> patients who were given [...] 25mg had a significant decrease in depressive symptoms
Is that enough to cause impairment?
Compass Pathways' Phase IIb psilocybin trial shows reduced depression symptoms
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Re: Compass Pathways' Phase IIb psilocybin trial shows reduced depression symptoms
#72> patients who were given [...] 25mg had a significant decrease in depressive symptoms Is that enough to cause impairment?
It's a serious trip, yes. More (by far) than most people would recommend someone do recreationally for their first time - it appears that high doses accompanied by a therapist are what has shown the most promise across various exploratory trials.
Re: Compass Pathways' Phase IIb psilocybin trial shows reduced depression symptoms
#73How does this get commercialized? I can't think of anything that's inherently cheap and easy to produce that you use for a few weeks and then never again that is also a financial cash cow the way most pharmaceuticals are. Disclaimer: I work for a pharma.
Why does it have to be commercialized?
Personally, I think the best option is it gets mainstreamed by knowledgeble guides working with individuals through the process, the mushroom growing is done by small-scale growers who do it with the passion and love this Medicine deserves, and the pill-makers are kept far and away from it.
Re: Compass Pathways' Phase IIb psilocybin trial shows reduced depression symptoms
#74In Michael Pollan's fascinating history of psychedelics, "How to Change Your Mind", he explores this. It was interesting to see how governments appeared to have no issue with psychedelics until Timothy Leary came on the scene.
Re: Compass Pathways' Phase IIb psilocybin trial shows reduced depression symptoms
#75Earlier quoted context omitted.
> This isn't like an SSRI. 25mg psilocybin isn't something you can just pop at the beginning of a workday. Your setting and "head space" matter a lot for how your "trip" (which we will now rebrand as "treatment") will go. This needs to be accounted for in future studies. This is what I worry about. It's likely great, when done in the care of a licensed and trained therapist . It's not the mystical panacea many will m…
The Huberman Lab podcast episode on depression touches on this. According to Dr. Huberman the quality of the trip is not important, the chemical changes the brain function regardless.
Anecdotally, I've also noticed the most profound lasting positive effects on my mood after the worst trip I ever had- an absolute nightmare for no good reason (same people I'd tripped with before, familiar places, etc), but the following couple weeks I was on cloud 9. There are so many confounding factors, but at the time I was completely convinced the trip was responsible for the following positive period.
The experience was sort of like an extremely intense workout, or emerging from a sweat lodge- it was painful, but led to a sort of rebirth. It may be simply, when you're already in good spirits prior to tripping, the results are just less noticeable afterward.
Re: Compass Pathways' Phase IIb psilocybin trial shows reduced depression symptoms
#76Earlier quoted context omitted.
The Huberman Lab podcast episode on depression touches on this. According to Dr. Huberman the quality of the trip is not important, the chemical changes the brain function regardless.
But is it solely the chemical changes in the brain that "fix" the depression, or does it also have to do with integrating what you've seen and experienced into your worldview?
Apologies in advance for the formatting, copied and pasted from YouTube transcript:
https://youtu.be/Xu1FMCxoEFc?t=5928
99:33 But one of the things that came up
99:35 and is a fundamental question that I had,
99:37 that I think probably many of you are asking,
99:38 is does the experience that one has on these compounds
99:43 make a difference for whether or not somebody gains relief
99:46 from depression, from these psilocybin journeys or not?
99:50 In other words, does it matter what they talk about?
99:52 Does it matter what they think about?
99:53 Does it matter if they have a good trip or a bad trip?
99:56 And I don't want to hold you in too much suspense,
99:58 I'll let Matthew provide the more thorough answer.
100:00 But what's really interesting
100:02 is there are some common themes to psilocybin administration
100:08 and experience that lead to relief from depressive symptoms,
100:11 but they are subjectively very varied,
100:17 meaning that whether or not people feel
100:20 they had a good experience or a bad experience,
100:22 whether or not people thought about their parents
100:24 or thought about the color of the ceiling,
100:27 doesn't seem to have too much of an impact
100:30 on whether or not they receive relief
100:32 during these studies in these clinical studies.
100:37 It seems like different people can have
100:38 lots of different experiences and still receive benefit.
100:42 And that points to something deeper.
100:45 It points to the fact that these drugs,
100:48 which is really what they are,
100:49 are rewiring neural circuitry in a common way
100:53 despite a diversity of experience while on the drug.
100:57 And that itself is really interesting.
100:58 And it takes us back to a place that we've been before
101:01 in this discussion, which is layer five of the cortex.
101:04 This area that ketamine seems to impact as well
101:06 by generating rhythms of the,
101:08 I mentioned one to three Hertz activity
101:10 in layer five of certain areas of the cortex.
Re: Compass Pathways' Phase IIb psilocybin trial shows reduced depression symptoms
#77As somebody who sometimes "treats" severe multi-decades-long depression with psychedelics, I'm not surprised that they'd have a positive impact but the news seems too unclear to my simple mind to make sense of a few things: 1- why is a private group on the stock market doing this, instead of public research & universities? vested interests in seizing a market of illegal drugs in a legal way worry me, because it's eas…
1. Pharmaceutical studies are extremely expensive so usually done through private sector. In this case compass has a patent for a certain way to synthesize psilocybin, but not a patent on psilocybin itself. However, the results of the study will generalize to psilocybin of all sources. Win win in my view.
2. There are many studies in the literature that compare "psycholytic" (which tend to accentuate pre-existing mental states) to "psychedelic" (which can trigger mystical/insight experiences) doses of psilocybin. I'd say it's reasonable to treat 1 mg as placebo.
3.i. The study followup is ongoing. One of the remarkable aspects of psilocybin treatment is that one dose can lead to lasting (ie >6 mo) effects on mood. See the john hopkins studies.
3.ii. Although the studies all have folks weaning off, concurrent SSRI, MAOI, and anti-psychotic use is not an absolute contraindication. They do not cause serotonin syndrome with psilocybin. But clinically I think this won't be a huge issue as most patients will only be trying psilocyin if 1. their ssri has failed or 2. they are opposed to trying ssris. cheers!
Re: Compass Pathways' Phase IIb psilocybin trial shows reduced depression symptoms
#78Earlier quoted context omitted.
Translating a dose in mg to the equivalent amount of dried mushrooms you would likely come across recreationally is quite difficult, but I believe 25mg equates to something like 4-5g of dried mushrooms which would be a full on trip beyond surfaces flowing like water :sweat-smile:
I did some brief googling on the topic earlier, and the best I could find was "anywhere from 5-20 milligrams of psilocybin per gram of dried mushroom". Which is very unhelpful for working out whether these people took a strong dose by recreational standards. :D
It's more or less impossible to know the psilocybin content of any one specific mushroom offhand, and it can vary greatly even between mushrooms from the same batch, thus microdosing with actual shrooms is an inexact science. You can grind them up into powder and mix it together to average it out, but the total psilocybin will still be an estimate at best.
There is 4 aco dmt, which is supposedly gets converted to psilocin just like psilocybin and I don't believe is illegal in the US, however it degrades very easily into psilocin if stored incorrectly so can be dicey to have since psilocin itself is still illegal.
Re: Compass Pathways' Phase IIb psilocybin trial shows reduced depression symptoms
#79The shrooms community has known about this for a long time, and now it's just about recreating the knowledge in peer-reviewed studies. Although there is a lot of "woo woo" on shrooms usage in the online communities, I do hope that researchers can extract the useful bits. This isn't like an SSRI. 25mg psilocybin isn't something you can just pop at the beginning of a workday. Your setting and "head space" matter a lot…
> 25mg psilocybin isn't something you can just pop at the beginning of a workday.
I would disagree. For many, 25mg is sub-perceptual.
Source: have done this over several year.
Re: Compass Pathways' Phase IIb psilocybin trial shows reduced depression symptoms
#80The shrooms community has known about this for a long time, and now it's just about recreating the knowledge in peer-reviewed studies. Although there is a lot of "woo woo" on shrooms usage in the online communities, I do hope that researchers can extract the useful bits. This isn't like an SSRI. 25mg psilocybin isn't something you can just pop at the beginning of a workday. Your setting and "head space" matter a lot…
Translating a dose in mg to the equivalent amount of dried mushrooms you would likely come across recreationally is quite difficult, but I believe 25mg equates to something like 4-5g of dried mushrooms which would be a full on trip beyond surfaces flowing like water :sweat-smile:
Isn't uptake through digestive tract unreliable? Mental disorders require extremely precise dosing, therefore probably should administer intravenously.