Could psilocybin be the key to treating anorexia? | Hacker News Reader

Could psilocybin be the key to treating anorexia?

scientificamerican.com

42 pointstzury75 comments

Anecdata, but an acquaintance of mine struggled with lifelong anorexia. Severe enough that he was hospitalized a few times. With great effort he could cling to the bottom of the "normal BMI" range, but his life was generally ruled by the eating disorder - he couldn't have meals with people, he had to do various exercise rituals.

He was an early participant in one of these psychedelic studies a few years ago. After the first treatment, he said he couldn't really tell if it had any effect. But six months later, he was totally changed - able to function almost normally.

We should exercise our usual amount of skepticism about miracle treatments, but my hope is that his experience can be replicated.

Science generally works on IF Then statements when it comes to treatment, IF you take this drug your blood pressure will increase, IF you exercise more your life expectancy will increase, with mental health issues there very few IF then treatments, there are only if maybe treatments, this is for a slew of reasons such as how we don't really understand it, symptoms can be caused by many different underlying issues, and legal risk of prescribing something that isn't proven effective. That being said, the IF maybe treatments are the only way to treat mental health, Psilocybin falls in this category.

Just about all common psychological medication (by which I mean antidepressants, antipsychotics, ADHD meds, etc) have a pretty weakly measurable effect and effectiveness. If you take them, your symptoms might improve. In some casesthey'll get a lot worse. In many cases it will have no effect on your symptoms. There are lots of side effects.

What's the difference here?

Psychedelics open your brain up to rewiring in some way, and can be used under direction to treat a lot of things. But of course, people who didn't like the Vietnam War used them recreationally, which is why the US government made them globally illegal.

Psychedelics desolve the conceptual prison your mind is in, the government made them illegal because they build those prisons.

Charitably, you could argue a functional society involves some amount of indoctrination into a set of shared beliefs and a large percentage of people losing that indoctrination would destroy society. Could the US function if everyone was a pacifist, anti-capitalist, hippie? I think that was and still is the primary concern.

Interestingly, we know the CIA tried to use psychedelics to make people become the opposite of hippies, and they failed. This was part of MKULTRA. They were banned shortly after this failure.

Psychedelics can dissolve more than the mind's conceptual prisons, perhaps much more of the mind than one would like. How did the hippie-era stereotype of the burned out acid head disappear so quickly from popular culture?

Kary Mullis is known to have used a lot of it and discovered PCR while off psychedelics. There's also the famous Hoffman's bycicle day. The stereotype is just that, and might be a result of lack of mental stimulation rather than LSD abuse, which is possibly the safest drug in terms of toxicity.

Why? Because it's not a very accurate stereotype.

I do first aid at music festivals and volunteer at a free clinic that serves a homeless population. I see a lot of spun folks and folks in varying stages of "burned out" (to use the term from the stereotype). I'm still in EMT school, but I've had to work with a lot of folks having adverse reactions to these substances.

Meth and alcohol, simply being poor, childhood trauma, getting into a bad medical situation, losing a job and not finding one; all of those things will put folks into some bad places.

But most substance abuse, in my limited experience, comes down to various traumas folks get into and maybe some chemical predispositions.

That's not how most of the folks I know who have had very adverse psychedelic experiences have gotten into those states. And it is generally a very transitory state.

While there are long-term psychological effects from stuff like acid (and IME, MDMA, Ket, and Nitrous are worse physiologically than things like LSD, C2B, DMT, psilocybin, mescaline, etc), generally psychedelic substances lead people to doing less of those drugs over time and that has a very different effect than, say, alcohol and chronic poverty.

Propaganda about these things has a hard time taking hold in the face of most folks lived reality.

Thank you for your service

Why has the stereotype of the coked-out stock trader or ketamine addicted delusional billionaire not held the same place in popular culture? Vagely functional coke heads are very, very common in certain circles

anyone i have met that did Psychedelics more than a few times, permanently changed their brain chemistry in a way that was obvious. sure they dissolve some kind of prison, but many people never make it back from that dissolution and end up somewhere worse

> did Psychedelics more than a few times

If you want to specify LSD, you should do that, not "psychedelics." There are many, many psychedelics. They have sometimes radical differences. You cannot generalize that word into "many people never make it back." That is flat-out wrong, not to mention harmful.

i disagree. i have a unique view of this type of drug use. i was part of a large social circle of psychedelic users, over the course of many years. i very rarely took part. i watched close friends change.

>There are many, many psychedelics. They have sometimes radical differences.

Psilocybin is a more selective 5-HT2A agonist than LSD and is more rapidly metabolised. At normal recreational or clinical doses, they really aren't very different. LSD isn't quite as well-researched as psilocybin as a psychiatric drug, but the data we have suggests that it isn't meaningfully different in terms of risks or benefits.

> anyone i have met that did Psychedelics more than a few times, permanently changed their brain chemistry in a way that was obvious. sure they dissolve some kind of prison, but many people never make it back from that dissolution and end up somewhere worse

Way to generalise. I also know people who drank water, went to sleep and never woke up.

Ego dissolution is dosage dependent and you don't need to reach that point to get positive benefits.

Also, many people do psychdelics that probably shouldn't.

unfortunately, I think repeated psychedlic use has deterministic and predictable changes to peoples personalities. its not some "awakening", its a structural change in the brain. i watched many close friends fade away after too much use

Surely, that's dosage dependent and frequency dependent. One per week vs once every three months vs once per year. Low dose vs medium dose vs high dose.

Plus, these things are illegal which means that most of the time you are not getting the real but instead pharmacologically similar substances that might have secondary effects. This is way you can't reliably imply a correlation because it is a black market and often what you think you consumed is not what you actually consumed.

Unless you actually tested what your friends consumed, you don't know what it was.

Pills and white powders get mixed up and adulterated that way, but I think everyone who eats mushrooms and hallucinates ate the right mushrooms. LSD is sometimes but rarely substituted for other hallucinogenic drugs that can be delivered on blotter paper, of which there aren't many.

>I think everyone who eats mushrooms and hallucinates ate the right mushrooms

That's a tautology. But what you meant is not true. Some of the compounds are chosen because they are chemically similar and have psilocybin like effects. Even if you were to test this with a standard kit it would be classified as psilocybin. Your average consumer would be none the wiser. The reason these compounds exist is literally because of that very reason. They were made in the context of slow moving policies targeting psychedelics by listing specific compounds.

I was under the impression that people ate dried mushrooms, not pure psilocybin extract? Are they sprinkling supermarket mushrooms with these other chemicals?

Depends, chocs and sweets laced with psilocybin are more discreet, taste sweeter and allows you to mass produce while controlling the amount of psychoactive that you sell so they are as popular as dried shrooms if not more.

no these people are deeply tied into the scene

They're not illegal everywhere.

You can grow mushrooms from spores and quality control the whole process.

maybe they outgrew you.

when you say your friends faded away, do you mean like they stopped being your friends, or like they became zombies? Because those are two very different interpretations

just less relevant, less social, not as "bright", less with it, more out in space

Maybe it helped them realize the futility of existence. I'd say that's worse. We're not meant to think about that until we're nearly dead from old age.

As I understand it it can be a lot worse, a lot better, or anywhere in between. Scientifically backed coaching can probably shift it towards the "better" side. This is a new area of research because the whole thing was written off for several decades due to the war on drugs.

Co-signed here with psilocybin being dangerous based on direct personal experience, and seeing inumerable issues with party friends. Apologists of psylocybin will sometimes say 'its not as harsh and dangerous as LSD.' Ok, damaging effects of this drug are always apologized away and covered up.

The biggest problem with psilocibyn is people are told its benign, then they go on a 'trip', and sometimes in their come-down delusion completely destroy their lives: leave their families, leave their career, and tend to 'come to' (if they do) several months later.

Bad trips are supposedly 'experiences' (and now your in the realm of metaphysics), and going to jail or hurting yourself and others supposedly just should be washed over, or, you have permanent anxiety while sober now.

The psychadelic apologists make themselves unfalsifiable because they can help people stuck in a purely materiastic mindset - which our souls know is completely false.

Anyone in the party scene, or 'psychonaughts' (as I was, and did massive amounts of mushrooms for years, and had friends doing the same, sometimes 2-5x a week), the consequences of screwing with your brain chemistry cannot be avoided.

Joe Rogan has done immense damage with minimizing risks of monkeying with your brain chemistry. This also relates to weed, which is not the weed of forty years ago compressed bricks with seeds in it, but its incredibly intense.

You'll never hear so many excuses about their drug addiction then from weed smokers who spend hundreds a week, and can't miss a single day of smoking, toking, edibles, oils.

NA and AA would be better paths to start with these trauma's, then fix the underlying trauma itself - which is also a spiritual problem, and not material. We, wealthy-west should theoretically be the most 'happy', and not lead for the last 60 years in depression, suicide, psychologists and psychiatrists, etc. Its not true, which is why nothing is working.

Or to summarize, as the meme goes - something like 'these non spiritual normies taking psychadelics getting one-shot by a seven-dimensional demon, now leave their husband and career, wanting to 'teach about love' in the amazon.'

If you're a real person, you've been shadowbanned since 2021 and don't seem to have noticed.

Sure but "somewhere worse" is usually defined relative to the current societal framework. Society requires almost every adult to participate in labor, if LSD made you want to sit around and make paintings all day instead of work we would consider it a negative even though it would be a positive within other conceivable societal frameworks. For example, if AI removes the need for labor then maybe it would be fine and even desirable for everyone to just be high and make paintings all day. The complete dissolution that some people experience is likewise terrible for society, because people with no ego are poor, unmotivated workers amongst other potential behavioral issues, but in a Tibetan monastery you might be considered a saint. Ramana Maharshi was supposedly found as a young boy living in a pit with flies and bugs eating away at his flesh, he was completely oblivious to even his personal wellbeing much less societal norms and expectations. He was and still is considered one of the greatest Vedic sages in recent history.

I'm not saying that everyone should go do LSD and I don't know the details or stories of the people you saw. Like I said, I understand the perspective of people who feel responsible for maintaining a social order. I'm just trying to point out how relative all of this is to societal frameworks.

They "never make it back" to what exactly?

What are you using as attributes to form a judgement of what is "worse"?

Drug use changes the way you vote. The people who were running the country during the Vietnam war recognized this and, along with the people who owned industry/media, didn't want that kind of change to go mainstream.

That was not why they started the war on drugs, and we have that on record.

Always beleive the record...

Yeah, Disenfranchise the hippies and the blacks by targeting those communities with heavy policing. Sorta like today where there's similar drug use levels between white and black populations, but one side is more heavily policed than the other.

Crack cocaine and cocaine are the same drug with a different delivery method but we all know exactly why one is punished more harshly. There's a federal policy that a given quantity of crack cocaine is to be treated as 10 times that quantity of regular cocaine, IIRC?

Perhaps you'd like to dig down into the stats using AI to find out that the gap in policing isn't really due to race. Check by poverty level, and perhaps by geographic areas.

I was trying to hide my power level but yeah, the point is to maintain a permanent "underclass" that can't pick and choose what work they take.

If everyone was truly free, we'd have to pay the real price to clean up shit and that would mean an inversion of our pyramid scheme.

Whose record?

Every time I see "does {PSYCHEDELIC} cure {AILMENT}" studies, I fear a recreation of the opioid crisis. They need to be studied as a treatment, yes, but people, doctors, and pharmaceuticals will abuse them given the opportunity and lack of oversight.

Psychedelics aren't even remotely addictive. People who take them usually don't want to take any more of them for months.

While most won't give you withdrawal symptoms, they can cause psychological addiction.

In the same sense that Pinterest can do so.

I lost a family member to anorexia, and the only thing I really regret is that I didn't suggest that we try psychedelic therapy now that everything else had failed and things looked pretty grim. I mostly blame myself for not pushing the idea. But I am also angry at the war on drugs which has caused all use of psychoactive drugs to be associated with such taboo.

Psychedelics arent that far from turning your brain off and then turning it back on again

but anyone i have met that did Psychedelics more than a few times, permanently changed their brain chemistry in a way that was obvious. clearly they are doing some kind of unraveling that doesnt fully bounce back

Why would you want your brain to ravel back up? I've worked at ayahuasca retreats and know many people who do it for a living (who are many of the most grounded people I know). Using these things in a therapeutic manner is a completely different thing than using them recreationally, might as well be a different substance. I'd guess those people who "permanently changed their brain" (whatever that means) were not in a context for actually healing.

I believe that the drugs cause structural changes to the brain that make it more difficult to function in the reward structure of society. You can claim through a philosophical lens that society is flawed and so this is okay, but ive seen it derail peoples lives, such that they are just living in some rural area with limited participation in real life

ive barely taken them, but i watched many people change over years of use.

> just living in some rural area with limited participation in real life

They might say the same thing about your lifestyle. The "reward structure of society" is highly abstract these days, arguably disconnected from "real life". You could say monks are disconnected from "real life."

This is a weird take, I think.

I guess it depends on what "derail" means (meaning, do you actually know one's internal state and if they are happy?). Is something wrong with living alone in a rural area if you are happy? (This sounds great to me, for reference!).

I've watched hundreds of people take them in great containers with great support. It's never a good idea to make big changes right away, but we take small steps to adjust our lives so we can actually be happy. Yes, even if that is less "productive". Why do we do the things we do anyways?

Clearly it impossible to observe brain chemistry by looking at a person.

Psychedelics does however have longterm behavioural effects that are statistically significant and to some extent observable.

Using a definition of brain chemistry that defines brain chemistry at an atomic level you may assert that a change in behavioural patterns reflect a change in brain chemistry. But with such a definition anything that a person experiences does that.

I attended a presentation at the maps conference in ‘23(?). The presenter said that the effect was not enduring for those on already on a path to recovery. She hypothesized that the body need nourishment and a lot of ancillary support to sustain that kind of neurological change.

(I’ll try to search for it when I have free time)

Psychedelic trips are taxing on the body and I think I agree with the hypothesis nutrients are underestimated in supporting a healthy mind in these states, from personal experience.

Sorry, but the answer is almost certainly no. We now have good quality data on psylocybin as a treatment for depression; at best, it's slightly more effective than existing treatments, at the cost of a small but significant increased risk side-effects (primarily severe acute anxiety and psychosis, possibly HPPD). We have less data on other psychedelics and other conditions, but none of it looks spectacular when you take into account the usual biases affecting small trials of novel treatments.

Psychedelics are likely to be a good option for some patients, it's good to have another tool in the armamentarium, but the idea that they're a revolution in psychiatry is simply no longer credible.

https://pubmed.ncbi.nlm.nih.gov/39627679/

Disclosure: I have participated in a clinical trial of psilocybin for treatment-resistant depression and did not see any meaningful benefit.

This is a treatment that can help people. just because it didn't help you does not mean it's ineffective in totality which is the stance you seem to take.

The question posed is "Could psilocybin be the key to treating anorexia?". Psychedelics are effective in treating some psychiatric disorders - I've been clear about that - but they are (at best) only marginally more effective than most existing treatments. That's a good thing, it will help some patients, but it's a million miles from being the key treatment.

We hear a lot of psilocybine lately, it cures altsheimer, people in coma awake miraculously. As long as we do not understand the workings, it reminds me of the days when radium or other nuclear substances were the cure for everything.

It's a drug that makes your neurons more susceptible to forming new connections. Of course it's going to be useful for a lot of brain treatment. In addition, it's highly illegal which means these things didn't get found out a lot sooner.

upside is that in most states you can just go buy the spores and they just so happen to conveniently have spawn bags right nearby. BUT DONT EVER COMBINE THE TWO AND WAIT A FEW MONTHS

Here on the east coast, you can just wait until May comes around and it rains a couple days in a row. Then, you can just go for a walk by your local river/creek and wade through the seas of Japanese knotweed, lesser celandine, and box elder maple while looking for mushrooms growing out of the wet woody debris. Between them and nearby mulch beds, SWIM has allegedly found psilocybe ovoideocystidiata pretty consistently for the past several years, in Minecraft. Just don't try and take any shortcuts with the identification. It's better to throw out questionable specimens than risk needing a liver transplant.

thats awesome, also on the east coast but northeast so nothing of note besides the nice fall weather to help cause a flush if they just so happen to get the process started this year... or something, not like id know

We don't fully understand the workings because it is (was?) classified as a drug, making research into it a lot more complicated. Thankfully there are charities and organizations that lobbied to make it more researchable.

Funny how 'drug' in English is a homonym for at the same time bad recreational substance and good one to cure illness.

In German it's Droge and Medikament

TIL I learned about Janus words that have two opposite meanings depending on context, also known as contronyms or auto-antonyms:

Cleave: To split apart ('cleave the wood') or to adhere closely ('cleave to one's principles')

Sanction: To give official permission/approval or to impose a penalty/ban

Oversight: Watchful supervision or an unintentional mistake/omission

Dust: To remove fine particles ('dust the shelf') or to sprinkle them on ('dust the cake with sugar')

Bolt: To secure firmly in place or to run away suddenly

Clip: To fasten together ('clip the papers') or to cut off ('clip the coupon')

Fast: Moving quickly or fixed firmly in place ('stuck fast')

Left: Departed (verb) or remaining (adjective)

Screen: To display/show ('screen a movie') or to hide/conceal

Weather: To withstand or endure ('weather the storm') or to wear away/deteriorate over time

Peruse: To read carefully and thoroughly or to skim casually

Trim: To decorate/adorn ('trim the tree') or to cut away excess ('trim the hedges')

Rent: To pay for the use of something or to receive payment for allowing someone to use something

Table: In British English, to propose for discussion; in American English, to postpone or remove from discussion

We hear a lot about LLMs lately, they solve reasoning, mimic empathy, and awaken consciousness miraculously. As long as we do not understand the workings of the mind and brain, it reminds me of the days when machine learning or Bitcoin were the cure for everything.

I think the main difference is that radium was new and people have been using psychedelics forever.

Yeah exactly, such "comparison is my passion" vibes from parent comment given radium was not used for ritualistic practices for thousands of years before Radium was even discovered

https://archive.ph/r7Rbt

Mushrooms have always made me vomit... So treat anorexia with bulimia? Hmmm.

This feels like a case where Betteridge's law of headlines applies, or at least should be presumed. [Recreational Drug] solves [malady] is such a hopeful go to and has recurred countless times.

I've partaken of 'shrooms a number of times: Fun times. I've even grown them (protip - not worth the trouble. It's amazing how something that grows in literal shit is suddenly the most fragile process imaginable when you try your PFTek method, and contamination will always be ruining your process). But people keep trying to make psilocybin a magic solution, and the studies have been extremely weak if not contradictory, and these stories always lean on worthless anecdotes.

SciAm really should prefer a headline such as:

Psilocybin opens up new pathways to treating anorexia

Not even that... One quoted study says it 'provides preliminary support for the feasibility, safety and potential efficacy' of the drug. The other study is funded by a company selling psychedelics as potential medicines...

Here's yet another anecdote of near-zero real value to add to the pile: I treated my severe treatment-resistant depression with ketamine infusions. It's obviously not the same as psilocybin, but I believe the current thinking is that psychoelics and dissociatives both have some positive effect on neuroplasticity, and that sorta checks out in my case. I'd say you need to combine it with some good cognitive behavioral therapy - it seemed to make CBT a lot more effective for me where it failed in the past because my brain was more open to rewiring. I haven't been re-treated in a few years now, but I still feel a lot better.

But you're also totally right - my story is just an anecdote, and these sort of headlines that used to have cannabis as a miracle cure for all types of things seem to have been replaced with headlines about psilocybin (or occasionally, ketamine) curing everything instead. I totally get the skepticism, but I'm a believer that we might be onto something w/r/t depression or other things that are treatable via CBT at least - the article mentioned "combined with talk therapy" ... not sure what therapy method was used alongside the psilocybin.

People tend to view these things as "pop the drug, and you're cured" but if you really want to make the most of the neuroplasticity, you need to make a conscious plan ahead of time so that you can guide the trip and focus on the problems you're genuinely facing.

The drug won't magically give you the answer but you may reach some more profound general breakthroughs regarding your own behavior, patterns you fall into unconsciously, etc.

Similar to how addiction and associated behaviors are really only resolved when the person addicted decides to make the change, you can use these to influence into a similar state.

Yes, for me it felt like the substance facilitates it so you do the mental work and introspection, allowing you the capacity to slow down and think through things, which won't miraculously happen if you aren't in a proper headspace.

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