Comment by DubiousPusher | Hacker News Reader

Comment by DubiousPusher | Hacker News Reader

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Because currently, psychadelics as a treatment for mental illness and neuroses are on about as firm of ground as cough medicine and chiropractic.

https://sciencebasedmedicine.org/reference/chiropractic/

https://pubmed.ncbi.nlm.nih.gov/11045895/

That is not to say we don't definitively know they do not work. We just dont know if they do anything or not. There is promising preliminary research but a lot of that research is coming out of a community that appears prone to some serious motivated reasoning. And there is a small cultural movement brewing that seeks to promote them despite our current ignorance. Proponents have made a mad dash to dump them into alt med toolbox to sit alongside acupuncture, cupping, ear candling, essential oils, etc.

Edit: Don't get me wrong. I really hope these do work as the current standards of care for most mental illness are terribly flawed. Lithium for example is amazing but it has horrible side effects, destroys your organs and for many eventually stops working. Abilify has saved a lot of people's lives but when you're on it, a lot of times you just fucking want to die. It would be great to move beyond SSRIs, mood stabilizers and antipsychotics.

MDMA successfully completed Phase III trials for PTSD: https://clinicaltrials.gov/ct2/show/NCT03537014 results here: https://www.pharmacytimes.com/view/phase-3-trial-of-mdma-the...

Psilocybin can provide peace to terminally ill patients: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367557/

and it's in Phase II trials for major depressive disorder: https://clinicaltrials.gov/ct2/show/NCT03866174

and already has successful results in a small cohort, as published in JAMA Psychiatry: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

hell, ketamine is FDA approved for depression: https://www.fda.gov/news-events/press-announcements/fda-appr...

> MDMA successfully completed Phase III trials for PTSD:

Cool. I look forward to seeing how it performs in long term practice.

> Psilocybin can provide peace to terminally ill patients:

Looks promising, though that is a single study with a small sample size.

> and it's in Phase II trials for major depressive disorder:

Again, compelling but small sample size

> hell, ketamine is FDA approved for depression

This approval is based on self reported symptom data from phase III trials and currently is backed up with any extrinsic measurements such as reduced suicide. It's not nothing but it's not a slam dunk yet.

Again, it's all very preliminary though it looks promising. I don't see any evidence to suggest it will become the standard of care soon but it may in the future. We just have to wait and see.

"That is not to say we don't definitively know they do not work. We just dont know if they do anything or not. There is promising preliminary research but a lot of that research is coming out of a community that appears prone to some serious motivated reasoning."

It's not just preliminary research.

At the time LSD was banned there were thousands of research papers on it, and I've read that it was the most widely studied psychoactive substance on the planet.

The research that's come out more recently about psychedelics has largely just confirmed what was already known about them, and what has become crystal clear is that they're actually far more effective for some very severe mental illnesses (like treatment-resistant depression and PTSD) than any other medication or therapy in existence.

That's fair. I just sometimes get the sense that people equate being "logical" to being very hardheaded and skeptical, only preferring well-established solutions. There is nothing inherently illogical about trying experimental approaches; in many cases if they don't work you can just move on.

This isn't exactly that, though.

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