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Psychedelics and mental illness

stuartritchie.substack.com

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Re: Psychedelics and mental illness

#61

Post by btilly »

I agree with the basic point of the article entirely.

However he shows the same kind of bias that he is speaking out again by not discussing the best known branch of such research. And that is MDMA for PTSD.

It is best known simply because it is, in fact, demonstrating that it works. The FDA has been repeatedly calling it a "breakthrough therapy" since 2017. It is in multiple phase 3 trials around the world that are going well, and full approval is expected this year. Research papers on it, like https://www.nature.com/articles/s41591-021-01336-3, are appearing in the top science journal in the world and are no less enthusiastic than a press release. Let me quote, "These data indicate that, compared with manualized therapy with inactive placebo, MDMA-assisted therapy is highly efficacious in individuals with severe PTSD, and treatment is safe and well-tolerated, even in those with comorbidities. We conclude that MDMA-assisted therapy represents a potential breakthrough treatment that merits expedited clinical evaluation."

So no matter how much questionable research there may be - and I'm sure it is a lot - let's not throw out the baby with the bathwater. There is also good research, and these drugs have the potential to make a huge difference.

Re: Psychedelics and mental illness

#62

Post by criticaltinker »

PragmaticPulp wrote: post #33
h2odragon wrote: post #2

I know a lot of cannabis fans (and count myself as one). Very, very few of them acknowledge that cannabis affects people inconsistently; one person's reaction to it can be very different than others. This is inconvenient for calling it a "medicine" so let's just ignore it. Psychedelics are even worse. The same dose of the same drug can produce wildly vary effects in the same person depending on factors we have troubl…

Psychedelic enthusiasts can be even worse in this regard. When someone does have a bad trip, they tend to reach for every possible excuse to avoid blaming the drug. This ranges from criticizing their "set and setting" to blaming "triggering an underlying mental health issue". The latter is particularly concerning in the context of treating mental health issues, because by definition everyone in that category has some…

Listen, your comments on all these threads make it clear you’re seriously pessimistic about psychedelic medicine, and that’s perfectly ok.

What bothers me is the incessant pushing of this agenda:

> anyone ending up in a psychedelic research study is doing so because they think psychedelics are promising for mental health and they want to try it out

> maybe the real reason psychedelics show efficacy in depression is that they are a sort of super-placebo

This amounts to uninformed armchair dismissal that is inconsistent with a growing body of scientific evidence, and easily refuted by a cursory survey of recent literature and clinical trial results.

Surely you’re familiar with double blind randomized placebo controlled studies? I’ve linked you to recent ones in other comments.

These methods aren’t perfect and your concerns certainly have merit in general - I just don’t understand why you continue to make these broad and suggestive claims without any supporting evidence.

Re: Psychedelics and mental illness

#63

Post by supertofu »

standardUser wrote: post #38
jamal-kumar wrote: post #22

Earlier quoted context omitted.

It's fun to send this "MAYBE YOU JUST HAVENT TRIED THE RIGHT STRAIN" [1] image to friends who don't like weed because it's a pretty hilarious embodiment of the downright anxiety the stuff engenders in a lot of people. I'm pretty sure it's like a genetic thing. I think I remember hearing something about the COMT gene being potentially affected if you smoke too much too early in life as a teenage stoner or whatever, an…

I'm convinced that the "normal" way Americans consume weed is basically an overdose for most people. Heavy users drive the market and the 30% THC and higher strains are targeted at those high-spending, high-tolerance users. I started to enjoy weed again when recreational stores opened up and I could find 10-15% THC weed that gets me pleasantly high, not paranoid and incapacitated.

I find that CBD-rich hemp still gets me "high", but the effect is extremely therapeutic. I hope low-THC cannabis is more widely studied.

High-THC cannabis has a very negative effect on my mind, mood, and motivation. But CBD-rich strains with low THC are perfect for handling my anxiety and autoimmune symptoms.

Re: Psychedelics and mental illness

#64

Post by mwattsun »

slibhb wrote: post #16

I like the article. With psychedelics, it's clear that much of the excitement comes from people (including scientists) who have used them and found their experiences helpful. That's not science but that doesn't mean it's wrong. Not everything is amenable to clinical study and this doesn't mean we should disregard it. And the issue isn't just psychedelics being hard to study. Mental health is hard to study. An overwei…

> Lots of people used LSD in the 60s and 70s and as far as I can tell they didn't usher in a new age of love, peace, and tolerance.

I would argue that LSD helped end the war in Vietnam. It's also not a fair criticism because governments around the world demonized LSD and made it a crime to partake, so you took it in an atmosphere of fear and paranoia. Hallucinogenics are only now given a fair test. There's already lots of anecdotal evidence that hallucinogens changed lives for the better (Steve Job, Richard Alpert.) A lot more has to change before a new age of love, peace and tolerance comes about, things like human greed and selfishness. No one is claiming that LSD turns people into angels.

Re: Psychedelics and mental illness

#65

Post by VictorPath »

>> Overall, it is difficult to see how prohibition of psychedelics can be justified as a public health measure” > This is activism, not science. As I said above, I actually support drug legalisation – but it’s far from appropriate to include this kind of thing so prominently in what’s supposed to be a neutral, factual scientific analysis.

Scientific studies that ingesting chemicals like THC are one of the reasons we have things like the Rockefeller drug laws. Activism from some in the scientific community is one reason people are rotting in jail for selling marijuana (while tobacco companies donate to politicians and in return get trade deals where it is illegal to have a law requiring warnings on cigarette packs.

People can be arrested for ingesting mescaline from peyote plants like Native Americans used to, scientific studies and activism is one reason for this, but scientists asking for people not to be imprisoned for getting mescaline from a cactus is not "appropriate".

(I have never tried mescaline but don't want to be imprisoned if I ever do)

Re: Psychedelics and mental illness

#66

Post by dr_dshiv »

slibhb wrote: post #51
dkjaudyeqooe wrote: post #49

Earlier quoted context omitted.

> An overweight man with no friends who plays computer games all day is not depressed unless he feels bad about it. This is entirely wrong. You can suffer from depression (and anxiety) and attribute it to other things, such as personality traits. Many people think "that's just me" with those that know them thinking the same. For less acute forms of depression such as dysthymia, that's common. People can think they're…

> This is entirely wrong. You can suffer from depression (and anxiety) and attribute it to other things, such as personality traits. Many people think "that's just me" with those that know them thinking the same. For less acute forms of depression such as dysthymia, that's common. People can think they're entirely normal and they're just not good at certain things. My post explicitly says the hypothetical man is happ…

I don’t know of any mental illness that isn’t accompanied by intense mental distress

Re: Psychedelics and mental illness

#67

Post by ActorNightly »

Skilbucks wrote: post #3

Do you think a disturbed work life balance could be a reason for mental illness as well?

From knowing a whole bunch of people with ranges of issues, my personal opinion is that it seems that certain people are just simply not "tuned" to their lifestyle/environment, and the mental health issues stem from a certain part of that psyche not wanting to change their environment.

Not that this would get past any ethics board, but it would be an interesting experiment if you took someone suffering from severe depression, fed them 10 grams of shrooms to reset their brain, and then put them in a remote village in South America with no phone or internet where basically their entire day has PURPOSE - i.e wake up, do work with fishing/farming/hunting construction, socialize in the evening, all as a group activity.

Re: Psychedelics and mental illness

#68

Post by colechristensen »

supertofu wrote: post #60
asdff wrote: post #56

Earlier quoted context omitted.

IMO the tolerance factor is huge with cannabis. Even for experienced daily smokers if you were to take a few days off, the effects are very noticeably more powerful. When you have zero tolerance, the drug feels like on another planet compared to something more familiar like alcohol. When you have a lot of tolerance, its a comfortable buzz you can be productive on, like a workingman's whisky drunk but without the slop…

This is an anecdotal and slightly off topic response to your note on cannabis tolerance. I am a frequent cannabis user and have been for a long time. While I no longer use psychoactive cannabis regularly (not in a fully legal state anymore) but I do use CBD, which purports to be non-psychoactive and, by law, has THC delta-9 levels of below 0.3%. What I find fascinating is that CBD absolutely has a psychoactive effect…

I think the opposite is what is happening, the regulated CBD products aren't regulated in a way that keeps them free of psychoactive components and nobody noticed yet or aren't too excited to try to change it, legalization being on the menu all over the place.

Re: Psychedelics and mental illness

#69

Post by ActorNightly »

newbamboo wrote: post #40

It’s easier to market “psychedelics” than meditation, prayer or something like DBT. We should learn from that and try to make more things as popular as psychedelics. “Put this little square of paper on your tongue” is much less of an ask than “sit in chair for 30 minutes everyday and be mindful of your breathing.” It’s like the McDonald’s approach to mental health, and who doesn’t love McDonald’s! Over a billion serv…

Psychs are absolutely not comparable to "sober" activities. While things like meditation have benefits, you are still largely operating in the same regimes within the neural network in the brain.

The main idea behind psychs is that they allow you to operate in a vastly different regimes. And, unlike McDonalds, and compared to other drugs, they are INCREDIBLY safe. It should be a no brainer for anyone needing them to use them.

Re: Psychedelics and mental illness

#70

Post by drooby »

I don’t fully understand the issue with blinding.

How is it different than trying to double blind talk therapy. Obviously someone knows that they are getting talk therapy, likewise, people obviously know they are getting psychedelics.

Yet we are still able to get experimental results supporting talk therapy and no one complains, right?

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