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Psychiatric risks for worsened mental health after psychedelic use

journals.sagepub.com

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Re: Psychiatric risks for worsened mental health after psychedelic use

#31

Post by jrflowers »

yieldcrv wrote: post #27
jrflowers wrote: post #4

Earlier quoted context omitted.

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

Exactly! People that say that they’ve benefited from psychedelics are uniquely dismissive and people that say that those people form a uniquely dismissive community that should be distrusted are not uniquely dismissive

Re: Psychiatric risks for worsened mental health after psychedelic use

#32

Post by skissane »

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…

That may be a factor, but it is likely more complex than just that.

SSRIs can cause some individuals to become disinhibited, impulsive. It is a particularly common symptom in children and adolescents (which is why many paediatricians and child psychiatrists hesitate to prescribe them), but more rarely can happen in adults too. Probably some people have a genetic susceptibility to it. It isn’t purely about ameliorating depression, since the same side effect has been observed in non-depressed children administered SSRIs (which aren’t solely used to treat depression, sometimes they are used to treat anxiety too, plus some children can end up being prescribed them when they have neither, due to misprescribing or off-label use.)

Disinhibition and increased impulsivity can increase the risks of suicidality/homicidality/etc

Re: Psychiatric risks for worsened mental health after psychedelic use

#33

Post by skissane »

swores wrote: post #29
cupcake-unicorn wrote: post #28

Earlier quoted context omitted.

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?

It is possible multiple processes are at work-it is possible that SSRIs increase violence risks independently of their antidepressant effect, and simultaneously their antidepressant effect also increases it. The two explanations aren’t necessarily mutually exclusive

Re: Psychiatric risks for worsened mental health after psychedelic use

#35

Post by cupcake-unicorn »

swores wrote: post #29
cupcake-unicorn wrote: post #28

Earlier quoted context omitted.

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?

No problem, I like to spread awareness of this stuff! BTW here are a few more RCTs about the relationship https://www.madinamerica.com/2021/03/antidepressants-still-l...

Honestly it's hard to say and I'm not even sure if you'd be able to study this empirically in this population. I do think that's why doctors fall prey to this bias, and especially so in a stigmatized population. "Ah, they were likely to have these symptoms anyway". It would be interesting to do a wider study, but there already was a history of these companies withholding damaging trials and results so I doubt it would be done, especially given that suicides have occurred in these trials.

I really do believe that these classes of medications are treated differently due to the great power the industry has on this issue. If you look up the background of NAMI it's quite suspect and reminds me about how doctors were getting textbooks that were written by the opioid prescribing company. NAMI goes on to inform public opinion and then this stuff becomes "fact". I'm glad the "too little serotonin" thing is being examined but it was crazy to see how many weirdly defensive memos and articles there were out when it first came out. I see I'm getting downvotes on my original comment but I do think it's extremely important to examine these intuitions and where they came from, because as we've seen some of this stuff has been based on profits/trial P-hacking/junk science.

Re: Psychiatric risks for worsened mental health after psychedelic use

#36

Post by coldtea »

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.

Meta-analyses are even less rigorous than a low power study

Re: Psychiatric risks for worsened mental health after psychedelic use

#37

Post by smt88 »

AnarchismIsCool wrote: post #11

You know when you see HN discussion on some subjects where you have significant background and it's hyper cringe? Psychology/neurology is one of those areas where the community's commentary is almost always extremely...factually challenged. Be very careful making health decisions based off of HN comments. Lots of people with strong agendas and weak subject matter knowledge. Also, be careful not to over-estimate your…

Your entire comment is about HN, not the article. Do you have anything substantial or interesting to say about the study?

Re: Psychiatric risks for worsened mental health after psychedelic use

#38

Post by rdtsc »

It’s pretty scary to me that so many people seemingly on whim are willing to upgrade their brain firmware. I often hear stuff like “and then my whole view on reality changed”. Unless there’s an easy way to upload the previous “factory image” so to speak, it feels pretty risky to experiment with that.

Re: Psychiatric risks for worsened mental health after psychedelic use

#39

Post by ssijak »

optimalsolver wrote: post #34

Reminder. Psychedelics can also lead to extremely traumatic experiences: https://www.reddit.com/r/DMT/comments/gb9ar0/dark_dmt_trip_r... This doesn’t get mentioned in the current “psychedelics as a cure-all” hype wave.

it gets mentioned

Re: Psychiatric risks for worsened mental health after psychedelic use

#40

Post by cupcake-unicorn »

skissane wrote: post #33
swores wrote: post #29

Earlier quoted context omitted.

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?

It is possible multiple processes are at work-it is possible that SSRIs increase violence risks independently of their antidepressant effect, and simultaneously their antidepressant effect also increases it. The two explanations aren’t necessarily mutually exclusive

Sure, but if that's what's going on, it should be researched further and taken seriously during prescribing. 100% guarantee that when psychedelics hit the market, doctors will fall prey to overstating the harms from studies like this while turning a blind eye to the wealth of evidence of greater likelihood of harms in prescriptions they churn out without blinking an eye.

I'm not anti medication, and I'm not saying that there are cases where the benefit doesn't outweigh the harm, but I do think the potential harms of each medication should be thoroughly investigated equally. Large companies with the ability to withhold damaging trials, sway the public opinion, and have a giant PR team and legal team at their disposal shouldn't be impacting our understanding of the real risks and science.

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