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Psychiatric risks for worsened mental health after psychedelic use

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Re: Psychiatric risks for worsened mental health after psychedelic use

#21

Post by tivert »

fragmede wrote: post #20
tivert wrote: post #19

Earlier quoted context omitted.

> but frequently make the mistake of thinking this means they are experts in everything. That condition has a name, and it is "Engineer's Disease" or "Engineer's Syndrome."

which tbh isn't fair to the doctors and lawyer who also suffer from the disease

> which tbh isn't fair to the doctors and lawyer who also suffer from the disease

Even if that's the case, I think framing it as "Engineer's Disease" is pretty critical for HN, which at times can become a literal orgy of it.

Also, SV culture amplifies Engineer's Disease into a destructive force only rivaled by its counterpart in finance. Doctors and lawyers who suffer from something similar are far more limited in their effects.

Re: Psychiatric risks for worsened mental health after psychedelic use

#22

Post by cupcake-unicorn »

This really just feels like fearmongering because this is a threat to big pharma. I mean, several commonly prescribed antidepressants have black box warnings about increased risk of suicide. When they trialed Prozac on people with no history of mental illness, someone committed suicide out of the blue. Fairly certain someone could cobble together a much more compelling meta analysis about even worse adverse effects of psych meds on similar populations, but due to NAMI and big pharma I think there's pressure not to draw those lines too clearly.

I think there's a clear bias in cases of big pharma approved meds to jump to "Oh, it wasn't the medication, the condition just worsened" and with psychedelics/weed to jump to "The substance use is causing this". Even when there is proof of RX medication worsening mental health conditions, it's common to have these relationships straight up denied by the prescribing doctor.

This isn't to say that there isn't a similar relationship in psychedelics, but it feels really disingenuous to me to be mentioning this outside of the wider context of psychiatric meds which somehow get a free pass for causing a much wider and dangerous range of side effects. If psychedelics cause less harm than commonly prescribed drugs in the same population, isn't that a good thing? We should understand these harms, but the bias of Big Pharma needs to be taken out of the picture.

Re: Psychiatric risks for worsened mental health after psychedelic use

#23

Post by piuantiderp »

tivert wrote: post #19
2four2 wrote: post #14

Earlier quoted context omitted.

I've found this to be generally true. Engineers are passionate and intelligent people, but frequently make the mistake of thinking this means they are experts in everything.

> but frequently make the mistake of thinking this means they are experts in everything. That condition has a name, and it is "Engineer's Disease" or "Engineer's Syndrome."

Midwitism and lack of culture

Re: Psychiatric risks for worsened mental health after psychedelic use

#24

Post by andy_ppp »

N of one but my friend (who always saw the world as very black and white) killed herself not long after doing Ayahuasca. I’m pretty sure it contributed to her death, she became an extreme fantasist about judgement and god, not a formalised religion but a personified fantasy with crazed rules and vengeances. It was not good.

Re: Psychiatric risks for worsened mental health after psychedelic use

#25

Post by swores »

cupcake-unicorn wrote: post #22

This really just feels like fearmongering because this is a threat to big pharma. I mean, several commonly prescribed antidepressants have black box warnings about increased risk of suicide. When they trialed Prozac on people with no history of mental illness, someone committed suicide out of the blue. Fairly certain someone could cobble together a much more compelling meta analysis about even worse adverse effects o…

> When they trialed Prozac on people with no history of mental illness, someone committed suicide out of the blue.

I hadn't heard about this before, and while I'm sure it is possible for any drug that messes with brain chemicals to cause someone to decide to kill themselves, I've always been told & read a different explanation for the suicide warning that comes with most (or all?) antidepressants:

Which is that a depressed person while at their lowest might think about suicide but not have the energy or willpower to do anything, but if they start taking a drug that partially fixes it, so they start having energy again, but doesn't fix their root problems so they still think that suicide would be preferable to life, and suddenly have energy to make that happen.

Which is also the reason that modern guidance is for antidepressants to be co-prescribed with talk therapy, to try to use drugs to let the person be able to work on their issues, rather than just hoping the drug can fix all issues.

Re: Psychiatric risks for worsened mental health after psychedelic use

#26

Post by WesternWind »

uniqueuid wrote: post #7

I find the design and results somewhat underwhelming (weak significance in a N=800 sample with >50% dropout). The authors also mention that they lack power, but the only correct answer then is not to do the study, include more people, more data points, or reduce measurement variance. That said, I think it's a refreshing perspective, and it seems like a good idea to look at effect heterogeneity in psychedelics use. Th…

A lower power study can still lend weight to a good meta analysis.

Re: Psychiatric risks for worsened mental health after psychedelic use

#27

Post by yieldcrv »

jrflowers wrote: post #4
yieldcrv wrote: post #2

> We find that 16% of the cohort falls into the “negative responder” subset. “they should have known they had a family history of schizophrenia before using it!” every dismissive psychedelic user that brags about increased empathy in the next breath but in all seriousness, yes I would like to see more studies so we can at least have side effects printed on the side of the package, so the right people can take informe…

This makes sense because people that have used psychedelics sharing their positive experiences are the bad guys and people that have used psychedelics sharing their negative experiences are the good guys

using anyone as a source for side effects is a dumb standard and we should reach parity with how other drugs are studied

just like this study is trying to chisel at

while psychedelic communities are uniquely dismissive

Re: Psychiatric risks for worsened mental health after psychedelic use

#28

Post by cupcake-unicorn »

swores wrote: post #25
cupcake-unicorn wrote: post #22

This really just feels like fearmongering because this is a threat to big pharma. I mean, several commonly prescribed antidepressants have black box warnings about increased risk of suicide. When they trialed Prozac on people with no history of mental illness, someone committed suicide out of the blue. Fairly certain someone could cobble together a much more compelling meta analysis about even worse adverse effects o…

> When they trialed Prozac on people with no history of mental illness, someone committed suicide out of the blue. I hadn't heard about this before, and while I'm sure it is possible for any drug that messes with brain chemicals to cause someone to decide to kill themselves, I've always been told & read a different explanation for the suicide warning that comes with most (or all?) antidepressants: Which is that a dep…

I can understand why you would have that reasoning, but SSRIs are commonly prescribed off label to populations for non-mental health related reasons, for example ED or urinary incontinence, and in these populations the relationship holds, leading to some governments and regulatory bodies to recommend or warn against use for these conditions.

"Although duloxetine reduced the symptoms of stress urinary incontinence and improved women’s quality of life, the harms related to suicidality and violence were 4 to 5 times more common with duloxetine than with a placebo, a meta analysis using patient level data by researchers from the Nordic Cochrane Centre showed." https://www.bmj.com/content/355/bmj.i6103

Re: Psychiatric risks for worsened mental health after psychedelic use

#29

Post by swores »

cupcake-unicorn wrote: post #28
swores wrote: post #25

Earlier quoted context omitted.

> When they trialed Prozac on people with no history of mental illness, someone committed suicide out of the blue. I hadn't heard about this before, and while I'm sure it is possible for any drug that messes with brain chemicals to cause someone to decide to kill themselves, I've always been told & read a different explanation for the suicide warning that comes with most (or all?) antidepressants: Which is that a dep…

I can understand why you would have that reasoning, but SSRIs are commonly prescribed off label to populations for non-mental health related reasons, for example ED or urinary incontinence, and in these populations the relationship holds, leading to some governments and regulatory bodies to recommend or warn against use for these conditions. "Although duloxetine reduced the symptoms of stress urinary incontinence and…

Wow, TIL, thanks!

Any idea if the logic I wrote about is also true? Or is it the same as how many doctors will talk about SSRIs working because depressed people "have too little serotonin", a myth that remains commonly believed despite research not backing it up?

Re: Psychiatric risks for worsened mental health after psychedelic use

#30

Post by uniqueuid »

WesternWind wrote: post #26
uniqueuid wrote: post #7

I find the design and results somewhat underwhelming (weak significance in a N=800 sample with >50% dropout). The authors also mention that they lack power, but the only correct answer then is not to do the study, include more people, more data points, or reduce measurement variance. That said, I think it's a refreshing perspective, and it seems like a good idea to look at effect heterogeneity in psychedelics use. Th…

A lower power study can still lend weight to a good meta analysis.

That is true, but there are also conditions where low-powered studies degrade meta-analyses. For example, if the panel attrition is caused by self-selection on unobserved variables, then the study contains bias that is not (and cannot be) accounted for, which skews the meta analysis. But yeah, those concerns are mostly about measurement not sample size.
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