Psychedelic frees up depressed brain, study shows
bbc.co.uk
bbc.co.uk
First out of the gate was ketamine (now on the market as esketamine), and currently psilocybin is being studied. It's showing promising results, however, the details re: dosing and adverse effects are still being worked out.
It's an inescapable fact: ALL drugs produce side effects (at least in some recipients). Who will or won't tolerate a given drug is mostly hard to predict beyond the overall odds.
Everyone in my field has seen individuals who have experienced serious harm due to use of hallucinogens including psilocybin. IMO using this class of drugs shouldn't be considered trivial. Sure, a lot of people have taken such "illicit" drugs without lasting problems, but response is a stochastic function. Odds of harm are no doubt small but as use spreads to a larger pool odds are adverse reactions will emerge.
Of course people with serious depression already have major brain dysfunction and likely vulnerable to exacerbated adverse effects. Compared to normal functioning there's sharply decreased room for error.
In medicine the primary rule is "above all do no harm". Absent sufficient data backing particular practices, choosing to step into new territory requires moving forward with great caution and care.
It's actually not so easy to assume that hallucinogen-naive test subjects will know the difference between psilocybin and placebo. Knowing the effects of a hallucinogen (i.e. reading about them) and actually experiencing the effects are quite different.
At least, this is something I found surprising after experiencing a hallucinogen (or any psychoactive drug besides caffeine) for the first time.
Going from caffeine and occasional marijuana to mushrooms was wild. You'd have a better chance of learning how to fly a helicopter from a book than understanding what psychedelics will feel like by reading or listening. Naive users might get fooled by a niacin flush or placebo, but once you've experienced it (and paid attention) there's no way you'll mistake the real thing.
It also gives you the perspective needed to appreciate music like Shpongle and hippie intellectuals like McKenna and Watts. If you haven't experienced psychedelics, you're like a blind person being told about colors. You literally can't understand it until you live through it. Like orgasms or childbirth or religious ecstasy, some things transcend mere explanation.
Psychedelics are great since they give you a shortcut right into the matrix, and you're confronted with the fact that you are indeed in a simulation, and that your existence in relation to the rest of the universe isn't nearly as distinct and cleanly delineated as you thought.
The radical changes in personality stem from whatever neural machinery that governs openness to experience. I think it makes sense that the change makes people less depressed and anxious. You allow yourself to pay attention to other things, and it becomes easier to avoid fixating and catastrophizing everything wrong in your life.
I'd like to see a trial in which the participants are unconscious for the duration of the "trip". This would not only be trivially blinded, but also help to establish whether the antidepressant effect stems entirely from the subjective experience, or whether there's a chemical component as well.
People always say, "the trip is integral!". But we don't actually know that, do we?
I'm not a health professional but I think medicine for the mentally ill is clearly overprescribed and this seems to be mostly a US thing. Although sadly, it is spreading.
Times past stepping into a therapists office you'd be sent to get zapped for being a gay man or a hysterical woman and prescribed all manner of questionable treatments from cigarettes to most recently opioids. I heard those things might be bad for you too.
The advice "we don't have data you should do nothing" is essentially a no-op. Useless, but you're fulfilling your primary rule, fair enough.
If the advice is "we don't have data on psychedelics, they have an unknown risk factor. But we do have data on this pill with a known factor, so you should take it instead".. well. We're all adults.
If you're in my office and I recommend a medication that you decide not to accept I'm not going to twist your arm to take it.
I might take calculated risks and do things myself, but when there are unknown risks due to utter lack of knowledge, you're right I wouldn't advise it for others. In my role trustworthiness is everything, it simply is wrong to do things that violate patients' trust. So true I won't take unnecessary chances with their health and well-being.
Not my job to defend conduct of others of decades ago. I could argue with your comment about "overprescribing", but really I see no point debating non-issues. Discussion only means something when based on facts, IOW it always comes down to specifics, not squishy generalities.
Shrooms is not cocaine, you can't OD on the stuff. That is not to say it can't cause other types of damage.
Not prescribing anything at all might be the safest course of action.
And here you also say that unlike the advice you give your patients you might decide differently when it comes to yourself.
> Not my job to defend conduct of others of decades ago.
I'm not saying this judgmentally, there doesn't seem to be an obvious way to reconcile all these things.
Your predecessors clearly also meant the best and gave the most prudent advice they could at the time. This is something to factor into the risk profile. The most trust worthy thing to do is admit that there are limits to our knowledge. But I understand why you would hesitate to provide this asterisk with your advice as a lot of people will take it poorly and rush to webmd and homeopaths as a result.
> I don't know how one can reasonably weigh between a medicine with known risks (and plausibly unknown risks!) and the unknown risks of something like psychedelics, which are not yet understood at all but anecdotatlly appear to potentially have a very high reward/risk ratio.
Yes, the key word in your statement is "anecdotally". Anecdotal evidence is not good enough. Need to have systematic, carefully vetted evidence documenting specific benefits and risks before it can be said the compound is understood well enough for general use.
There's a process to work out drug dose/risks. A prospective treatment goes through phase 1/2/3 trials. Basically it's about discovering the characteristics of a drug, good, bad and ugly. Well, at least as much as can be discovered in the course of it.
> That is not to say it can't cause other types of damage.
Exactly so. Hallucinogens can be bad for people with predisposition to psychosis, mania, panic attacks, dissociation. That's maybe ~3% of the total population. People may not know or care if they're at risk, so it can be a problem.
> And here you also say that unlike the advice you give your patients you might decide differently when it comes to yourself.
What I mean is that I have an obligation, taken an oath, that I won't knowingly expose patients to unnecessary risks of harm. It's always about having evidence that benefits exceed risk. It's a judgement call to be sure. In any case everything is done under full disclosure and consent.
I might be willing to take on a risk myself with less sure evidence of benefit than I could justify recommending to patients. There I have a higher burden of proof to meet. IOW I can experiment on myself but I won't experiment on others who might go along with it just because they trust me.
> The most trust worthy thing to do is admit that there are limits to our knowledge.
Fully agree and any trustworthy person would say "I don't know" when in fact one doesn't know something. When it comes to human knowledge it's always limited. For one thing we can't know what is unknowable, capabilities are constrained by our neurophysiological construction.
I'm OK with saying so when I don't know. It happens a lot.
One more point. It's true past practices in medicine are troubling to us now. I have qualms about certain things being done now. But cultures evolve, ideas of what's acceptable and not change. Applying today's ideas of standards to prior generations is likely to lead to a negative judgement, but is that a fair appraisal of our predecessors?
If we take a hard, critical look at our own time, and think about how some contemporary practices (not just in medicine) will be viewed by people 100 years from now, really what will they think of us? Plenty of current things would qualify, but it's hard for us to see them that way. Culture is invisible to the people embedded it it.
I'm gonna let out a galaxy-level eye roll when the FDA comes out with a "prescription" psilocybin x mg/kg or whatever. People have been taking mushrooms since the stone ages. The standard that these drugs have to meet is just so freaking high compared to say, Ambien, or Xanax, or Zoloft, or Prozac, which are given to at-risk populations by default.
Is there actual evidence showing that depressed individuals are more likely to suffer adverse effects?
I understand this is a standard disclaimer, but I thought I'd throw in that the drug depressed persons should really avoid taking alone is alcohol, especially in large quantities
But then coming down after a few hours was an emotional dumpster fire. It was really hard to endure emotionally; self-doubt, paranoia, and extreme sadness. But after many trips, not overreacting to those feelings, and knowing they'd pass, became a skill.
It was never less painful to come down, but it did become expected, understood, and manageable. That skill has since served me well in other contexts.
From my own experience making and taking a simple drug, just experiencing good thoughts once in a while kind of pulls me out of persistent/chronic depression. I know I'm getting better when I start thinking "wow, trying to kill myself was actually horrifying yo!".
The trick, imo, is to take something that is guaranteed to make you think happy/different thoughts (not only feel good). Which is why I think there's better options than psychedelics that can cause bad trips, at least for some types of depression. Which is also why cannabis can work but is very hit or miss - it having short or long term negative effects is very likely.
Now if only it wasn't so fucking hard and risky to create and use your own medication. Alcohol is perfectly legal and absolutely life destroying. But God forbid you even possess something illegal - they'll make sure you don't end your years of suffering. Oh the Hugh manatee.
But I'm also sure they've helped many people as is evidenced by the replies here.
The older I get (and the more I hear about people ODing in the news and from friends), the more I think that drugs as a whole are bad and alcohol is only borderline acceptable because of inertia
I can't imagine anyone physically ODing on LSD if it's legit. But there's two risks: adverse mental reactions and adverse physical reactions if the shit you take isn't real
Good to see more and more science come out to explain the mechanics.
We are on the verge of drastic improvements in mental health across the board but I fear that a certain industry with commercial interests will naturally seek to do anything and everything to make sure their interests are unaffected.
consequently when I type some comment near the end of the work day, it gets downvoted initially but then drastically attracts upvote outside the said work hour.
Either way it's great for the people that had positive experiences but also sounds scary in general, what if the profound change flips the other way?
With no physical dependency potential, low abuse potential, and an LD50 of above 250mg/kg, the only significant danger from taking mushrooms comes from the police.
So be extreeemely careful with this.
Seprately to the point above, I eventually noticed that I could get really emotional on a micro-dose and would feel suicidal. I once did a micro-dose before work in the morning that resulted in sending a very emotionally charged email to a coworker. Haven't touched the stuff since then.
I agree with the safety. Had an astronomical trip yesterday and I feel great for it. Fascinating journey into the nature of my consciousness and the things I fear for no reason.
If you have a history of mental illness in your family, it is not advised to experiment with psychedelics as they can waken up latent mental illness you never thought you even had.
Psilocybin containing mushrooms & truffles were once legal in Ireland and you could just walk into a headshop and buy them like cigarettes. They were banned after someone jumped from a balcony to their death[0] after taking them, presumably after having an acute psychosis.
[0] https://www.independent.ie/opinion/analysis/how-tragedy-led-...
IMO it's the circulation of this trope that kills. People on psychedelics while having emotional issues and acting out know exactly how they're expected to behave.
And apparently, this guy jumped less than an hour after taking a small amount of them. I can't imagine he was feeling much of anything yet, although others' experiences may vary from mine.
https://www.irishtimes.com/news/should-the-law-be-based-on-a...
I've had a few (always learned a lot, so all net positive experiences) but I understand the damage it can do for a person that's not fully mentally stable.
1) (set) A bad trip can result in a massive setback in terms of one's mental health -- which can take months or even years to overcome. This risk is significantly mitigated by the presence of an expert (which may be a therapist, and may be a seasoned psychonaut) who can talk through issues as they arise for the tripper.
2) (setting) People on mushrooms occasionally do really stupid shit. A naive user might not expect the trip to last for hours, realize they're "late" for some real-world engagement, and get into a car to drive there. Early into one of my first trips, I noticed that a 20m cliff appeared to be getting shorter... nearly short enough to jump. This can be mitigated by the presence of an expert (or, honestly, almost any sober adult), who should ensure that the immediate environment is effectively baby-proofed.
TL;DR alcohol is not helpful and can be very disruptive for some.
it doesn't https://health.usnews.com/conditions/mental-health/depressio...
> Shamans, curanderos and experienced users of ayahuasca advise against consuming ayahuasca when not in the presence of one or several well-trained shamans
I think a seasoned psychonaut friend who actually cares about you and isn't trying to get paid might be nice.
What the hell does a therapist have to do with it? You can just tell this is going to be another bs licensed profession in the future. Welcome to Spores'R-Us may I take your order.
You... trip.. with your drug dealer? Huh?
And if your therapist has a "clean supply" and you buy from them, are they not now your drug dealer?
How are these people stealing your car?
WHAT.
No, I don't trip with my dealer. Nor do I recommend it: I suggest that a risk you could incur is your dealer stealing from you while you're blitzed on the floor of your apartment. And should that happen, the police will happily book you for admitting to one crime while reporting another.
And, yes, your therapist would technically be your dealer at that point. But, key difference: the strictures of legality are stacked in your favor at that point.
I go outside to buy my drugs like a gentleman. If the cops come calling just tell them Dave's not here man.
Also if your therapist is selling you shrooms that is still a felony for both of you despite them having a license. The license is for therapy only, not a get out of jail free card.
If a researcher is administering shrooms as part of a study I think you can relax about your car being stolen buddy. Or take the bus there just in case. :P
And I suggested there's no reason your dealer should ever know where you live. So your best response is to call me high. Alright'y then, heh.
> Not everybody can find a seasoned psychonaut, though. The closest they'll have access to is their drug dealer.
Nowhere did I suggest that anything following that was a good idea.
If that is too overwhelming and difficult perhaps you're not ready for the experience in the first place. This isn't a dig at anybody.
The absolute necessity for a guide is also a completely baseless claim. It is prudent advice I suppose but nobody can really promise you a risk free trip or good results.
This is hardly uncharted territory. I'd start with reading some Terence McKenna rather than taking advice from randoms online/offline.
There is a reasonable body of work and advice on the subject available for those who seek it but you need to use your own judgment, and have good judgment.
Paying for an authority figure (note that I specifically opted not to use the word expert) to do your thinking for you doesn't always work.
The hell that a therapist has to do with it is the one you are experiencing in the moments just before the root gets uncovered, which hell may seem to last an eternity as the uncountable previous experiences of self-judgement become condensed into the space of now, and not just the experiences, but the very part of your personal identity to which in a way you are fully attached and without which you would feel loss, even though you consider it a pattern that introduces chaos into your daily experience. A good therapist, even one without extensive personal root cause psychedelic experience, will be able to help you navigate that hell, and reach the root. Without the proper structure and guidance you might not reach that experience of even beginning the work on the root, and if you do, a different outcome could be that you do not uncover the root, remain with the memory of a bad trip in which "I got stuck in a loop of self-judgement that seemed to never end", and are potentially further away from coming back to that subject and finishing the work by burying the root due to this experience, because if I went through that and didn't finish it in that sitting, I am for sure gonna take a nice long break from trying to understand self-judgement, and the condensed experience that would have led to uncovering the root will have had at least some temporary impact on my sensitivity, so I'll be fine dealing with self-judgement for a while.
I completely understand your worry though, and have one of my own, because it seems to me very possible that a future awaits where the structure of psychedelic work is not known, and the work will be limited to the surface, curing depression, learning incredible skills, and not realise the possibilities for the deep work. My worry is that psychedelics will be productised before their depth capacity is fully understood, and the product will be so appealing, near limitless in application and well marketed, that the depth work will have to wait for the next disruption opportunity in the product cycle, which in this market seems to be counted in the thousands of years.
I’m not sure how much, if any, scientific rigor was applied in the past - I hope that changes.
This is extremely rare. For perspective, there are people who drink once and overdo it, and end up dying in accidents or fights. But no one talks about it because it's equally rare and alcohol is socially accepted.
>People on mushrooms occasionally do really stupid shit.
Sober people do really stupid shit all the time, too.
Anecdotally I've taken 6g of dried shrooms (they are decriminalized here, for what that's worth) and was still able to refill my coffee and walk up and down a flight of stairs without spilling it or falling. I still wouldn't drive like that, but liquor impairs my fine motor skills a lot more. Driving myself to the hospital if I had to would've been possible off shrooms, but I can't say the same about half a bottle of whiskey.
Every drug is slightly different for every individual and no two highs are identical, sure, but for most nothing bad happens with psychedelics.
Note that amphetamines also carry similar risks: for example, if given to someone with bipolar disorder, they can cause schizoaffective disorder.
But when faced with the real world manifestation of these ideas, my emotions play out like these thoughts are indeed false. And I'd expect the reinforcement to correct this over time. But it hasn't. Causes great anxiety in quiet moments, and i'm hyper aware of certain social situations. It also comes up in dreams sometimes.
The idea about myself came up mid-trip, and from it poured out empathy for others (good) but somehow the anxiety inducing parts never left.
How does a control group work here? It's (presumably?) pretty clear to the people who got the mushrooms that they got something pretty unusual and powerful, where nobody gets that kind of jazz from anti-depressants. I feel like that would stomp all over trying to narrow down the placebo effect
the study compares effects both reported and measured.
double blind is important to not introduce "outside" influences, but it's not intended that the subject not experience what they take, quite the opposite, that's what is being measured.
If the people who took it report dizziness (aha!), but the people who took the placebo also report dizziness (doh), then that's not evidence that the drug produces dizziness.
Ever been prescribed Effexor®? I assure you, some anti-depressants in some people are an acid trip.
https://twitter.com/RCarhartHarris/status/151390616463902310...
I wonder whether someone wants to promote the topic or just get upvotes for later lobbying some other posts on HN.
Weren't researches done way back in 60-70s?
A great shame, because psychedelic therapy has so much potential. Just a single data point, but my life was turned around by some formational experiences on LSD and Psilocybin. Glad to see research heating up in this area again.
Except for only one friend, who ended up suicidal and delusional beyond repair, frequent mental hospital dweller (although all doctors said drugs could only exacerbate a pre-existing condition, but not create it from scratch).
I wonder why so big discrepancy between internet and real life here.
tl;dr If you're in medical or psychological fields and the only empirical evidence you have to back up a claim is from the 60s you are on shaky ground and need to collect more data.