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

medscape.com

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

#101

Post by kjkjadksj »

cubefox wrote: post #56

Unfortunately it's hardly possible to do proper case control studies with psilocybin, since the psychedelic effects cause unblinding. The participants know whether they are in the treatment or control group. > Normally the journey is quite inward, so patients do not require active support during the psychedelic experience [around 6 hours]. Sometimes they do require some hand-holding, or helping them to 'let go', or b…

Hardly an issue. When people do similar studies measuring say the effects of prescribed exercise vs not they are also unblinded but we still get good data.

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

#102

Post by DiscourseFan »

iancmceachern wrote: post #97
DiscourseFan wrote: post #82

Ok like most of you I’ve taken psychedelic drugs. I’ve had bad experiences sure, but I’m fine now. The issue is that what people generally say, like, “oh sometimes you need to encounter your demons,” maybe that will be temporarily traumatizing—in general people recover from that. The real issues are…more complex. More complex than any diagnoses in the DSM can cover. The brain is very complicated, and everyone’s brain…

Yeah, maybe don't take "very high doses". I've not done that. And not had any seriously bad experiences. Maybe like everything else is all about moderation?

It was 500ug of LSD mixed with probably 6 or 7 drinks of alcohol. Suffered serotonin syndrome for a few days afterwards.

Regardless I’ve heard stories of people having severe long term psychological issues from even relatively light doses, simply because of how their body in particular interacted with the drug.

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

#103

Post by striking »

farts_mckensy wrote: post #88
striking wrote: post #77

Earlier quoted context omitted.

Psylocybin? Easily? You have to put effort into making an experience with psylocybin meaningful and helpful. It could go wrong very easily, especially for those who are in a difficult situation or headspace. (Speaking from experience.) As for SSRIs? Safe, effective, with a handful of annoying side effects. Straightforward to use, low potential for misuse, requires sustained use for any intended effects. A doctor who…

Impotence and weight gain are not just "annoying" side effects. They seriously impact your life. Just putting that out there.

I'm not claiming they don't. Everyone experiences SSRIs differently and it's common to shop around until you find one whose side effects impact your life in a more tolerable way.

That's in contrast to psylocybin, which has substantially more serious potential acute side effects, ones that are more difficult to understand and treat should they occur.

I'm not saying psylocybin is unsafe or that SSRIs are always preferable. But if I'm asked to compare their safety? The choice is obvious, weight gain notwithstanding.

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

#104

Post by kjkjadksj »

dillydogg wrote: post #9

I think a major criticism of how this study is designed is that it is not truly "blinded". I doubt many of the participants were unsure if they received psilocybin vs escitalopram. That being said, there are a number of studies that suggest this is an effective treatment, so I hope this can become more available to those who need it. However, for treatment resistant depression (especially with a catatonia component),…

Being blinded isn’t some gold standard. For example we know exercise leads to good health outcomes from unblinded studies. Every study on fitness ever done is unblinded and we consider these results to be a ground truth.

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

#105

Post by farts_mckensy »

DiscourseFan wrote: post #82

Ok like most of you I’ve taken psychedelic drugs. I’ve had bad experiences sure, but I’m fine now. The issue is that what people generally say, like, “oh sometimes you need to encounter your demons,” maybe that will be temporarily traumatizing—in general people recover from that. The real issues are…more complex. More complex than any diagnoses in the DSM can cover. The brain is very complicated, and everyone’s brain…

I'm a little ambivalent about this response. It sounds like you're describing invasive thoughts of some kind, though your description is vague. At any rate, despite the perceived negative effects, by your own account, it apparently spurred you to lead a healthier life; in other contexts, this is precisely the thing that is praised when it comes to psilocybin.

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

#106

Post by Der_Einzige »

pier25 wrote: post #16
awestroke wrote: post #4

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...

In Oregon enforcement of what passes for our drug laws here is so lax (cops quiet quit long before covid) that it's de-facto legalized.

I've literally walked down Portland and had random homeless people unprompted yell out "Want to buy some shrooms?"

There have been unlicensed openly practicing shrooms businesses which survived far longer than one would expect for such a "regulated" industry.

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

#107

Post by farts_mckensy »

DiscourseFan wrote: post #102
iancmceachern wrote: post #97

Earlier quoted context omitted.

Yeah, maybe don't take "very high doses". I've not done that. And not had any seriously bad experiences. Maybe like everything else is all about moderation?

It was 500ug of LSD mixed with probably 6 or 7 drinks of alcohol. Suffered serotonin syndrome for a few days afterwards. Regardless I’ve heard stories of people having severe long term psychological issues from even relatively light doses, simply because of how their body in particular interacted with the drug.

It's such a bad idea to combine alcohol with psychedelics. You should lead off with exactly what you took so as not to mislead others.

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

#108

Post by Der_Einzige »

standardUser wrote: post #91
8b16380d wrote: post #22

Funny, psilocybin has been largely detrimental to the mental health of everyone I know.

I've have done a lot of drugs and know a lot of people who have done a lot of drugs, and psilocybin is far and away the substance that is most loved and gets the best reviews. It's not even close.

Thoughts on Mescaline/Peyote?

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

#109

Post by bandyaboot »

zozbot234 wrote: post #87
DiscourseFan wrote: post #82

Ok like most of you I’ve taken psychedelic drugs. I’ve had bad experiences sure, but I’m fine now. The issue is that what people generally say, like, “oh sometimes you need to encounter your demons,” maybe that will be temporarily traumatizing—in general people recover from that. The real issues are…more complex. More complex than any diagnoses in the DSM can cover. The brain is very complicated, and everyone’s brain…

Taking psychedelics is a bit like trying to fix a Swiss watch with a sledgehammer: it might just work, but that's not the way to bet. Therapy and well-guided meditative practice can be a lot gentler than that.

This is sort of how the mechanism of psychedelics fixing depression comes across to me as well. But, surely there must be much more to it, since, as you’re of course aware, fixing a Swiss watch with a sledgehammer will have a very low success rate. The other end of the analogy spectrum could be that it’s a bit like a chemical catalyst. There’s a lot of resistance to a reaction happening on its own, but will very likely happen if given the proper jolt.

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

#110

Post by me551ah »

DiscourseFan wrote: post #102
iancmceachern wrote: post #97

Earlier quoted context omitted.

Yeah, maybe don't take "very high doses". I've not done that. And not had any seriously bad experiences. Maybe like everything else is all about moderation?

It was 500ug of LSD mixed with probably 6 or 7 drinks of alcohol. Suffered serotonin syndrome for a few days afterwards. Regardless I’ve heard stories of people having severe long term psychological issues from even relatively light doses, simply because of how their body in particular interacted with the drug.

500ug of LSD isn’t really a standard dose. It’s almost double your typical dose.
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