January of 2020 and September of 2022, Twitter suspended more than 11000 accounts for breaking covid misinformation policy. Twitter is no longer going to do that. They did not appear to formally announce the change, but some Twitter users last night spotted

a note added to the page on Twitter's website which says effective November 23, 2022. That's about a week ago. Twitter is no longer enforcing the COVID-19 misleading information policy. They don't explain why, but they simply say it is no longer being enforced. What is important to understand here is that this is all part of a package of changes being brought to Twitter under the false pretense, the false pretense that Twitter became over the last couple of years some kind of woke left wing disinformation or forced information or speech policing platform. We know that's not the case from independent studies done about messaging on Twitter. But also there were so many people overtly spreading covid disinformation that 11000 accounts were suspended. Part of what Elon Musk has been doing is restoring many of those suspended accounts to their former glory, I guess they would say. And this is just part of it.

What do I think is ultimately going to happen with Twitter? I really don't know. There are some who are sure that Twitter will evaporate and go away. I just don't think so. I think there's too many people on the platform. Will Twitter be weakened by fleeing advertisers and user abandonment? It's completely plausible. But there is no question that Twitter is changing. And people have written to me and they said, David, I've noticed with tears. They said, David, I see you're not tweeting as much. There is something that just makes me not that interested in participating on the platform. Hey, nobody. I'm not under the pretense or delusion that everybody's out there waiting for my tweets. I'm not making I'm not making a statement

of any kind. I just see that the engagement quality has declined. I see that the Twitter blue thing has also not been particularly exciting. And I'm just less interested in posting to Twitter. That's all that's going on. Where we will be three, four months from now, we will see. But officially now, covid disinformation, maybe not welcomed, but certainly allowed on Twitter. You know how tough it can be to navigate the online news constantly being thrown at us. And that's why I love our sponsor Ground News, which is an app and website that allows you to easily compare how any individual story is being covered by different sources. Every story comes with a bias bar

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You'll get their top tier vantage subscription for 40 percent off. Go to ground dot news slash Pacman. Try it for free or subscribe to get unlimited access to all of their news analysis tools. That's ground dot news slash Pacman. The link is in the podcast notes. The science tells us that one of the best ways to get consistent deep sleep is lowering your core body temperature. When your body stays cooler at night, you're more comfortable and your sleep is better. Our sponsor Sleep Me is the home of Chili Sleep, the customizable climate controlled sleep solutions that can improve your sleep by

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starts now or please no more Trump. That's another coupon code. Please no more Trump. Speaking of which, Donald Trump throwing democracy in the toilet and flushing it 10 to 15 times at two thirty in the morning. We knew he was up to something weird in the middle of the night, didn't we? Donald Trump saying that Carrie Lake should be installed as the governor of Arizona. You know, if you go back and look at the history of, generally speaking, overwhelmingly the 20th century, but also to some degree, the 21st,

and you look at leaders who were, quote, installed. It's not a particularly good history. And that is exactly what Donald Trump is now demanding happen in the middle of the night. Donald Trump posting to his platform Truth Social. Well, call it what you want. Quote, massive numbers of quote and fully capitalized broken voting machines in Republican districts on Election Day. Capital letters everywhere. None of them make sense. Mechanics sent in to, quote, fix them, made them worse. Kerry had to be taken to a Democrat area which was working perfectly to vote. Now understand that none of that is true. Her opponent ran the election.

This is yet another criminal voting operation. So obvious. Kerry Lake should be installed governor of Arizona. This is almost as bad as the 2020 presidential election. Remember, it's almost as bad because nobody's the bigger victim than Trump, which the unselect committee refuses to touch because they know it was capital F fraudulent. Look at what is happening here. This went from summer 2020. Well, you know, there might be problems

that Democrats take advantage of because of mail in voting and early voting. No evidence of it, but it was a much smaller claim to I won. I won and they stole it from me in November of 2020. Now to install the loser. Install the loser, make her the governor, even though she actually lost. If we win, it's a fair election. If we don't bring out the pitch forks, demand a new election, say it's fraud and blah, blah, blah, blah, blah. Now, one of the craziest things about this is that Carrie Lake is still insisting that they're going to get this one back. Now, much like with all of these people, we don't know to what degree are they grifters, to what degree are they liars, to what degree are they victims? I am struggling to believe that Carrie Lake has even a one percent belief that they are going to somehow get her to be the governor of Arizona. And yet she just posted as a reply to Donald

Trump's troth, quote, Arizonans have no faith and trust in our elections. And what's notable is she capitalizes faith, trust and elections, just like Trump does. Very weird. She goes on to say our election officials are incompetent or worse. They have failed us. The fake news ignores our fake elections and expect us to just, quote, move on. We won't. America will not survive if we don't demand election reform now. Do we think for a second that Carrie Lake really believes she is going to be appointed the governor of Arizona, installed as the governor of Arizona, declared the winner of the governor of Arizona race? I am really struggling to believe that. And what I think is actually going on here is that this is

Carrie Lake's continued addition to be Donald Trump's vice presidential running mate in 2024. Marjorie Taylor Greene has made it clear she wants to be Trump's running mate in 2024. And Carrie Lake is making it clear as well. And as I've said before, not all of the people claiming that 2020 was stolen really believe it. Some of them say it because they realize that it is the thing you're supposed to say if you are showing your allegiance to Donald Trump's team. And I believe that that is part of what is going on here as well. If you believe that Carrie Lake believes she is going to be the governor of Arizona, let me know in the comments and make sure you're, of course, subscribed on YouTube in order to be able to comment at YouTube dot com slash the David Pakman show. We are continuing to very closely look at the December 6th Georgia runoff between incumbent Democratic Senator Raphael Warnock and challenging Republican candidate Herschel Walker. Now, we've already

talked about how Herschel Walker has no business being senator from Georgia. I'm going to give you yet another example of that a little bit later on in the show. But one of the interesting questions has been, is Donald Trump going to show up to try to help Herschel Walker? Barack Obama is showing up to try to help Raphael Warnock that we know and he will be campaigning with him. But Donald Trump is apparently so toxic at this point in time that Republicans are trying to keep him as far away from Georgia and as far away from Herschel Walker as possible. New York Times reports Trump plans limited role in Georgia Senate runoff. The former president who held two big rallies before the state's two runoff elections two years ago,

both of which Democrats won, will steer clear of Georgia before next week's Senate election. And when you look at why, you very quickly understand it. Michael Bender writes for the New York Times, Donald Trump will not cross the Florida state line to campaign with Herschel Walker during the final week of the Georgia Senate runoff election after both camps decided the former president's appearance carried more political risks than rewards, campaign officials for the two Republicans said Monday. Do we believe that Trump was sitting there going, you know what? It's true. I've become such a ticking time bomb and a hothead and liability

that it's probably best that I not go. Probably not. It's probably the people around Trump who got together with those running Walker's campaign and said, we're going to try to keep him away. Trump is planning a call with supporters and will continue sending online fundraising pleas for Walker. Now, those online fundraising pleas default to 90 percent of the money actually going to Trump. And here is sort of the key line of the article. The decision to keep Trump out of the spotlight was a response largely to the former president's political style and image, which can energize his core supporters, but also motivate Democratic voters and turn off

significant segments of moderate Republicans. One other really interesting element of this in Georgia, that political math has become a net deficit for Trump. That's a critical line. Who opened his 2024 presidential campaign two weeks ago in 2020? He was the first Republican presidential candidate to lose the state in 28 years. Earlier this year, his handpicked primary challengers, Governor Brian Kemp and Secretary of State Brad Raffensperger, were both trounced. This is more interesting in terms of 2024. Now, I don't want to diminish the importance of getting that 51st Senate seat in Georgia. The data is looking pretty good for Raphael Warnock. We never count our chickens before

they catch. We never, you know, you use whatever metaphor you want. That is an election we have to fight for. We're going to be covering it, including up to the live results on December 6th. But there's another component to this, which is what is Trump's path to victory in 2024? And what I mean by that is if you start with the 2020 map and you say what was marginal here, you certainly look at Georgia. Now, the problem with that math is flipping Georgia alone from 2020 won't give Trump the presidency. So you need Georgia and something else or you got to flip Pennsylvania. Georgia's increasingly looking bad for Trump. And part of that signal is exactly what's happening in Georgia right now. So when we

think about can Trump win and listen, I was one of the guys that a week before the 2016 election said, I think Hillary's got it in the bag and I was wrong. So I am not going to fall for this again, particularly two years early and say, oh, Trump has no path to victory in 2024. The difference is we've seen what a Trump map looks like. And Georgia is an important part of that map. Georgia is an important signal when we think about 2024 and Georgia is looking so bad for Trump that he's being kept away when it comes to Herschel Walker. That's why it's so critically important right now. Let me know what you see as Trump's map and path to victory there. And maybe we'll even do we're not going to do maps between now and

November of twenty twenty four. But maybe we'll do one sample map to sort of look at what it could be. Send me your thoughts. Make sure that you are subscribed on YouTube. Make sure that you are following us on Facebook at Facebook dot com slash David Pakman show. Much new content coming. The white paper on how to talk politics without ruining relationships is now available at David Pakman dot com slash guide. A thousand people have already downloaded this.

I am stunned. We were thinking, well, if 250 people download this thing, it's probably a good start. A thousand people have dot com slash guide. calories. Perfect. If you do keto or low carb or like me, you're just trying to stay conscious about sugar intake. You get the satisfying, crunchy, salty, sweet experience you were looking for without the sugar. Monk Pack comes in flavors like sea salt, dark chocolate, caramel sea salt. They launched two new flavors, which are great peanut butter, cocoa chip and dark chocolate cocoa. I keep MunkPak granola bars and nut and seed bars in the pantry at all times. They're great on the go for a quick snack while you're working. If you don't love them as much as I and our team do, MunkPak will

refund all of your money or exchange the product, whichever you prefer. Go to MunkPak.com and you'll get 20 percent off your first order with the code Pacman at checkout. That's M-U-N-K-P-A-C-K dot com. Use code Pacman for 20 percent off. The info is in the podcast notes. Today, we're going to be speaking with Dr. John Kristol, who's a psychiatrist and Yale University professor, maybe best known for the discovery of the rapid antidepressant effect of ketamine in depressed patients. Dr. Crystal, really great having you on. I appreciate it. Really a pleasure to be here today. So maybe to start with, before we talk about ketamine specifically, it'd be great to hear from you a little bit about depression more generally. You know, you talk to five different psychiatrists. You'll often get five at least slightly different answers about to what degree is depression situational or caused by a chemical or hormonal

imbalance or some combination, or it depends on the particular case. What's your sense of our best understanding about depression at this point? Sure. So I think there are some things that we can all agree on. One, that it's far more common than we ever thought to that. It has far more detrimental effects on people's lives than we probably had previously appreciated. And three, that a lot of people who try to get treatment for depression find that the treatment that they start out with isn't giving them the kind of full response that they're looking for. And as a result, even for many people who are in treatment, depression continues to take a toll on them.

And I think another thing that we would agree about depression is that it's really fundamentally different than having a bad day. Now, we've all had a bad day. We've all probably had moments of despair even. But to sit in that state all day, every day, or most of every day is a totally different experience that is hard to appreciate if you haven't been through it yourself. And so when we get to questions of causes, we have to appreciate that there are enormous, depression is a very broad term, and there are probably many different kinds of depressions. And unfortunately, this is one area where psychiatry has not really led us to a satisfactory place. In other words, we appreciate that there are different types of depression that people might have. Some that are purely a reaction to bereavement or getting fired or having your marriage break up and where you have an issue or a problem that you just can't kind of work through and it takes you down into this really negative place. But there

clearly are other people who have depression that comes on, as you point out, because of a hormonal imbalance, because of a medical problem, because of other kinds of things going on in the body. And we know a lot more about the interplay between the body and the brain in relation to depression than we ever did before. And one of the things that we've learned is that medical problems in the body, heart disease, asthma, arthritis, all of these things, even obesity, can contribute to a process in the body called inflammation, which when we think of inflammation in our joint, we think of a sore joint. When we think of inflammation in the brain, it affects the way that the circuits are regulated and can contribute, we think, to depression.

But there is also probably a genetic contribution, about 30% or so of the risk for depression is genetic. And one of the things that you can see in some people who don't have a major life stress and don't have a medical problem contributing is that some people out of the blue, just part of their own makeup will experience depression. And that's really important in all of these cases, you know, whether it's primarily stress, primarily hormonal, primarily genetic vulnerability, there's still, we're talking about this very complex interplay of a person and their surroundings. And so it's not surprising that we treat depression sometimes with psychotherapy, sometimes with medications, sometimes with both

and other things like getting a lot of social support, getting good exercise, having a healthy diet can all help people be make get their best chance of recovering from their depression. So before we talk about ketamine, just briefly treating depression with SSRIs from the research I did before our interview, it seems like it's pretty clear that the SSRIs work better than placebo. They don't necessarily work at numbers that are incredibly overwhelming. It's not 90 percent, but it does seem better than placebo. Is that still your understanding? And what exactly are SSRIs doing in the brain?

Speaker 3 Yeah. So so first, absolutely. SSRIs are extremely helpful for many people. And and so I'd say if people were just starting their, having their first experience of depression and they get treated with an SSRI, that they could expect about a for many people, perhaps because of the complex interplay that we were talking about, is that it can be a chronic or recurring disorder. And so what sometimes happens is that people who maybe in their first episode responded to the SSRI find that later on the medication isn't working so well. So how SSRIs work is to raise the level of serotonin bathing the brain by preventing its reuptake after release. So it does increase the brain's exposure to depression. And then it's the brain's reaction to having so much serotonin around that evokes adaptive changes in the brain that help the regulation of mood and other aspects to function

better. And this process is dependent on the ongoing availability of serotonin in the brain. So if you stop the SSRI abruptly, many people will find that their depression symptoms will come back. Or if you just deplete the body of serotonin, deplete the brain of serotonin, even though people are staying on the SSRI medications, they may have a transient relapse. And that was done for research purposes to help to understand how these medications work. So that's a general introduction to the SSRIs. So let's now talk a little bit about ketamine. Maybe what is ketamine? What were some of the early medical uses that at least it was tested

for? And then how did this start to become something that was thought of as maybe effective for depression? Yeah, well, to me, it's a remarkable story. So ketamine is a drug that was identified as an anesthetic medication in the 1960s. And a good friend and colleague, Dr. Ed Domino, first gave this drug to people and helped to describe its peculiar effects, which he and others called dissociative anesthesia, which is its capacity to produce a kind of twilight state that people sometimes call dissociation. And they didn't know how it worked when they discovered it. In fact, the field of neuroscience really didn't figure out how ketamine worked by blocking the action of glutamate at one of its receptors called the NMDA subtype of glutamate receptor. Now you might say, wait, I've heard of serotonin before. I haven't heard of glutamate. And how is that? Why would you think of glutamate for depression? So this gets

back to, in a way, the logic that carried us to test ketamine first in depressed patients, which is that for a long time, from the first identification of these transmitters to, I'd say, certainly the mid to late 1990s, maybe even later, most people thought of depression as a disorder of the norepinephrine, like noradrenaline, or serotonin systems of the brain. These are chemical systems in very primitive parts of the brain that project to the higher centers of the brain and tune the activity of these higher brain centers. So they reasoned if serotonin was awry, not functioning right, maybe if we give a serotonin reuptake inhibiting drug, we'll treat the symptoms of the depression by normalizing serotonin. Well, research by several groups, including the work done here at Yale by my colleague

Dennis Charney and Pedro Delgado, George Henninger, and others, they showed that if you deplete the body of serotonin, you don't produce depression. If you deplete the body of norepinephrine, you don't produce depression. And that the biology of depression is more complicated. In some ways, this was a kind of intellectual crisis moment for thinking about the biology of depression. And the way that Dr. Charney and I reasoned our way around this problem was to say, well, maybe if depression doesn't predominantly live in the serotonin or norepinephrine nerve cells themselves, maybe depression lives in the targets of norepinephrine and serotonin, the higher brain centers. And the two main brain centers we thought of were the cerebral cortex, the highest executive

control of our thought and behavior and emotion, and the limbic system, the generators or drivers of emotional experience in the brain. And with that came a kind of an aha moment, which is if depression is a cortical disorder, not a brainstem disorder, then the intrinsic signaling mechanisms of these higher brain centers, the main information highways of the higher brain centers should be involved in depression and its treatment. And those information highways

involve the neurotransmitter glutamate as the main excitatory neurotransmitter of the cortex, like 90% of the synapses. So we thought, let's test a drug that blocks one of these glutamate receptors. The drug we chose to do that was ketamine. And what we found was this rapid improvement in mood within 24 hours, say, of a single dose of ketamine in a large number of the people we tested. What is the dosage idea when it comes to ketamine? Is it the type of thing that is it is taken daily like an SSRI? Do the effects fall off similarly or differently? Like is it how how would it be administered? Right. So so Time magazine called ketamine the anti antantidepressant.

And that is because it doesn't work like anything else we know. First, unlike a medication that you give a little bit of the drug, you don't have much effect of the drug, and you take it every day as part of your daily life. That's not at all what ketamine is like. What ketamine is, is you give a dose that is high enough to trigger the antidepressant response. And those antidepressant effects last a week or two in people. And so people generally start getting two doses a week, then after a month or so, one dose a week, then every other week. And so when people are maintained on it, if they need to be maintained on it, they may only get a dose once every three weeks or once a month. And by spreading it out, people don't become tolerant to it. They tend to, if anything, to become more sensitive to the

antidepressant effects. And it turns out in the long-term data with S-ketamine, the version of ketamine developed by Janssen, that it's very helpful in preventing relapse of depression. And so that it's a good long-term treatment as well as a strategy for producing a rapid antidepressant response and to help people who haven't previously responded to antidepressant medications. Are the doses large enough when they are given that they have a sort of psychoactive or maybe dissociative type effect? When given in the way that we and both we in our laboratory with ketamine and later Janssen with S-ketamine give ketamine, yes, they tend to produce psychoactive effects. They can make people feel spacey. They can have altered sensory perception. They might experience, for example, that their

arm or your fingers feel longer, or they may have a feeling that the room is breathing in or out. And what we find is that if we prepare people for those kinds of effects, if we're with them when they are having those experiences, and then if we can have the chance to talk about them afterwards, that people can both understand what's going on, not find it very frightening, and have overall a good experience. Last thing I wanted to ask about, what's the sort of regulatory and legal status right now of using ketamine in this way per the FDA? Yes. So S-ketamine, the S-isomer of the ketamine molecule, ketamine comes in two mirror images. And so one of the mirror images, the S-isomer of ketamine is developed by Janssen and approved by the FDA for the treatment of

treatment-resistant depression and depression in the context of suicide risk. The standard ketamine that's used in anesthesia is approved by the FDA for anesthesia. Right. And what that means is that doctors can prescribe the racemic ketamine for whatever they want, but it is not approved by the FDA for the treatment of depression. And that means that doctors who are prescribing this form of ketamine have some additional liability because it's not endorsed by the FDA. Also, the consequence of it not being approved by the FDA is that some insurance companies only cover the escatamine version. The escatamine version is given as a nasal spray, and people take a certain number

of puffs of the as ketamine is FDA approved and increasingly covered by insurance and Medicare and Medicaid. We have been speaking with Dr. John Crystal, who's a psychiatrist and Yale University professor. Really interesting. And we look forward to reading more about these uses. Really appreciate your time today. It's wonderful, wonderful to be here and talk about this area. So thanks for having me on. We talk about it all the time. One of the biggest contributors to climate change is deforestation.

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. ..... All right. Let's take a look at a couple of other things. You know, one of the things I really hate is hypocritical people and people who project, who say you're this, you're this, you're this when really I'm the one who is this. And there is no greater example of this than the right's view on speech and free speech. And we are all about being the party of speech. We saw during covid that what they claimed to be wanting to be the party of free speech became something very different. It became we get to tell everyone what content they have to allow on their platform. Wait a second.

Doesn't Twitter then before it was owned by Elon Musk, doesn't Twitter have these almost godlike free speech rights as a company which we shouldn't regulate to decide what sort of content do they want on their platform? That's their speech. No, they should be forced to allow people to spread drinking urine cures, COVID or whatever it is that they want to spread. We know that they are complete and total hypocrites. And I have unfortunately a downright dangerous example of this for you today. Georgia Republican Senate candidate Herschel Walker says that he wants protesters arrested if they're protesting after 5 p.m. It's not a free speech zone. It's a free speech time.

You can have the free speech during business hours on weekdays. And if you've got to work a job, then screw you. Sorry, you can't protest. Listen to this. One thing people got upset about me because it hurts everybody's right to a peaceful protest. And I know during these times we have that we can put something in place. And I said, peaceful protest. Let's say a peaceful protest from eight in the morning to five in the afternoon. Yeah. After night, that means the host loves it. We probably so you need to go home and you all get arrested. That's from Dan Zanzel movie. You either want to go home or go to jail because it's not peaceful anymore.

Right. By definition. It's not peaceful after 5 p.m. I guess if you have a day job, sorry, you can't protest. This is not free speech. My friends, the government shall not not infringe on anyone's speech. Before 5 p.m. and then after 5 p.m., everybody's got to go home. Now, there's two different layers to this. OK, I understand to pretend that Herschel Walker has any idea what he's talking about for a second. I am open to the idea that a 3 a.m. protest is far more likely to degenerate into trouble and violence and whatever than a 6 p.m. protest. I'm with you on that. Most municipalities already have noise ordinances and all sorts of other infrastructure which apply rules about blocking streets and sidewalks, you know, all sorts of different things.

OK, but the idea that eight to five is when any kind of protest is allowed, isn't supportive of free speech, isn't supportive of exactly the values that these Republicans claim to be supportive of. Now, I don't really expect Herschel Walker to know or understand any of this as he, you know, quite literally as he runs for Georgia Senate from his house in Texas. That's his Texas house. That's basically where he lives. The idea of, well, he Georgia. OK, let's not even get into that. But the imagery is particularly stunning here. He doesn't understand anything that's going on. But it is yet another example of how these Republicans claim to be all about a

and sometimes they are quite literally against a. And as is again the case. We have to take a step back and say, is this the intent of those who were the creators of the Constitution and the framework that we have in the United States when it comes to not just issues of speech, but issues of freedom of and from religion where now they say, well, freedom from religion, not really. And by freedom of religion, really, they're talking about Christianity. And oh, OK, so freedom of and from religion actually really just means establishing Christianity. OK. You go through these one by one by one and you start to see they don't actually practice what they preach

when the rubber hits the road or when it comes time to put your money, whatever phrase you want to use. It's just stuff that they say until it becomes inconvenient. That's the bottom line. My pillow CEO and founder, Mike Lindell, known colloquially as Pillow, almost like Cher or Madonna or Kanye, maybe for a better example. He is now running for chairman of the Republican National Committee. This is absolutely the best. This guy is increasingly cuckoo for Cocoa Puffs. And I can think of no more logical choice to run such a nutty party

than Mike Pillow. Here he is on Real America's Voice. We're still trying to figure out what that is explaining he's running. Speaker 4 This year is two is 100 percent all in. I've seen a big the RNC is one of the most important organizations in our country and it's sinking. The ship is going down and it needs, you know, it needs a leader and it needs a business leader. It needs someone that knows how to fix things. By the way. Can we be done with we need a business person to lead the country here, there or the other place. Prior to Trump, we really didn't have any examples of business people making good presidents. We now have had a business person president,

one of the worst disasters that I can remember. And now they want to do it again in another position. I mean, listen, if you want to ruin your party with that, go for it's not making too much sense to me how to be proactive in moving forward with a change in footprints. The footprint of our country has drastically changed. It's went all over the board. Things that you thought you could always count on, you can't count on anymore. You can't, you know. And so, no, this is 100 percent a need. And believe me, people came to me. That's how it first sparked this. These were big donors. And when the big donors are going to leave and when the RNC, when you have its own members going, hey, we want to their donors are given and and your and your party is

going to crumble. And it's already you can't if they don't have a plan of something different coming in, a different input, you're going to get the same output, Steve. So I say to that, you want you want to make this you you want to succeed. You get you get me elected to the all these states where, you know, one of those hundred and sixty eight people that I'm going to call each and every one of them. Yeah. OK, so listen, pillows running.

Is this just what Republicans need? Is he, in a sense, the most logical choice? I hope that this happens. I think it would be an absolute disaster for the Republican Party. One of the I am not a fan in any way of Rona Rona, Rona McDaniel, Rona McDaniel. But at least she was from the wing that sometimes would realize, hey, you know, it's probably not great for us for Trump to come to Georgia to help Herschel Walker. He's probably doing more damage than than helping at this point in time. She had some connection to reality in terms of MAGA, even if I find her politics completely deplorable.

Pillow is a guy who will go, what we need is Trump. We need Trump everywhere. We need lawsuits everywhere. We need lawsuits everywhere. We need to talk about how we won every election that we actually lost. And we know how that turned out for them in twenty twenty two. So I welcome Mike Pillow running here. We have a voicemail number. That number is two one nine two.

David P. I got a voicemail from a guy who he calls pretty frequently. He seems to think I'm still talking about Bernie Sanders. Now, I supported Bernie twice. I believe that Bernie's time has come and gone. I don't think Bernie's even thinking about running in twenty twenty four. I haven't talked about Bernie in months, but here's a caller who seems to be under the impression that I'm still talking about Bernie. Speaker 4 I still haven't figured out what motivates you to constantly downplay Bernie's ability to get into the White House. He would have easily gotten into the White House except for the fact that he's an actual economic and social populist. Speaker 1

OK, so a couple of different things here. First of all, I've already gone through the math. It's very popular to say Bernie definitely would have beaten Trump had he been the nominee in 2016. I have not actually seen the evidence of that. I voted for the guy in the primary in 2016. I have not actually seen a compelling mathematical case made for why Bernie would definitely have defeated Trump in 2016, where Hillary did not. Bernie couldn't even win the primary. Well, it's because the DNC. OK, yes, to some degree, that's true.

But I have just simply not seen the math of that. Donald Trump wasn't Donald Trump hijacked some of Bernie's economic talking points. You know that. Donald Trump received an inordinate amount of artificial help. Otherwise, the American people would have never voted for a lifelong con man and career criminal and fast talker and a bully like Donald Trump. Part of me. the American people would have never voted for a lifelong con man and career criminal and fast talker and a fully like Donald Trump. Part of me, it sounds like this guy stuck six years ago.

I think he's talking more about 2016 than 2020. Guys, I got it. We're going to listen to a little more of this. I have to tell you, I don't know why I'm getting a phone call about this. I haven't mentioned Bernie even in passing in months. And it seems like this caller is talking about a six year old election. He didn't win the popular vote. He got in there with that stupid relic called the Electoral College.

Yeah, we know that. And that's not unique to Trump. You and I both know that. Has Bernie been given an honest level playing field to compete with, he would have easily won the White House. We both know that. I just don't know that. Be honest with yourself. Donald Trump received an inordinate amount of help. He received help from the media, from the leadership of the Democratic Party. That's right.

And of course, the Republican Party. Listen, there's another minute and a half to this voicemail. I'm not going to play it. I don't fully understand whether the issue is this guy thinks I've been talking about Bernie or that this guy is still rehashing a six year old election? Yes, we look at history to understand what what is going on and to understand the future. Of course, I understand that. But I just don't really know what's going on and it's worrying me a little bit. Let me know what you think. Always, always welcome all calls. But sometimes speech has consequences and it might

be me wondering what the hell is going on. We have a great bonus show for you today. We have been following the World Cup in Qatar, Qatar, Qatar. Everybody has a different pronunciation. OK, that's not what the issue is. Someone ran onto the field with a rainbow flag during the match between Portugal and Uruguay. Uruguay, please, folks. One of my favorite teams, by the way. And this, of course, relates to a lot of the extreme right wing insanity of Qatar. We're going to talk about it on the bonus show. Number two, San Francisco is considering a law that would allow law enforcement robots to use lethal force.

Is that a good idea? It's sounding like a very bad idea. We're going to talk about it. And thirdly, a Florida woman has sued Velveeta claiming that it's macaroni takes longer than three and a half minutes. What does that make any sense? What are the damages? Well, we're going to talk about all of it and more on today's bonus show. Ladies and gentlemen, please get the bonus show. Oh, the bonus show where you want to make money. Everybody else that makes money to

fund themselves is bad. Well, it makes money to fund the show and pay salaries and pay health insurance and do the things that good employers try to do. Alex, thank your lucky stars every day. You're not Dave Packman. Well, that's fine. I fortunately I don't have a billion dollar settlement against me. Bonus show. Join Pakman dot com. You sign up. You get instant access. And again, I want to remind you, we have a new free offering. It's all funded by the same membership program. We have and I believe it's an eight or nine page white paper building arguments without burning bridges. People call in. I can hear them crying. They have tears. They say, David, I need to talk to my crazy uncle about his right wing politics, but I don't want to ruin the relationship. We have a guide for how to talk about politics with people and how to at least get them to reconsider their views. It is free. It is completely free at David Pakman dot com slash guy.

We will see you on the bonus show and back here tomorrow.