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Psilocybin bests SSRI for major depression in first long-term comparison
161–170 of 397 posts
Re: Psilocybin bests SSRI for major depression in first long-term comparison
#162I 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.
"Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial" (2018)
https://www.bmj.com/content/363/bmj.k5094>
Re: Psilocybin bests SSRI for major depression in first long-term comparison
#163Earlier quoted context omitted.
Is it something that you still take here and there or was it a time limited therapy ? Congrats on finding a cure for your ailments
I did 3 sessions of 8 grams in silent darkness for 3 weekends in a row and that basically "beat the devil out of me" as they say - it was very very difficult, and a lot of work, but well worth it.I've only felt the "brain haze" (I call it) once since then, I took a gram and went for a long walk in the forest, back to no haze. It's been about 7/8 months and I can feel the "haze" building in my mind again, so I plan to…
Totally agree. The variance between species can be dramatic! 2.5 grams of Golden teacher was a standard trip, vs 0.5 grams of PES Amazonian was enough to send my friend into a full blown “awakening” (physical responses and everything).
It’s fascinating how they can hit different.
Also important to keep in mind the same dose can hit someone different each time depending on surrounding life conditions. I’m a big believer that the mushrooms “show you what you need to see” at any given moment, and that can sometimes range considerably.
Re: Psilocybin bests SSRI for major depression in first long-term comparison
#164Earlier 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.
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Re: Psilocybin bests SSRI for major depression in first long-term comparison
#165Ok 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…
Anyone who has ever tried to fine-tune medication for psychological issues knows how challenging it can be to get the dosages and combinations just right. In my experience, even medications within the same class can have different effects on different people, especially when combined with drugs from other classes.
The interactions between medications, as well as the patient’s individual response, are hard to predict. These reactions can change over time, too, as bodies and brains adapt, and lifestyles shift.
Yet, you often hear oversimplified statements like "depression means you have too little serotonin," "feeling sluggish means you lack noradrenaline," or "difficulty focusing means you have too little dopamine." These explanations are so reductive that they barely make sense.
The more I read about drug trials, the more I realize how little I — and even many professionals — truly understand about how these medications work and the best way to make informed treatment decisions.
Re: Psilocybin bests SSRI for major depression in first long-term comparison
#166Earlier 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…
I guarantee you the number of people who have died from SSRI misuse is higher than the number of people who have died from psilocybin misuse. I'm not referring to things a person may do in a given state, I'm talking about effects from the drugs themselves. I'm not aware of a single recorded person who has taken any dose of psilocybin, and died from "psilocybin overdose". While it may be uncommon, it is possible to ov…
Sure, psylocybin won't kill you, but the threat of inescapable psychological distress is real. Maybe it's less likely if you aren't predisposed to psychosis, but you can't easily know for sure that you're not.
And yes, it's possible to misuse SSRIs, but taking an obviously oversize dose is still often a treatable situation. Combining them with depressants I think is a degree of misuse that is incomparable.
Re: Psilocybin bests SSRI for major depression in first long-term comparison
#167Earlier 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.
That’s a massive dose and you mixed it with alcohol. That is in no way a responsible way to try out psychedelics. You are right that everyone reacts differently which is why you don’t take a very large dose mixed with other drugs.
Anecdotally, ayuasca quite literally saved my life and helped me tremendously when I was spiraling into a deep depression. Psychedelics when taken responsibly in a controlled environment under supervision can help a lot of people.
Re: Psilocybin bests SSRI for major depression in first long-term comparison
#168This 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? Unles…
It's counterintuitive to me that a more specific concept/subgroup of a phenomenon would be less useful than a larger catch-all category. Is the self-rated questionnaire depression scale used in this study a good "rigorously operationalized concept"?
We are successfully treating people with this exact kind of indication/operationalization with real success already. For instance, the indication criteria for ECT basically follow the "burnout profile" I described above, with the addition of "treatment resistant to therapy and medication," and it has shown by far the best effectiveness for that kind of depression.
I completely disagree that it's not possible to operationalize the concepts above, for instance with standard BDI or MADRS, supplemented with a ratio with a cutoff to indicate a large fall in everyday functioning. Like an extremely large fall in Global Functioning Scale (GAF) localized to a distinct and pattern-breaking period in a person's life. If you think that these concepts are fuzzy and qualitative, I really hope you have even greater criticism towards this study, not to speak of concepts like anxiety, trauma, and ADHD, which are completely off the rails when it comes to diffuseness and subjectivity.
But even if you are right, that burnout-depression and existential anxiety are not possible to study because of their vagueness, it still would not make this study helpful as it's presented. Or am I mistaken? Do you think it's a good and helpful study, whose implications I should fight for in our clinic? And would I see a marked improvement in our patients, compared to SSRIs for the "Depression" group?
I am willing to admit I am wrong. The only goal is to actually help people.
Re: Psilocybin bests SSRI for major depression in first long-term comparison
#169> "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…
> Psilocybin seems to help reconnect people with a part of themselves they only dimly remember
Is there science behind this statement?
From what I know, we understanding psychedelics work. We don’t know precisely how.
Re: Psilocybin bests SSRI for major depression in first long-term comparison
#170Earlier quoted context omitted.
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 rejec…
Schedule I drugs specifically? The regulation around them is inescapably rooted in a culture of hating recreational drugs.