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Comment by erispoe | Hacker News Reader

This is not how psychedelics for treatment resistant depression is tested. The most common treatment protocol is a single psychedelics session assisted by 2 therapists (preceded by a few therapy sessions and some follow-ups). Overwhelmingly the evidence point to very significant effects lasting months after the session.

This is far from "a never-ending psychedelic trip". If you follow the evidence for the most researched treatment protocol, this would involve a session every year or half-year.

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> The most common treatment protocol is a single psychedelics session assisted by 2 therapists (preceded by a few therapy sessions and some follow-ups).

Ketamine is approved by the FDA for depression and also has a history, albeit shady, of being prescribed off-label at IV clinics. This is far more common than psychotherapy while taking medication and much less expensive too.

> If you follow the evidence for the most researched treatment protocol, this would involve a session every year or half-year.

In this small survey 60% of patients returned once a month or more for maintenance infusions.

A Survey of the Clinical, Off-Label Use of Ketamine as a Treatment for Psychiatric Disorders https://pubmed.ncbi.nlm.nih.gov/28669202

Psychotherapy is seen as prohibitively expensive because of the way it is currently practiced where the patient must see the therapist on an ongoing basis. This isn't necessarily a bad thing, it's a lot like seeing a personal trainer on a regular basis but it's certainly an expensive way to stay fit. Psychedelic therapy seems to be an option that helps make a much smaller number of sessions "stick". If you only have to do 3 sessions a year then it means the therapists can see a much larger number of patients and the overall cost for each patient could go down.

My opinion is that most people could handle (small) group therapy as well which could further reduce cost and might actually have a number of benefits for those involved.

FWIW, Ketamine is not a psychedelic. It's a dissociative.

It doesn’t affect the same receptors as “classic” psychedelics (LSD, DMT, Mescaline) but dissociatives aka dissociative psychedelics are wildly psychedelic at high doses. It seems ludicrous to insist otherwise. Is Salvinorin-A not a psychedelic?

I have a prescription and take it every three days. A clinically effective intranasal dose is about as psychedelic as a couple of beers.

I think you have it a little backwards. IME, psychedelics give dissociative effects along with the psychedelic experience and the dissociative experience is solely dissociative on its own.

I think there's a lot of confusion on what a psychedelic experience is and it gets confused with a hallucinogenic experience, which both classes of substance can offer.

I’ve been following this stuff since the mid 90s and am familiar with the terminology.

What do you assert is the difference between a psychedelic experience and a hallucinogenic experience then? Dissociative I agree only partially overlaps with psychedelic on a venn diagram but hallucinogen and psychedelic I understand as synonymous.

Hallucinations are pretty concretely defined, medically. Seeing stuff that isn't there. Hearing stuff that isn't there. Things moving when they aren't.

For me, the psychedelic experience is more about the "Ah hah! we're all in this together! We're all the same thing! I've removed the veil and barriers I've built up all my life and can finally see clearly what it's All About." I'm sure it's different for others, but I don't experience that "oneness" or "connection" on dissociative. It feels like I am born again, free to be vulnerable and experience the world without the lenses that society and myself have placed over my eyes.

I think the term there is "entheogenic" a la DMT:

https://www.vice.com/en_us/article/ep4dxk/its-official-dmt-m...

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