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Psilocybin bests SSRI for major depression in first long-term comparison

medscape.com

11–20 of 397 posts

Re: Psilocybin bests SSRI for major depression in first long-term comparison

#11

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.

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.

Re: Psilocybin bests SSRI for major depression in first long-term comparison

#12
post #3

Taking LSD every few months was the best antidepressant I’ve ever tried and I’ve tried a bunch

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.

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.

Re: Psilocybin bests SSRI for major depression in first long-term comparison

#13
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.

Re: Psilocybin bests SSRI for major depression in first long-term comparison

#14

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 ma…

> 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.

Re: Psilocybin bests SSRI for major depression in first long-term comparison

#15
post #11

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.

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.

[deleted]

Re: Psilocybin bests SSRI for major depression in first long-term comparison

#16

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.

It's already being used in therapy. Oregon is giving licenses.

https://www.oregon.gov/oha/ph/preventionwellness/pages/psilo...

Re: Psilocybin bests SSRI for major depression in first long-term comparison

#17

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.

I doubt about everywhere, as shrooms are sold in shop around here.

Re: Psilocybin bests SSRI for major depression in first long-term comparison

#18

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 ma…

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?

Re: Psilocybin bests SSRI for major depression in first long-term comparison

#19

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 ma…

> 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.

Re: Psilocybin bests SSRI for major depression in first long-term comparison

#20

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 contentiou…

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