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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

#121

Post by phoronixrly »

tastyfreeze wrote: post #64
phoronixrly wrote: post #49

Earlier quoted context omitted.

> 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…

Many people here are speaking from experience. I trust my own judgment over some knob in the FDA that is steeped in a culture of drug control.

> Many people here are speaking from experience. I trust my own judgment over some knob in the FDA that is steeped in a culture of drug control.

Let me paraphrase this:

Many people here are parroting stuff based on a sample size of 1, who lived to tell the tale. You trust your own judgement based on those people before the rigorous safety and effectiveness studies for the FDA, on a whim that the FDA approves or rejects drugs based on their... ? Culture of hating recreational drugs?

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

#122

Post by Galaxeblaffer »

me551ah wrote: post #110
DiscourseFan wrote: post #102

Earlier quoted context omitted.

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.

250ug of good acid is still a very high dose! 500ug is more like triple of a typical sane dose. milage may vary i guess but 300ug sent me out of this world

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

#123

Post by jowdones »

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.

[flagged]

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

#124

Post by hx8 »

kjkjadksj wrote: post #104
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.

The randomized controlled double-blind study is a gold standard. It solves for so many different biases. Without it the burden of proof is higher. Luckily, the evidence that exercise is healthy is so overwhelming that we have a scientific conciseness.

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

#125

Post by wizzwizz4 »

bandyaboot wrote: post #109
zozbot234 wrote: post #87

Earlier quoted context omitted.

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 like…

A better analogy might be "fixing a heart attack with your fists". It might work, if the problem is fibrillation or a blocked artery and if the impact resolves it… or it might just cause further injury without resolving anything. (Or it might resolve the heart attack, but then cause a stroke a few minutes later.)

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

#126

Post by earnesti »

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.

I agree, that taking psychedelics is likely not a good idea. But the analogue gives in my opinion totally wrong picture of the actual risks. Psychedelics, at least psilocybin, are quite harmless compared to almost any other substances. The reason for that is that they aren't very habit forming.

Personally I used psilocybin recreationally back in the days. Got once bad experience and ended up in a psychosis and to hospital. I got better in couple of days and long term effects were nonexistent.

Then I have couple of friends whose basic substances are just legal alcohol and cigarettes, and boy have they fucked their lives with those. It just takes a long time to do it that but psilocybin for sure does not lead to that kind of path.

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

#127

Post by wizzwizz4 »

layer8 wrote: post #117
phoronixrly wrote: post #49

Earlier quoted context omitted.

> 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.

This is generally what the regulatory system tries to accomplish.

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

#128

Post by DiscourseFan »

farts_mckensy wrote: post #105
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.

> it apparently spurred you to lead a healthier life

No, I stopped mostly after I’d recovered. And I definitely wasn’t “healthier” then, just addled.

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

#129

Post by hackernewds »

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…

Did you take it in a controlled environment like the study suggests? Every time serious conversation of medical progress comes up, it's polluted by naysayers with anecdata about how they took it while raving beside a live volcano.

We need to give psychedelics a fair chance, and sure after we can discount them. The article suggests at scale there is potential

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

#130

Post by el_nahual »

Will add a personal anecdote on my mental-health journey and the impact psylocibin has had on my life.

Bio:

- Late 30s.

- Long history of depression my entire life. "Melancholic" child. Bad drunk teenager. Suicidal in college (failed attempt).

- No drugs except alcohol until I was in my mid 20s.

I've been prone to major bouts of depression my entire life. I went to therapy multiple times a week for years and got on SSRI's towards the end of university as a response to a failed (but serious) suicide attempt.

SSRI's never did anything for me except make me feel like shit (and not be able to take one). Eventually I went off them and sort of got by, and I managed to stay safe by drinking no alcohol. Therapy twice a week was an utter waste of time and money.

Then, sort of on a whim, I grew some mushrooms at home with my then fiancée and we took them together. I was mid 20s and had no prior experience with any drug but alcohol. Not knowing what I was doing, we took a BIG dose. I had a trip that was fun at first and then became quite unenjoyable.

For the next twelve months I felt like myself again. The change was subtle but, over a long term, quite obvious.

After about 18 to 24 months, my depression came back. We took mushrooms again and the same thing happened. A year of well being in exhcange for 2 fun hours and 6 tough ones.

So about every two years I'll take a big (2-4g dry) dose of mushrooms and...it's like magic. I feel like myself again. I'm "back." Life is not happy, none of my problems go away, but I feel like I'm an agent in my own life as opposed to a spectator.

The well being lasts about a year or 18 months (less if I've been drinking alcohol). It's almost never as bad as when I was suicidal, but it still sucks. For me depression is like being a professional chef and one day your taste buds make everything taste like ash. Or a painter and one day you see colors less and less.

Last year I went into a VERY deep depression, so deep that I refused to take mushrooms until my wife basically forced me to. Same thing. The very next day I felt like "I was back."

Those things changed my life.

I've since had fun with other drugs maybe 5 times. Acid a couple times, molly a couple times. Cheap (wtf) fun for a half a day, but nothing like the impact mushrooms have on my mind.

I've had one bad trip while taking mushrooms recreationally. I don't understand who would take those things for fun, at night.

Strictly during the day, well-rested, with loved ones, and in nature!

I'm also convinced that the impact they have on me is purely chemical. It has nothing to do with "facing my demons" or "connecting with a higher spirit" or anything like that. I just get off my stupid rut.

"Neurons that fire together wire together" as they say, and when I'm depressed it's the stupid neurons that fire together. Mushrooms makes a whole different set fire, and fire hard, and that seems to be enough.

The deepeest lesson I've gotten while on shrooms is:

"I'm trying my best. Everything is actually fine."

Pretty good lesson.

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