5 ms·
> While members of the psychedelic cohort received 25 milligrams of psilocybin during the sessions, considered a medium-to-heavy dose of the drug, those in the
by yosito 6y ago
> While members of the psychedelic cohort received 25 milligrams of psilocybin during the sessions, considered a medium-to-heavy dose of the drug, those in the antidepressant group received 1 milligram. Such a low dose is typically provided in psychedelic studies in lieu of a placebo
Doesn't seem like well-designed study.
- galangalalgol 6y agoCan you explain why for those of us unfamiliar?
- realce 6y agoWell it's not actually a placebo to start with.
- AstralStorm 6y agoThere is no way to placebo control a psychedelic really, as that effect is easily discerned, even in a closed label trial. Therefore, a comparison protocol is used instead, which is anyway superior to pure placebo control. A different psychedelic, which is not expected to have an antidepressant effect, or a low, psychoactive but not antidepressant dose. Or known non-psychedelic antidepressants which have been placebo tested.
- ghgdynb1 6y agoI think the concern is that you could still be getting pharmacodynamic effects at 1mg, so the control wouldn’t really be a control. It’s entirely feasible that you could get good results and limited side effects at dose x, and poor results overwhelmed by side effects at dose 25x.
- nicklecompte 6y agoI agree that this is a bad flaw but the reasoning about the “nocebo” effect does make sense: administering a placebo actually confounds the results if the participants know it’s a placebo, and it will be pretty obvious it the pill you took doesn’t have any psychedelics. Studies like these are inherently difficult, this isn’t an issue of poor design.
- the-dude 6y agoThe article specifically says this is to prevent nocebo effects.
- TaupeRanger 6y agoYou criticize the study but don't provide any arguments against the methodology. Tell us what you know about WHY they give people low doses in the control group, then explain why you think a different method would be better. These aren't idiots designing studies.
- ipaddr 6y agoNot the parent but perhaps allowing for a third group with no antidepression medication.
- spiritplumber 6y agoHow would one make that work though in this case?
- ridaj 6y agoTFA features a very reasonable explanation in the next few sentences. If participants are going to a session where they'll be essentially locked in with a psychiatrist for a few hours and take only a placebo, they'll know it, and they'll get more depressed from knowing that they're in the placebo arm. So instead a small dose is provided which has some lesser effects, avoiding to break the participants' "blindness" to the protocol.
- deleted 6y ago[deleted]
- hutzlibu 6y agoWell, true, but it seems hard to design such a study comparing psychedelics and common antidepressants. Because a antidepressant works pretty much on its own. But when you treat with psychedelics, you have to have a very professional therapist guiding the patient, otherwise you will get all kinds of effects. (So I argue success depends very much on the therapist) And a patient will notice, whether they just get a mushroom trip, or not. So what they did, they gave the control group 1 mg of antidepressant and told them, they are microdosing psilocybin. Not really ideal, but how to improve?
- AstralStorm 6y agoIt's a valid comparison design. An alternative is to use a high dose of a known non-antidepressant psychedelic, if one exists, as control. That would have to be something outside ergoloid, tryptamine and psylocybin families, which are likely to have those effects. Tough problem.
- hutzlibu 6y agoAren't psychedelics by definition mind altering? Sounds hard to find a psychedelic that isn't influencing the mind. Some mild hallucinogenics might work, but then the participants may not have mushrooms experience before, otherwise they know when to be fooled.