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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

#301

Post by TeaBrain »

fsckboy wrote: post #264
thegrim33 wrote: post #173

The results are based on a grand total of 25 people in the psilocybin group and 21 people in the SSRI group. The sample size is pretty small. The methodology is also kind of strange, the psilocybin group got a total of 20 hours of in-person therapy during their 'treatment' and 6 follow-up skype calls, whereas the SSRI didn't get anything other than the 6 month questionaire. Those 20 hours of personalized therapy whil…

> The results are based on a grand total of 25 people in the psilocybin group and 21 people in the SSRI group. Statistical significance is based on sample size, and is independent of population size. Let that sink in, doesn't matter if your population is 100K or 8 billion, when you sample you are trying to understand the probabilities in your sample, not in the population. Therefore, (think about the birthday paradox…

>Therefore, (think about the birthday paradox, doesn't matter how many people in the world, a few dozen in the room with you is an adequate sample), it should not surprise you that statistical significance is achieved through a much smaller sample size than most non-statisticians have intuition for.

This response on the supposed the lack of importance of a sample size is completely wrong on just about every claim. The parent comment had a valid point. Just because a population may fit a certain distribution, does not mean that any given sample size will also fit that distribution. Samples are used to ideally create a representative group of a population, that is smaller than the population. However, the sample size required to come close to a representative distribution can vary between populations and variables being examined. Also, using the birthday paradox is a terrible example and has nothing to do with statistical significance, as the so-called birthday paradox is just a simple function.

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

#302

Post by throwup238 »

asveikau wrote: post #294
throwup238 wrote: post #271

Earlier quoted context omitted.

I suspect there’s a lot of self selection at work already. The vast majority of people don’t jump straight into psilocybin and LSD, they progress to them by taking softer drugs like alcohol and cannabis. I think a lot of people who don’t need “adjustment” figure out drugs don’t do much for them and stop before they take the intense psychedelics, or they figure it out at lower doses and stop before they take the inten…

Are you saying the claim that psychedelics are effective treatment for depression, PTSD, addiction etc. are simply because those who try it suffer those conditions? What about the part where they say it works effectively? Because I don't think alcohol or cannabis are claimed to be an effective treatment for these conditions in the same way that psychedelics are. The idea that it works seems irrelevant to your conclus…

No that’s not what I’m saying.

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

#303

Post by asveikau »

throwup238 wrote: post #302
asveikau wrote: post #294

Earlier quoted context omitted.

Are you saying the claim that psychedelics are effective treatment for depression, PTSD, addiction etc. are simply because those who try it suffer those conditions? What about the part where they say it works effectively? Because I don't think alcohol or cannabis are claimed to be an effective treatment for these conditions in the same way that psychedelics are. The idea that it works seems irrelevant to your conclus…

No that’s not what I’m saying.

Ok. Then I misread.

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

#304

Post by dymk »

tastyfreeze wrote: post #72
dymk wrote: post #54

Earlier quoted context omitted.

From what I understand, those “magic mushroom” edibles sold in head shops and gas stations are amanita muscaria derived, which is a completely different psychoactive substance with different alkaloids. Toxic to the liver too, in ways that a cubensis is not.

Northern shamans drank reindeer urine after the animals had eaten amanita muscaria. Passing through the animals reduced the toxic component but left enough alkaloid to trip balls. Maybe the gas station edibles have removed the toxin.

Personally, I trust gas station drugs as much as I trust their tuna sandwiches

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

#305

Post by ethagnawl »

8b16380d wrote: post #22

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

As someone who has personally dealt with mental health issues I attribute to use of cannabis, I agree with the underlying sentiment here.

The people in this thread saying things like, "they wear off" or dismissing clinical treatment for depression as "suits ripping people off" are delusional and embodying bad stereotypes. Just because you and your bros took mushrooms, had a few laughs and carried on "working hard on saas" or even had a beneficial, religious-type experience doesn't mean that there aren't also risks or that everyone will have a similarly beneficial experience. It's been known for decades -- both empirically and scientifically -- that psychoactive substances can surface latent or bring about psychological issues (e.g. cannabis and schizophrenia) in some people.

Now, I'm not against use of these substances medicinally or recreationally but to pretend like there is no risk and that they're a one-size-fits-all miracle cure is reckless, naive and dumb. As mushrooms and cannabis become more widely available and more powerful (in the latter case), I suspect we'll be hearing a lot more about this class of issues in the coming years.

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

#306

Post by BowBun »

lovethevoid wrote: post #229
SoftTalker wrote: post #216

Earlier quoted context omitted.

"The system" has no interest in curing your depression. They want you to keep making therapy appointments, and they want you to keep refilling prescriptions. Individual doctors may or may not have this view. I'm talking about "the system." Just consider the incentives. That tells you all you need to know.

I don't think you've really considered the incentives either. The system has as much interest in curing your depression as it does curing obesity. Long term, these conditions are very costly. It takes people out of peak condition, reduces labor pool, increases number of patients taking up resources at hospitals and doctors offices, and so on. A system which encourages these things is a failing one, as taxpayer costs…

I think your argument is as valid as the one you're responding to.

>The system has as much interest in curing your depression as it does curing obesity.

Ironically enough, the system hasn't cured obesity (if you believe obesity is primarily caused by a poor environment) and seems to instead to be headed towards managing symptoms by hacking our hormones and brains with semaglutides, etc. But at least you can work.

If you use a similar train of thought applied to depression - we're now in a situation where something like 50 million Americans are on antidepressants or antianxiety medication. 1 in 6. This is also treating symptoms and putting people into a state of being able-bodied without being so well as to remove their dependency on the drug. But at least you can work.

So I think the original idea fits with the concerns you outline. Mass producing a few drugs to keep a majority of the population able-bodied might not be that much money in the big picture.

I'm not a firm believer in this theory, but I can totally believe an overly complex system with poor incentives and no absolute oversight can lead to these outcomes.

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

#307

Post by tootie »

mtlmtlmtlmtl wrote: post #177
tootie wrote: post #11

Earlier quoted context omitted.

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.

Purely out of curiosity, which drug is this, if you don't mind me asking?

Sodium oxybate. Active ingredient is GHB. I was stunned to find out this was a therapeutic but apparently it was developed for potential therapies and was only coincidentally discovered to be intoxicating. I used to suffer debilitating cataplexy and sodium oxybate has nearly wiped it out.

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

#308

Post by HKH2 »

dustyventure wrote: post #265
striking wrote: post #166

Earlier quoted context omitted.

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.

While fishing for that right dosage of SSRIs you have a person with new boughts of mania and suicidal tendencies where there's no clarity on how to stop the experiment due to the complexity of blood level accumulation. If SSRIs started as illegal drugs, with i.e. people starting them dodging medical supervision, I think the system would be telling us they are insanely risky and well beyond many scheduled drugs.

bouts*?

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

#309

Post by risenshinetech »

fsckboy wrote: post #264
thegrim33 wrote: post #173

The results are based on a grand total of 25 people in the psilocybin group and 21 people in the SSRI group. The sample size is pretty small. The methodology is also kind of strange, the psilocybin group got a total of 20 hours of in-person therapy during their 'treatment' and 6 follow-up skype calls, whereas the SSRI didn't get anything other than the 6 month questionaire. Those 20 hours of personalized therapy whil…

> The results are based on a grand total of 25 people in the psilocybin group and 21 people in the SSRI group. Statistical significance is based on sample size, and is independent of population size. Let that sink in, doesn't matter if your population is 100K or 8 billion, when you sample you are trying to understand the probabilities in your sample, not in the population. Therefore, (think about the birthday paradox…

This comment is a shining example of the phrase "not even wrong".

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

#310

Post by fsckboy »

yieldcrv wrote: post #282
fsckboy wrote: post #279

Earlier quoted context omitted.

the vast majority of people who try psychedelics are not trying to escape untreatable clinical depression, they are doing it recreationally, for a roller coaster ride which they believe connects them with the Almighty or the Unknowable or the Dao or the All-loving Everpresent or the "insert word that sounds profound" These people are inspired—perhaps by the Almighty, i'm not judging—to preach The Gospel of psychedeli…

what point do you think needed to get across to me? did you think you were replying to someone else? my response was sufficiently broad to factor in non-positive and negative experiences and had nothing to do with the hyperbolic praise of some psychedelic users and that community

turns out I don't write my comments just for you. what did you write that you think so clearly showed you understood what I originally said that I wouldn't think other people suffered the same misapprehensions?
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