Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

US could soon approve MDMA therapy

nature.com

Post reply on HN
Print view View original

391–400 of 406 posts

Re: US could soon approve MDMA therapy

#391

Post by tbalsam »

462436347 wrote: post #365

Almost 350 comments, none of which mention how dangerous MDMA is, especially to the kidneys, the heart, and the serotonergic neurons of the brain?

Please read the original Phase III and earlier studies where they thoroughly address these questions under the treatment modalities being tested.

The process for drug approval is extremely rigorous for a reason, and does have some downsides as a result. Let's not negate that work please by ignoring all of the hard work that's already been done to show exceptionally safe viability within the context it's being used in.

As noted above/below in different comments, the dose/dosing period/etc always makes a difference in whether a drug is harmful or helpful. In this case, the benefits strongly outweigh the downsides within this particular narrow kind of usecase, and of course hopefully we'll be able to get an even better handle on that in a broader set of examples in the ongoing Phase IV studies.

Plus, it's not like MDMA is some new chemical or anything like that. It's pretty darn well characterized under a variety of treatment/usage conditions at this point.

Re: US could soon approve MDMA therapy

#392

Post by s1artibartfast »

eimrine wrote: post #381
ImPostingOnHN wrote: post #336

Earlier quoted context omitted.

it's worth noting that MDMA generally doesn't seem to be one of those drugs that "masks the problem", and can be quite useful in "dealing with the root cause"

Dealing with the root cause seems more about lsd/dmt. Masks the problem temporarily is about alcohol. Mdma is about mask the problem long term. But the problem I am having in mind is not war-related PTSR. I don't imagine how to heal from problem when you are a massacre survivor. Especially if you were mobilized against your will.

People obviously have different types of problems, and here I divide them into issues with how you relate to yourself or how you relate to others.

I think that the appropriate substance depends on the nature of the problem. If the nature of the problem is a lack of empathy and interpersonal connection, I think MDMA could be a good fit. It can provide biological and experiential practice in dropping the barriers people put up between themselves and others.

Mushrooms, LSD, and hallucinogen seem better suited for addressing motivation and control issues as well as cognitive dissonance within an individual.

Re: US could soon approve MDMA therapy

#393

Post by ImPostingOnHN »

eimrine wrote: post #386
ImPostingOnHN wrote: post #382

Earlier quoted context omitted.

MDMA doesn't seem to be one of those that masks the problem, short term or long term, but rather one that helps deal with the root cause: when you're not afraid to discuss a subject due to the pain it causes, you can discuss it

How it can be possible when a patient wants to talk about traumatic experiense to a specialist, for the sake of getting rid of PTSR, but he afraids to talk about it because of... what may happen? What kind of pain may block even talking about it? I have built an idea while reading those PTSR-witnessers that mobilization for males is an analog of rape for females and the pain is not from killing and seeing kills but f…

how can it be possible that a person is sad when they should be happy? people are irrational, emotional meat bags

in the context of MDMA assisted psychotherapy, people objectively use it to discuss painful topics and memories to deal with root causes

I'm not sure how to answer some of the psychology specific details, and so apologize, but given that MDMA does indeed seem to be one of those drugs that helps people deal with the root causes of their issues, I'm sure the info is out there for someone determined to learn it

I wish you luck with your business idea

Re: US could soon approve MDMA therapy

#394

Post by rrrrrrrrrrrryan »

haswell wrote: post #223
hammyhavoc wrote: post #142

Earlier quoted context omitted.

I wish more people spoke about their negative experiences with psychedelics. It's a sobering and necessary counterpoint to most of what floods these threads of how it changed someone's life, but the "how" is largely ambiguous.

As studies continue, it seems that a key component is a safe and therapeutic environment and a trained guide who can help the person navigate what they experience. People most often get in trouble when they bring a recreational drug mindset, or are predisposed to certain conditions, or have not worked with a therapist to have foundational tools to manage the experience. The risks are absolutely real and should not be…

I think the medical community is still catching up to the knowledge that experienced users have - even today, I'd still recommend newbies read up on the stuff themselves, and do it with someone experienced that they trust.

The research will eventually catch up, and within a decade or two tripping in a doctor's office will be much more responsible and fruitful. Doctors can already provide a lot of pharmacological advantages: they have access to consistent, predictable, controlled dosages, and access to prescription antipsychotics to end a trip if it is not going well, which is obviously a much better situation than eating a few mushrooms with an unknown amount of psilocybin then hanging on and hoping for the best.

Re: US could soon approve MDMA therapy

#395

Post by DanBC »

corry wrote: post #383
vonnik wrote: post #282

Contrary data point to encourage caution with MDMA: MDMA can reset your dopamine baseline much lower. That is, after you come down, you may feel depressed, and it may be hard to climb out of that depression for a while. Use caution please.

While I think parent confused dopamine and serotonin, I'd echo this sentiment. In the rave community terms like "blue Monday" or the grimmer "suicide Tuesday" are there for a reason. Many people have a week or even more of 'depression', which thankfully seems transitory for most (although we all know depression can lead to negative feedback loops). And while caution is definitely needed, the research is mind-blowing.…

> the research is mind-blowing.

Drug companies said that about ketamine, and then they realised they couldn't make much money from ketamine infusions, so they tweaked ketamine to get eskatamine and turned it into a nasal spray. That's patentable and it gives them more money.

The results are pretty poor though.

SSRIs had mind-blowing research, but that was based on very carefully selected test subjects. As soon as it got rolled out to the general population the efficacy drops pretty alarmingly. Some people don't get much benefit from them (SSRIs are a useful, life-saving medication. I am not saying these meds are useless for everyone). See also SNRIs, exercise, etc etc.

Re: US could soon approve MDMA therapy

#396

Post by wnolens »

waboremo wrote: post #348
wnolens wrote: post #335

Earlier quoted context omitted.

I've seen 5-6 therapists over the past decade. I'd love to find the right one, but so far my experience is between neutral and strongly negative. My closest friends are far more empathic and life-experienced people, a few quite capable of removing themselves from a conversation for my benefit.

Yeah that's understandable, and that's a low number relatively speaking as this is a problem that really hasn't been solved. There are places like psychologytoday that provide a decent database to finding potential therapists (with good enough filters to really narrow down what you want to get into and feel safe around), but it can still be very tough. Especially when you consider how many people go so long without b…

Each one of those therapists I saw for at least 6 months, at least one for 2y. There's probably 4-5 more I saw for 2-3 sessions before abandoning.

With all this experience, I still don't know how I would filter a list of therapists except maybe remove ones that seem married to a particular method/style. Like a real relationship (that you don't pay for), it takes time to get to know eachother. And at anywhere from $100-400 (nyc.. sigh) per session, it's not free to keep trying (ignoring the emotional costs..).

And my experiences have taught me that like any regular person, therapists can be deeply wounded individuals or struggling with their own demons. Maybe they've conquered them, maybe they're hiding behind a facade of being able to 'help' others. It's messy. I think there's something weird/wrong about our current zeitgeist putting therapists on a pedestal or that everyone should go to one. They aren't doctors, and you aren't necessarily sick.

Re: US could soon approve MDMA therapy

#397

Post by wnolens »

abyssin wrote: post #341
haswell wrote: post #223

Earlier quoted context omitted.

As studies continue, it seems that a key component is a safe and therapeutic environment and a trained guide who can help the person navigate what they experience. People most often get in trouble when they bring a recreational drug mindset, or are predisposed to certain conditions, or have not worked with a therapist to have foundational tools to manage the experience. The risks are absolutely real and should not be…

Interestingly, my recent bad experience was in what I expected to be the safest and most therapeutic environment available to me. What I discovered instead was an irrational culture with an immature fascination for shamanism. My individual experiences, informed by my research, were more beneficial (and cheaper as well). Knowing the topic and a trip-sitter you know might prove a better choice than trusting self-procla…

> What I discovered instead was an irrational culture with an immature fascination for shamanism

Hilarious revelation to have from a trip. I never put it like that in my mind, but I feel kind of similar.

My take is.. people want an external locus of control and/or instructions on how to live so bad that in the modern bent towards Atheism/Agnosticism, they transfer that responsibility elsewhere (star signs, tarot cards, psychedelics, their political party, some 'expert'..)

Re: US could soon approve MDMA therapy

#398

Post by 462436347 »

tbalsam wrote: post #391
462436347 wrote: post #365

Almost 350 comments, none of which mention how dangerous MDMA is, especially to the kidneys, the heart, and the serotonergic neurons of the brain?

Please read the original Phase III and earlier studies where they thoroughly address these questions under the treatment modalities being tested. The process for drug approval is extremely rigorous for a reason, and does have some downsides as a result. Let's not negate that work please by ignoring all of the hard work that's already been done to show exceptionally safe viability within the context it's being used in…

> Please read the original Phase III and earlier studies where they thoroughly address these questions under the treatment modalities being tested.

The problem is these drugs aren't being presented as dangerous pharmaceuticals that still have worthwhile cost-benefit ratios for certain serious conditions. Instead the "drugs are good" crowd actually argues, laughably, that they're completely safe, and safer than alcohol (I don't drink, btw), despite extremely good observational data suggesting moderate drinking doesn't increase all-cause mortality, while no similar data at present exists for these drugs.

Here's an example of something they never discuss: https://slatestarcodex.com/2018/06/06/hppd-and-the-specter-o...

The "microdosing" fad is one of the best examples of how uninformed people are about the dangers of psychedelics, thanks to the propaganda. If I polled 100 of these microdosers at random and asked them about 5HT2B, do you honestly think more than half would know what I was talking about, and what my concerns are? Yeah, some are highly informed and know what risks they're taking, but they're the exception.

Re: US could soon approve MDMA therapy

#399

Post by 462436347 »

buildbot wrote: post #369
462436347 wrote: post #365

Almost 350 comments, none of which mention how dangerous MDMA is, especially to the kidneys, the heart, and the serotonergic neurons of the brain?

Well, I have no idea personally about MDMA, but many, many drugs are very dangerous to those organs and neurons. For example, any anti-fungal is pretty toxic to you too. Or Chemo. Acetaminophen (Tylenol) is not easy on your liver. Everything in medicine has a risk factor that must be weighed against the benefits.

Comparing it to chemotherapy doesn't really undermine my point, does it? And the ultimate goal of the proponents is not just to get these drugs made available via prescription, but to make them as legal as marijuana.

Re: US could soon approve MDMA therapy

#400

Post by nkozyra »

themitigating wrote: post #387
nkozyra wrote: post #88

Earlier quoted context omitted.

> Perfection isn't required and as others have noted there are countries with far less problems so obviously it is possible Never said it was impossible to improve. I said it was impossible to "fix" society.

Fix doesn't mean perfection either. Come on, it means bring things to a level consistent with other similar countries. Your absolute take on this is a deflection to avoid any change

> Your absolute take on this is a deflection to avoid any change

I have never said we shouldn't improve things. That's very much a strawman.

Post reply on HN