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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

#111

Post by standardUser »

HKH2 wrote: post #84
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…

So are you okay with people choosing their own dose of SSRIs?

A prescribing doctor will not magically know the precise amount of an SSRI a patient should be taking, or which one to take. For most patients, finding the right drug and dosage is a process. And just like with psilocybin, no one would want to take a random amount. Like with any drug, a person would want to be informed and have proper guidelines about dosage from the start.

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

#112

Post by zozbot234 »

jtrn wrote: post #100

This comment ignores the possible effectiveness of both psilocybin and SSRIs and focuses on the usefulness of the research itself. I actually believe that both have a role in psychiatry, but this study tells me nothing with regards to therapy. Working as a clinical psychologist, who also reads a lot of research, this study is just another brick in the wall that I am banging my head against when it comes to doing actu…

> ... burnout-related depression (person worked normally their whole life but is suddenly just empty of energy and does not look forward to anything with joy) ... existential depression and anxiety that is driven by pathological self-focus (not egotism, but inability to stop focusing on one's own inner states)

Is there any rigorous operationalization of these concepts, that might be explored in further studies? Unless one can be found, these fuzzy, heavily qualitative descriptions are unlikely to be helpful for future researchers.

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

#114

Post by thfuran »

bobthepanda wrote: post #80
iluvcommunism wrote: post #67

It’ll be good to find positive effects in natural remedies like this. It is ironic we try to keep people safe from themselves but end up dolling out ineffective or destructive drugs instead. A case in point, opium being illegal, but a lab derivative 1k stronger fentanyl, legal and 300k killed globally over the last 10 years.

Where are you that fentanyl is legal in a way opium is not? In the US both are schedule II and approved for medicinal use.

And it's mostly not legally acquired fentanyl that's killing people.

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

#115

Post by standardUser »

Der_Einzige wrote: post #108
standardUser wrote: post #91

Earlier quoted context omitted.

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?

I've known far fewer people who have taken it. Unlike mushrooms, I have heard stories of prolonged and difficult trips that sound much more challenging and arguably dangerous than a average-dose mushroom trip.

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

#116

Post by [deleted] »

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.

[deleted]

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

#117

Post by layer8 »

phoronixrly wrote: post #49
state_less wrote: post #31

> "Psychiatrists really focus on negative symptoms of depression. So, if you are not sad anymore, if your sleep or appetite is not impaired, they think you're better. But if you look at what patients define as important, they say it's the degree in which their life is meaningful, in which they can connect with people around them, in which they can function in everyday life," Barba said. A more wholistic approach to h…

> I often hear people talk about the risks of psychedelics, which are to be considered, but what’s the risk of doing nothing or withholding the best treatment? The risk is to make things worse. And I know that I am preaching to people that are of the opinion that they know better than the FDA, scientists and doctors and are all for self-medicating based off of the echo chamber here and a few cherry-picked, limited an…

> The risk is to make things worse.

That risk exists in many medical interventions. We need to quantify that risk and weigh it against the chances of making things better.

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

#119

Post by fluorinerocket »

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 is nuts

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

#120

Post by hx8 »

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…

If there is a medical question that double-blind studies cannot answer, that doesn't mean the question is unanswerable. It means we should be more skeptical of non-blinded studies (or worse studies that pretend to be blind), and we should look for alternative ways to address biases.
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