[HN Gopher] Psilocybin bests SSRI for major depression in first ...
___________________________________________________________________
Psilocybin bests SSRI for major depression in first long-term
comparison
Author : Thomvis
Score : 374 points
Date : 2024-10-12 11:46 UTC (11 hours ago)
(HTM) web link (www.medscape.com)
(TXT) w3m dump (www.medscape.com)
| newsclues wrote:
| Taking LSD every few months was the best antidepressant I've ever
| tried and I've tried a bunch
| drcongo wrote:
| This is surely no surprise to anyone who's ever had a good
| trip. I'd love to do this in a proper, controlled therapy
| setting, I suspect it would do me the world of good.
| abyssin wrote:
| You're right to explicitly mention the part about the good
| trip. As always in this kind of discussions, there has to be
| a reminder that psychedelics should be used cautiously, being
| conscious about the risks associated with a potential bad
| trip.
|
| My only bad trip was in a proper, controlled therapy setting
| -- at least that's how it was presented to me.
| awestroke wrote:
| I wonder how much of an uphill battle it will be to get
| psilocybin approved for therapeutic use compared to synthetic
| psilocybin analogues that are being trialed right now. Psilocybin
| can't be patented and it's already scheduled as a narcotic
| everywhere.
| tootie wrote:
| I'm taking a prescription med that is basically a schedule 1
| drug that's been very slightly modified and declared schedule 3
| and prescribed through a tightly controlled program. I'm even
| taking a generic version.
| mtlmtlmtlmtl wrote:
| Purely out of curiosity, which drug is this, if you don't
| mind me asking?
| pier25 wrote:
| It's already being used in therapy. Oregon is giving licenses.
|
| https://www.oregon.gov/oha/ph/preventionwellness/pages/psilo...
| Der_Einzige wrote:
| In Oregon enforcement of what passes for our drug laws here
| is so lax (cops quiet quit long before covid) that it's de-
| facto legalized.
|
| I've literally walked down Portland and had random homeless
| people unprompted yell out "Want to buy some shrooms?"
|
| There have been unlicensed openly practicing shrooms
| businesses which survived far longer than one would expect
| for such a "regulated" industry.
| Muromec wrote:
| I doubt about everywhere, as shrooms are sold in shop around
| here.
| chiefalchemist wrote:
| Where is here?
| foolfoolz wrote:
| california has mushroom stores
| dymk wrote:
| In the US, those aren't from mushrooms that contain
| psilocybin or related neurotransmitter analogs
| snozolli wrote:
| It definitely happens:
|
| https://www.seattletimes.com/business/oregon-store-
| allegedly...
|
| https://www.sfgate.com/cannabis/article/sf-magic-mushroom-
| ch...
| cpucycling7 wrote:
| Geneva is home to the only Swiss hospital offering psychedelic-
| assisted therapy. [0]
|
| Also, Peter Gasser, a Swiss therapist acquainted with LSD
| during the 1988-1993 window, was granted approval to carry out
| the first controlled study of LSD-assisted psychotherapy in
| more than 40 years. [1]
|
| [0] https://www.swissinfo.ch/eng/science/can-psychedelics-
| therap...
|
| [1] https://theswisstimes.ch/lsd-and-magic-mushrooms-how-
| switzer...
| Jerrrrrrry wrote:
| The 2018 Hemp Farm bill gave the balls back to the citizens
| that the 2013 Analag act neutered.
|
| Seeing mushroom extracts with all the alkaloids included
| besides psilocybin at gas stations may be a temporary point of
| stability until I can go to the "21+" store in 2030 to get my
| preferred arylcyclohexylamine and phenylethylamine variant.
| dymk wrote:
| From what I understand, those "magic mushroom" edibles sold
| in head shops and gas stations are amanita muscaria derived,
| which is a completely different psychoactive substance with
| different alkaloids. Toxic to the liver too, in ways that a
| cubensis is not.
| tastyfreeze wrote:
| Northern shamans drank reindeer urine after the animals had
| eaten amanita muscaria. Passing through the animals reduced
| the toxic component but left enough alkaloid to trip balls.
| Maybe the gas station edibles have removed the toxin.
| roywiggins wrote:
| signs point to no:
|
| https://www.cbsnews.com/news/magic-mushrooms-found-in-
| recall...
| Jerrrrrrry wrote:
| I was aware but I should know to put disclaimers in drug
| posts on HN at this point, as others may not be; thank you.
|
| That being said, it did have an uncomfortable but brief
| 'burning/cleansing' feeling reminiscent of Lyseragmides
| that that most tryptamines / 4-aco-DMT / penis envy /
| cubensis / 5-MEO-[xxx] did not, and more visual distortions
| with notably less headfuckery / low body load.
|
| I recommend a single try; the tolerance seemed to eliminate
| effects nearly immediately.
| ValentinA23 wrote:
| https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_i...
|
| >Post-SSRI sexual dysfunction (PSSD)[62][63] refers to a set of
| symptoms reported by some people who have taken SSRIs or other
| serotonin reuptake-inhibiting (SRI) drugs, in which sexual
| dysfunction symptoms persist for at least three
| months[64][65][66] after ceasing to take the drug. The status of
| PSSD as a legitimate and distinct pathology is contentious;
| several researchers have proposed that it should be recognized as
| a separate phenomenon from more common SSRI side effects.[67]
|
| >The reported symptoms of PSSD include reduced sexual desire or
| arousal, erectile dysfunction in males or loss of vaginal
| lubrication in females, difficulty having an orgasm or loss of
| pleasurable sensation associated with orgasm, and a reduction or
| loss of sensitivity in the genitals or other erogenous zones.
| Additional non-sexual symptoms are also commonly described,
| including emotional numbing, anhedonia, depersonalization or
| derealization, and cognitive impairment.[64][68] The duration of
| PSSD symptoms appears to vary among patients, with some cases
| resolving in months and others in years or decades;
|
| https://www.pssdnetwork.org/
|
| At least, the mushroom didn't steal my mojo
| bitcurious wrote:
| Can psilocybin restore the mojo, or are you just commenting on
| the downside of SSRIs?
| erie wrote:
| One dude recounted how psilocybin helped him have the best
| experience with the happy ending , as being out of this
| world, but the timing was perfect, not sure if it was 'How to
| Change Your Mind | | Netflix, or another one there.
| hackernewds wrote:
| happy ending?
| 1986 wrote:
| the little death.
| ValentinA23 wrote:
| Not a cure but a treatment (sample size: 1)
|
| https://www.reddit.com/r/pssdhealing/comments/10tjyen/a_trea.
| ..
| johnnybzane wrote:
| Within a few hours of taking zoloft I lost all sensation in my
| genitals and it's stayed that way for years
|
| I've since gotten all my hormones tested (normal), and doctors
| are suggesting I cycle between TRT HCG & Clomid + Dopamine
| Agonists
|
| I don't have ED. My symptoms are purely genital
| numbness/anorgasmia/failure to finish.
|
| I submitted a complaint to the FDA last year. I understand
| they're currently being sued over this.
|
| I don't understand how SSRIs aren't classified as reproductive
| toxins.
| cpucycling7 wrote:
| This has been common knowledge among mushroom friends for a long
| time now. But it's always nice when the mainstream population
| gets "something official" that helps them open up to knowledge
| that is otherwise being censored quite everywhere.
|
| Also, SSRI can definitely kill your sex life - and by extension
| your relationship(s) as well. And not just short-term
| (physiological changes have been observed). SSRIs have never been
| the best option (except for pharmaceutical companies).
| Mistletoe wrote:
| It's a neat study. I don't know how you account for the intense
| placebo effect of a psychedelic experience for six hours though.
| We know that traditional antidepressants may work through this
| method already where you feel "different" and fix yourself.
| Trials with an active placebo often have results very similar to
| antidepressants.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/
|
| I guess maybe it doesn't even matter in the end as long as people
| feel better.
| delichon wrote:
| > I don't know how you account for the intense placebo effect
| of a psychedelic experience for six hours though.
|
| If what they discovered is a particularly powerful way of
| applying a placebo effect, that could be just as clinically
| useful. Maybe more so since it could apply to more conditions.
| strken wrote:
| For obvious reasons you probably can't put a patient under
| general anaesthetic before giving them either the placebo or
| the drug, but I wonder what would happen if you did. Does a
| patient have to be awake to see the antidepressant effect? How
| do sedation and sleep differ?
| ajb wrote:
| There has been a study of that on ketamine, where they used
| patients who needed to be put under anaesthetic for other
| reasons. I'll try and find it in a bit...
|
| Edit: found it https://www.astralcodexten.com/p/does-
| anaesthesia-prove-keta...
| BugsJustFindMe wrote:
| > _I don't know how you account for the intense placebo effect
| of a psychedelic experience for six hours though._
|
| You don't need to. It doesn't really matter whether it's the
| trip itself that works, the belief that a trip will work, or
| some other aspect of the molecule. The drug category it's being
| compared to also has its own placebo effects. It is entirely
| reasonable to compare the complete holistic experience of
| taking each.
| ulrikrasmussen wrote:
| This might not be ethical, but given a psychedelic naive
| population, I wonder if the control could be given a non-
| serotonergic psychedelic such as salvinorin A. There would
| definitely be a noticeable effect, but for someone who hasn't
| studied the effects of psilocybin, they may not realize it. The
| downside is that in order to keep the duration similar, you'd
| probably have to administer the salvinorin using an IV drip,
| and a six hour salvia trip could quite possibly be too
| traumatic.
| parpfish wrote:
| It might be nice to also have a non-psychedelic non-sari as
| well. Right now a patient could use whether they tripped or
| not to determine exactly which treatment they received. But
| if you had the full 2x2 design of {drug has trip, drug has no
| trip} x {drug is supposedly therapeutic, drug is non
| therapeutic} the existence of a trip wouldn't reveal their
| exact treatment
| chiefalchemist wrote:
| This is true of most if not all drugs / studies. That is, the
| drug gets "credit" for the placebo effect. Sure they took the
| meds, but that's correlation in at least some. That is, in some
| the drug did not actuay work but they still get to benefit from
| the placebo effect.
|
| I rarely see this discussed. I'm not sure why (short of actual
| cellular test showing it was the drug that did triggered the
| success some of the success even in the group taking the real
| meds is still the placebo effect).
| dillydogg wrote:
| I think a major criticism of how this study is designed is that
| it is not truly "blinded". I doubt many of the participants were
| unsure if they received psilocybin vs escitalopram.
|
| That being said, there are a number of studies that suggest this
| is an effective treatment, so I hope this can become more
| available to those who need it. However, for treatment resistant
| depression (especially with a catatonia component), intranasal
| ketamine is very hard to beat. Only topped by ECT in my
| experience.
| RobotToaster wrote:
| How would you effectively blind a study on a drug with such
| obvious "side effects"?
|
| I can see such unreasonable objections being used to prevent
| it's approval though.
| keepamovin wrote:
| That was the "reason" the FDA nuked the MDMA approval.
| "Unblinded because people could tell if they were on placebo
| or active therefore how do we know it wasn't just placebo
| effect based on belief"
|
| Seems spurious as:
|
| - 1) how do you reliably measure "people could tell"?;
|
| - 2) if people sensed it, likely they can sense when they are
| on active in a whole range of effective medicines, so seems a
| biased / moved-goalpost application of the "rules";
|
| - 3) what does it matter if the strength of the drug effect
| is greater than the strength of the placebo? Ie, surely they
| can model and subtract and control, so what does it matter if
| the actual effect is more than placebo?
|
| Ugh...
| Jerrrrrrry wrote:
| Having tried all the drugs, Ketamine and its cousins are very
| "preppy" - the idealization and ruminating seem to be more
| side-steppable; as if they were intrusive thoughts that were a
| minor annoyance.
|
| With the after-glow lasting weeks however, it seems to
| facilitate/allow a period of self-reflection (using whatever
| else possibly as an aide) that is notably absent of self-pity.
| fullspectrumdev wrote:
| The doses of psilocybin being used were so low as to be barely
| perceptible.
| jdietrich wrote:
| The participants received a 25mg dose; I can assure you that
| such a dose is _very much_ perceptible.
|
| https://www.thelancet.com/journals/eclinm/article/PIIS2589-5.
| ..
| fullspectrumdev wrote:
| Ah, I made a calculation error by an entire order of
| magnitude while converting that to "grams of dried
| mushroom".
|
| Yeah that dose you would notice a fair bit - it's
| equivalent to about 2.5g dried cubes.
| kjkjadksj wrote:
| Being blinded isn't some gold standard. For example we know
| exercise leads to good health outcomes from unblinded studies.
| Every study on fitness ever done is unblinded and we consider
| these results to be a ground truth.
| hx8 wrote:
| The randomized controlled double-blind study is a gold
| standard. It solves for so many different biases. Without it
| the burden of proof is higher. Luckily, the evidence that
| exercise is healthy is so overwhelming that we have a
| scientific conciseness.
| dredmorbius wrote:
| "Parachute use to prevent death and major trauma when jumping
| from aircraft: randomized controlled trial" (2018)
|
| <https://www.bmj.com/content/363/bmj.k5094>
| NickM wrote:
| _I think a major criticism of how this study is designed is
| that it is not truly "blinded". I doubt many of the
| participants were unsure if they received psilocybin vs
| escitalopram._
|
| This is already a problem for most psychiatric drug trials;
| studies have found that most people can tell if they're on an
| SSRI or in a control group, since the side effects are pretty
| noticeable.
|
| There is evidence that this skews study results, to the point
| that some scientists believe that SSRIs may only be "effective"
| because the obvious side effects make them a good active
| placebo.
| jdietrich wrote:
| Obligatory notes of caution:
|
| The primary outcome of depression symptoms (QIDS-SR-16) was not
| significantly different between the groups. The sample size is
| small and unrepresentative of the real-world population of
| depression patients - the trial participants are very
| disproportionately male and university-educated. There are
| obvious and much-discussed issues with blinding in psychedelic
| trials.
|
| These results point to a treatment that may be superior to
| treatment-as-usual for a minority of patients, but the results
| certainly aren't revolutionary. There is still the potential for
| significant risk in wider clinical populations who may have
| psychiatric comorbidities that would exclude them from trials
| like this, and in delivering psychedelic treatments in more
| normal clinical settings that are likely to be far less carefully
| controlled than a clinical trial.
| neom wrote:
| Psilocybin saved my life. I'm no longer suicidal, I'm no longer a
| practicing alcoholic, and outside of a few things here and there,
| I'm generally at peace with my life. I cannot express how
| grateful I am for psilocybin.
| agumonkey wrote:
| Is it something that you still take here and there or was it a
| time limited therapy ?
|
| Congrats on finding a cure for your ailments
| infamouscow wrote:
| Psilocybin tolerance starts building immediately. Even if you
| microdose (100 mg), it will stop being effective after 3-4
| days.
| vlabakje90 wrote:
| 100mg psilocybin is several times a heroic dose, but 100ug
| is far below a microdose. Do you mean 100mg of dried
| mushrooms?
| dymk wrote:
| I think he means 100mg of mushroom body, which might be
| 1-2mg of psilocybin.
| dymk wrote:
| Tolerance also wanes quickly. In 3 days of abstaining,
| you're nearly entirely back to baseline tolerance. In 2
| weeks you're entirely back to baseline.
| hilux wrote:
| Is there evidence of this?
| neom wrote:
| I did 3 sessions of 8 grams in silent darkness for 3 weekends
| in a row and that basically "beat the devil out of me" as
| they say - it was very very difficult, and a lot of work, but
| well worth it.I've only felt the "brain haze" (I call it)
| once since then, I took a gram and went for a long walk in
| the forest, back to no haze. It's been about 7/8 months and I
| can feel the "haze" building in my mind again, so I plan to
| do another 1g in the forest sometime in the coming weeks.
|
| However, my personal experience has been that Psilocybin !=
| Psilocybin - the mushroom itself is super important to the
| process, much like Indica and Sativa have different ways of
| connecting you to the mind and the aether, Psilocybin (at
| least for me) VERY much is the same thing, and it's much
| starker than cannabis is. Getting into woo-woo land here so
| apologize: I have some concern that just "Psilocybin" isn't a
| good prescription, that the "spirit" that works on you is
| unique to the mushroom family, and that both not knowing the
| mushroom to prescribe and also being clinical about it
| (Psilocybin vs Mushroom) may not be a good direction to go in
| to help people with their issues. I also think that about
| LSD, it might work a bit for a while, but imo it's not the
| best tool.
| samatman wrote:
| Anecdotal case study involving a community of about a
| hundred enthusiasts: many in this community held the
| opinion you do, which is that something about the mushrooms
| themselves is unique to the psilocin experience (psilocybin
| is not always present, and in any case, metabolizes to
| psilocin).
|
| Then 4-actyl DMT, sometimes call psilacetin, became broadly
| available. This is a synthetic pro-drug for psilocin, just
| as psilocybin is a naturally-occurring pro-drug for
| psilocin.
|
| After that, the opinion that the mushroom _per se_ had
| anything to do with the experience became very rare. It
| turns out that psilocin is meaningfully different from, in
| particular, LSD, 2C-B, and MD(M)A.
|
| There's definitely something special about it. But that
| something is also present when it comes in vitro, not just
| in vivo.
| tristanMatthias wrote:
| Totally agree. The variance between species can be
| dramatic! 2.5 grams of Golden teacher was a standard trip,
| vs 0.5 grams of PES Amazonian was enough to send my friend
| into a full blown "awakening" (physical responses and
| everything).
|
| It's fascinating how they can hit different.
|
| Also important to keep in mind the same dose can hit
| someone different each time depending on surrounding life
| conditions. I'm a big believer that the mushrooms "show you
| what you need to see" at any given moment, and that can
| sometimes range considerably.
| andoando wrote:
| It's really hard to say because your mental state of
| being, how tired/hungry/etc you are, and thr environment
| you take it in are huge factors.
|
| Taking it alone vs with friends is going to be a dramatic
| difference on its own, just because of what neural
| pathways are active when you take them.
| namaria wrote:
| I'm of the opinion that psychedelics can fulfill a similar
| role to religious catharsis for the maintenance of mental
| health.
| andoando wrote:
| 8 grams in one sitting? Im not even so worried about the
| psychological response but even a gram can give me extreme
| stomach pain and nausea that ruins the whole thing.
| xkcd-sucks wrote:
| making a tea with slightly acidic not-too-hot water helps
| quite a lot
|
| also chewing fresh ginger or ginger tea
|
| starting on an empty stomach, of course
|
| but surprisingly, sometimes a little bit of miso soup
| midway can help with the "gastroparesis" type nausea that
| can emerge late stage
|
| and also a little bit of diphenhydramine if it's still
| bad (like less than an antihistamine dose)
|
| even if it is all kind of lipstick on a pig :)
| M4v3R wrote:
| Thanks for sharing this, you're not the only one. I have a
| close friend who tried LSD as a last resort to get the best of
| his severe depression and suicidal thoughts (after being on
| SSRIs for his entire life) and just one session completely
| removed his suicidal thoughts for _months_. After this
| experience he repeats this whenever he feels the dark thoughts
| are coming back and it always curbs them down almost
| completely. It's mind-blowing how well it worked for him.
| fsckboy wrote:
| just consider, if it's so powerful in adjusting his brain,
| it's probably equally powerful in adjusting anybody's brain,
| and what if your brain doesn't need adjustment? there's no
| reason to think it's "idempotent" so to speak.
|
| https://en.wikipedia.org/wiki/Idempotence is the property of
| certain operations in mathematics and computer science
| whereby they can be applied multiple times without changing
| the result beyond the initial application
| foobiekr wrote:
| Same. I came to them as an older person (late 40s) who
| basically had only tried pot a few times prior, and nothing at
| all before late thirties. I don't drink.
|
| My few experiences, the first few times, over the course of a
| year, spread apart by 3-4 months, went from extremely dark to
| .. just positive, except the last one, where I had no visuals,
| no bliss at all, and just came to terms with something else in
| our lives that was going wrong.
|
| The dark ones were rage and anger, and now it seems just gone,
| like there's nothing there. Like a weight lifted, and seemingly
| long term.
| ghnws wrote:
| SSRIs did the same for me.
| whalesalad wrote:
| Same. Grew them myself. Microdose regularly. Take big trips
| once in a while. It completely changed my life.
| hilux wrote:
| That is so wonderful to hear!
| andoando wrote:
| Can you share some info on how much you took, and in what
| setting you took them, what you did on the trip, etc? I have a
| bunch of shrooms sitting in my cabinet but I havent had got any
| life altering effect out of them.
| 8b16380d wrote:
| Funny, psilocybin has been largely detrimental to the mental
| health of everyone I know.
| api wrote:
| In what way were they using it? In what dosages? Was it
| pharmaceutically pure or bought from some dude?
|
| Overdosing on SSRIs or using them haphazardly could be pretty
| detrimental too.
| mouse_ wrote:
| my experience has been very different for everyone I know
| joemazerino wrote:
| Agreed with a caveat: SSRIs and other antidepressants are far
| worse.
| giantg2 wrote:
| "Funny, psilocybin has been largely detrimental to the mental
| health of everyone I know."
|
| This statemwnt is true for the people I know who have used it
| in a recreational manner. This statement is also false for the
| people I who who have self-treated with it in a controlled
| setting.
| standardUser wrote:
| I've have done a _lot_ of drugs and know a lot of people who
| have done a lot of drugs, and psilocybin is far and away the
| substance that is most loved and gets the best reviews. It 's
| not even close.
| Der_Einzige wrote:
| Thoughts on Mescaline/Peyote?
| standardUser wrote:
| I've known far fewer people who have taken it. Unlike
| mushrooms, I have heard stories of prolonged and difficult
| trips that sound much more challenging and arguably
| dangerous than a average-dose mushroom trip.
| foobiekr wrote:
| Mescaline is like the angry lover version of mushrooms. I
| did it once, two years ago to understand why it has been
| used, traditionally, as the baseline for comparison for
| psychedelic substances, and it was enlightening; it is
| certainly a tasting menu of the classical psychedelics,
| having at different points in the experience the flavor of
| stimulants, LSD, mushrooms and finally something all its
| own, but it is also much grittier and less loving than
| mushrooms.
|
| Mescaline is _rough_. And honestly the "you are done with
| it before it is done with you" thing is 100% true, it is
| also very long lasting.
| romseb wrote:
| What are the more preferred plants/substances for personal
| growth and mental health?
| state_less wrote:
| > "Psychiatrists really focus on negative symptoms of depression.
| So, if you are not sad anymore, if your sleep or appetite is not
| impaired, they think you're better. But if you look at what
| patients define as important, they say it's the degree in which
| their life is meaningful, in which they can connect with people
| around them, in which they can function in everyday life," Barba
| said.
|
| A more wholistic approach to health care would be beneficial. For
| folks looking for more depth or purpose, Psilocybin seems to help
| reconnect people with a part of themselves they only dimly
| remember.
|
| I often hear people talk about the risks of psychedelics, which
| are to be considered, but what's the risk of doing nothing or
| withholding the best treatment?
| phoronixrly wrote:
| > I often hear people talk about the risks of psychedelics,
| which are to be considered, but what's the risk of doing
| nothing or withholding the best treatment?
|
| The risk is to make things worse.
|
| And I know that I am preaching to people that are of the
| opinion that they know better than the FDA, scientists and
| doctors and are all for self-medicating based off of the echo
| chamber here and a few cherry-picked, limited and flawed by
| default (like in the case of this one) studies on the first
| page of Google.
| HKH2 wrote:
| I don't want people self-medicating with psilocybin, just
| like I don't want people self-medicating with SSRIs.
|
| Which is more dangerous?
| phoronixrly wrote:
| The best thing to do is to consult with a physician on
| matters related to your health.
| maeil wrote:
| That's not clear cut. There clearly exist plenty of
| combinations of "situation + physician" where this is
| _not_ the best thing to do. To claim otherwise may as
| well be religious dogma.
| phoronixrly wrote:
| I'm sorry, but how is trusting a person who dedicated 10+
| years of their life studying/practicing this, and relying
| on rigorous safety and effectiveness research of drugs
| religious dogma? Are you sure you know what religion is?
| Are you sure you know what science is? Are you just
| trolling?
| beagle3 wrote:
| If you actually read the effectiveness and safety
| research with a critical eye, you would realize
| "rigorous" is often the wrong adjective, whereas "cherry
| picked" to the point of "fraudulent" is often more in
| line with reality.
|
| Case in point: 50,000 people died, with about 5 times as
| many suffering life-changing serious adverse events, from
| "rigorous research" on the safety of Vioxx. Yes, it has
| since been pulled from the market, which FDA apologists
| often construe as "system working as designed". No, it
| isn't, even in the least, when you go into the details.
|
| Also: Purdue and OxyContin.
|
| Regulatory capture of the FDA is decades old at this
| point. Ignoring that is not a rational or healthy
| position.
| farts_mckensy wrote:
| I don't know, why don't we ask my colon? Oh, wait, we
| can't. I was prescribed accutane, subsequently got
| ulcerative colitis so bad that they had to remove the
| organ entirely. The surgeon said my colon was literally
| falling apart in his hands as he took it out. Blind
| deference to authority of doctors lead to this situation.
| They do not always make great decisions, especially if
| there is a financial incentive for them to do otherwise.
| bobthepanda wrote:
| At the very least, consulting with one or more physicians
| gives more data points than you would otherwise have. If
| your goal is to know more, having other opinions is
| pretty fundamental.
| dingnuts wrote:
| that's easy to say when you forget about the state of
| healthcare.. everywhere, actually. I was going to say the
| US but in other countries it's not like you can just pop
| in for a chat about taking shroomies, either.
|
| I'm not sure having a ten minute meeting with a stranger
| who has a PhD in internal medicine is going to yield
| useful strategies for curing the existential dread
| underpinning your depression whether you're there to
| discuss getting zonked on LSD or something more
| "traditional" like Xanax
| phoronixrly wrote:
| > it's not like you can just pop in for a chat about
| taking shroomies
|
| You sure can just pop in to discuss options for your
| crippling depression though? And sorry, I do indeed live
| in a country with a functioning healthcare system, not
| the US.
| dingnuts wrote:
| In the US normally you talk to a therapist (not a doctor)
| or psychologist (not a medical doctor) about your
| depression at length, and then if you're deemed
| sufficiently depressed you get a short consult with a
| psychiatrist (finally a doctor) to prescribe medication.
| This is when you would theoretically finally be able to
| bring up shrooms, and your psychiatrist will laugh at
| you, write an Rx for an SSRI, and you'll see him next
| year when the Rx expires
|
| I'm not sure how it is in most countries but I'd expect
| the biggest difference is that it will cost you money in
| the US, but I've read many many horror stories about
| people waiting many months to have only a short chat with
| a physician from other countries. The lack of time
| available to spend taking to physicians seems to be a
| problem in other places too
|
| my point is that consulting a doctor with random
| questions isn't a simple, casual thing people can easily
| do in most places. in most places you have to plan ahead
| and either wait a long time for an appointment, and/or
| there is a cost barrier.
|
| if you have examples of countries where people are able
| to get to know their doctors on a personal level and can
| afford in time and money to talk to their physicians for
| more than a few minutes per year, please link them below
| standardUser wrote:
| The US government severely restricts research on Schedule
| 1 drugs like psilocybin. Physicians don't have the data
| they need to inform patients.
| Der_Einzige wrote:
| The idea that doctors aren't constantly "off base" and
| must be deferred to uncritically is pretty terrible.
|
| For example, it took literally two decades after it
| became well known that peptic ulcers were mostly caused
| by bacteria for the medical community to embrace giving
| anti-biotics for GI pain. To this day, there are still
| many American doctors who don't actually know about the
| Nobel Prize given in 2000 for this discovery, and claim
| it's "stress" and tell you to go home. Some claim they
| "know" but than try to "change your gut PH" and still
| refuse to give antibiotics due to "superbug" risk.
|
| This is a "small" thing (GI pain is not small to those
| who have it) - but if the doctors are screwing up such a
| small thing institutionally, what else do they mess up
| on?
|
| One is travelers sickness. Doctors in the USA do not want
| to perscribe front line antibiotics for it because of
| fear of superbugs - but they'll uncritically go eat their
| lunch at a McDonalds that same day, where they consume
| meat bathed in antibiotic slop which is more likely to
| contribute to superbugs then the amoxicillin that they
| didn't give you would have.
|
| Or what about right now, when it's become clear that
| Ozempic is literally a super-drug. Every doctor on earth
| should be trying to give that stuff to literally anyone.
|
| I can go to "third world countries" with deregulated
| health systems and get infinitely better care that I have
| real control over for on the orders of 1 USD (that's how
| much it cost for me in Thailand to get front line
| antibiotics for travelers sickness INCLUDING THE DOCTORS
| VISIT!)
|
| Why do we still sell Neosporin despite doctors wanting it
| off the market (also for risk of superbugs)? Why do few
| people in America use Providone-iodine for wound
| treatment despite it being by far the best solution
| scientifically for it (and it stains yellow)? Maybe it's
| because we're stupid. There really aren't better
| explanations.
|
| What about Circumcision? I'd straight up put doctors who
| do it in jail and many European nations would do the
| same. American doctors think circumcision is just fine,
| and long, deeply bitter swaths of medical ethics journals
| are dedicated to fighting over this again and again.
|
| Or what about the widespread disagreement over even basic
| stuff like digital rectal exams? There's no agreement on
| if they are worth it because often sticking one's hand up
| the butt of an old man does more damage to them than
| finding out that they (like everyone else at old age)
| have benign prostate cancer?
|
| Doctors in America have not earned their position of
| deference. The scientifically minded on HN who do their
| own research can and often do know how to treat certain
| conditions better than white-coats.
| m_fayer wrote:
| I really wish we would retire this chestnut already. As
| if there's a reasonable grownup option here and
| everything else is playing with matches.
|
| No it's not the best thing to do to brave huge waiting
| lists, call a hundred providers none of whom are taking
| new patients, pay a fortune out of pocket, and/or be
| faced with a distracted impatient person stuck to their
| screen who has 10 minutes for you.
|
| And I live in Germany, not the US.
| striking wrote:
| Psylocybin? Easily?
|
| You have to put effort into making an experience with
| psylocybin meaningful and helpful. It could go wrong very
| easily, especially for those who are in a difficult
| situation or headspace. (Speaking from experience.)
|
| As for SSRIs? Safe, effective, with a handful of annoying
| side effects. Straightforward to use, low potential for
| misuse, requires sustained use for any intended effects. A
| doctor who already has familiarity with a patient's mild or
| moderate symptoms of anxiety or depression may very well
| just prescribe one if asked and if not contraindicated. Not
| that you should randomly start popping Prozac, but it's
| unlikely to hurt you if you did.
|
| Ask your doctor, try the things that doctors currently
| believe are most likely to work first. If for whatever
| reason you choose to go beyond the current medical
| consensus, please stay safe and keep your doctor up to
| date.
| HKH2 wrote:
| So are you okay with people choosing their own dose of
| SSRIs?
| standardUser wrote:
| A prescribing doctor will not magically know the precise
| amount of an SSRI a patient should be taking, or which
| one to take. For most patients, finding the right drug
| and dosage is a process. And just like with psilocybin,
| no one would want to take a _random_ amount. Like with
| any drug, a person would want to be informed and have
| proper guidelines about dosage from the start.
| jorvi wrote:
| > Psylocybin? Easily?
|
| Err.. no?
|
| This is from the Dutch National Institute for Public
| Health and the Environment:
| https://www.rivm.nl/bibliotheek/rapporten/340001001.pdf
|
| Page 19 onward has the charts. What do do we find at the
| very low end in terms of chronic and acute toxicity?
| Shrooms ("paddos") and LSD.
|
| It always blows my mind how anti-drug people will do a
| handwavey gesture to the authority of institutes like the
| FDA, but never actually check up on what actual research
| says.
|
| > As for SSRIs? Safe, effective, with a handful of
| annoying side effects.
|
| Except the multitude of ways you can put yourself into a
| serotonin coma.
|
| I agree with your assessment that (first) use of
| psychedelics should be under proper guidance. But what
| you refer to, "going bad", can sometimes be a traumatic
| past experience that people have stuffed away and by
| surfacing and processing it they can move past it. It's
| not always meant to be kumbaya and flowers.
|
| Educate yourself, then talk.
| striking wrote:
| I'm not saying psylocybin can't be used safely, nor have
| I made any claims about its relative toxicity or harm
| relative to other scheduled drugs. If you're arguing
| anything else, I don't think that report says what you
| think it says. As for my position, I live in SF, it's
| decriminalized here, I support that. So there's no need
| for your rude presumption that I find it generally
| unsafe.
|
| I'm also unfamiliar with the dose of SSRIs that would
| send you into a coma, but I'm fairly certain it's
| shockingly large. Happy to be informed otherwise.
|
| edit to reflect parent edit: yes, I'm aware that
| breakthrough experiences can be helpful. I'm also saying
| they should not be your first resort.
| wizzwizz4 wrote:
| > > You have to put effort into making an experience with
| psylocybin meaningful and helpful. It could go wrong very
| easily, especially for those who are in a difficult
| situation or headspace. (Speaking from experience.)
|
| > _What do do we find at the very low end in terms of
| chronic and acute toxicity? Shrooms ("paddos") and LSD._
|
| Breaking your mind doesn't count as toxicity. You're not
| responding to the point you tried to refute.
| worik wrote:
| > Breaking your mind doesn't count.....
|
| Hyperbole
| hackernewds wrote:
| toxicity is the least of _psychoactive_ drugs problems
| farts_mckensy wrote:
| Impotence and weight gain are not just "annoying" side
| effects. They seriously impact your life. Just putting
| that out there.
| striking wrote:
| I'm not claiming they don't. Everyone experiences SSRIs
| differently and it's common to shop around until you find
| one whose side effects impact your life in a more
| tolerable way.
|
| That's in contrast to psylocybin, which has substantially
| more serious potential acute side effects, ones that are
| more difficult to understand and treat should they occur.
|
| I'm not saying psylocybin is unsafe or that SSRIs are
| always preferable. But if I'm asked to compare their
| safety? The choice is obvious, weight gain
| notwithstanding.
| NickM wrote:
| _I 'm not claiming they don't._
|
| You were clearly implying they don't when you downplayed
| all SSRI downsides as "a handful of annoying side
| effects".
|
| Weight gain kills. Suicidal ideation also kills many
| people when they start SSRIs. People have killed
| themselves because of permanent sexual dysfunction caused
| by SSRIs that never went away after stopping the drugs
| (and yes, this is a known possible adverse effect listed
| in the official prescribing information).
|
| I don't think the choice is as "obvious" as you're making
| it out to be.
| striking wrote:
| I wasn't aware of PSSD (I don't seem to be alone on that
| front).
|
| Leaving this link for others to pick up for more
| information: https://annals-general-
| psychiatry.biomedcentral.com/articles...
| LocalH wrote:
| I guarantee you the number of people who have died from
| SSRI misuse is higher than the number of people who have
| died from psilocybin misuse. I'm not referring to things
| a person may do in a given state, I'm talking about
| effects from the drugs themselves. I'm not aware of a
| single recorded person who has taken _any_ dose of
| psilocybin, and died from "psilocybin overdose". While
| it may be uncommon, it is possible to overdose on SSRIs.
| striking wrote:
| Sure, psylocybin won't kill you, but the threat of
| inescapable psychological distress is real. Maybe it's
| less likely if you aren't predisposed to psychosis, but
| you can't easily know for sure that you're not.
|
| And yes, it's possible to misuse SSRIs, but taking an
| obviously oversize dose is still often a treatable
| situation. Combining them with depressants I think is a
| degree of misuse that is incomparable.
| worik wrote:
| > but the threat of inescapable psychological distress is
| real.
|
| Really?
|
| That is true of any meaningful experience
|
| The danger with psychedelic drugs is very low
|
| They wear off
| dustyventure wrote:
| While fishing for that right dosage of SSRIs you have a
| person with new boughts of mania and suicidal tendencies
| where there's no clarity on how to stop the experiment
| due to the complexity of blood level accumulation.
|
| If SSRIs started as illegal drugs, with i.e. people
| starting them dodging medical supervision, I think the
| system would be telling us they are insanely risky and
| well beyond many scheduled drugs.
| dyauspitr wrote:
| Definitely psilocybin. For instance, if you take psilocybin
| and then spend some time in a cow slaughterhouse house, you
| might go crazy. The same wouldn't be true of SSRIs.
| tastyfreeze wrote:
| Many people here are speaking from experience. I trust my own
| judgment over some knob in the FDA that is steeped in a
| culture of drug control.
| phoronixrly wrote:
| > Many people here are speaking from experience. I trust my
| own judgment over some knob in the FDA that is steeped in a
| culture of drug control.
|
| Let me paraphrase this:
|
| Many people here are parroting stuff based on a sample size
| of 1, who lived to tell the tale. You trust your own
| judgement based on those people before the rigorous safety
| and effectiveness studies for the FDA, on a whim that the
| FDA approves or rejects drugs based on their... ? Culture
| of hating recreational drugs?
| tastyfreeze wrote:
| The FDA exists to tell you, a free individual, what you
| are allowed to put in your body. It has been a very long
| time since the FDA has been about safety only. It is
| wholly captured by business interests in food and drug
| industries. So yes, they, and the government culture as a
| whole, hate recreational drugs that they don't control in
| some way. No shooms for you but drugs that cause suicidal
| ideation are prescribed by the millions.
|
| I am wary of people "looking out for your safety" when
| there is financial incentive to do otherwise.
| tikhonj wrote:
| Schedule I drugs specifically? The regulation around them
| is inescapably rooted in a culture of hating recreational
| drugs.
| farts_mckensy wrote:
| Is there any evidence that psilocybin "makes things worse" or
| are you just concern trolling?
| DiscourseFan wrote:
| Probably not...the question is, does Psilocybin have a
| higher incidence rate of users suffering episodes of severe
| depression or psychosis than, say, SSRIs. Amongst all the
| "spiritual" drugs, even counting THC, Psilocybin is the
| most well tolerated--even so, SSRIs tend to still be very
| safe, even if they are not very effective.
| phoronixrly wrote:
| The best thing to do is to consult with a physician on this
| matter, even if side effects, drug interactions and
| precautions are readily available and cardiac arrest and
| death are among them. Idk, is this worse?
| WhitneyLand wrote:
| My suspicion has always been the majority of adverse
| reactions have related to improper dosing.
|
| Anyone can have a horrible response with too high of a dose
| yet with self-medicating theres no sure way to know the
| amount of medicine you've ingested even if weighing.
| phoronixrly wrote:
| Rigorously determining the proper effective and safe dose
| is part of the approval process.
| layer8 wrote:
| > The risk is to make things worse.
|
| That risk exists in many medical interventions. We need to
| quantify that risk and weigh it against the chances of making
| things better.
| wizzwizz4 wrote:
| This is generally what the regulatory system tries to
| accomplish.
| biorach wrote:
| Right. But there was Oxycontin. So it's obviously got its
| flaws.
| dimal wrote:
| And psychiatric drugs don't ever make things worse? As
| someone who was severely injured by FDA approved,
| scientifically validated medications, I'd say some healthy
| distrust of a corporate-captured bureaucracy is warranted.
| Remember, OxyContin was FDA approved. Did the FDA ever launch
| an investigation into how they allowed that disaster to
| happen? No. They didn't so much as say "whoops".
| delusional wrote:
| > A more wholistic approach to health care would be beneficial.
|
| Maybe. My personal experience has been that those "negative
| symptoms" were in fact the entire disorder. I didn't need
| purpose or depth. I needed to not be so sad that I couldn't
| function. I needed to be able to hold a coherent thought for 5
| minutes without getting stuck into a negative spiral of self
| loathing.
|
| I want "purpose" and "connection", but those things are what
| everybody on earth are looking for. The search for those things
| is the _stuff_ that life is made of. I needed help to get back
| to a place where I could pursue those things. Pursuing them is
| my life.
| photochemsyn wrote:
| The article discusses the risks of treatment:
|
| > 'He added a word of caution for therapists that "psilocybin
| requires active confrontation of painful, negative emotions and
| people who take this drug need to be open and prepared for the
| idea that they are going into a state where they may probably
| end up crying and confronting whatever they are maybe running
| away from in their lives. Not everyone may want to do this."
|
| The long-term consequences of trying to avoid such issues seem
| considerable, e.g. it might lead to schizophrenia if people try
| to wall off parts of their memories they find intolerable,
| though that's just speculation at this point.
| JumpCrisscross wrote:
| > _Psilocybin seems to help reconnect people with a part of
| themselves they only dimly remember_
|
| Is there science behind this statement?
|
| From what I know, we understanding psychedelics work. We don't
| know precisely how.
| roughly wrote:
| > A more holistic approach to health care would be beneficial.
|
| I've commented on this elsewhere, but with psychedelics in
| particular we wind up in a weird space around our normal
| approaches to health - for instance, there's a lot of effort
| right now on finding the chemical mechanisms by which
| psychedelics affect mood, with the goal of creating substances
| which have the same impact on depression without the
| phenomenology of the trip. My suspicion is the trip is the
| treatment, or at least part of it - that the experience of
| being in an entirely different mindstate, of reacting to the
| world in a fundamentally different way using different mental
| pathways for several hours - is a core part of the treatment.
| Medicine has a bad habit of ignoring the patient's lived
| experience - to look at the patient broadly as a mechanism, and
| particularly as a collection of mechanisms, and to see things
| like hypertension* as something to be treated with a chemical
| offset and not a reflection of the full factors of a person's
| life. My hope is that the psychedelics will help us recognize a
| paradigm shift here (like, in data leading to changes in
| practice, not just in their normal way), but I think they've
| still got too much of the taint of the hippie on them to really
| be taken seriously.
|
| * I'm using hypertension as just an example of a particular
| ailment, I'm not making a statement on the treatment
| hypertension in particular.
| keepamovin wrote:
| But no patent, so this is "misinformation" haha
| chiefalchemist wrote:
| When this topic comes up on HN I'm always sure to mention the
| book:
|
| "How to Change Your Mind" by Michael Pollan
|
| There's also a Netflix doc series based on the book.
|
| https://michaelpollan.com/books/how-to-change-your-mind/
| sub7 wrote:
| I do LSD once a year with close friends and a beautiful view and
| it's fantastic at making me appreciate beauty in the world and
| feel like everything is in it's natural place.
|
| Shrooms sadly do not agree with my digestive system.
| cubefox wrote:
| Unfortunately it's hardly possible to do proper case control
| studies with psilocybin, since the psychedelic effects cause
| unblinding. The participants know whether they are in the
| treatment or control group.
|
| > Normally the journey is quite inward, so patients do not
| require active support during the psychedelic experience [around
| 6 hours]. Sometimes they do require some hand-holding, or helping
| them to 'let go', or breathing exercises. The important part is
| the integration work that comes afterwards," Barba added. [...]
|
| > However, [Rucker] noted, it is also possible that the results
| reflect biased reporting between groups. This is more likely here
| because studies involving psilocybin tend to attract those with
| positive preconceptions about psilocybin and negative
| preconceptions about conventional antidepressants
| teaearlgraycold wrote:
| You could compare against other psychedelics. I'd be interested
| in that.
| zozbot234 wrote:
| You could also test it on severely sleep-deprived
| experimenters undergoing sensory isolation, but that would
| never get IRB approval.
| roywiggins wrote:
| Sleep deprivation is thought to temporarily relieve
| depression in a lot of people, so it wouldn't really be a
| placebo anyway.
|
| https://www.pennmedicine.org/news/news-
| releases/2017/septemb...
| cubefox wrote:
| Yeah. Especially a comparison with LSD seems interesting.
| However, if both perform similarly, this could either mean
| they both work or they both don't work.
| kjkjadksj wrote:
| Hardly an issue. When people do similar studies measuring say
| the effects of prescribed exercise vs not they are also
| unblinded but we still get good data.
| hx8 wrote:
| If there is a medical question that double-blind studies cannot
| answer, that doesn't mean the question is unanswerable. It
| means we should be more skeptical of non-blinded studies (or
| worse studies that pretend to be blind), and we should look for
| alternative ways to address biases.
| dontwearitout wrote:
| I've never found it compelling that blinding isn't possible for
| drug-naive patients. There are other drugs that could induce a
| "trip" and an unfamiliar individual could mistake for a minor
| psychedelic experience.
| NickM wrote:
| _Unfortunately it 's hardly possible to do proper case control
| studies with psilocybin, since the psychedelic effects cause
| unblinding._
|
| This is a problem with SSRIs as well; studies have found most
| people can correctly guess if they're in the study group or
| control group.
|
| A true double blind study would require a drug that has similar
| side effects via an unrelated mechanism, but nobody has
| attempted that as far as I'm aware.
|
| There was this interesting one though where they deceived
| patients into believing they were taking an "active placebo"
| instead of an SSRI, and found that the benefits went away,
| which is very interesting and raises a lot of questions about
| the true efficacy of these medications:
| https://www.nature.com/articles/s41398-021-01682-3.pdf
| iluvcommunism wrote:
| It'll be good to find positive effects in natural remedies like
| this. It is ironic we try to keep people safe from themselves but
| end up dolling out ineffective or destructive drugs instead. A
| case in point, opium being illegal, but a lab derivative 1k
| stronger fentanyl, legal and 300k killed globally over the last
| 10 years.
| bobthepanda wrote:
| Where are you that fentanyl is legal in a way opium is not? In
| the US both are schedule II and approved for medicinal use.
| thfuran wrote:
| And it's mostly not legally acquired fentanyl that's killing
| people.
| lumb63 wrote:
| Exercise also bests SSRIs. Having had multiple close family
| members and friends try various cocktails of SSRIs and other
| drugs for depression, bipolar disorder, and borderline
| personality disorder, and having to see the side effects they
| experience, and how many different dosings and combinations need
| to be tried before they find something that doesn't _make them
| worse_ , I would not recommend such medication to anyone with
| similar issues without trying other more conservative approaches
| first.
| DiscourseFan wrote:
| Ok like most of you I've taken psychedelic drugs. I've had bad
| experiences sure, but I'm fine now.
|
| The issue is that what people generally say, like, "oh sometimes
| you need to encounter your demons," maybe that will be
| temporarily traumatizing--in general people recover from that.
| The real issues are...more complex. More complex than any
| diagnoses in the DSM can cover. The brain is very complicated,
| and everyone's brain is a bit different, and we do not know,
| really, what goes on in there when you take a drug like
| Psilocybin. Sometimes something gets a little knocked out of
| place, and the system doesn't fully recover.
|
| The last time I took a very high dose of psychedelics I couldn't
| think straight for a few weeks after. Thoughts came out of
| nowhere, I had no control over them; often the constant,
| unceasing flow of thought was distressing and uncomfortable.
| Thankfully I could still talk to people--talking made me better.
| I got plenty of sleep, cut out all drugs, even caffiene, got
| regular exercise and ate a very healthy diet: about a year and a
| half later I was back to my old habits. But it wasn't an easy
| recovery, and certainly not one any psychiatrist could've treated
| adaquetely. But, now I know to be more careful in the future.
| zozbot234 wrote:
| Taking psychedelics is a bit like trying to fix a Swiss watch
| with a sledgehammer: it might just work, but that's not the way
| to bet. Therapy and well-guided meditative practice can be a
| lot gentler than that.
| bandyaboot wrote:
| This is sort of how the mechanism of psychedelics fixing
| depression comes across to me as well. But, surely there must
| be much more to it, since, as you're of course aware, fixing
| a Swiss watch with a sledgehammer will have a very low
| success rate. The other end of the analogy spectrum could be
| that it's a bit like a chemical catalyst. There's a lot of
| resistance to a reaction happening on its own, but will very
| likely happen if given the proper jolt.
| wizzwizz4 wrote:
| A better analogy might be "fixing a heart attack with your
| fists". It _might_ work, if the problem is fibrillation or
| a blocked artery and if the impact resolves it... or it
| might just cause further injury without resolving anything.
| (Or it might resolve the heart attack, but then cause a
| stroke a few minutes later.)
| earnesti wrote:
| I agree, that taking psychedelics is likely not a good idea.
| But the analogue gives in my opinion totally wrong picture of
| the actual risks. Psychedelics, at least psilocybin, are
| quite harmless compared to almost any other substances. The
| reason for that is that they aren't very habit forming.
|
| Personally I used psilocybin recreationally back in the days.
| Got once bad experience and ended up in a psychosis and to
| hospital. I got better in couple of days and long term
| effects were nonexistent.
|
| Then I have couple of friends whose basic substances are just
| legal alcohol and cigarettes, and boy have they fucked their
| lives with those. It just takes a long time to do it that but
| psilocybin for sure does not lead to that kind of path.
| phoronixrly wrote:
| Thank you for the balanced opinion. It's a rarity here.
| AnthonBerg wrote:
| There is actually a ton of incredibly fascinating knowledge
| about what psychedelics do - neuroimmunobiologically the
| effects are profoundly interesting. It's a surprisingly sharp
| and specific instrument, certainly double-edged though.
|
| https://www.frontiersin.org/journals/immunology/articles/10..
| ..
| namaria wrote:
| This isn't some erowid report. This is actually about studies
| being made by professional researchers who are publishing
| their results.
|
| Evidence based medicine is always better than layman opinions
| like 'psychedelics are a mental sledgehammer'.
| jrflowers wrote:
| Conversely, for some people trying to fix depression with
| therapy and guided meditation can be a bit like trying to fix
| a Swiss watch with therapy and guided meditation. Everybody
| is different!
| iancmceachern wrote:
| Yeah, maybe don't take "very high doses". I've not done that.
| And not had any seriously bad experiences. Maybe like
| everything else is all about moderation?
| DiscourseFan wrote:
| It was 500ug of LSD mixed with probably 6 or 7 drinks of
| alcohol. Suffered serotonin syndrome for a few days
| afterwards.
|
| Regardless I've heard stories of people having severe long
| term psychological issues from even relatively light doses,
| simply because of how their body in particular interacted
| with the drug.
| farts_mckensy wrote:
| It's such a bad idea to combine alcohol with psychedelics.
| You should lead off with exactly what you took so as not to
| mislead others.
| DiscourseFan wrote:
| As I said my experience incurred more risk of severe long
| term side effects, but those are possible in any
| circumstance with any psychedelic with even a single, low
| dose.
| me551ah wrote:
| 500ug of LSD isn't really a standard dose. It's almost
| double your typical dose.
| Galaxeblaffer wrote:
| 250ug of good acid is still a very high dose! 500ug is
| more like triple of a typical sane dose. milage may vary
| i guess but 300ug sent me out of this world
| Nesco wrote:
| I know a guy who took 1000ug. He told me he had side
| effects / visual glitches for about an entire week
| notfed wrote:
| According to Erowid, a "light" dose is 25ug-75ug, a
| "standard" dose is 50ug-150ug, and a "heavy" dose is
| 400ug+.
| fluorinerocket wrote:
| 500ug is nuts
| AnthonBerg wrote:
| Thank you for telling the story.
|
| To me, it's interesting to consider the inflammatory
| aspects - the immunomodulatory effects of LSD and other
| psychedelics on one hand and alcohol on the other.
|
| It's well established but little-known that psychedelics
| have a very significant inflammation-reducing effect which
| includes drastic reduction of neuroinflammation. (I'm
| fairly sure that this is a primary reason why they work for
| depression and anxiety; There's basically always elevated
| inflammatory biomarkers with these disorders. Stress is
| directly causative of neuroimflammation.)
|
| Here's a really solid review paper from 2017 - today a lot
| more knowledge has been accumulated: https://www.frontiersi
| n.org/journals/immunology/articles/10....
|
| Alcohol is known to be pro-inflammatory.
|
| I have a hunch that these two disjoint forces on the same
| physiological systems can have made things worse.
| alemanek wrote:
| That's a massive dose and you mixed it with alcohol. That
| is in no way a responsible way to try out psychedelics. You
| are right that everyone reacts differently which is why you
| don't take a very large dose mixed with other drugs.
|
| Anecdotally, ayuasca quite literally saved my life and
| helped me tremendously when I was spiraling into a deep
| depression. Psychedelics when taken responsibly in a
| controlled environment under supervision can help a lot of
| people.
| AStonesThrow wrote:
| > Suffered serotonin syndrome for a few days afterwards.
|
| What sort of physician diagnosed you with Serotonin
| Syndrome? What symptoms did you describe to them, and what
| criteria/evidence did they use to arrive there? Were they
| able to use differential diagnosis to rule out other
| conditions?
|
| Did you return to the same physician after the symptoms
| ceased?
| hmcq6 wrote:
| You got serotonin syndrome from LSD?
|
| That is incredibly rare, so rare I can't find any other
| documented cases
|
| Edit: did you test it to make sure it was real LSD?
| Klonoar wrote:
| I'm somewhat surprised there's only one comment here
| asking this.
| wnolens wrote:
| Had a very similar experience. Took ~2y to fully go away.
| farts_mckensy wrote:
| I'm a little ambivalent about this response. It sounds like
| you're describing invasive thoughts of some kind, though your
| description is vague. At any rate, despite the perceived
| negative effects, by your own account, it apparently spurred
| you to lead a healthier life; in other contexts, this is
| precisely the thing that is praised when it comes to
| psilocybin.
| DiscourseFan wrote:
| > it apparently spurred you to lead a healthier life
|
| No, I stopped mostly after I'd recovered. And I definitely
| wasn't "healthier" then, just addled.
| hackernewds wrote:
| Did you take it in a controlled environment like the study
| suggests? Every time serious conversation of medical progress
| comes up, it's polluted by naysayers with anecdata about how
| they took it while raving beside a live volcano.
|
| We need to give psychedelics a fair chance, and sure after we
| can discount them. The article suggests at scale there is
| potential
| phoronixrly wrote:
| In my experience (this thread, too), the conversation gets
| polluted by people that swear by their self-medication and
| call more cautious people naysayers.
| feoren wrote:
| How come every time we try to have a conversion, it always
| ends up all "point counterpoint" and "personal experience
| with the topic" and "differing personal experience" and
| "discussion of how those experiences relate to the topic"!?
| EVERY TIME!
| DiscourseFan wrote:
| Its almost as if all experience is subjective...
| phoronixrly wrote:
| The only valuable conversation about such research is an
| objective discussion of the quality of the study at hand.
| worik wrote:
| > The only valuable conversation about such research is
| an objective discussion of the quality of the study at
| hand.
|
| No
|
| People's lived experience is very useful
| ants_everywhere wrote:
| Those are called anecdotes.
|
| Empirically, they're usually not nearly as useful as
| people think. People are on average unreliable observers
| of their own experiences.
|
| Much better than individual anecdotes are collections of
| anecdotes that are searchable and somewhat categorized. A
| lot of old school drug forums provide this.
|
| Much better still is systematically varying data and
| taking statistics to separate signal from noise.
| DiscourseFan wrote:
| In the pre-modern world people had a very different
| relationship to death and there wasn't anything like anxiety
| as its experienced today. Psychedelics are essentially an
| attempt to bring someone back to a more "authentic"
| experience of life before technological controls settled in.
| Perhaps its better to take the chance? I think so, but I want
| others to recognize it as a genuine risk that is truly
| unpredictable and not a personal failing on the part of the
| user.
| griffzhowl wrote:
| I wonder what you mean by saying there wasn't anything like
| anxiety as it's experienced today in the premodern world.
| The term "anxiety" comes from Latin "anxietas", and Old
| English had "angsumnes", both with apparently similar
| meanings, so it seems the idea has been around for a while,
| and most likely because it's a basic human emotional
| condition that could occur in various circumstances
| throughout history and prehistory.
|
| As for a relationship to death, it's difficult to
| generalise over all people throughout history, but for
| example in medieval Europe where you had a seemingly quite
| vivid belief in the possibility of hell after life, that
| could result in some extreme anxiety of the most
| inescapable kind. Maybe that accounts for some of the more
| extreme behaviours of those times, who knows.
| dimal wrote:
| > we do not know, really, what goes on in there when you take a
| drug like Psilocybin
|
| FYI, same goes for SSRIs. The scientific consensus is that the
| serotonin deficiency theory of depression was wrong. When SSRIs
| actually work, we still don't know why.
|
| I've had bad trips, too. Very bad, but I still think that
| psilocybin (in a controlled, supportive setting) is a better
| bet. My bad trips were all due to being in bad settings and
| being completely unprepared for what could go wrong. I was
| young and dumb and just fucking around. But tripping in
| positive supportive settings was incredibly helpful. And if we
| do find a way to do this right, then people don't have to take
| drugs for the rest of their lives. Psychiatric drugs are
| generally lifelong sentences, and negative side effects tend to
| compound over time, which often leads to polypharmacy, and more
| side effects.
| DiscourseFan wrote:
| I agree. But I don't think psychedelics are the end all be
| all, that's all
| Levitating wrote:
| SSRIs barely work. For mild to moderate depression a placebo
| works similarly or better. Only for severe cases of
| depression are SSRIs found to be helpful because they
| surpress all emotion.
| grandpoobah wrote:
| Worked great for me. Placebo might have worked too, but
| doctors don't prescribe those!
| drakonka wrote:
| Maybe the effect is different when prescribed for something
| other than depression, but I did not find my SSRI to
| suppress my emotions. It simply helps me curb rumination
| and negative thought spirals. Helps to feel "lighter" and
| simultaneously more grounded. If anything, that allows me
| to feel _more_ positive emotion rather than suppressing it.
| hn_version_0023 wrote:
| Cool, glad you had a positive experience. My experience
| was the opposite: emotionally numb to the point where
| awfully bad things happened in my presence and I barely
| shrugged.
|
| Being unable to feel joy or pain, being unable to cry
| when a loved on passed on; these were the hallmarks of my
| time on SSRIs. Never again will I subject myself to these
| drugs.
|
| It took me twice as long to get off them as I was on
| them. Two years of prescribed meds, 4 years to get off
| them. Six years of my life spent as a literal zombie
| person.
|
| We don't know why they work or don't. Our experiences are
| just anecdata.
| worik wrote:
| > Our experiences are just anecdata.
|
| Just?
|
| Anecdotes matter
| dymax78 wrote:
| ~50% response rate for people with major depressive
| disorder isn't "barely working" -- for millions of people,
| SSRIs significantly improve their quality of life.
| Unfortunately, there is no "one size fits all" solution and
| often those of us with MDD have to try different
| medications, in conjunction with a (good) therapist before
| we find what works best.
|
| Personally, I've run the gamut on SSRIs and they never
| suppressed all emotion.
| zdragnar wrote:
| This is blatantly false. I've been on a few. Some didn't
| help, some made me worse. The one I'm on now is extremely
| helpful, and saved me.
|
| None of them had any suppressant effects on my emotions at
| all.
| bugbuddy wrote:
| > Ok like most of you I've taken psychedelic drugs.
|
| I would like to see some actual data because my assumption has
| always been that most people have never tried any. I personally
| have not had any. I have always subscribed to the slippery
| slope theory of vice.
| DiscourseFan wrote:
| Most people in this thread who are taking the position I'm
| critiquing, then
| worik wrote:
| > I have always subscribed to the slippery slope theory of
| vice
|
| Me too
|
| Come on over the skiing is great!
| imwillofficial wrote:
| "Like most of you"
|
| "Objection, assuming facts not in evidence"
| peepee1982 wrote:
| Anyone who has ever tried to fine-tune medication for
| psychological issues knows how challenging it can be to get the
| dosages and combinations just right. In my experience, even
| medications within the same class can have different effects on
| different people, especially when combined with drugs from
| other classes.
|
| The interactions between medications, as well as the patient's
| individual response, are hard to predict. These reactions can
| change over time, too, as bodies and brains adapt, and
| lifestyles shift.
|
| Yet, you often hear oversimplified statements like "depression
| means you have too little serotonin," "feeling sluggish means
| you lack noradrenaline," or "difficulty focusing means you have
| too little dopamine." These explanations are so reductive that
| they barely make sense.
|
| The more I read about drug trials, the more I realize how
| little I -- and even many professionals -- truly understand
| about how these medications work and the best way to make
| informed treatment decisions.
| washadjeffmad wrote:
| I had a profoundly difficult trip that affected me deeply. It
| felt eternal, and when I emerged, I could feel it in my head
| like some antimemetic parasite that fed off disgust and terror.
| I can still remember the feeling, twenty years later, if I try,
| so I don't. I had to learn how not to be influenced by it, and
| in doing so, learned about myself. And as I changed, because I
| was aware of what I knew, I knew when I'd changed.
|
| Our selves are not immutable, steady states. Our experiences
| shape us. It's a lesson learned to guard that carefully and
| jealously.
| dingnuts wrote:
| funny, I could have written the same post but about boring
| old general anesthesia given before surgery
| SoftTalker wrote:
| How long ago?
|
| Every general anesthesia I've had was basically "OK you'll
| start to get sleepy now" and then "ok we're finished" and
| zero awareness of any elapsed time.
| johnmaguire wrote:
| The paper here is worth a look:
| https://news.ycombinator.com/item?id=36323275
|
| Also this post has stuck with me through the years:
| https://news.ycombinator.com/item?id=24566568
|
| Be sure to scroll down to the comment thread started by
| myself248.
| brandall10 wrote:
| Why did you take a very high dose?
|
| As someone who was experienced with psilocybin some 20+ years
| ago, I always took fairly consistent doses (roughly 3 grams),
| as I could sense taking much more would be playing with fire.
| This was pretty much a given amongst my circle of a dozen
| friends who experienced these trips with me... hero doses were
| almost never a good or healthy idea. Fun to read about on
| Erowid though, mostly as cautionary tales.
|
| My time with the substance ended after two bad trips (after a
| few dozen great ones over a period of 5 years), but neither
| produced any sort of even minor lasting effect.
| appplication wrote:
| > Why did you take a very high dose?
|
| Hindsight is 20/20 but often it's not clear at the time if
| it's a bad idea or how bad it can be. I think it's not such a
| fair question to someone struggling to find effective
| treatment for mental health issues to make a mistake on
| dosing. Especially given both government and medical field
| have historically not amenable to openly communicating harm
| reduction or safe guidelines for experimentation with this
| particular medicine.
| jrflowers wrote:
| For folks that are interested in anecdotes about psychedelics,
| I recommend reading Erowid expertise vaults as what gets
| volunteered here is very narrow and not representative of the
| population as a whole.
|
| I would know, as _my_ psychedelic mega dose stories are very
| different from this and also completely unique to me.
|
| I've done 500ug of LSD and it was great fun. I scheduled a day
| off to rest ahead of time and was back to normal after that.
|
| 250ug of LSD + 1 full ounce of golden teacher psilocybe
| cubensis and had a somewhat spiritual experience, took a couple
| days before I wanted to resume normal life.
|
| + a dozen or more similar stories
|
| There is a reason why "set and setting" is repeated so heavily
| when instructing people on how to use these substances. Any
| discussion of potential subjective benefits or harms of a
| psychedelic in the context of an experience without specific
| accounting for that is fundamentally incomplete.
|
| That being said, if my experience sounds ridiculous to you,
| that's because it's unique to me, just as others' are unique to
| them. There isn't really much to be gained by talking about
| individual experiences other than it's an entertaining topic of
| discussion. It gets everybody exactly _nowhere_ closer to
| establishing the objective clinical value of these things,
| though.
| sva_ wrote:
| 'great fun' seems like a weird way to describe a 500ug trip.
| Did you have some tolerance before this, and do you have very
| high confidence that the dosage is accurate?
| jrflowers wrote:
| No tolerance, and yes the dosage was accurate.
|
| I picked "great fun" as a description as a shorthand
| because, while I could write more about it, it had little
| to no net positive or negative impacts on my mental health.
| For the purposes of this discussion, "Great fun" is kind of
| meant to communicate that the story is neither a warning or
| a recommendation regarding depression or any other mental
| health condition.
| rjbwork wrote:
| >Thoughts came out of nowhere, I had no control over them;
| often the constant, unceasing flow of thought was distressing
| and uncomfortable.
|
| I want to touch on this. "You" never have any control of your
| thoughts, because "you" isn't really a thing. Psychedelics and
| meditation teach us this if you pay close attention. The
| thoughts arise from nowhere and we - the imagined, but illusory
| - self are mere observers along for the ride that is
| consciousness.
|
| I can imagine that using a substance such a psilocybin could
| cause your thought patterns to have both short and long term
| changes in quality (in terms of substance, not of superior
| gradation), however. It's also possible that your experience
| led to your paying greater attention to the thoughts that did
| arise, and over time the feedback loop of consciousness along
| with taking better care of yourself led to greater moderation
| of their genesis.
| gmoot wrote:
| "You" can learn to steer your mind by choosing which of these
| thoughts to capture and dwell on, by monitoring them.
|
| There is voluminous writing in the area of monastic
| spiritually about this. On the one hand, they affirm that
| these thoughts aren't chosen, using the vocabulary of sinful
| thoughts introduced by demons. But it's also clear that
| change is possible through prayer/meditation (not exactly
| identical to modern ideas about mindfulness).
| rjbwork wrote:
| I tend to agree that change is possible and you can learn
| to steer, but that too is no choice.
| beardedwizard wrote:
| This is a real risk I see overlooked and minimized often.
| People should not assume it can't happen to them.
| baxuz wrote:
| What 2 decades of on & off therapies and meds couldn't fix, a
| single psilocybin trip fixed in 5 hours. That's all the proof I
| need.
|
| Not even getting into the side-effects of SSRIs including PSSD,
| brain zaps, lethargy, and a whole lot more.
|
| I just don't understand people who do this shit recreationally,
| as it was quite possibly the worst experience I had in my life.
| jorgesborges wrote:
| If you don't mind my asking, what about the experience was so
| bad? Did it take time or work to process the experience for it
| to have its beneficial effect?
| baxuz wrote:
| It's fine, I'm ok with sharing, although some of this might
| sound gibberish as it's hard to explain. Note, that I am not
| trying to impart any sort of mystical value to this, or
| trying to be poetic.
|
| It's an incredibly scary experience that makes you feel like
| you're disintegrating in a metaphysical sense. Your mind,
| perception, body. Yourself. Like you're falling apart, being
| disassembled and that you will never be able to get yourself
| together again. You have no agency. And then you are gone. I
| believe this is what they call "ego death".
|
| And then after you're gone, you're left with all these pieces
| of yourself. Including a lot of them that you forgot ever
| existed. Or how they fit together. Or some that you were
| subconsciously aware of but never perceived them. Like
| opening a shelf of Legos from your childhood. It's very
| dream-like.
|
| Then comes the awareness, understanding and grief. I've never
| cried as much in my life, and I'm not a crying person.
|
| Then comes hope.
|
| And you get to assemble yourself back again. Feels like
| something between waking up, coming back to reality and a
| chain-reaction of those "AHA!" moments.
|
| And then you're back, but you're not the same, and you
| understand more about yourself.
|
| While the next few months were some of the best I had in
| decades, I'm extremely averse to repeating this experience,
| as it feels really traumatic.
|
| I was in a controlled, safe, although not a clinical
| environment, and I am terribly aware how much this can fuck
| your brain up in ways I can probably never imagine. We have
| no idea how this machine works and this is basically
| decompiling an incredibly complex binary during execution,
| moving code around, recompiling, and hoping it works.
| jtrn wrote:
| This comment ignores the possible effectiveness of both
| psilocybin and SSRIs and focuses on the usefulness of the
| research itself. I actually believe that both have a role in
| psychiatry, but this study tells me nothing with regards to
| therapy.
|
| Working as a clinical psychologist, who also reads a lot of
| research, this study is just another brick in the wall that I am
| banging my head against when it comes to doing actual evidence-
| based therapy. I actually read the entire paper and the pre-
| registration. The title on Medscape and the article are, to me,
| completely reading the research wrong, and just another example
| of the actual research design and findings living in a different
| universe than the press release and subsequent discussion.
|
| Let me try to communicate why I feel this way by summarizing the
| research in my way, as opposed to the title: "Psilocybin Bests
| SSRI for Major Depression in First Long-Term Comparison."
|
| Hers my take: Research finds no significant difference between
| psilocybin and SSRI in the primary outcome from pre-registration
| (self-reported depression on an emailed form), even when only
| administering SSRI for 6 weeks, where the maximum effect of SSRI
| is expected at 12 weeks. As such, this does not even qualify as
| standard treatment with SSRI. This is after excluding 90% of the
| applicants for the study. The effectiveness is primary supported
| by p-hacking, as seen by reporting additional measures not in the
| registered, where some of them favor psilocybin. And SSRI
| actually scores BETTER in the main outcome.
|
| Now, someone might come along and call me cynical, mistaken, or
| worse. But having been through this with biofeedback,
| metacognitive therapy, light therapy, mindfulness therapy, and
| ketamine treatment already, I can clearly see the same pattern:
| lying by omission, p-hacking, not taking into account the
| "decline effect," borderline acceptable results. It all
| culminates in a big nothingburger, and any progress for my field
| remains stagnant. Based on the quality of this study, I am
| certain that if we just aggressively started treating depression
| with psilocybin, I just know that it wouldn't make much
| difference, because I have been through it before with the exact
| same numbers and effect sizes, just different treatment
| modalities.
|
| Here is the best indication I found for SSRI: Resistant phobic
| anxiety (panic attacks that don't stop even after long exposure),
| and burnout-related depression (person worked normally their
| whole life but is suddenly just empty of energy and does not look
| forward to anything with joy). These are examples that very often
| make a big difference with SSRI, in conjunction with therapy.
|
| Psilocybin seems to work best for existential depression and
| anxiety that is driven by pathological self-focus (not egotism,
| but inability to stop focusing on one's own inner states).
|
| But these personal theories are just that, and the studies that
| keep getting funding are very seldom useful, at least for me, as
| I genuinely am trying my best to help my patients.
| zozbot234 wrote:
| > ... burnout-related depression (person worked normally their
| whole life but is suddenly just empty of energy and does not
| look forward to anything with joy) ... existential depression
| and anxiety that is driven by pathological self-focus (not
| egotism, but inability to stop focusing on one's own inner
| states)
|
| Is there any rigorous operationalization of these concepts,
| that might be explored in further studies? Unless one can be
| found, these fuzzy, heavily qualitative descriptions are
| unlikely to be helpful for future researchers.
| jtrn wrote:
| It's counterintuitive to me that a more specific
| concept/subgroup of a phenomenon would be less useful than a
| larger catch-all category. Is the self-rated questionnaire
| depression scale used in this study a good "rigorously
| operationalized concept"?
|
| We are successfully treating people with this exact kind of
| indication/operationalization with real success already. For
| instance, the indication criteria for ECT basically follow
| the "burnout profile" I described above, with the addition of
| "treatment resistant to therapy and medication," and it has
| shown by far the best effectiveness for that kind of
| depression.
|
| I completely disagree that it's not possible to
| operationalize the concepts above, for instance with standard
| BDI or MADRS, supplemented with a ratio with a cutoff to
| indicate a large fall in everyday functioning. Like an
| extremely large fall in Global Functioning Scale (GAF)
| localized to a distinct and pattern-breaking period in a
| person's life. If you think that these concepts are fuzzy and
| qualitative, I really hope you have even greater criticism
| towards this study, not to speak of concepts like anxiety,
| trauma, and ADHD, which are completely off the rails when it
| comes to diffuseness and subjectivity.
|
| But even if you are right, that burnout-depression and
| existential anxiety are not possible to study because of
| their vagueness, it still would not make this study helpful
| as it's presented. Or am I mistaken? Do you think it's a good
| and helpful study, whose implications I should fight for in
| our clinic? And would I see a marked improvement in our
| patients, compared to SSRIs for the "Depression" group?
|
| I am willing to admit I am wrong. The only goal is to
| actually help people.
| krzat wrote:
| Psychiatry seems to be very symptom based, depression is an
| umbrella term for many completely different problems that show
| as "big sad".
|
| Maybe it would be more productive to base diagnosis on some
| kind of brain imaging.
| modeless wrote:
| Bad headline. Psilocybin was not significantly different for
| depression symptoms. Also there was no control group. Confidence
| intervals were very large. Yet another unconvincing study with
| bad journalism.
| el_nahual wrote:
| Will add a personal anecdote on my mental-health journey and the
| impact psylocibin has had on my life.
|
| Bio:
|
| - Late 30s.
|
| - Long history of depression my entire life. "Melancholic" child.
| Bad drunk teenager. Suicidal in college (failed attempt).
|
| - No drugs except alcohol until I was in my mid 20s.
|
| I've been prone to major bouts of depression my entire life. I
| went to therapy multiple times a week for years and got on SSRI's
| towards the end of university as a response to a failed (but
| serious) suicide attempt.
|
| SSRI's never did anything for me except make me feel like shit
| (and not be able to take one). Eventually I went off them and
| sort of got by, and I managed to stay safe by drinking no
| alcohol. Therapy twice a week was an utter waste of time and
| money.
|
| Then, sort of on a whim, I grew some mushrooms at home with my
| then fiancee and we took them together. I was mid 20s and had no
| prior experience with any drug but alcohol. Not knowing what I
| was doing, we took a BIG dose. I had a trip that was fun at first
| and then became quite unenjoyable.
|
| For the next twelve months I felt like myself again. The change
| was subtle but, over a long term, quite obvious.
|
| After about 18 to 24 months, my depression came back. We took
| mushrooms again and the same thing happened. A year of well being
| in exhcange for 2 fun hours and 6 tough ones.
|
| So about every two years I'll take a big (2-4g dry) dose of
| mushrooms and...it's like magic. I feel like myself again. I'm
| "back." Life is not happy, none of my problems go away, but I
| feel like I'm an agent in my own life as opposed to a spectator.
|
| The well being lasts about a year or 18 months (less if I've been
| drinking alcohol). It's almost never as bad as when I was
| suicidal, but it still sucks. For me depression is like being a
| professional chef and one day your taste buds make everything
| taste like ash. Or a painter and one day you see colors less and
| less.
|
| Last year I went into a VERY deep depression, so deep that I
| _refused_ to take mushrooms until my wife basically forced me to.
| Same thing. The very next day I felt like "I was back."
|
| Those things changed my life.
|
| I've since had fun with other drugs maybe 5 times. Acid a couple
| times, molly a couple times. Cheap (wtf) fun for a half a day,
| but nothing like the impact mushrooms have on my mind.
|
| I've had one bad trip while taking mushrooms recreationally. I
| don't understand who would take those things for fun, at night.
|
| Strictly during the day, well-rested, with loved ones, and in
| nature!
|
| I'm also convinced that the impact they have on me is purely
| chemical. It has nothing to do with "facing my demons" or
| "connecting with a higher spirit" or anything like that. I just
| get off my stupid rut.
|
| "Neurons that fire together wire together" as they say, and when
| I'm depressed it's the stupid neurons that fire together.
| Mushrooms makes a whole different set fire, and fire hard, and
| that seems to be enough.
|
| The deepeest lesson I've gotten while on shrooms is:
|
| "I'm trying my best. Everything is actually fine."
|
| Pretty good lesson.
| Grandeculio wrote:
| No shit.
| debacle wrote:
| I have been taking seratonin precursors (5-HTP, a supplement) for
| about 4 months at a very low dosage (.3 of the "normal dose").
|
| My chronic depression is mostly gone, but I have noticed an
| uptick in physiological signs of anxiety (though no mental
| signs).
|
| But more importantly, my gut health is better than it has been in
| 12 years. I am eating more and losing weight. My energy levels
| have skyrocketed. My impulsiveness has catered so hard that I was
| worried my libido was impacted. My executive function issues and
| ADHD are greatly minimized.
|
| All from a supplement. Utterly life changing.
| Ey7NFZ3P0nzAe wrote:
| Good for you. I'll just add that there is a non zero chance
| that getting checked out or mentionning at least to your closed
| ones about what you noticed would be a net benefit in plausible
| futures, as thyroid issues, bipolar disorder, various
| endocrinoloical disorders etc could also cause what you
| perceive as benefits.
| photochemsyn wrote:
| Full research article:
|
| https://www.thelancet.com/action/showPdf?pii=S2589-5370%2824...
|
| Study design and methods:
|
| > "All the patients provided written informed consent and after
| discontinuing any pre-trial antidepressants, enrollees received
| two oral doses of psilocybin (1 mg or 25 mg) with accompaniment
| from two experienced therapists for ~6-8 h, separated by 3 weeks,
| as well as daily pills (escitalopram 10-20 mg or placebo
| capsules). Thirty patients were randomised to PT and 29 to ET."
|
| > 'The PT condition consisted of two high-dose (25 mg) treatment
| sessions with the serotonergic psychedelic psilocybin,
| administered with support from two study therapists...and daily
| placebo capsules. The ET condition consisted of daily doses of
| the selective serotonin reuptake inhibitor (SSRI) escitalopram -
| 10 mg for three weeks followed by 20 mg for a further three weeks
| --as well as equivalent psychological support including dosing
| sessions with placebo-like doses of psilocybin (1 mg)."
|
| This is an interesting way to address the placebo issue, giving a
| noticeable microdose of psilocybin (1 mg) versus the active dose
| (25 mg) for the non-control group.
|
| Fundamentally I think psilocybin's main overall psychological
| effect is to push subconscious issues up into the mind's
| conscious processing space. Large doses can generate visual
| hallucinations related to those subconscious issues which can be
| unpleasant, even terrifying, for many people, so that's why
| caution is warranted. Extremely large doses cause complete
| dissociation from external sensory input, which is of course very
| dangerous for the unprepared individual in an uncontrolled
| situation - an experience unlikely for any herbivore to want to
| repeat, hence the evolutionary selection pressure for
| biosynthesis of such compounds by plants and fungi.
| thegrim33 wrote:
| The results are based on a grand total of 25 people in the
| psilocybin group and 21 people in the SSRI group. The sample size
| is pretty small.
|
| The methodology is also kind of strange, the psilocybin group got
| a total of 20 hours of in-person therapy during their 'treatment'
| and 6 follow-up skype calls, whereas the SSRI didn't get anything
| other than the 6 month questionaire. Those 20 hours of
| personalized therapy while they were dosing had no effect on
| their psychology? Any change was all a result of the psilocybin
| and not the 20 hours of therapy?
|
| They also measured results by a self-administered 16 question
| "quick inventory" depression survey. To enter the study they had
| to be officially diagnosed with major depression by a doctor, but
| the results of the study were based completely around a self-
| reported 16 question questionaire?
| notfed wrote:
| If that's true, I'm confused how this is a "double-blind,
| randomized, controlled trial"?
|
| Also, what's up with drug studies always having such a low
| sample size? Is it really that hard to find people who'd
| volunteer to get free drugs?
| Affric wrote:
| Often you're not allowed on your medication for any of your
| other health issues.
| londons_explore wrote:
| We need a new approach to randomly controlled trials.
|
| I propose a new approach: Rather than given treatment vs
| not given treatment, we instead vary the dose _slightly_ ,
| and we include the whole world in the trial.
|
| Ie. instead of taking 100mg of Advil, instead you will
| receive somewhere between 95mg and 105mg of Advil. You
| won't be told how much you got - but the barcode on the box
| will encode that info. That already might be the case due
| to allowed inaccuracies, but now we're gonna measure and
| record it.
|
| Later, the data of which box was dispensed is combined with
| any other relevant medical records, and across the hundreds
| of millions of people involved, any benefit/disadvantage of
| a small increase or decrease in dose will become apparent.
| refulgentis wrote:
| This doesn't sound very helpful
| malfist wrote:
| That's not generally how drugs work. There's wide margins
| on how much dose is required for clinically significant
| results. Not only is the 110 pouns petite woman taking
| the same dose of aspirin as a 400lb elite powerlifter,
| but the effects can't be quantified in high resolution.
| The woman can't say her pain was 5% less than the
| powerlifter, and they can't say their pain was 5% more.
| andoando wrote:
| Its expensive. Statistically speaking its really not that
| small. You can always argue p hacking but these are always
| useful as a means to do further research
| napoleongl wrote:
| The article states that both groups received psychological
| support though. The only mention of 20 hours I find in the
| article is as an option to psilocybin. Does the original
| research article say something else?
| luckydata wrote:
| Therapy is such a wash statistically that I'm not particularly
| confused or concerned by that, and everyone that has ever taken
| psylocibin knows the results are typical.
| arcticbull wrote:
| It's kinda interesting you say that because studies show that
| SSRIs are not much better than placebo for treating
| depression, and that therapy plus SSRIs is the best treatment
| available right now.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/
| fsckboy wrote:
| > _The results are based on a grand total of 25 people in the
| psilocybin group and 21 people in the SSRI group._
|
| Statistical significance is based on sample size, and is
| independent of population size. Let that sink in, doesn't
| matter if your population is 100K or 8 billion, when you sample
| you are trying to understand the probabilities in your sample,
| not in the population.
|
| Therefore, (think about the birthday paradox, doesn't matter
| how many people in the world, a few dozen in the room with you
| is an adequate sample), it should not surprise you that
| statistical significance is achieved through a much smaller
| sample size than most non-statisticians have intuition for.
| seeknotfind wrote:
| The issue your parent comment raises is that this random
| group may not represent someone that's trying to evaluate
| what techniques can help them, regardless of the statistical
| significance within that group. It makes me sad that they
| introduce other random variables, as incontrovertible
| evidence of efficacy could help a lot of people!
| shadowtree wrote:
| Ah, but does it beat exercise, fresh air and sunlight?
|
| https://www.mayoclinic.org/diseases-conditions/depression/in...
| Molitor5901 wrote:
| Very much related. Many people are getting shrooms through
| establishments selling it in the form of chocolate. However it is
| apparent that much of that is adulterated and synthetic.
|
| https://news.ycombinator.com/item?id=41283493
| xterminator wrote:
| Psychedelics are nice and powerful - maybe too powerful. I don't
| trust the system to use them responsibly. I'd rather obtain and
| use them on my own than as part of some private - or governmental
| - initiative. There's no one to trust more than a good friend to
| be there for you when the ride gets bumpy, not some guy in a suit
| doing it for the money.
| throwup238 wrote:
| Thankfully it's just mushrooms. It must be one of the easiest
| drugs to grow yourself after just dropping a cannabis seed in
| the ground. As long as spores are accessible it'll be
| "democratized" and even in places like California where they're
| illegal to ship, they're still easy to get.
|
| It's a lot harder to accurately dose in its natural form
| though.
| the_gorilla wrote:
| As an outside observer, I have to notice that doctors and "the
| system" have lost such trust that people prefer self-medicating
| with illegal drugs.
| SoftTalker wrote:
| "The system" has no interest in curing your depression. They
| want you to keep making therapy appointments, and they want
| you to keep refilling prescriptions.
|
| Individual doctors may or may not have this view. I'm talking
| about "the system." Just consider the incentives. That tells
| you all you need to know.
| Sharlin wrote:
| When "the system" subsidizes your therapy and your
| prescription drugs (as in most civilized societies), and
| indeed pays for your medical leave and loses value in the
| form of lost workdays, it definitely doesn't have much of
| an incentive to keep you in therapy or on drugs.
| iknowSFR wrote:
| I get the impression that there's misalignment on what
| "the system" is to each commenter here. One side views it
| as the larger society and the other as the pharmaceutical
| industry.
| lovethevoid wrote:
| I don't think you've really considered the incentives
| either.
|
| The system has as much interest in curing your depression
| as it does curing obesity. Long term, these conditions are
| very costly. It takes people out of peak condition, reduces
| labor pool, increases number of patients taking up
| resources at hospitals and doctors offices, and so on. A
| system which encourages these things is a failing one, as
| taxpayer costs would only continue to balloon.
|
| Additionally, since the thread is about psilocybin, people
| would still be filling up prescriptions for those.
|
| Also, self-medicating is also very costly. Not only to the
| system, as people often wind up in hospitals due to laced
| products or incorrect doses (see marijuana in a lot of
| states where dealers really aren't concerned about
| quality), but also to the individual. People are spending
| absurd amounts of money on vitamins and mushroom teas and
| all that in hopes it helps, but rarely is that the case due
| to these categories not being strictly regulated.
| detourdog wrote:
| I think the advertising of pharmaceutical is big loss of
| faith. Not to mention the opioid crisis.
|
| If medicine was an honorable industry in the USA the might be
| more faith.
| crazygringo wrote:
| > _There 's no one to trust more than a good friend to be there
| for you when the ride gets bumpy, not some guy in a suit doing
| it for the money._
|
| I couldn't disagree more.
|
| Your good friend most likely doesn't have the slightest idea
| how to handle things if your trip goes south. Especially when
| they're on their own "ride". That's not to disparage anyone,
| but just to state the fact that there is training around these
| things that comes from lots of experience.
|
| And therapists are not "some guy in a suit doing it for the
| money". You don't get rich doing psychotherapy -- you do it
| because you genuinely want to help people. And never in my life
| have I seen a therapist in a suit.
|
| This isn't to say that every therapist is great or that every
| friend is terrible -- just that the relative success rates of
| being able to help someone on a bad trip, both during and
| after, are going to be a lot higher on the side of trained
| therapists. Because of the training.
| xterminator wrote:
| >Your good friend most likely doesn't have the slightest idea
| how to handle things if your trip goes south.
|
| Yes they can, everyone experienced can. It's part of having
| empathy.
|
| >Especially when they're on their own "ride".
|
| The trip sitter doesn't trip while sitting.
| anonymouse3112 wrote:
| Anecdotally: worked for me, would absolutely do it again.
|
| People worry about various side-effects: I work extremely hard
| and know others who have done psychedelics and continue with b2b
| saas and similar.
|
| That said, it's serious stuff. I think it permanently increased
| the amount that I like music; other studies show longtitudinal
| changes to big-five personality traits. Proceed with caution.
| sedatk wrote:
| How do you even go about proper dosing and frequency of
| psilocybin use? Just random guess?
| snek_case wrote:
| You can look at studies done using psylocybin for a start,
| but also, adjust based on your own experience. Most people
| use between one and two grams of mushrooms, with two grams
| being quite strong strong for many people.
|
| Some people are tempted to push the dosage so far as they can
| take it to experience "ego death", and I don't think that's
| necessary for therapeutic effects. Not quite sure how safe it
| is to push the dosage as high as you can either. There's some
| kind of esoteric belief in some circles that you'll get some
| magic enlightenment, connecting with another realm if you
| trip hard enough, but imo that mostly attracts people who
| already have fragile mental health.
| staticvoidstar wrote:
| Not totally random, but yeah it's kind of a crap shoot. But
| to be fair it's no different than a lot of other
| pharmaceuticals where it's just trial and error until you
| figure out what works for you.
|
| So like pharmaceuticals, you figure out your goals, go with
| something in the range that works for most people. It doesn't
| hurt to start very small (0.25g), which some people do every
| day. There's a lot of variables including strains and even
| when/what you ate last, where you are in any kind of hormone
| swing (men have them too), so trial and error is about as
| best we can get for now (recreationally). This is why I'm
| really excited by these new pharmaceuticals.
| wisemang wrote:
| Anecdotal but whenever I've been asked for this guidance
| (having been around the block, but not a shaman by any means)
| I ask about the person's dreams. Do they usually remember
| them, how intense are they? More intense = start with lower
| dose (maybe .5g). Less so maybe start with 1 or 1.5g. Of
| course this is subjective and relative but a rule of thumb
| that has worked reasonably well.
|
| For frequency, that depends on a variety of factors I
| suppose.
| pessimizer wrote:
| From what I recall, SSRIs only show an effect greater than
| placebo in major depression, and that effect goes away if the
| placebo is active (i.e. the placebo makes you a little sick, so
| you can "feel it working.")
|
| Great idea to compare a new trendy treatment with promise of
| potential financial windfalls to another treatment that barely
| works. If you kept feeding them cocaine under medical
| supervision, they'd probably report feeling slightly better, too.
| They're recreational drugs. People take them because they feel
| good. The most common symptom of depression is to take refuge in
| drug consumption.
| black_puppydog wrote:
| Lol, I opened this in a tab in background and until I
| foregrounded the tab it reloaded every 2 seconds or so. I hate
| the modern web... :)
| AI_beffr wrote:
| in 2020 i was very interested in psychedelics because of the
| breakthrough with PTSD and MDMA via MAPS. so i read pihkal and
| tihkal and i started reading a biochemistry textbook and
| generally took an intense interest in that area. and i went to
| oakland when i had the chance to be back in the bay area and i
| went to zide door and bought a small amount of psilocybin. at a
| bohemian friends house (it has since been cleaned out and sold,
| perhaps the last such house in the bay area at the time!) i took
| the little capsule in my palm and contemplated if i really wanted
| to take the risk. and i did. it was not a large enough dose to
| produce a psychoactive effect -- i think i had read that a
| psychoactive dose was not necessary to see benefits in mental
| health. there is one effect that i remember very clearly. it was
| when it got later into the night that i noticed something subtle
| but extremely strange. i felt awake or energized in some way. and
| i realized that my whole life, during the evening and late hours
| i would be sort of depressed and not feeling good. and so that
| was the first time that i felt lucid and energized after dusk. my
| whole life i had always known that i feel very depressed and
| agitated at dusk. but this experience really showed me how
| abnormal it was. later on i made a connection that is very oddly
| absent in medical circles that explains this. you know how when
| someone is having a deadly allergic reaction they are meant to
| use what is known as an "epi-pen?" thats because epinephrine,
| whats inside the pen, reduces inflammation. but what isnt
| mentioned or connected anywhere to anything is that when you go
| to sleep at night your body massively reduces the level of
| epinephrine that circulates in your blood so that you can sleep.
| inflammation therefore must increase. and inflammation is
| implicated in many psychiatric disorders including and perhaps
| most of all with depression.
|
| one time much later i was in the hospital because i had a bad
| fever. maybe i was being kind of paranoid for going in. but as i
| was laying in the hospital bed my fever suddenly broke. and a
| wave of intense depression, unmistakable, washed over me. i
| thought this might be turning into an emergency but soon enough
| it passed as if nothing had happened. it was very useful to know
| about the connection between inflammation and depression during
| that little journey.
|
| why is the connection between inflammation and various
| psychiatric diseases not taken seriously by the medical
| establishment? because its too complicated of a subsystem for a
| statistical study to tease it out. even if it were the sole cause
| of depression it still wouldnt lend itself to any study that is
| not exploring directly the biochemical mechanism. expect some
| breakthroughs in this area.
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