Psychiatric risks for worsened mental health after psychedelic use
journals.sagepub.com
journals.sagepub.com
That said, I think it's a refreshing perspective, and it seems like a good idea to look at effect heterogeneity in psychedelics use. Thinks like bayesian trees (BART) can help identify subgroups that react differently to stimuli along specific characteristics.
https://www.reddit.com/r/DMT/comments/gb9ar0/dark_dmt_trip_r...
This doesn’t get mentioned in the current “psychedelics as a cure-all” hype wave.
> and out of pure immaturity and desire to breakthrough I packed 100mg into the bowl.
https://psychonautwiki.org/wiki/DMT says heavy dosage is 60mg+.
> This doesn’t get mentioned in the current “psychedelics as a cure-all” hype wave.
No. You forgot to mention 100mg is way above heavy dosage.
RIP Richard Skibinski (July 17, 2022)
https://www.reddit.com/r/Psychedelics_Society/comments/uzed2...
https://www.legacy.com/us/obituaries/legacyremembers/richard...
Steve Jobs stated LSD was “one of the two or three most important things I ever did in my life”
Francis Crick saw the double helix of DNA on LSD
Kary Banks Mullis, the biochemist who won the 1993 Nobel Prize in Chemistry for his improvements to the polymerase chain reaction technique: “It [LSD] was certainly much more important than any courses I ever took.”
Ralph Abraham claimed the insights he had while on psychedelics such as LSD profoundly influenced the development of his mathematical theories.
And there's more and I am not even mentioning that most artists are using something.
So yeah, if you can get Nobel prize you can definitely get PhD. You do you, I don't know what you have achieved but don't claim you posses some universal truth.
You also might "crap on the roof with your ass on the ground" to (miss)quote Castaneda.
Definitely, those few experiences will be with me till my last breath.
Some people say if you keep up to date on global news, the opposite may be even more true.
I'll probably travel a little within the US but in the space of therapy stuff, I'd much rather accept that I'm simply not a travel person, than actually bother traveling.
On par with new age crystal healing and chakra points.
I first tried LSD about 10 years ago and have taken various forms of psychedelics once or twice a year since. Some of them were, without a doubt, the most profound experiences of my life. You're right about the vague transcendentalist nonsense. The problem is there are no words to describe it adequately.
Despite only having pleasant experiences myself, I would never encourage any friend or stranger to try them. That is something only they can decide with their own research and risk appetite. There are absolutely serious potential consequences.
I think the worst consequence for me is that I have started to like weird music like psytrance even when sober.
The universe does not know or care about our laws and they are incomplete.
For example, we have no idea how consciousness works, so at this point we stop at "I don't know", rather than inventing explanations.
I don't know if consciousness is computable -- I suspect it isn't.
If it is not computable then we cannot come up with laws to explain it.
Or maybe the whole universe is computable but its kolmogorov complexity is larger than its information capacity.
I agree that the universe doesn't care how we approximate these laws, but only that they clearly exist.
If these laws exist, they are certainly not material, unless you redefine material, and that is why I am no longer a materialist :)
However, I don't think any materialist would deny laws of physics exist. We might say that how materials interact with each other is an intrinsic property of material itself, just as an electron behaves as though it has a certain mass.
What definition of material would you use that separates it from its laws?
I'm not saying that psychedelics are for everyone, or that anyone should take them on a whim and without preparation. However, it's just incorrect to equate their ability to change people's lives for the better to crystal healing or similar.
After all, asking someone what it was like to stand at the top of a mountain they'd just climbed, admiring the view, you're likely to get similar "hand-waving" answers about connection to something bigger than them, but you probably wouldn't argue that climbing a mountain and taking in the view is a worthless experience that amounts to nonsense.
Her suicide is very sad but I can relate. Rest in peace.
Personally it took me at least a month to feel functional again and then probably a year to start feeling better. Prior to that I struggled immensely with depression most of my life and abusing substances was my attempt to pull out of it, so to bottom out intensely like that feels extremely hopeless.
Once again giant disclaimer that I’m not authority, but I learned more about how psychedelics work from neuroscientists who research them and it was very illuminating. They are extremely potent in regards to neuroplasticity which seems like why they can be heaven or hell (https://en.wikipedia.org/wiki/Psychoplastogen). My best take away from the scientists was to space trips out by several months similar to what you should do for MDMA. Frequently redosing keeps your brain activity from stabilizing. That’s not their advice or strong statements (they were avoiding advice-giving entirely), of course, just what I took away.
Years later and I have done a lot introspection and learning and I have taken psychedelics again. I can identify my own anxiety, paranoia, or bad patterned thoughts creeping up and talk myself back. I don’t attribute that traumatic experience or drug use in general to improving my circumstance and I sure as hell don’t recommend it but it does seem like my life going to total shit was a step I needed to take to get it back together. Therapy would’ve been easier.
Had a similar experience to you but took it in a different way. Came down out of the craziness and realized "hey, I'm still here, shit could be a lot worse"
But I don't get why you still came back to them after having a negative reaction. Seems like a good sign to stop
Whereas in other groups a cascade effect sometimes happens and many people in such groups can experience mental health issues, and trauma.
There's that common call to examine "set and setting" but it's often a crap-shoot, due to the chaotic number of variables.
I've seen lifelong schizophrenia triggered by nothing more than a bit of binge drinking. For some people it takes trauma to trigger bad things, some drugs, some have luck and manage to go through life with such a thing without ever experiencing it. Powerful tool, nothing more, nothing less.
Sorry for your loss.
Recalling my mushroom days.... Okay, I think I get it. Psychedelic experience is, in part, about embracing the beautiful chaos of the universe. Surrendering to the charms of free-flowing wild information at scale so huge there's no chance of imposing your own orderly corrections - as you might in normal every day life via OCD. That's my armchair take anyway.
Psychiatric history | Negative responders (%) | Non-responders (%) | Positive responders (%)
OCD | 0.0 | 25.0 | 75.0It's a murky subject due to the traditional way being far removed from clinical environments. Anything artificial like therapy props would stand out under the influence of psychedelics, but I guess they've thought of that. Good luck to them.
Although while under the influence of psychedelics you're unlikely to arrange your sock drawer with compulsive order. You're more likely to free the socks from captivity.
I have been taking psychedelics for 50 over years. I am retired psychotherapist and I do not have a predisposition to mental ill health. I was also a substance misuse worker and methadone dispenser for over 10 years. I gave up smoking hash when I was 40 years old.
I did notice that with the introduction of skunk and the increase of up to 20% more Tetrahydrocannabinol (THC), there were more and more people being sectioned under the mental health act with psychosis. Whereas prior to skunk when people generally smoked good old fashioned, Moroccan, Lebanese and Afghani hashish it was a rarity.
I know a range of people of different ages who partake in psychedelic use and have no trouble, like me, in holding down a professional job role and engaging fully in life.
As with all drugs there is a risk, however, the risks with Psyceedelics are very low in comparison with other drugs.
We must not use individual cases to determine the safety of any drug.
Here in the UK the media went wild over reports that a 18 year old girl (Leah Betts) had died from taking MDMA. Very rarely are the true facts given; The coroner said that "water intoxication", and not an allergic reaction to the drug, was the cause of death.
I have a great deal of respect for Professor David Nutt who is an English neuropsychopharmacologist specialising in the research of drugs that affect the brain and conditions such as addiction. His recommendations to the government to reclassify drugs were rejected and he was sacked.
heroin is top of the list - alcohol is 5th on the list - LSD is 14th on the list - Ecstacy is 18th on the list
Can you please share the list? Went through the article hoping to find one but either I am blind or its not there.
As for rest of the comment - thank you for your work and balanced insight. All this could have been researched to death (and optimal solutions be picked up based on results with regard to population health) if this stuff wasn't illegal for so long and governments acknowledged that people can actually get (a bit) high, since they can already ie drink themselves to death.
He’s been working in the field for quite a while, and many of the drug harmfulness diagrams that pop up every now and then are from one of his papers.
Do you feel a "hero's" dose is necessary, or do you see benefit in micro dosing psychedelics. Or any dose in between for that matter.
“they should have known they had a family history of schizophrenia before using it!”
every dismissive psychedelic user that brags about increased empathy in the next breath
but in all seriousness, yes I would like to see more studies so we can at least have side effects printed on the side of the package, so the right people can take informed risks
It seems that right now people are too worried about a bad result messing up their ability to talk casually about their trips
I just want side effects to be based on less conjecture
science lets its beliefs die, faithful die with their beliefs
right now, psychonauts seem to be in the latter group and its not helping the science form at all
just like this study is trying to chisel at
while psychedelic communities are uniquely dismissive
oddly consistent in your other recent posts
dang, is this substantive to you?
Controlling for the substance and amount as well as having a professional, caring guide to help the patient through the experience will be a FAR different experience than eating a fist-full of shrooms at a party some stranger gave you while under the influence of other things...
I think there's a clear bias in cases of big pharma approved meds to jump to "Oh, it wasn't the medication, the condition just worsened" and with psychedelics/weed to jump to "The substance use is causing this". Even when there is proof of RX medication worsening mental health conditions, it's common to have these relationships straight up denied by the prescribing doctor.
This isn't to say that there isn't a similar relationship in psychedelics, but it feels really disingenuous to me to be mentioning this outside of the wider context of psychiatric meds which somehow get a free pass for causing a much wider and dangerous range of side effects. If psychedelics cause less harm than commonly prescribed drugs in the same population, isn't that a good thing? We should understand these harms, but the bias of Big Pharma needs to be taken out of the picture.
I hadn't heard about this before, and while I'm sure it is possible for any drug that messes with brain chemicals to cause someone to decide to kill themselves, I've always been told & read a different explanation for the suicide warning that comes with most (or all?) antidepressants:
Which is that a depressed person while at their lowest might think about suicide but not have the energy or willpower to do anything, but if they start taking a drug that partially fixes it, so they start having energy again, but doesn't fix their root problems so they still think that suicide would be preferable to life, and suddenly have energy to make that happen.
Which is also the reason that modern guidance is for antidepressants to be co-prescribed with talk therapy, to try to use drugs to let the person be able to work on their issues, rather than just hoping the drug can fix all issues.
"Although duloxetine reduced the symptoms of stress urinary incontinence and improved women’s quality of life, the harms related to suicidality and violence were 4 to 5 times more common with duloxetine than with a placebo, a meta analysis using patient level data by researchers from the Nordic Cochrane Centre showed." https://www.bmj.com/content/355/bmj.i6103
Any idea if the logic I wrote about is also true? Or is it the same as how many doctors will talk about SSRIs working because depressed people "have too little serotonin", a myth that remains commonly believed despite research not backing it up?
I'm not anti medication, and I'm not saying that there are cases where the benefit doesn't outweigh the harm, but I do think the potential harms of each medication should be thoroughly investigated equally. Large companies with the ability to withhold damaging trials, sway the public opinion, and have a giant PR team and legal team at their disposal shouldn't be impacting our understanding of the real risks and science.
Well I mean, it is, at least to some extent. The FDA has officially put a "black box" warning on antidepressants that they can increase the risk of suicide, especially in the young, and so have its counterpart agencies in several other countries. All doctors know about it – whether they all take that risk seriously enough is a matter of opinion, some are much more hesitant about prescribing them than others are. And it remains an active area of research.
> 100% guarantee that when psychedelics hit the market,
Here in Australia, they only let psychiatrists prescribe them (started in July last year for psilocybin and MDMA), and only for individually approved psychiatrists who have completed a training programme in psychedelic treatment. This is similar to our existing restrictions on prescribing psychostimulants–which most Australian states only permit psychiatrists and paediatricians to prescribe absent special approval–albeit even stricter. They'll likely relax the rules over time, but very unlikely non-psychiatrists will ever be legally allowed to prescribe them (outside of exceptional circumstances).
From what I understand, the approach in the US is different, as far as the DEA is concerned, theoretically, any doctor can get a DEA number which lets them prescribe any Schedule II/III/IV controlled substance. However, in practice, there are a number of drugs which very few US doctors would dare write a script for, even though by the letter of the law they are allowed to do it, because they don't want the "extra attention" the DEA will give them if they do – methamphetamine is a good example. (Technically, any Australian doctor can legally write a script for methamphetamine, but it is almost impossible to fill, because unlike the US, it isn't approved for sale in Australia–not because it is a controlled substance, rather because it lacks our equivalent of FDA-approval–the only way to actually fill the script would be to get a government permit to import it for an individual patient, and there is zero chance they'd approve such a permit unless the prescriber was a senior psychiatrist.)
Also the training and approval is paramount, they are doctors not magicians and many don’t even have a good understanding of nutrition let alone this type of drugs.
Honestly it's hard to say and I'm not even sure if you'd be able to study this empirically in this population. I do think that's why doctors fall prey to this bias, and especially so in a stigmatized population. "Ah, they were likely to have these symptoms anyway". It would be interesting to do a wider study, but there already was a history of these companies withholding damaging trials and results so I doubt it would be done, especially given that suicides have occurred in these trials.
I really do believe that these classes of medications are treated differently due to the great power the industry has on this issue. If you look up the background of NAMI it's quite suspect and reminds me about how doctors were getting textbooks that were written by the opioid prescribing company. NAMI goes on to inform public opinion and then this stuff becomes "fact". I'm glad the "too little serotonin" thing is being examined but it was crazy to see how many weirdly defensive memos and articles there were out when it first came out. I see I'm getting downvotes on my original comment but I do think it's extremely important to examine these intuitions and where they came from, because as we've seen some of this stuff has been based on profits/trial P-hacking/junk science.
SSRIs can cause some individuals to become disinhibited, impulsive. It is a particularly common symptom in children and adolescents (which is why many paediatricians and child psychiatrists hesitate to prescribe them), but more rarely can happen in adults too. Probably some people have a genetic susceptibility to it. It isn’t purely about ameliorating depression, since the same side effect has been observed in non-depressed children administered SSRIs (which aren’t solely used to treat depression, sometimes they are used to treat anxiety too, plus some children can end up being prescribed them when they have neither, due to misprescribing or off-label use.)
Disinhibition and increased impulsivity can increase the risks of suicidality/homicidality/etc
Anecdotal, but I've never once met a doctor who adequately described the risks of an SSRI to me as a patient, and even some who have pushed back when I've told them of my own dangerous reactions and other risk factors the drugs have. They really should, as should the risks of new psychedelic based drugs hitting the market. I don't have a problem with the study that's posted. What I do have a problem with is that I feel as if this information is going to be disproportionately used to deny access to RX psychedelics, when existing RXs with similar or worse risk factors aren't discussed in this manner at all.
I've tried SSRIs several times, more than one (and an SNRI and MAOI too). They never did anything for me other than cause unpleasant side effects.
The best cure for depression I've ever found is Vyvanse/lisdexamfetamine. Is that because I was never actually depressed and my real problem all along was ADHD? Maybe... but, on the other hand, I'm pretty sure sometimes my depression has been an independent problem from my ADHD and sometimes a much bigger one. The fact is, psychostimulants have an antidepressant effect, and are sometimes even prescribed off-label to non-ADHD patients in order to treat depression (generally only for "treatment-resistant depression", i.e. "we've tried all the antidepressants and none of them work"). I think it could possibly benefit more people with depression (at least they should try it), but psychiatrists are discouraged from prescribing it for them (here in Australia, psychiatrists actually need per-patient government approval to legally prescribe stimulants off-label). In practice, it is easier to convince a psychiatrist that you have ADHD, than it is to convince a psychiatrist to prescribe you stimulants for something other than ADHD.
Nearly every school shooter was on an antidepressant, but somehow that never makes headlines.
The particularly heavy-handed enforcement from 1970s onwards that spawned the term itself broadened into a war against the social and cultural opposition to the status quo - still partly racial in nature as various black civil rights and black power movements were a significant part of that, but also targeting anti-war protesters, "pinkos" etc.
Feels like another publish or perish paper.
That condition has a name, and it is "Engineer's Disease" or "Engineer's Syndrome."
Even if that's the case, I think framing it as "Engineer's Disease" is pretty critical for HN, which at times can become a literal orgy of it.
Also, SV culture amplifies Engineer's Disease into a destructive force only rivaled by its counterpart in finance. Doctors and lawyers who suffer from something similar are far more limited in their effects.
I think that's kind of missing the point. Also, I don't think many doctors are making the switch to engineering. Why would they? There are probably far more engineers becoming doctors than vice versa (though the total numbers in both directions are likely small).
The specific problem with Engineer's disease, is that engineers have the job of building things for others, and thus have the opportunity to force their half-baked ideas onto them. SV has amplified that and turned it into a monster, by elevating things like "disruption" into something like a moral imperative.
The counterpart in finance and the closely related managerialism rival it because those jobs involve control of others.
Doctors though? If they get arrogant about some other field, they usually just end up hurting themselves or a few others (like they learn to sail, get in over their heads, and sink their ship in a storm). They don't have a mechanism to do more damage.
> A line I often hear from programmers is that programming is like "having to build a plane while it's flying", implicitly making the case that programming is harder than designing and building a plane since people who design and build planes can do so before the plane is flying1. But, of course, someone who designs airplanes could just as easily say "gosh, my job would be very easy if I could build planes with 4 9s of uptime and my plane were allowed to crash and kill all of the passengers for 1 minute every week".
We tend to think that some problems are only as complex as our understanding of them.
It's also against HN guidelines to comment about the site itself instead of something substantial that promotes discussion.