[HN Gopher] LSD-like molecules counter depession without the trip
       ___________________________________________________________________
        
       LSD-like molecules counter depession without the trip
        
       Author : hericium
       Score  : 309 points
       Date   : 2022-10-02 03:28 UTC (19 hours ago)
        
 (HTM) web link (www.ucsf.edu)
 (TXT) w3m dump (www.ucsf.edu)
        
       | danielunited wrote:
       | Don't mushrooms treat depression as well?
        
         | mmsnberbar66 wrote:
         | The key thing in the title is "without the trip"
        
       | GenerocUsername wrote:
       | Doubt.
       | 
       | It's maybe possible that LSD (and per the article, LSD-like
       | chemicals) has a chemical effect on depression, but based on the
       | fact that MANY different psycadelics exhibit similar anti
       | depression abilities, it seems more likely that it is the actual
       | experience of the trip that confers most of the benefit.
        
         | tpm wrote:
         | I am also doubtful, but the new molecules look quite a bit
         | different to both LSD-like and tryptamine psychedelics, so it
         | will be interesting to see what will the test subjects say, if
         | it gets that far.
        
         | desro wrote:
         | [citation needed]
        
           | rippercushions wrote:
           | There is significant evidence that MDMA, LSD and psilocybin,
           | which are all psychedelic drugs but wildly different
           | chemically, have a significant impact on depression.
           | 
           | https://en.wikipedia.org/wiki/Psychedelic_therapy
        
             | waffleiron wrote:
             | Every single one of these has an effect on serotonin
             | receptors, there are a lot of clinical antidepressants that
             | don't make you trip but affect serotonin.
             | 
             | So I don't think this is actually proof of the trip being
             | needed
        
               | rippercushions wrote:
               | The difference is that antidepressants have a temporary
               | effect on serotonin levels and thus need to be taken
               | continuously, while a "trip" on psychedelics appears to
               | actually be able to rewire your brain, so a single dose
               | can have permanent or at least much more long-lasting
               | effects.
        
               | eurasiantiger wrote:
               | There's also some evidence that those serotonergic
               | antidepressants actually worsen depression and make it
               | chronic.
        
               | [deleted]
        
         | GavinMcG wrote:
         | "It's possible that consuming glucose (and other forms of
         | sugar) has an effect on weight gain, but based on the fact that
         | MANY different foods exhibit similar weight-related effects, it
         | seems more likely that it is the actual experience of _flavor_
         | that makes the body convert calories to fat."
        
           | betwixthewires wrote:
           | ...except sweetness isn't what all those foods have in
           | common?
        
           | namero999 wrote:
           | Precisely. That's why the placebo effect is so effective.
        
           | peanut_worm wrote:
           | Not really a fair comparison. How can you compare weight gain
           | to a mental illness?
        
           | andai wrote:
           | Wasn't there something about artificial sweeteners causing
           | the brain to release hormones that lead to insulin
           | resistance? So the brain is reacting to the "flavor" rather
           | than the actual sugar (or more precisely, the neurological
           | pathway that consciousness experiences as sweet taste is also
           | linked to this sugar-related physiological chain reaction).
        
             | kolinko wrote:
             | I think this might've been a myth.
             | 
             | I wore a constant glucose monitor for a while (Veri), and
             | drinking soft drinks filled with all kinds of artificial
             | sweeteners caused no glucose changes. If sweeteners caused
             | a spike in insuline, I would see glucose levels fall.
             | 
             | I tried finding research on the subject once, and couldn't
             | find anything legit.
        
               | naasking wrote:
               | > I wore a constant glucose monitor for a while (Veri),
               | and drinking soft drinks filled with all kinds of
               | artificial sweeteners caused no glucose changes.
               | 
               | It doesn't cause immediate changes, it causes long-term
               | changes to glucose response by altering the gut
               | microbiome. Here's a recent double-blind randomized
               | controlled trial showing these effects that was discussed
               | on HN a few weeks back:
               | 
               | https://www.cell.com/cell/fulltext/S0092-8674(22)00919-9
               | 
               | This is the first study that I think showed this pretty
               | conclusively.
        
             | Etheryte wrote:
             | Yes, it was on the frontpage of HN a few weeks ago. Off the
             | top of my head the results were that certain artificial
             | sweeteners spike insulin and some don't.
        
               | fuckstick wrote:
               | This doesn't pass the smell test for an in vivo result.
               | If they spiked insulin in a physiological meaningful way
               | without actual glucose you'd expect hypoglycemia. It's
               | not like insulin resistance is an acute process.
        
               | naasking wrote:
               | You should read the study:
               | https://www.cell.com/cell/fulltext/S0092-8674(22)00919-9
        
               | fuckstick wrote:
               | Did you? It doesn't contradict anything I stated.
               | 
               | I don't think the GPs informal synopsis characterizes the
               | gist of that paper in any meaningful way.
        
               | schrodinger wrote:
               | I thought it was that the reduce insulin sensitivity, so
               | you're affected when you DO have sugar on the future?
        
           | sheen wrote:
           | I heard an interesting counterploint the other day. I think
           | the statement is completely unfounded but figured I'd share
           | because it sounds reasonable...
           | 
           | "Memories are formed by neural pathways, and it is these
           | memories / correlations that form a basis for (some) mental
           | illness. Taking psychedelics can help take another
           | perspective on these memories and rewrite these these
           | pathways / correlations."
        
             | phnofive wrote:
             | This is specifically true for some phobias:
             | 
             | https://ec.europa.eu/research-and-innovation/en/horizon-
             | maga...
        
               | Sugimot0 wrote:
               | Wow this sheds some new light on an anecdotal experience
               | if mine:
               | 
               | I once watched a climber free climb a moderate 30 meter
               | route me and my friends had just completed with ropes,
               | and he mentioned his LSD hallucination was peaking as he
               | saw us at the top.
               | 
               | I considered that maybe climbers like him have
               | exceptionally higher risk tolerance or a habituated
               | comfort with psychedelics and climbing. However, as
               | someone with a reasonable amount of exposure to both of
               | those (separately), it still baffled me. This feels like
               | a more palatable explanation in tandem with higher risk
               | tolerances and habituation.
        
           | jnovek wrote:
           | While this is a completely fair counterpoint, the part that
           | GP didn't mention is that a patient's subjective experience
           | is usually ignored or minimized in psychological research,
           | which prefers to focus on behavior and biological phenomena
           | (because they are easier to measure).
           | 
           | It seems to me like the "trip" aspect is at least worth some
           | investigation.
        
         | dqpb wrote:
         | Maybe the only reason you associate positively with the trip is
         | that it's paired with anti depressant effects.
        
         | galaxyLogic wrote:
         | Maybe it's part of the "actual experience" that you don't feel
         | depressed any more. The hallucinations, who needs those.
         | Therapeutically what matters is the increased feeling of well-
         | being that lasts for weeks if not longer.
        
           | puchatek wrote:
           | A trip is more than a series of visual disturbances. It's an
           | emotional rollercoaster. Your perception of yourself and your
           | surroundings changes drastically and you have many insights
           | that you perceive as very significant. This can help take
           | your attention away from irrelevant things and direct it to
           | more meaningful things in your normal life.
           | 
           | And even the hallucinations can show you that we construct
           | our realities in every instant of our lives. You know this
           | already of course but knowing and experiencing are two
           | different things.
        
           | Out_of_Characte wrote:
           | The hallucinations do really help. Its very difficult to be
           | depressed when all the trees are dancing and shining. LSD and
           | the likes also avoids congnitive hallucinations in most
           | people so you're perfectly aware that it's just the wind.
        
             | sterlind wrote:
             | set and setting. 2C-E showed me how I was a tiny spec, on a
             | tiny speck of a planet, in an infinitely large universe,
             | cold and unfeeling and uncaring, loved only in a tiny way
             | by only a couple of other tiny specs, all of whom would die
             | in a brief instant, cosmically speaking. it was like Carl
             | Sagan showed up to tell me how meaningless my existence
             | was.
             | 
             | also, unbearable sensory overload as the panic attack
             | worsened, seconds took minutes to pass, and my kidneys felt
             | like they were failing (they were fine though.)
             | 
             | the ego death was more or less permanent. my "self" never
             | recovered, I had to build a new one. uncanny experiences of
             | feeling like I wasn't my parents' real daughter, that my
             | phone was a dead person's. I wasn't the same person. but
             | this person is better than she was.
             | 
             | so.. worth it in the (years-)long run, but hardly sunshine
             | and roses! bad trips are scary. 2C-E is known for being
             | cold and analytical, but I'm sure you can have similar
             | experiences on acid.
        
             | peanut_worm wrote:
             | What is a "cognitive hallucination"? LSD can absolutely
             | change your thought patterns
        
             | Schroedingersat wrote:
             | Unless the thing that makes the trees dance and shine
             | rather than loom and glow ominously is the same thing that
             | has the anti depressant effect.
             | 
             | I personally think pearl clutching about the idea someone
             | might have fun whilst benefiting from medicine is stupid
             | and there's no reason psychedelics should not be available
             | to anyone who is screened for potential contraindications,
             | but there's no reason to assert that all of the different
             | effects are inexorably linked.
        
           | Nursie wrote:
           | > Therapeutically what matters is the increased feeling of
           | well-being that lasts for weeks if not longer.
           | 
           | But what if that is a consequence of the 'hallucinations'
           | changing your perspective on things? What if the psychedelic
           | break with baseline reality for a few hours is the trigger
           | that changes things?
           | 
           | It's definitely interesting to try and understand. I also
           | just react poorly to people trying to create 'useful'
           | versions of a drug without the 'fun' parts. I don't dabble
           | any more but the experience of compounds like these was well
           | worth the time invested.
           | 
           | (I put hallucinations in quotes above because I think there's
           | a difference between the psychedelic experience and something
           | all-out hallucinatory, read erowid reports on belladonna,
           | datura and brugmansia for the latter)
        
         | heavyset_go wrote:
         | I agree with this. There are novel tryptamines that exist that
         | bind to 5HT2A but don't cause a trip. I've tried a couple of
         | them. They do have effects upon mood, generally positive, but
         | they are distinctly different than the effects on mood from an
         | actual trip.
         | 
         | I think the difference comes from the meaning and significance
         | that come from the experience of the trip itself. The meaning
         | is logically and emotionally interwoven with your perspective,
         | effectively changing it. I believe experience is required for
         | that profound perspective shift, and non-psychedelic 5HT2A
         | agonists don't provide that experience.
        
         | [deleted]
        
         | ipnon wrote:
         | There are also primarily dopaminergic psychedelics like
         | ibogaine that have even more potent therapeutic benefits. This
         | suggests it is not sertonergic effects that are the primary
         | therapy.
        
       | armatav wrote:
       | Can't possibly let people go on any sort of subjective journey,
       | can we?
        
       | enviclash wrote:
       | What food types contain something like that? Anything healthy?
        
         | puchatek wrote:
         | Those molecules were engineered IIUC. They don't exist in
         | nature
        
       | westmeal wrote:
       | I just saw an episode of the Simpsons where Lisa finds a flower
       | that makes scorpions in the desert docile, so she makes an
       | extract of the flower to test that theory for her school science
       | fair only to find that it makes old people bearable to be around.
       | Long story short, a pharmaceutical company finds out and before
       | long they synthesize a pill that does the same - with the side
       | effect of the patients eyeballs popping out of their sockets.
        
       | ianbutler wrote:
       | Someone who isn't me had long lasting, maybe permanent, positive
       | impacts with regards to depression the one time they did LSD.
       | They did it in a very safe environment with very close friends,
       | but hopefully we can understand the mechanism and isolate how to
       | better help people without the stigma attached.
        
       | heap_perms wrote:
       | That's just missing the point completly.
        
       | captainmuon wrote:
       | OK, now make a molecule which gives you a trip without the
       | psychological effects. It would be cool to have a sober mind and
       | at the same time see completely realized halucinations (not
       | pressing-on-the-eyebulb I see weird colors, but fully formed
       | people and things undistinguishable from reality, like when you
       | are dreaming). I'm not sure that's even possible.
       | 
       | But I think you could invent a lot of interesting recreational
       | drugs in theory, alas nobody is developing them because there is
       | no incentive and they would be illegal. Soma? Cigarettes that are
       | safe? Aphrodisiacs? Drugs that let you tweek your personality?
        
         | Synaesthesia wrote:
         | I think there's a limit to what can be achieved with drugs,
         | still a lot awaits to be discovered out there. Did you ever
         | read Shulgin's PIKHAL and TIKHAL?
         | 
         | LSD doesn't so much give you those kind of hallucinations
         | (seeing people that aren't there etc), in fact it's effects are
         | pretty hard to nail down, all kinds of things can happen on a
         | trip.
         | 
         | But the closest analogy is still a "model psychosis", in other
         | words you will experience what people have when they have
         | psychosis, for about 8-10 hours.
        
       | classified wrote:
       | I'd much prefer it _with_ the trip, but then that's only possible
       | if you don't have to work the next day, let alone the same day.
        
       | macrolime wrote:
       | It could perhaps also be that it would work without the trip for
       | some people, for example if the depression was more like
       | metabolic/chemical or something in nature, while for other people
       | the depression was caused by their life situation or other issues
       | and working through it through a trip would help.
       | 
       | So basically like antidepressants and psychotherapy, both work
       | but some people get more out of one or the other.
        
       | neuroma wrote:
       | Maddening paywalled article;
       | https://doi.org/10.1038/s41586-022-05258-z Honestly why bother
       | doing the science for public good on public money if the
       | information can't be disseminated freely.
        
       | kayodelycaon wrote:
       | Interesting. It has the opposite effect of antipsychotics and
       | antidepressants that act the same receptors.
       | 
       | Makes me wonder if studying LSD could help with the treatment of
       | schizophrenia and bipolar disorder.
       | 
       | My personal experience is the brain becomes very plastic during
       | manic episodes, especially when they border on or cross into
       | psychosis. In a way similar to stories I've read about LSD.
        
         | Synaesthesia wrote:
         | Yes my friend who had a psychotic break told me it was "just
         | like an acid trip", that didn't end. I've had all kinds of
         | delusions on LSD, it's interesting because afterwards you can
         | reflect on the odd thoughts you just had (if you don't take
         | them too seriously!) It sure can be insightful, in the right
         | space.
        
         | SamoyedFurFluff wrote:
         | Generally schizophrenia and schizophrenia spectrum disorders
         | are an instant no-go for hallucinogenic drugs like LSD. It's
         | been known to trigger psychotic episodes and mental health
         | crisis. Schizophrenia and manic episodes aren't necessarily the
         | same or behave similarly, and where they overlap is via
         | schizoaffective disorder.
        
         | wise0wl wrote:
         | That was one of the original purposes for LSD---it was billed
         | as a "psychomemetic", in that it mimicked the state of
         | psychosis and made it so therapists could better study and
         | treat the disease in isolation.
        
       | ipnon wrote:
       | This is the million dollar question in psychedelic research
       | today: Are the serotonergic effects of the psychedelic
       | tryptamines primarily responsible for the therapeutic effects, or
       | is the profound religious-mystical component indistinguishable
       | from the positive changes observed? It is a profoundly expensive
       | question. If pharmaceutical companies can deliver a pill that
       | cures depression and gives life meaning without forcing users to
       | face their angels and demons, then the FDA would give approval
       | before the ink on the submission form had dried. As it stands, it
       | would seem the predominant opinion in the community of
       | psychedelic researchers is that the religious-mystical effects
       | are the primary therapeutic vector. It is very difficult to meet
       | God and walk away cynical and melancholy.
        
         | sallystarace wrote:
         | I am a religious person who happens to have enjoyed LSD in my
         | time. I have had the most profound experiences during my many
         | trips, and not a single one that was at all like the sense of
         | awe I get from worship.
         | 
         | I love the headspace that you get into during the trip. It is
         | great for finally addressing issues that you have set aside.
         | After the trip however, you think that all your ideas are good,
         | then it wears off, so either way it is not useful just by
         | itself.
        
           | mistermann wrote:
           | Note that "you" refers to you, _and some other people_ , but
           | not necessarily all other people.
           | 
           | I would even classify this realization as an exception to
           | your "is not useful" rule.
        
           | ipnon wrote:
           | I made a poor choice of words. It would have been better to
           | say "the experience of the ineffable and reckoning with
           | intensely personal beliefs." I meant no blasphemy with my use
           | of religious and Christian terms.
        
         | bowsamic wrote:
         | [deleted]
        
           | ruined wrote:
           | if i were unhappy with my life after an epiphany, i would
           | simply act to change my situation
        
             | bowsamic wrote:
             | The only great impulse of change I had after my trips was
             | an intense urge to kill myself
        
               | ruined wrote:
               | what, with no reason? you didn't have a why? fix the why.
        
               | ceejayoz wrote:
               | Not all whys are known, and not all known whys are
               | fixable.
        
               | bowsamic wrote:
               | It didn't show me a why it just showed me that I want to
               | die. Other LSD users say I should take more at a higher
               | dosage but that seems like a bad idea
        
               | ruined wrote:
               | you keep looking at LSD for feelings you're having while
               | sober. examine your reasons for your feelings now. if you
               | can't identify your own motivations, how can you
               | attribute cause like that?
        
               | bowsamic wrote:
               | I wasn't ever suicidal before, I was after, that's all I
               | know
        
               | mistermann wrote:
               | A theory / thought experiment:
               | 
               | Take "it just showed me that I want to die" and unpack
               | every single word into an absurdly and "pedantically"
               | complex, _comprehensively and perfectly correct_
               | articulation of the(?) precise meaning in this context.
               | In doing so, use various forms of articulation, not only
               | paragraph /narrative form.
               | 
               | If you are doing it right, ideally you will find yourself
               | having to fight against your own mind at several points
               | during the analysis.
               | 
               | Work on the problem for a month or six, even just two or
               | three minutes at a time now and then. I propose that at
               | the end of this process, you will possess more knowledge
               | than you did before.
               | 
               | There are various techniques to accelerate this process,
               | but I will let you figure those out on your own along the
               | way. As a hint: consider various topics of discussion
               | that arise on the website you are on.
               | 
               | I should probably also note: this is not necessarily a
               | risk-free undertaking, so maybe build some safeguards
               | into your methodology.
        
               | bowsamic wrote:
               | I have literally no idea what the hell you are talking
               | about
        
               | chaps wrote:
               | What dosage did you take? I've heard low doses can
               | actually be a deeply frustrating experience.
        
               | bowsamic wrote:
               | 100ug
        
               | andai wrote:
               | Curiously, antidepressants can trigger suicide in
               | suicidal people because they give them the energy to act
               | on those impulses.
               | 
               | My friend was suicidal, and psilocybin was the only thing
               | that made him go back to wanting to be alive (though the
               | effect only lasted ~2 weeks each time).
        
               | parineum wrote:
               | >Curiously, antidepressants can trigger suicide in
               | suicidal people because they give them the energy to act
               | on those impulses.
               | 
               | As someone with somewhat first hand experience with this,
               | it's not exactly "gives them the energy".
               | 
               | The anti-depresents I started taking worked exactly as
               | advertised. The "problem" was I wasn't just depressed, I
               | was also just not happy with life. Anti-depresents can
               | get you out of a depression but they won't make you
               | happy.
               | 
               | It was a bit enlightening to understand the difference
               | between the sadness I felt and the depression but it can
               | also make you feel more helpless when the depression
               | lifts and you still don't really want to wake up
               | tomorrow.
               | 
               | As a result of this experience, I think it's
               | irresponsible to prescribe anti-depresents without
               | accompanying therapy.
        
             | naasking wrote:
             | > if i were unhappy with my life after an epiphany, i would
             | simply act to change my situation
             | 
             | It's anything but simple if you're depressed. You seem to
             | think that insight drives motivation, but in depressed
             | people these are often decoupled. You can have all the
             | insights you want but the motivation to do anything just
             | does not manifest.
        
           | isoprophlex wrote:
           | The experience is highly variable between people. I'm sorry
           | you had such a rough time, and I'm hoping that things are at
           | least slowly getting better for you.
           | 
           | About the god thing, my 2 cents. "god" doesn't always mean
           | Christian White Old Guy on a Cloud Looking Angrily Downwards.
           | There's a less narrow interpretation.
           | 
           | If psychedelics strip away your day-to-day preoccupations,
           | and show you life with a vastly different set of mental
           | filters in place, many people experience a transcendent
           | feeling of belonging to something bigger than their sober
           | selves. A connectedness to other humans and nature that goes
           | beyond ordinary experience. The idea that death isn't so bad,
           | only suffering is; and suffering is the price we must pay for
           | the ability to see its opposite, beauty.
           | 
           | Which people then conversationally condense to "yeah you meet
           | god"
        
             | bowsamic wrote:
             | So they just mean a transcendent, spiritual experience?
        
               | isoprophlex wrote:
               | Yeah i guess that's a lot more accurate if you want to
               | avoid the cultural baggage of the god-word
        
               | swayvil wrote:
               | _It expands your consciousness_ is a popular way of
               | describing it.
               | 
               | Imagine a chronic obsessive cellphone gazer. One day he
               | lifts his nose from the screen. Sun! Clouds! Birds and
               | squirrels!
               | 
               | Except moreso.
        
               | bowsamic wrote:
               | But shouldn't God be in all things, including the
               | profound, if he's really the Absolute? I doubt he'd be
               | limited to our human conception of nature
        
               | swayvil wrote:
               | I prefer to observe first, theorize second.
        
               | bowsamic wrote:
               | So He is more of a Kami?
        
               | swayvil wrote:
               | That would be one of those theories.
        
               | canadiantim wrote:
               | This is a really good explanation
        
           | Schroedingersat wrote:
           | Meeting is just a way of describing a numinous experience. I
           | have heard atheists, christians, pagans and sikhs alike use
           | the term. Mathematicians often use it to describe especially
           | profound proofs regardless of religion.
        
           | PraetorianGourd wrote:
           | I am confident the OP meant "meet God" as short-hand for "a
           | spiritual and transcendental experience wherein the ego is
           | destroyed and rebuilt anew with a profoundly different
           | perspective".
           | 
           | I don't think anyone would earnestly claim that there is zero
           | risk to any hallucinogenic experience. One of my hopes is
           | that through study we can better understand the ingredients
           | that lead to profoundly positive experiences vs. profoundly
           | traumatizing experiences. And anyone who claims we know that
           | today is acting in bad faith.
        
             | ipnon wrote:
             | Roland Griffiths' foundational psilocybin study did not
             | have any adverse outcomes. They used a simple protocol: no
             | patient or patient family history of schizophrenia or
             | bipolar, patients underwent cognitive behavioral therapy
             | before and after the trial, patients were made to develop a
             | warm and trusting rapport with the physicians before
             | administration, and a physician was on hand for the
             | duration of the psilocybin administration to coach the
             | patient through unforeseen disturbances and administer
             | anxiolytics in the case of panic attacks. With this simple
             | protocol they reported no adverse affects, although they
             | also did not report a 100% rate of efficacy. Griffiths
             | wrote an entire separate study on this protocol, it is
             | self-recommending.
        
         | loceng wrote:
         | They're looking for a pill they can patent, and then will
         | demonize and do a fear campaign on the non-patentable options.
         | 
         | If the supposed anti-depressant effect of whatever specific
         | molecule they claim doesn't induce relatively rapid nerve
         | generation, opening up previously closed or blocked off
         | pathways - that pruned off arguably due to trauma and lack of
         | use - then they likely aren't as powerful as where the mystic
         | effects come from; it's the temporary turning off, removing the
         | ego mind from the algorithm of the mind/the mind's eye -
         | allowing you to see reality very differently then you've been
         | formed rigidly in beforehand; some tribes give Ayahuasca to
         | their babies to keep them open as they develop, rather than
         | letting trauma and/or natural processes lock them into more
         | narrow behaviour and thinking patterns.
        
           | [deleted]
        
         | jokoon wrote:
         | Meeting God or finding meaning in life is not on the
         | requirement list for the FDA. There other ways to evaluate
         | treatments for depression.
        
         | avidiax wrote:
         | I have not heard the claim that it's the mystical experience
         | doing the work. I have heard some theories about the glutamate
         | system in the brain, which is strongly affected by e.g.
         | ketamine, psilocybin.
         | 
         | My experience with ketamine treatment for TRD is that it was
         | lots of awesome shapes and colors and sense of melting into the
         | floor, but definitely no communion with "god" or "mystics", no
         | special reexamination of the self or amazing new perspective.
         | Despite that, I still experienced some improvement in symptoms.
         | 
         | I would hope that pharmaceutical research can reduce the time
         | and expense related to this treatment and the side effects like
         | nausea, and less on the moral panic that some people use these
         | drugs for fun somehow.
        
           | Stevvo wrote:
           | "I have not heard the claim that it's the mystical experience
           | doing the work."
           | 
           | This claim has been the prevailing view of almost every
           | psychedelic researcher from the 60s until ~10 years ago. It
           | was also a big contributor to there being almost zero human
           | research into psychedelics over that time period.
           | 
           | It's still the prevailing view today, but not talked about
           | because researchers can actually get funding if they lie
           | about it.
        
           | dylan604 wrote:
           | >My experience with ketamine treatment for TRD is that it was
           | lots of awesome shapes and colors and sense of melting into
           | the floor, but definitely no communion with "god" or
           | "mystics", no special reexamination of the self or amazing
           | new perspective
           | 
           | I've heard people also make similar comments to the LSD or
           | psylocibin experiences as well. In my personal experience,
           | that's purely a matter of dosage. Sounds like an obvious
           | thing, but not everyone knows how a particular dosage will
           | affect them. Any particular dose that is just a fun time for
           | one person might be 1:1 meeting with a higher power for
           | someone else.
           | 
           | This is where I hope honest legal regulation would help.
           | Rather than having to think about how many stems/caps you can
           | eat from SourceA vs SourceB, you can just take a capsule that
           | is accurately measured at X mg. Maybe you need to take half
           | or take 2, but at least it would be the same each time.
        
           | s0berpotato wrote:
           | I was introduced to the idea through a podcast of Lex Fridman
           | hosting John Vervaeke. The idea is that being trained in some
           | methods enables you to better re-frame ideas, reality etc.
           | when under the effect of these substances and then to be able
           | to integrate them to your life once you are sober. Basically
           | to identify when something you identified and felt while
           | under the effect is more "real" since your brain makes
           | connections which don't usually happen. The training allows
           | you to see these connections as something more than noise.
        
           | hallway_monitor wrote:
           | The trip you had was different than what people experience on
           | LSD or psilocybin. You still had a trip. You broke out of
           | your normal frame of mind and were able to comprehend things
           | from a perspective that you couldn't previously conceive of.
           | It seems to me like this is the important component and not
           | whether you think you met God or your creator. It seems to
           | make sense that the changes in yourself afterwards are due to
           | the experience and not to the chemistry, and I wonder if the
           | people focusing purely on the chemistry have never had a
           | trip.
        
             | galangalalgol wrote:
             | It also lines up with people getting similar benefits from
             | serious meditation practice or dramatic life experiences.
             | 
             | The common theme is that all these things change
             | perspective, and none of them are entirely safe.
        
             | ohbleek wrote:
             | My experience is that the majority of the people focusing
             | on the chemistry have ever oriented a trip and it was the
             | impetus for going into research that focuses on the
             | chemistry.
        
         | lm28469 wrote:
         | > If pharmaceutical companies can deliver a pill that cures
         | depression and gives life meaning without forcing users to face
         | their angels and demons, then the FDA would give approval
         | before the ink on the submission form had dried
         | 
         | Instead of selling xxx tonnes of xanax&co per day worldwide and
         | make absolutely outrageous profit doing so ? Doubt
        
           | ceejayoz wrote:
           | Xanax has been generic for decades. This happens to all
           | medications. Pharmacy _loves_ newly patentable venues like
           | this. It'd be another new, expensive pill or infusion to
           | market.
        
             | parineum wrote:
             | It's almost like the patent system is meant to spur
             | innovation and development of new things.
        
           | sixQuarks wrote:
           | Exactly. Very naive thinking.
        
           | jasonhansel wrote:
           | You do know that these new psychedelic-like drugs are going
           | to be patented and probably quite expensive, right?
        
             | fragmede wrote:
             | That's not even hypothetical either. Ketamine was proven to
             | have great anti-depressant effects so Johnson &Johnson came
             | out with their own patentable formulation of it called
             | Spravato.
        
               | BurningFrog wrote:
               | Not exactly.
               | 
               | Ketamine is _well known_ to have great anti-depressant
               | effects, but since it 's long out of patent, no one has
               | the incentive to spend $1B to get the FDA approval for
               | it.
               | 
               | So J&J invented the chiral twin molecule (the mirrored
               | version), got it approved, and it's now sold as Spravato.
               | 
               | To me this is 100% a regulation bug rather than some
               | misfeature of capitalism or corporate greed.
        
               | feet wrote:
               | They didn't invent anything, they just made a specific
               | enantiomer
        
               | heavyset_go wrote:
               | J&J didn't invent esketamine, they patented the use and
               | formulations of esketamine for certain conditions.
        
               | avidiax wrote:
               | I don't think it's a regulation bug to require a study to
               | approve a drug for a certain use.
               | 
               | The bug is that we don't incentivize funding expensive
               | studies to discover unpatentable (i.e. cheap) treatments.
               | 
               | The minimum "patch" would be that the governments of the
               | major drug markets decide that effort and discovery of
               | applications count as a basis for patents. Then a drug
               | maker could fund their studies based on which drug
               | candidate is the most promising, not which is the most
               | promising but also novel and thus patentable.
               | 
               | Much better, would be to have the governments presiding
               | over the major drug markets get together and create a
               | proportional fund to cover studies for the public's
               | benefit. The economics of that would be similar to
               | private companies, but at least the profits would go
               | towards further research.
        
               | [deleted]
        
               | BurningFrog wrote:
               | > _I don 't think it's a regulation bug to require a
               | study to approve a drug for a certain use._
               | 
               | That's actually not how it works.
               | 
               | When a drug is FDA approved for a certain use, doctors
               | are free to prescribe it for anything the think it's
               | useful for. This is called "off label" use, and is ~20%
               | of prescriptions in the US. This "loophole" cures a lot
               | of people!
               | 
               | And there are some clinics who do use regular Ketamine
               | for depression. The main problem for them is that
               | _insurance_ will not cover this usage.
               | 
               | > _The bug is that we don 't incentivize funding
               | expensive studies to discover unpatentable (i.e. cheap)
               | treatments._
               | 
               | This I agree with. Though I'd expect some philanthropic
               | billionaire to get to that long before any governments
               | would.
        
               | Natsu wrote:
               | Normal ketamine is a mix of both antiomers. Spravato is
               | only s-ketamine in an inhaler.
               | 
               | Also, while some see the trip as the point of this, I
               | woke up at knife point due to psychosis caused by that.
               | Yet it also really does basically cure depression, if not
               | accompanying anxiety, and it is known to cause new
               | psychosis.
               | 
               | So I hope this works out and can be used on people who
               | really need to avoid the psychosis caused by ketamine.
        
               | mmsnberbar66 wrote:
               | tbh never heard of ketamine psychosis
        
               | Natsu wrote:
               | It can apparently trigger them in susceptible people. I
               | got to see it first hand.
        
               | kennedywm wrote:
               | $1B? Is that an exaggeration? I can't seem to find
               | anything close to that number anywhere. Perhaps you're
               | mistaking the low-end cost of developing a new drug
               | (around a billion, but it can be three times that) with
               | the cost of FDA approval.
        
               | BurningFrog wrote:
               | It's probably the full cost of getting an approved drug,
               | including a lot more than the approval itself.
               | 
               | So that number was probably 10x off. That doesn't change
               | the conclusion though.
               | 
               | I learned all this from Scott Alexander. All details
               | here: https://slatestarcodex.com/2019/03/11/ketamine-now-
               | by-prescr...
        
           | yodsanklai wrote:
           | Xanax is available in generic form and costs almost nothing.
        
         | pgt wrote:
         | Something Huberman said on his podcast about alcohol is that
         | the anti-depressive effects of SSRIs are not due to serotonin,
         | but due to neuroplasticity.
        
           | jnovek wrote:
           | Can you elaborate on this, please? I've never heard this
           | hypothesis and I don't totally understand what it means.
           | 
           | Are you saying that SSRIs trigger changes in the brain? What
           | changes? Why do they trigger these changes?
           | 
           | Genuinely curious.
        
             | twic wrote:
             | It's been decades since i studied this stuff, but i
             | remember there being a very promising line of work on the
             | connections of the growth factors BDNF and NGF, which
             | promote neuroplasticity, to depression. Seems it's still
             | being worked on:
             | 
             | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174655/
             | 
             | https://pubmed.ncbi.nlm.nih.gov/30235967/
        
             | heavyset_go wrote:
             | The theory is that hippocampal neurogenesis could be a
             | factor in the treatment of depression. The hypothesis is
             | based on the fact that effective antidepressants trigger
             | neurogenesis, and not all antidepressants have the same
             | mechanisms of action.
        
             | snek_case wrote:
             | Yes, SSRIs trigger change in the brain. That's why the
             | effect is not instant when you start taking the pill, the
             | change needs some time to start to happen. In particular,
             | it's believed that depressed people have lower levels of
             | neuroplasticity. Their brains are less able to adapt to
             | their current circumstances and they're stuck in negative
             | thought patterns. SSRIs help increase the brain's ability
             | to grow new connections and help the brain adapt, which
             | helps you get out of negative thought patterns.
             | 
             | If you're interested enough to watch a whole talk about
             | this (you can jump to around 26 minutes):
             | https://www.youtube.com/watch?v=k2AdebIbx5Y
        
               | loceng wrote:
               | Leading also to an increase in rate of suicide compared
               | to placebo, and arguably increased homicide as well; guns
               | being the misdirection narrative.
               | 
               | Edit to add: Downvotes even though in 2015 the FDA
               | required "black box" suicide warnings on SSRIs because
               | what I'm saying is true?
        
               | snek_case wrote:
               | There's this narrative going around that antidepressants
               | bad because medication bad, psychiatric industry evil,
               | modern medicine bad, yadda yadda yadda.
               | 
               | The problem is, everybody's brain chemistry is unique and
               | different, because our genetics are different. Some
               | antidepressants work for some people and not others. I've
               | personally tried 5 of them. Only one of them worked on
               | me, and it had some unfortunate side-effects (messed with
               | my sleep). My ex-girlfriend used a different
               | antidepressant (Zoloft). Personally, I've tried Zoloft
               | and all it did was make me sleepy all the time, but I've
               | found Lexapro was quite effective and useful for getting
               | my life back on track.
               | 
               | The way efficacy studies are done right now is, we
               | measure the average effect on a group of people. That's
               | doesn't really make sense when you think that everyone's
               | genetics are unique and the antidepressant could be
               | making some people better and some people worse, right?
               | Maybe half the group feels better, but a quarter of the
               | group becomes suicidal. Then on average, you see scores
               | going up, you see the drug is beneficial on average... It
               | would be kind of like giving everyone in a group a
               | prescription for eyeglasses, all with the same
               | prescription, and measuring that on average, participants
               | can read better with the eyeglasses than not.
               | 
               | In some ways, modern medicine is still very primitive.
               | Flooding the whole brain with a chemical and hoping that
               | it interacts with the right receptors and has a
               | beneficial effect without too many side effects if you
               | have the right genetics is very primitive. It's the best
               | we have right now though, and antidepressants in general
               | are probably more helpful than not, but yes, people
               | SHOULD be aware that they might very well not work on
               | them.
        
               | heavyset_go wrote:
               | I've written about this in the past a lot[1], but 5HT2C
               | activation is the primary cause of suicidal ideation when
               | starting SSRIs. Once 5HT2C is downregulated after a few
               | weeks, the feelings and akathisia caused by 5HT2C
               | activation dissipate, as does suicidal ideation.
               | 
               | 5HT2C activation can be very, very uncomfortable, and can
               | exacerbate depression, anxiety and suicidal thoughts.
               | Downregulation results in an equilibrium where those
               | feelings and symptoms are relieved over time, however.
               | 
               | [1] https://hn.algolia.com/?dateRange=all&page=0&prefix=t
               | rue&que...
        
         | Silverback_VII wrote:
         | What about very cheap and nonetheless effective "treatments"
         | like exercise,sleep hygiene, magnesium, zinc, fish oil, onion,
         | galic, saffron and even simply eating edible non psychoactive
         | mushrooms? all these have been associated with a reduction in
         | depressive symptoms.
         | 
         | but obviously nobody can make a fortune with these simple
         | advices.
        
           | okaram wrote:
           | 1. Most of those are not actual treatment, and the
           | association is spurious.
           | 
           | 2. Tons of depressed people are still depressed even though
           | they exercise, eat well and sleep.
           | 
           | 3. Tons of people are making fortunes peddling these and
           | similar 'cures' to everything :)
        
           | 6stringmerc wrote:
           | This is true but it's modeled after behaviors in the big
           | picture - you just described a lot of effort and commitment
           | versus taking a pill, maybe doing therapy / counseling once a
           | week or two, and just living life. I'm getting back into
           | fitness routine and it takes time, effort, and money that
           | typically aren't subsidized by the corporate gigs I've
           | worked.
        
             | nonrandomstring wrote:
             | > you just described a lot of effort and commitment versus
             | taking a pill
             | 
             | Funny but I have come to regard the "effort and commitment"
             | as part of the recovery mechanism. Causal or concomitant, I
             | have no idea, let's just say 'linked'.
             | 
             | By the same token I have come to regard "convenience" as,
             | if not a great evil, some kind of joker/trickster that
             | lures us down a dark path.
        
             | j-bos wrote:
             | This strikes me so much. Exercise is a proven health
             | booster and yet health insurance doesn't cover gym
             | memberships or exercise equipment. Why is that?
        
               | michaelmarkell wrote:
               | Treatments like exercise also have high variance -
               | depending on the circumstance and how diligently you
               | implement it, it may have no effect, a big effect, or
               | even cause injury in the worst case.
               | 
               | Insurance likes low variance outcomes because they're
               | easier to model accurately
        
               | msgilligan wrote:
               | I'm not in the insurance industry and have no idea what
               | the actual reason is.
               | 
               | And I don't know what the statistics are, but a
               | significant percentage of people with gym memberships
               | rarely go to the gym. I suspect the percentage of people
               | with free (i.e. payed for by insurance) insurance who
               | rarely go would be much higher.
        
               | msgilligan wrote:
               | Further thought: Maybe insurance companies could pay,
               | reimburse, or reduce rates for those who can reliably
               | prove they are exercising.
        
               | jan_Inkepa wrote:
               | My insurance offers reduction if you pass a basic health
               | check each year. It's kinda nice but also sets up a
               | slightly adversarial relationship with my doctor, which I
               | don't like.
        
               | heavyset_go wrote:
               | I've seen plans that subsidize gym memberships.
        
               | parineum wrote:
               | >health insurance doesn't cover gym memberships or
               | exercise equipment
               | 
               | Because neither of those things are necessary to
               | exercise.
               | 
               | I bet if you asked your GP for some body weight exercises
               | you could do at home he'd happily provide some for you
               | and insurance would cover the visit.
        
           | guerrilla wrote:
           | As I've argued before, if someone can diet and exercise then
           | they aren't very depressed, so most of that advice is useless
           | and why people work on drugs since taking a pill daily is
           | much easier to accomplish for someone who can't get out of
           | bed or find a reason to do anything at all.
        
             | Silverback_VII wrote:
             | Magnesium, zinc and fish oil supplements don't seem very
             | hard to take. And what about a cold shower of 2 min each
             | day? also easy to implement without much effort if one is
             | willing to suffer a little bit.
        
               | guerrilla wrote:
               | > Magnesium, zinc and fish oil supplements don't seem
               | very hard to take.
               | 
               | Obviously people do that and it works for a handful, but
               | rather ineffective in general.
               | 
               | > willing to suffer a little bit.
               | 
               | Yeah, no. That's definitely not something a seriously
               | depressed person can do, I say as someone doing that now.
               | People who suggest these things are completely out of
               | touch with what depression means. You'd be lucky if they
               | were taking shows _at all_.
        
               | Silverback_VII wrote:
               | >but rather ineffective in general.
               | 
               | Study with 22 people with major depression: "Treatment
               | with both omega-3s was associated with a significant
               | improvement in depression, with an average 64% drop in
               | symptoms for the EPA group and 71% in the DHA group."
               | 
               | https://www.webmd.com/depression/news/20210618/fish-oil-
               | supp....
        
               | guerrilla wrote:
               | > Study with 22 people
               | 
               | i.e. worthless. DHA is being studied and has massive
               | effects on inflammation but the science is definitely not
               | there for depression. You need to adjust your
               | epistemology if you are making decisions based on tiny
               | studies like that.
        
               | hallway_monitor wrote:
               | Seems like 22 subjects is better than zero. One is better
               | than zero so if it worked for one person that's probably
               | worth trying for a second. I hate how people act like you
               | can't try anything until it has had a study with
               | thousands of people over years. Sure, that increases
               | confidence but in most cases the study doesn't invent a
               | treatment, it just adds trust in the effectiveness.
        
               | guerrilla wrote:
               | No, that's not how it works at all or else we should also
               | recommend fairy crystals at the same time. Anyway, people
               | _do_ try it. That 's the point. It's common practice and
               | it's known to not work for most people with severe
               | depression. It's only a matter of time that we have
               | strong meta-meta studies showing that definitively. For
               | now, here's a Cochrane meta-study that reviews 35 studies
               | [1].
               | 
               | 1. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651
               | 858.CD...
        
               | Silverback_VII wrote:
               | >i.e. worthless
               | 
               | Certainly not and considering the almost non-existent
               | side effects, it is at least worth a try since it looks
               | very promising. You are right that it is a tiny study but
               | it doesn't mean that it has no value.
               | 
               | I have to say that I know people like you very well, I
               | almost can hear the "go see a therapist and take your
               | meds" or better "don't try and certainly don't think you
               | can solve this on your own". A positive force first and
               | foremost acknowledge people's potential and doesn't put
               | roadblocks everywhere.
        
             | lm28469 wrote:
             | But that's the thing, a lot, if not the majority, of people
             | getting prescribed these awful drugs aren't depressed, they
             | just have a shitty life, a shitty job, no hygiene, no
             | nutritional education, are going through a hard place, etc.
             | 
             | Giving pills to these people is a crime
        
               | guerrilla wrote:
               | Why do you think you know this? What do you base it on?
        
               | heavyset_go wrote:
               | It's not your place to decide if the quality of life
               | improvements others experience with medication are worth
               | it or not. Sometimes life gives people circumstances that
               | are hard to cope with, and sometimes medication helps
               | them cope.
        
           | xen2xen1 wrote:
           | I'll take it in good faith you're not just being a nasty
           | troll, but that's a LOT of work for someone who is depressed,
           | enough to be a non-starter. In reality drugs should probably
           | be seen as a way to start better life habits. The benefits of
           | hose habits are real, but getting there is a lot.
        
           | BurningFrog wrote:
           | Those things can often work, but the depressed mind is often
           | 100% convinced that there is no way out. Nothing you do can
           | make a difference.
           | 
           | Intellectually you can agree that all those things are worth
           | doing.
           | 
           | But some deep calculating part of your mind will see that
           | between hard work that will not help, and doing nothing which
           | will also not help, the latter is the rational choice.
        
         | feet wrote:
         | There are other serotonin receptors at which psychedelics are
         | active besides 2a
        
       | swayvil wrote:
       | Common cardboard tube generates all the joys of astronomy without
       | magnifying any heavenly bodies.
        
         | isoprophlex wrote:
         | Combining common cardbord tube - astronomy with real LSD might
         | eventually get you what you need wrt. inspection of heavenly
         | bodies.
         | 
         | (Picturing people lying on a lawn taking turns looking through
         | a cardboard telescope)
        
         | taylorius wrote:
         | Very good! :D The whole endeavour does have a rather an air of
         | "keep the worker drones functional and content".
        
       | isoprophlex wrote:
       | As someone with a background in organic chemistry, I have a silly
       | nit to pick with the phrasing "LSD-like molecules"
       | 
       | These molecules look nothing like LSD! Structurally they are as
       | different from eachother as a dog is to a flying squirrel.
       | 
       | Of course they _act_ like LSD by binding to 5HT2a. This is
       | absolutely terribly pedantic and probably only applies to the
       | mind of someone who wants to see the molecules first, and the
       | rest of the research later, but I would have preferred
       | "Molecules that act like LSD can counter depression without the
       | trip"
        
         | kaoD wrote:
         | I'm curious about this and someone here might know. Why do they
         | bind to the 5HT2a receptor yet not cause trips?
         | 
         | I always assumed the difference in strength between, say, DMT
         | and psilocybin was because DMT was "more agonist" (pardon the
         | layman terms).
         | 
         | Do these molecules intrinsically not cause trips, or is this
         | more akin to microdosing? Would a higher dose of these
         | molecules cause a trip?
        
           | ekianjo wrote:
           | Because not just one receptor is involved
        
           | valec wrote:
           | different ligands can bind to the same receptor in different
           | ways and cause different signaling cascades. look up "biased
           | agonism"
        
             | tux3 wrote:
             | It's fascinating how Nature effortlessly creates these
             | leaky abstractions, completely opposite to how we design
             | systems, and makes good use of the constant layering
             | violations where we would see unmaintainable code that we
             | can't wrap our heads around.
             | 
             | When we design signaling mechanism, they deal with the
             | layer below while presenting a simpler digital interface to
             | the layer above. Your Ethernet PHY has to care about
             | electrical details, but to the IP stack it's just a stream
             | and sink of bytes. No weird side-band edge cases effects,
             | like if the IP stack could affect DC balance by changing
             | the mix of 1s and 0s it sends out.
             | 
             | But those G protein-coupled receptors -- or whatever it is
             | -- it seems like if you don't want to miss important side-
             | band edge case signals, you really have to model them as
             | this 3D structure that threads through the membrane 7
             | times, that you can jiggle on one side to change the shape
             | it has on the other side.
             | 
             | The receptor-agonist abstraction makes total sense from a
             | human perspective (and it's a good and useful model), but
             | at the end of the day the Wikipedia lists nine different
             | types (partial, super-, inverse, co-, irreversible, biased,
             | ..) of agonists, multiple of which can apparently apply to
             | a single ligand ("can concurrently behave as agonist _and_
             | antagonists at the same receptor, depending on effector
             | pathways or tissue type").
             | 
             | Nature seems to have absolutely no preference for clean
             | abstractions, and I don't know how to feel about that, but
             | it's fascinating to me. Maybe my horrible code is actually
             | universally optimal under a non-human optimizer =)
             | 
             | Or maybe it's just intrinsically hard to make clean
             | abstraction out of chemistry? I wonder if it _would_ be
             | beneficial for a large system like the body to be built out
             | of cleaner (less powerful) abstractions that don't expose
             | all their internal details, but maybe stochastic DNA
             | mutations with natural selection isn't a good enough
             | optimizer to find that place in humanity genomespace?
             | 
             | Death is so out of style compared to Adam and SGD.
        
               | stackbutterflow wrote:
               | I think that's called five-billion-years-of-trial-and-
               | error driven development.
        
               | heavyset_go wrote:
               | I disagree. We build happy paths for our designs, but
               | there are plenty of vectors for attack and modification
               | outside of things like exposed APIs and other "contracts"
               | we bake into systems. You see this all the time with
               | viruses, jailbreaks, virtualization, and hardware
               | hacking.
               | 
               | If we had instrumentation that allowed us to poke and
               | prod at microscopic integrated circuits, there would be a
               | lot of attack vectors exposed there, too.
               | 
               | After all, our abstractions are built upon implementation
               | details, and if you can play with the implementation
               | itself, those abstractions and contracts are up for grabs
               | when it comes to modifications.
        
               | magicalhippo wrote:
               | > like if the IP stack could affect DC balance by
               | changing the mix of 1s and 0s it sends out
               | 
               | For those that don't know, avoiding DC bias due to the
               | distribution of 0's and '1 in the transmitted data is a
               | real concern and something that's engineered into many
               | transmission protocols. A common choice is a form of
               | paired disparity code[1] like 8b/10b[2], found in HDMI,
               | DisplayPort and PCIe 1.0/2.0, and variations[3] like
               | 128b/130b for PCIe 3.0 or 128b/132b for USB 3.x.
               | 
               | [1]: https://en.wikipedia.org/wiki/Paired_disparity_code
               | 
               | [2], https://en.wikipedia.org/wiki/8b/10b_encoding
               | 
               | [3]: https://en.wikipedia.org/wiki/64b/66b_encoding#Techn
               | ologies_...
        
               | kortex wrote:
               | > No weird side-band edge cases effects, like if the IP
               | stack could affect DC balance by changing the mix of 1s
               | and 0s it sends out.
               | 
               | As someone who started in chemistry and moved into
               | computers, this made me laugh out loud hard. It's an
               | absurd and absolutely perfect analogy for the weird shit
               | biology does all the time.
               | 
               | I think it is intrinsically hard to make clean
               | abstractions out of chemistry. Biochemistry even more so.
               | Chemical synthesis in the lab is all about the loop of:
               | react under ideal conditions, work up, extract, purify,
               | repeat. Biochemistry is just...fancy soup.
               | 
               | You get some barrier, especially for really nasty stuff,
               | like peroxisomes, but there is just tons of diffusion.
               | Especially with neurochem, where usually drugs have to be
               | the right lipophilicity to cross the BBB but also
               | specific to targets.
        
               | nonrandomstring wrote:
               | > like if the IP stack could affect DC balance by
               | changing the mix of 1s and 0s it sends out.
               | 
               | Brilliant! I'm going to steal that for a datacoms lecture
               | to hammer home 'layers'.
        
         | gpcr1949 wrote:
         | (I have a background in organic chemistry as well)
         | 
         | I somewhat disagree with this. Measuring chemical similarity is
         | notoriously difficult, see these two interesting blog posts
         | from a cheminformatic angle [0][1]. The molecules are not only
         | pharmacologically similar but even chemically at least somewhat
         | similar, perhaps in the same way a dog has much more
         | similarities with a flying squirrel than with, let's say a
         | church. I would argue the main active molecule [2] is
         | relatively similar to LSD (compared to other well known
         | psychedelics) due the presence of the tetrahydropyridine unit,
         | which is also present in LSD, albeit connected to the 3
         | position of the indole in a different way. Also, there is a
         | pharmaco*phor*ic similarity: positively charged N and 5-6 fused
         | aromatic ring oriented in the same way with some degree of
         | rigidity (though you could argue this is just a roundabout way
         | to bin it in a category of 5ht2a binders). So in this way, I
         | feel that it has something like an LSD-based design philosophy
         | to it.
         | 
         | Quantitatively, making use of one of the most common similarity
         | metrics, the Tanimoto similarity of ECFP4 fingerprints, the
         | similarities to LSD, psilocin, DMT and mescaline are
         | respectively 0.17,0.15,0.18 and 0.07. In other words, the
         | similarity is low to all compounds and the indole derivatives
         | are about equally far removed from the compound from TFA,
         | although a bit closer than mescaline. The numbers probably
         | rather follow your line of reasoning.
         | 
         | Finally, I'd also like to remark that I consider the fact they
         | generated quite novel chemical matter a plus: most of the
         | people working on generating new 5HT2A agonists are currently
         | using quite conservative classic SAR approaches, for example
         | creating constrained (e.g. Lophora's azetidines) or
         | deconstructed versions (e.g. Delix's ring opened LSD variants
         | and ibogaine analogs) of better known compounds, or even just
         | prodrugs of known compounds (Field trip's FT104 is a 4-HO-DIPT
         | prodrug). This will also make it easier for them to fight
         | patent challenges if this series of compounds will lead to a
         | clinical candidate.
         | 
         | [0]
         | http://www.dalkescientific.com/writings/diary/archive/2020/0...
         | 
         | [1]
         | http://www.dalkescientific.com/writings/diary/archive/2020/0...
         | 
         | [2] The SMILES string of molecule 69 from the paper, which is
         | the one from the cryo EM structure:
         | `C[C@@H]1C=C(c2c[nH]c3ncccc23)CNC1`
        
         | carrychains wrote:
         | Your preference is unnecessarily pedantic and logically reduces
         | in specificity to the exact phrasing that peeves you.
        
           | isoprophlex wrote:
           | Definitely!
        
         | cwkoss wrote:
         | The article was written from the perspective of a 5HT2a
         | receptor
        
         | amelius wrote:
         | > These molecules look nothing like LSD!
         | 
         | Who said "look"?
         | 
         | You're being pedantic about your own interpretation.
        
         | 9991 wrote:
         | They didn't say "LSD-shaped". There are lots of ways to be
         | "-like", and one is acting in a similar manner. Your training
         | is blinding your thinking.
        
         | bfung wrote:
         | Haha, I feel ya -
         | 
         | As a computer/tech person, when business people say real-time,
         | or AI (when they just want simple statistics) I get the same
         | annoyance and react with the pedantism (you don't need REAL-
         | time, just sub-second latency).
         | 
         | But for the non-experts and layfolk, many KNOW what LSD does,
         | but none of us know what 5H... yup. =)
        
           | erikpukinskis wrote:
           | Simple statistics can be AI. AI just stands for Artificial
           | Intelligence. An if-statement can be AI.
           | 
           | Are you thinking of machine learning?
        
           | throw827474737 wrote:
           | Being pedantic (and a smartass) the same, "real-time"
           | original definition is that some calculation/reaction of the
           | system is guaruanteed to be always bounded and within the
           | system rqequirements (usually for it not to fail). So
           | depending in the use case and application, real-time can be
           | sub-second, or even seconds/minutes.
           | 
           | E.g. if the instagram folks require likes to happen in real-
           | time for all users around the world that is fine to be within
           | seconds, but a safety critical application in a car must
           | respond within milliseconds.. "you don't need REAL-time, just
           | sub-second latency" in general does not make much sense,
           | sounds more like this application real-time requirements just
           | lie in the sub-second resolution region?!
        
           | SirRuthven wrote:
           | > react with the pedantism...
           | 
           | Some pedant has to say it: shouldn't that be "pedantry"?
        
             | bfung wrote:
             | LOL - true, thx.
        
         | xdfgh1112 wrote:
         | "LSD-like" can mean "acts like" just as well as "looks like",
         | so you're being hyperpedantic.
        
           | snek_case wrote:
           | Actually, I don't think he's being pedantic at all. LSD binds
           | to a wide array of proteins and receptors in the brain
           | (including dopamine receptors) and the binding profile of
           | this substance is most likely very different from that of
           | LSD. Likely to be much more specific to 5HT2a, closer to
           | psilocybin than LSD. IMO they just said "LSD-like" because it
           | would make a nice headline.
           | 
           | See this diagram on wikipedia for LSD binding affinities
           | (lower means more affinity): https://en.wikipedia.org/wiki/Ly
           | sergic_acid_diethylamide#/me...
        
             | realce wrote:
             | Scientists are excited about a new hotdog-like food that
             | prevents depression without the meat: cake!
        
           | ekianjo wrote:
           | or alternatively the headline is just super clickbaity by
           | adding LSD when it was not needed.
        
             | alehlopeh wrote:
             | So using LSD in a title makes it clickbaity? Come on,
             | that's ridiculous. Don't squeeze the life from that term by
             | applying it to anything you don't like.
        
               | Retric wrote:
               | The comparison to LSD is sensationalized and misleading
               | making it clickbait even if the link is not deceptive.
               | https://en.wikipedia.org/wiki/Clickbait
        
               | ekianjo wrote:
               | > So using LSD in a title makes it clickbaity
               | 
               | Yes alluding to something illegal makes it clickbaity.
        
           | quietbritishjim wrote:
           | I guess it's like the question of: could you say an SSD is
           | "hard drive-like" even though it works totally differently? I
           | would say you validly could.
        
             | boloust wrote:
             | While you could say a drug is "LSD-like" because one of the
             | many receptors it targets is also targeted by LSD, that
             | would be more akin to saying a keyboard is "hard-drive-
             | like" because they both plug into a computer.
             | 
             | Biology is extremely complex, and even drugs that have
             | similar receptor binding profiles can have very different
             | effects.
             | 
             | Most drugs will have action across a wide range of
             | receptors. There are a multitude of drugs that target the
             | 5-HT2A receptor, including the most common antidepressants
             | and antipsychotics, for example.
        
               | jcynix wrote:
               | Hmm, depends on the receptor, where the molecule or the
               | hard drive docks to?
               | 
               | So USB hard drives might be keyboard like (for USB
               | keyboards), but hard drives which dock to the SATA
               | connector aren't ...
               | 
               | Anyway, such comparisons sometimes limp and sometimes
               | don't have any legs at all.
        
         | doctor_eval wrote:
         | Well, they are both mammals, so at some level a dog actually
         | _is_ squirrel-like.
        
           | erikpukinskis wrote:
           | A dog is extremely squirrel-like. Compared to a fish or a
           | fungus or a sequoia a squirrel and dog are basically the
           | same.
        
         | lifeisstillgood wrote:
         | "This is absolutely terribly pedantic and..."
         | 
         | Don't worry. You're in the right place :-)
        
           | motbus3 wrote:
           | Don't worry Y in Ycombinator is for pedantic XD
        
             | arjvik wrote:
             | Actually if we're being pedantic, it's capitalized as
             | YCombinator.
        
               | kn8 wrote:
               | Y Combinator ;)
        
               | panxyh wrote:
               | But Why Combinator?
        
             | chalst wrote:
             | Fixpoints are too powerful a concept to be added safely to
             | any but the most pedantic minds.
        
         | tpm wrote:
         | Or even "Molecules that act like LSD in regards to 5ht2a can
         | counter depression without the trip". Because LSD is also
         | active at other targets, and presumably those new molecules
         | too.
        
           | ithkuil wrote:
           | Or perhaps they don't, that's why you get some effects and
           | not others (as desired)?
        
             | tpm wrote:
             | The probably strongest and most selective currently known
             | 5ht2a agonist, 25I-NBOMe, is a psychedelic, and also
             | (unlike LSD, which is less strong and less selective), much
             | much more toxic and user reports say that the effects, both
             | on body and mind, are much worse. So this is a complicated
             | topic and I look forward to reading user reports from these
             | new molecules, if they decide to test them.
        
               | gavinray wrote:
               | Eh, I wouldn't call the mental effects of NBOMe's
               | objectively worse than say LSD -- just different
               | 
               | Now, the body load/vasoconstriction + other physical
               | effects, definitely. You can always tell the NBOMe is
               | kicking in when you get shuttery cold from
               | vasoconstriction and have a weird motor rigidity.
               | 
               | Also FWIW, there are more potent agonists than NBOMe. I
               | know of at least one discovered by Nichols' lab that they
               | refused to publish for fear of use as an aerosolized bio-
               | weapon.
        
         | mseidl wrote:
         | Maybe a flying squirrel compared to a flying dog would be
         | better?
        
         | sva_ wrote:
         | Where can you see these molecules?
         | 
         | I wonder how they look like compared to serotonin and some
         | tryptamines
         | 
         | https://i0.wp.com/sitn.hms.harvard.edu/wp-content/uploads/20...
        
       | c7DJTLrn wrote:
       | Pharma really will do anything to find a depression drug they can
       | sell for huge markup when LSD, ketamine, and psilocybin are
       | already known to work effectively.
        
         | [deleted]
        
         | jasonhansel wrote:
         | I can imagine someone saying the same thing about aspirin.
         | "Pharma will do anything to sell you aspirin pills, when you
         | can just get salicylates the natural way from willow bark."
         | 
         | No. Standardization, rigorous testing, and FDA approval are
         | good things.
        
           | zwkrt wrote:
           | it would be nice if the standardization could come from using
           | the substances that we already have, even if just as a
           | sensible start. I can understand mushrooms being iffy because
           | they comlpex and vary (even between mushrooms of the same
           | species), but LSD is a single molecule already!
           | 
           | I would love to see a future where I can get a government-
           | standardized tab of acid. Of course this will never happen.
           | The reason they are investigating how to get the 'good'
           | effects without the 'bad/uncontrollable' effects is because
           | of who is deciding what 'good' and 'bad' are. 'Good' = Allows
           | people to continue functioning at a high level with the
           | current power structures in place. Put in other words, it is
           | only worthwhile to cure someone's depression if you can do it
           | without the cure involving that person realizing that their
           | current government isn't working for them.
        
             | chevman wrote:
             | That's literally what they did. Started with their
             | knowledge of LSD and went from there using a similar
             | chemical.
        
             | jasonhansel wrote:
             | Personally, I wouldn't want to take a medication that would
             | permanently change my political views.
             | 
             | I seriously doubt there's a drug that reliably makes your
             | political opinions more correct and truthful, but I'm sure
             | that there are drugs that impair your judgment so much that
             | you cannot tell you are impaired. So I would suspect that
             | LSD falls into the latter category, not the former.
             | 
             | If the changes are irreversible, I certainly wouldn't want
             | to take that risk.
        
           | mmsnberbar66 wrote:
           | I would like to hear why this person is being downvoted
        
             | 5co wrote:
        
       | benevol wrote:
       | This sounds like "Nutella - without the chocolate flavor".
       | 
       | But making big pharma insanely rich - once again.
        
         | avidiax wrote:
         | Yes. Let's work around the moral panic that some people might
         | enjoy tripping for a few hours under medical recommendation and
         | supervision by not even investigating whether existing
         | psychedelics are a viable treatment, and instead assuming that
         | the trip needs to be removed.
         | 
         | It would be one thing if psychedelic treatment for mental
         | health were widespread and the time off from work or the
         | experience was distressing to patients. But we've skipped step
         | one there, and it has absolutely nothing to do with how
         | unprofitable effective psilocybin, ketamine or LSD treatments
         | would be.
        
       | simonebrunozzi wrote:
       | Typo in the title: depession -> depRession
        
       | pfkurtz wrote:
       | LSD:
       | 
       | Multiple times I did it with others and profoundly deepened my
       | relationship with those individuals.
       | 
       | Another time I did it by myself and saw the face of evil and I've
       | never been so terrified, but I survived and wouldn't change a
       | thing.
       | 
       | I don't think any of that can be captured by whatever neuro-
       | binding effect is being mimicked by these designed molecules.
       | 
       | I also took antidepressants for awhile once and it was diet and
       | exercise and commitment to changing my life and talking to a
       | therapist that was what helped; but I know others who need to
       | take pills every day or things go bad. I wish there was a short
       | treatment for people who need that.
        
         | teawrecks wrote:
         | > I don't think any of that can be captured by whatever neuro-
         | binding effect is being mimicked by these designed molecules
         | 
         | Agreed, it sound like they do _not_ cause any hallucinations,
         | so you would likely not  "see the face of evil".
         | 
         | > it was diet and exercise and commitment to changing my life
         | and talking to a therapist that was what helped;
         | 
         | Speaking from my armchair, from what I understand about
         | clinical depression, these are the things that someone who is
         | _not_ depressed can do because they  "crave" them. For people
         | who _are_ depressed, there is a (possibly intermittent)
         | neurological imbalance that is preventing them from craving
         | these things which would otherwise keep them functioning
         | normally. While it may be possible to _power through_ the
         | depression, and do these things until the imbalance is
         | resolved, I would argue that this is only due to a temporary
         | break or recession of their depressive symptoms, something that
         | an effective antidepressant should aim to do.
         | 
         | I'm not claiming my view is true, I'm looking for feedback on
         | how correct/incorrect my view is.
        
           | logicchains wrote:
           | https://www.nature.com/articles/s41380-022-01661-0 this paper
           | was published recently, shows there's actually a lot less
           | evidence for the "depression is caused by a neurotransmitter
           | imbalance" hypothesis than people tend to believe.
        
         | Synaesthesia wrote:
         | The effects used to be classified as a "model psychosis" in the
         | 1950's by psychiatrists. That classification was simply
         | dismissed by the government as it implied LSD had useful
         | research properties: allowing individuals to experience the
         | effects of mental illness for 8 hours and then sobering up.
         | 
         | The government was adamant that LSD and psychedelics had to
         | have no legitimate medical or scientific value, and they had to
         | be banned. To be fair they had escaped controlled use and were
         | being used as "party drugs".
         | 
         | But anyway, it sure can be a hella scary and strange
         | experience, and not always pleasant. Handle with care.
        
       | jokowueu wrote:
       | I have tried most of these non psychadelic analogs
       | 
       | They don't do anything such as iso-dmt for example
        
       | acchow wrote:
       | Uhhh, why would you do this? You can learn so much during a trip
       | to solve some of the fundamental issues/trauma behind your
       | depression.
        
         | scaramanga wrote:
         | As someone who has enjoyed tripping, and is generally positive
         | about the benefits of the experience, there are a number of
         | reasons that spring to mind.
         | 
         | You may not have the luxury of time for that. Or even a save
         | place to do it. What if you are in a vulnerable and insecure
         | housing situation? Living on the streets? etc.
         | 
         | You may not feel ready for that. For example if you feel
         | anxious and avoidant about having a raw and truthful
         | "conversation" with your self because of what you might find
         | there, then it probably means that it isn't a great idea.
         | 
         | Perhaps you don't have the access to talk therapy, supportive
         | friends and family, and the like, to trip-sit you, or to
         | discuss and process your experiences with after the trip.
         | 
         | I don't think it would be fair to take options off the table
         | because you (we) think one is better. I mean, why drink a can
         | of PBR, when fine whiskey exists? Why masturbate when you can
         | have sex, which is clearly superior? The fact that one
         | proposition exists does not take the other one away.
         | 
         | That said, with the way the laws are, one proposition IS taken
         | away by prohibition so really it's a question of why put one of
         | them through FDA approval to enter widespread usage while the
         | other one sits in a weird limbo where the vast majority of
         | those seeking it are forced in to an illicit drug trade which
         | endangers them. But that question has a lot more to do with the
         | moral and political failings of our society.
        
         | fsloth wrote:
         | Perhaps a depression drug that does not induce a psychedelic
         | experience is psychiatrically safer than one that would?
         | 
         | One would need some background in psychiatry and/or
         | pharmacology to answer this I think. I'm guessing such talent
         | is present on this site :)
        
         | comboy wrote:
         | It may be that somebody depressed does not feeling like
         | exploring unknowns, or brave enough to lose himself and
         | experience something completely different.
         | 
         | Also, I don't think it's necessary wise to suggest somebody
         | depressed go on such trip. It can take you different places.
         | Sure, it may be fine 9 out of 10 times, but if somebody gets
         | stuck in some negative positive feedback loop (heh) he may end
         | up with a trauma.
        
         | bananamerica wrote:
         | I don't do recreational drugs, but don't LSD trips make you
         | pretty useless for a while? If my morning psych medication
         | required me to be non-productive for 4 hours, it would be hard
         | to find a place for it in my daily routine.
        
           | tsukurimashou wrote:
           | LSD isn't for daily routine unless you microdose (and even
           | then you don't take it everyday) a trip is more like 8-12h
        
           | yieldcrv wrote:
           | 4, thats cute
        
         | int_19h wrote:
         | It's not an either-or. You can't be tripping all the time,
         | either.
        
         | yieldcrv wrote:
         | Not everyone has 14 hours of trip time and another half a day
         | of shock
         | 
         | With the risk of lifelong HPPD
        
         | jasonhansel wrote:
         | Not everybody wants to hallucinate.
        
       | mizaru wrote:
       | *in mice
        
         | yellow_lead wrote:
         | Can anyone tell me the standard for determining if a mouse is
         | depressed? Or anxious? Just curious
        
           | Synaesthesia wrote:
           | Or tripping? I think that we can ascertain some things from
           | their physiological responses, eg fear, anxiety and being
           | content. Obviously there's a lot we don't know about their
           | internal state. Psychedelics really need to be tested on
           | humans.
        
             | krispyfi wrote:
             | https://en.m.wikipedia.org/wiki/Head-twitch_response
        
               | YorkshireSeason wrote:
               | What scientifically credible, i.e. at least stably
               | reproducible, connection does the head twitch response in
               | mice have to do with depression in humans?
        
           | YorkshireSeason wrote:
           | There is nothing credible.
           | 
           | This research direction is an example of _" cargo-cult
           | science"_ [1] as Feynman understands the term. (That does not
           | mean that the hypothesis is necessarily wrong.) There is a
           | reason for "in mice" being an internet meme [2].
           | 
           | [1] https://calteches.library.caltech.edu/51/2/CargoCult.htm
           | 
           | [2] https://nitter.eu/justsaysinmice
        
       | knodi wrote:
       | Does this worry anyone that this drug will be abused? Doesn't
       | everyone like to feel good no matter the day. What if your
       | employee gives this to you because you hate your work?
        
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