5 ms·

Aren’t psychedelics extremely likely to cause psychosis in users?

bzb4 6y ago
In very much the same way currently used antidepressants can trigger schizophrenia and other related, latent disorders in users?
- codebolt 6y ago
  Somebody can have a disposition for psychotic illness and live a whole lifetime without it manifesting. Drugs could be the trigger that destroys that person's life. Maybe these drugs should be allowed to be used in certain clinical settings, but I wish they had a better grasp on the risk factors for psychosis, so they knew who not to give it to. Certainly they should be kept illegal for recreational use, including marijuana.
  - andai 6y ago
    I'm against criminalization but I'm also against widespread recreational use until we have a technology to tell you if you have a predisposition or not. I've seen a lot of people's lives ruined by psychosis, and all but one were chronic cannabis users for 1-2 years prior. A causal relationship has been established. It gradually alters brain function over time. For some people (arguably 2%), this eventually pushes them over a threshold for psychosis. It seems there's no way of knowing in advance if you will be one of them.
    - looper_dude 6y ago
      Well, if your life is fucked up and not in a stable mindset before deciding to take them, or there's a history of mental illness in your family, those would be some red flags to seriously consider before purchasing your ticket.
      - andai 6y ago
        Exactly. And yet, those are precisely the kind of people who are the most attracted to the substance. Previously it was suspected to be a mere correlation -- that there's something about underlying mental disorders that draws one to cannabis, rather than cannabis causing mental disorders. In recent years, they have established a causal relationship cannabis -> psychosis (assuming the predisposition is there, of course).
- o-__-o 6y ago
  Considering we don’t know the mode of action of SSRI’s then no, it’s very much not the same..
  - winocm 6y ago
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381222/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381222/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207076/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207076/
ta17711771 6y ago
Not cause, IMO. More like suss out/shed light on existing issues that may be getting ignored/masked.
- deleted 6y ago
  [deleted]
yCombLinks 6y ago
I've never seen anything to support that past antedoctes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747247/#:~:text=Among%20people%20without%20a%20lifetime,CI%200.1%20to%200.7%2C%20p%20%3D https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747247/#:~:tex...
- kps 6y ago
  “Among people without a lifetime extremely stressful event…” It's not unlikely that people fitting the context of this article, i.e. clinical depression, have had a lifetime extremely stressful event, causally or consequentially.
- Natsu 6y ago
  I've nearly been a murder-suicide victim due to esketamine, so yes, it definitely exists. In fact, they screen out people out of the trials with psychosis due to this known potential side-effect. They also remove people from the trials for things like that. It's too bad, because other than that side-effect, it was doing a lot of good.
  - JBReefer 6y ago
    Wow, can you elaborate?
    - Natsu 6y ago
      Not much to tell, my partner took esketamine for a few months for treatment-resistant depression. I woke up one day to someone holding a knife and sobbing uncontrollably, calmed them down and took the knife away. The treatment stopped after that, of course, and sharp things got put away quickly. Thankfully there are no guns in the house. There may have been latent psychosis prior.
wishinghand 6y ago
Where is this claim supported?
rhombocombus 6y ago
Think about the differences between a recreational drug experience (i.e. the experiences which precipitated the psychosis to which you are referring) and taking a known dosage of a drug in a clinical setting with supervision. Now let's visit the reality that many studies have now been completed on the clinical efficacy and potential of these medications. This isn't someone taking acid in a phish parking lot, there are now real clinical trials on a couple different drugs that were vilified by drug war propaganda that are now known to have substantial clinical potential.
kryogen1c 6y ago
No, but the kernel of truth here is that unguided, amateur trips can have negative consequences. However, studies have been showing extremely positive outcomes under controlled circumstances with experienced guides.
taurath 6y ago
Not anywhere near extremely, but there's not actually good data as research is banned since the late 60s. They are a powerful tool.
bduerst 6y ago
Psychedelics can cause HPPD (temporary) and Visual Snow Syndrome (permanent) in people, where they hallucinate while completely sober, sometimes indefinitely for the rest of their lives. As someone with Visual Snow Syndrome (not contracted from drugs) it is a private living hell that risking it is not worth whatever trade off you get from discovering yourself. This is going to rub some people the wrong way on HN, but until we know more about these neurological conditions, I wouldn't recommend doing these drugs outside of a clinical setting where there are very clear benefits.
- elric 6y ago
  Do you have a source about psychedelics being a cause of VS? I'm also curious what makes you say that VS is a hallucination, when it seems much more like a hyperawareness of visual noise.
  - bduerst 6y ago
    The short description is it's a hallucination, the long description is that it's not a hallucination, but seeing more of what's there, all the time. Like seeing the white blood cells in capillaries on the surface of your eye lens, the wrinkles in the gel on the back of your eye, and triple imaging between both feeds from both eyes overlaying a consolidated stereo view. IME explaining visual snow syndrome (VSS) to a layman is a lot like trying to explain color to a blind person, so I keep it short. There isn't much known about the mechanism that causes VSS/HPPD, but the current line in the sand that they draw for performing VSS studies is that HPPD is temporary (<6 months) and VSS is permanent. HPPD is long known to be caused by psychedelics, but the permanent HPPD is now being re-diagnosed as VSS since they're the same symptoms and activity in PET scans. Unfortunately, there are not a lot of studies I can link to because they've only just started researching it these past couple years, but the neuro opthamologists and psychiatrist I work with have VSS patients who contracted the syndrome after using LSD or acid, with one as far back as the 70's.
- djannzjkzxn 6y ago
  If you don’t mind me asking, what is hell about visual snow? I have some visual artifacts including snow but they don’t cause any suffering. They are just things I can see that don’t have any emotional significance. I don’t think about them unless my attention is drawn to them somehow. Maybe the snow is more disrupting for you than my artifacts are? Do they limit your ability to perceive the world?
qntty 6y ago
Definitely a small risk, but not an extreme one.
horsemessiah 6y ago
Definitely possible, but not at all extremely likely.
CryptoBanker 6y ago
Definitely not extremely likely for most. Those who are most at risk are those who have a family history of psychiatric illness
currymj 6y ago
they can, although so can SSRIs, surprisingly, by sometimes triggering mania. it's good for experienced professionals to be involved who can look for warning signs beforehand, evaluate the risks, and intervene quickly if things go badly. i find it a little troubling and irresponsible when people go around promoting psychedelic drugs, advocating that everyone ought to take them. if you're going to do that, i think you ought to always include a long disclaimer about the negative side effects, just like the drug companies do on TV.
- andai 6y ago
  Re: antidepressants triggering mania: it is the same with stimulants prescribed for ADHD.
andai 6y ago
The risk is if you have a genetic predisposition that chronic cannabis use will interact with in a way that eventually (typically 2 years) causes psychosis. There currently appears to be no way of knowing in advance. I expect 98% of people will be fine (based on predisposition numbers), but I've almost run out of fingers on which to count the ones who were not so lucky. The outcome may be different if psilocybin is used occasionally, and cannabis is used never. Sadly I have not met or heard of such a person.
- rocgf 6y ago
  Do you happen to have a source for this? Intuitively, 2% sounds like a very high number to me for what is being implied.
  - andai 6y ago
    It's a ballpark number, between the prevalence of bipolar disorder (1-3%) and schizophrenia (0.5%). It could be 1%, it could be 0.1%. This doesn't change the point, that you cannot predict the long-term impact to your neurochemistry until it happens to you. You won't know if you're one of the unlucky 1/1000, until you know, and then it's too late. I've seen it happen to nine people, and most of them did not recover to a normal standard of living.
    - rocgf 6y ago
      Ah, correct, I see where my confusion came from before. While I think you are largely correct, your explanation might be a bit incomplete. As far as my understanding goes, these mental disorders generally have an early onset, around your early 20s, and the question of whether drugs cause them or simply speed up the timeline is unanswered. This is partly why you should abstain from drugs as long as possible - it is better to start at 25 than at 16. In other words, if you are 30, never had any mental issues and you start smoking cannabis, you are unlikely to develop schizophrenia, for example. I may be wrong with the above, and I'd love to be corrected.
dokem 6y ago
I wouldn't call it extremely likely. I think you are underestimating how prevalent psychedelics already are in our society. Whenever I see people trying to be afraid of psychedelics I just think that they would probably outlaw sex too if given the chance.

bzb4 6y ago

In very much the same way currently used antidepressants can trigger schizophrenia and other related, latent disorders in users?

codebolt 6y ago
Somebody can have a disposition for psychotic illness and live a whole lifetime without it manifesting. Drugs could be the trigger that destroys that person's life. Maybe these drugs should be allowed to be used in certain clinical settings, but I wish they had a better grasp on the risk factors for psychosis, so they knew who not to give it to. Certainly they should be kept illegal for recreational use, including marijuana.
- andai 6y ago
  I'm against criminalization but I'm also against widespread recreational use until we have a technology to tell you if you have a predisposition or not. I've seen a lot of people's lives ruined by psychosis, and all but one were chronic cannabis users for 1-2 years prior. A causal relationship has been established. It gradually alters brain function over time. For some people (arguably 2%), this eventually pushes them over a threshold for psychosis. It seems there's no way of knowing in advance if you will be one of them.
  - looper_dude 6y ago
    Well, if your life is fucked up and not in a stable mindset before deciding to take them, or there's a history of mental illness in your family, those would be some red flags to seriously consider before purchasing your ticket.
    - andai 6y ago
      Exactly. And yet, those are precisely the kind of people who are the most attracted to the substance. Previously it was suspected to be a mere correlation -- that there's something about underlying mental disorders that draws one to cannabis, rather than cannabis causing mental disorders. In recent years, they have established a causal relationship cannabis -> psychosis (assuming the predisposition is there, of course).
o-__-o 6y ago
Considering we don’t know the mode of action of SSRI’s then no, it’s very much not the same..
- winocm 6y ago
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381222/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381222/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207076/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207076/

ta17711771 6y ago

Not cause, IMO. More like suss out/shed light on existing issues that may be getting ignored/masked.

deleted 6y ago
[deleted]

yCombLinks 6y ago

I've never seen anything to support that past antedoctes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747247/#:~:text=Among%20people%20without%20a%20lifetime,CI%200.1%20to%200.7%2C%20p%20%3D https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747247/#:~:tex...

kps 6y ago
“Among people without a lifetime extremely stressful event…” It's not unlikely that people fitting the context of this article, i.e. clinical depression, have had a lifetime extremely stressful event, causally or consequentially.
Natsu 6y ago
I've nearly been a murder-suicide victim due to esketamine, so yes, it definitely exists. In fact, they screen out people out of the trials with psychosis due to this known potential side-effect. They also remove people from the trials for things like that. It's too bad, because other than that side-effect, it was doing a lot of good.
- JBReefer 6y ago
  Wow, can you elaborate?
  - Natsu 6y ago
    Not much to tell, my partner took esketamine for a few months for treatment-resistant depression. I woke up one day to someone holding a knife and sobbing uncontrollably, calmed them down and took the knife away. The treatment stopped after that, of course, and sharp things got put away quickly. Thankfully there are no guns in the house. There may have been latent psychosis prior.

wishinghand 6y ago

Where is this claim supported?

rhombocombus 6y ago

Think about the differences between a recreational drug experience (i.e. the experiences which precipitated the psychosis to which you are referring) and taking a known dosage of a drug in a clinical setting with supervision. Now let's visit the reality that many studies have now been completed on the clinical efficacy and potential of these medications. This isn't someone taking acid in a phish parking lot, there are now real clinical trials on a couple different drugs that were vilified by drug war propaganda that are now known to have substantial clinical potential.

kryogen1c 6y ago

No, but the kernel of truth here is that unguided, amateur trips can have negative consequences. However, studies have been showing extremely positive outcomes under controlled circumstances with experienced guides.

taurath 6y ago

Not anywhere near extremely, but there's not actually good data as research is banned since the late 60s. They are a powerful tool.

bduerst 6y ago

Psychedelics can cause HPPD (temporary) and Visual Snow Syndrome (permanent) in people, where they hallucinate while completely sober, sometimes indefinitely for the rest of their lives. As someone with Visual Snow Syndrome (not contracted from drugs) it is a private living hell that risking it is not worth whatever trade off you get from discovering yourself. This is going to rub some people the wrong way on HN, but until we know more about these neurological conditions, I wouldn't recommend doing these drugs outside of a clinical setting where there are very clear benefits.

elric 6y ago
Do you have a source about psychedelics being a cause of VS? I'm also curious what makes you say that VS is a hallucination, when it seems much more like a hyperawareness of visual noise.
- bduerst 6y ago
  The short description is it's a hallucination, the long description is that it's not a hallucination, but seeing more of what's there, all the time. Like seeing the white blood cells in capillaries on the surface of your eye lens, the wrinkles in the gel on the back of your eye, and triple imaging between both feeds from both eyes overlaying a consolidated stereo view. IME explaining visual snow syndrome (VSS) to a layman is a lot like trying to explain color to a blind person, so I keep it short. There isn't much known about the mechanism that causes VSS/HPPD, but the current line in the sand that they draw for performing VSS studies is that HPPD is temporary (<6 months) and VSS is permanent. HPPD is long known to be caused by psychedelics, but the permanent HPPD is now being re-diagnosed as VSS since they're the same symptoms and activity in PET scans. Unfortunately, there are not a lot of studies I can link to because they've only just started researching it these past couple years, but the neuro opthamologists and psychiatrist I work with have VSS patients who contracted the syndrome after using LSD or acid, with one as far back as the 70's.
djannzjkzxn 6y ago
If you don’t mind me asking, what is hell about visual snow? I have some visual artifacts including snow but they don’t cause any suffering. They are just things I can see that don’t have any emotional significance. I don’t think about them unless my attention is drawn to them somehow. Maybe the snow is more disrupting for you than my artifacts are? Do they limit your ability to perceive the world?

qntty 6y ago

Definitely a small risk, but not an extreme one.

horsemessiah 6y ago

Definitely possible, but not at all extremely likely.

CryptoBanker 6y ago

Definitely not extremely likely for most. Those who are most at risk are those who have a family history of psychiatric illness

currymj 6y ago

they can, although so can SSRIs, surprisingly, by sometimes triggering mania. it's good for experienced professionals to be involved who can look for warning signs beforehand, evaluate the risks, and intervene quickly if things go badly. i find it a little troubling and irresponsible when people go around promoting psychedelic drugs, advocating that everyone ought to take them. if you're going to do that, i think you ought to always include a long disclaimer about the negative side effects, just like the drug companies do on TV.

andai 6y ago
Re: antidepressants triggering mania: it is the same with stimulants prescribed for ADHD.

andai 6y ago

The risk is if you have a genetic predisposition that chronic cannabis use will interact with in a way that eventually (typically 2 years) causes psychosis. There currently appears to be no way of knowing in advance. I expect 98% of people will be fine (based on predisposition numbers), but I've almost run out of fingers on which to count the ones who were not so lucky. The outcome may be different if psilocybin is used occasionally, and cannabis is used never. Sadly I have not met or heard of such a person.

rocgf 6y ago
Do you happen to have a source for this? Intuitively, 2% sounds like a very high number to me for what is being implied.
- andai 6y ago
  It's a ballpark number, between the prevalence of bipolar disorder (1-3%) and schizophrenia (0.5%). It could be 1%, it could be 0.1%. This doesn't change the point, that you cannot predict the long-term impact to your neurochemistry until it happens to you. You won't know if you're one of the unlucky 1/1000, until you know, and then it's too late. I've seen it happen to nine people, and most of them did not recover to a normal standard of living.
  - rocgf 6y ago
    Ah, correct, I see where my confusion came from before. While I think you are largely correct, your explanation might be a bit incomplete. As far as my understanding goes, these mental disorders generally have an early onset, around your early 20s, and the question of whether drugs cause them or simply speed up the timeline is unanswered. This is partly why you should abstain from drugs as long as possible - it is better to start at 25 than at 16. In other words, if you are 30, never had any mental issues and you start smoking cannabis, you are unlikely to develop schizophrenia, for example. I may be wrong with the above, and I'd love to be corrected.

dokem 6y ago

I wouldn't call it extremely likely. I think you are underestimating how prevalent psychedelics already are in our society. Whenever I see people trying to be afraid of psychedelics I just think that they would probably outlaw sex too if given the chance.