12 ms·

Psychedelic frees up depressed brain, study shows

127 points by bencollier49 5y ago

deepsun 5y ago
> drug could treat depression Weren't researches done way back in 60-70s?
- marc_io 5y ago
  Yes, but they became illegal in 1971, before researchers had a chance to further explore the action of psychedelics.
- grenoire 5y ago
  As this area was gaining legitimacy in the late 70s, Reagan and the War on Drugs happened, which made legally obtaining the substances difficult, and research funding dried out.
  - flente 5y ago
    The backlash actually started sooner than that, and largely due to the excesses of Tim Leary, et al. Michael Pollan's book "How To Change Your Mind" covers it in detail. 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.
    - deepsun 5y ago
      I read "it changed my life" so many times on internet, but from personal experiences and many friends I don't know anyone who'd noticeably changed their life for better. 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.
- after_care 5y ago
  60s and 70s research does not meet modern standards. The validity of almost all medical and psychological research done in the era is very questionable. Some research done in this time was very good, but with psychedelics we are really starting back from square 1 because we've just begun researching it in earnest. 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.
causi 5y ago
Patients with depression are warned not to take psilocybin on their own. 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.
- system16 5y ago
  The possibility of a bad trip in someone who is not prepared for the experience should not be understated. When reality crumbles around you for the first time, you may not make the best decisions and could hurt yourself or others. Novice users should definitely start with a low dose, and be in the company of someone they trust in an environment where they feel safe.
  - eldenwrong 5y ago
    Furthermore not everyone can deal with the aftermath of a bad trip. I've seen people get messed up for a long time because they believed the delusions they had.
    - titoasty 5y ago
      Yep. 15 years later, still messed up. Not with delusions, but with the constant fear of being in that state again. The descent (is it the correct translation?) was more than particularly rough. I was kinda anxious before, but after it's been a constant hell of anxiety/depression/stress, avoiding anything that can trigger these feelings (yeah, I'm looking at you, sugar). So be extreeemely careful with this.
  - after_care 5y ago
    I agree with everything you said, but would also advise caution for more experienced users as well.
  - ne0flex 5y ago
    Definately agree. Two years ago, the death of a close friend lead me to try psilocybin as a means gaining a different perspective / coping with the loss. I don't think my scale was calibrated properly and ended up taking a fairly large dose. I wasn't at all prepared for the come up, where my body felt like it was overheating and I kept drinking chugging water feeling as though I was going to pass out. It scared the hell out of me. Luckily, I was able to call my friend who was experienced with this type of stuff and he guided me through it. If it wasn't for him, I definitely would've freaked out and done something stupid. The experience scared me that I wouldn't touch the stuff outside of micro doses. 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.
AnthonBerg 5y ago
Psychedelics are profoundly immunomodulatory – 5-HT2A agonists are psychedelics are antiinflammatory: https://www.frontiersin.org/articles/10.3389/fimmu.2015.00358/full https://www.frontiersin.org/articles/10.3389/fimmu.2015.0035...
huachimingo 5y ago
They should test induced psychedelic-like experiencies without substances too, like meditiation or trance with music...
petesergeant 5y ago
> In the first, everyone received psilocybin; and in the second - a randomised controlled trial - some were given the drug while others were given a different antidepressant 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
- zapataband1 5y ago
  The second trial was to compare escitalophram with psylocibin. Both groups were given psilocybin -> then brain scan. Then after a few weeks one group given escitalophram and one group given the placebo -> then brain scan. From what I can tell briefly reading the abstract.
- fsckboy 5y ago
  How does a control group work here? It's (presumably?) pretty clear to the people who got the mushrooms 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.
  - obscur 5y ago
    You mean that blinding is not meant to be able to separate the effect from placebo? If so, I don't agree. I often hear it mentioned in the context of psychedelic research that it is a problem that psychedelics result in unblinding. E.g. Carhart-Harris the other day https://twitter.com/RCarhartHarris/status/1513906164639023108 https://twitter.com/RCarhartHarris/status/151390616463902310...
- moistly 5y ago
  > nobody gets that kind of jazz from anti-depressants Ever been prescribed Effexor®? I assure you, some anti-depressants in some people are an acid trip.
tomatowurst 5y ago
in another thread I mentioned psilocybin mushrooms and how it helped depression in a lasting way I was downvoted to oblivion because it was "shaman and not based on science". 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.
- whalesalad 5y ago
  I’ve been surprised by the negative opinion of self medicating held by a vocal group here. I can honestly say this medicine saved my life. I put my hands in the care of “the system” for too long and it never got me anywhere. A few months of microdosing, occasional tripping, and meditation/breathwork has completely changed the trajectory of my life.
  - tomatowurst 5y ago
    happy to hear that brother, I also note that this might be geographically related, I saw at one point (posting outside west coast 9~5pm) rise to 20 upvotes, and then downvoted (during work hours in west coast). 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.
zwieback 5y ago
I've heard this many times now: psilocybin and related drugs anecdotally are breakthrough treatments for some patients. Does that mean the "brain gets rewired" or is the experience so profound that it changes the patient's outlook? 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?
- neves 5y ago
  Michael Pollan book "How to change your mind" is excellent. He give very good explanations about it.
- whalesalad 5y ago
  Both. Neurogenesis occurs at the physical layer but there can also be a shift in userland based on your experience.
daenz 5y ago
Speaking from personal experience, psychedelics can have a very emotionally cathartic effect. At the end of it, you feel like you were a sponge full of emotion that has just been wrung out. I can definitely see how if you're "stuck" in some kind of pattern, exercising those emotions can help get you "unstuck." I would probably recommend someone do this once every other year.
- ta8645 5y ago
  My personal experience is decades old, but different. I never had an emotional release provided by LSD. Instead, there were enjoyable visual hallucinations, ability to concentrate, and a heightened appreciation of beauty. 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.
  - daenz 5y ago
    Thanks for sharing. I should have clarified that my experience was with psilocybin
  - emmanuel_1234 5y ago
    This is fascinating, my experience is quite the opposite. The coming up is a very uncomfortable experience, both physically and mentally, but the coming down is the best thing ever: everything is at piece, in its right place, the world has a beautiful glistening aspect to it. I truly bite the bullet of the up phase to bask in the comfort of the coming down phase.
jotm 5y ago
Psilocybin has been in the news lately, but I'd say many drugs that cause a significant, immediate and forceful shift in thinking can work for depression. 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.
mwattsun 5y ago
> Patients with depression are warned not to take psilocybin on their own. 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
derevaunseraun 5y ago
Psychedelics are weird: some people will speak very positively about them. Other people get fucked up for life. It's like rolling a dice. Imho that's not a risk any person with sound judgement would take. 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
- AnonCoward4 5y ago
  As far as I know you can't sensibly OD on LSD for example. It doesn't really cause addiction and to OD you need to take something like 100x the effective dose.However the psychosis danger would still be a valid concern ("rolling a dice" puts it quite nicely)
  - derevaunseraun 5y ago
    the OD part wasn't with respect to LSD but towards drugs in general. I've known people who got started with psychedelics, then moved on to molly (not real MDMA, like the dangerous synthetic street shit), and onto other stuff after that. It makes people more susceptible to drug culture 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
- mudcrab 5y ago
  Humans can be allergic to anything - re-read your post replacing 'Psychedelics' with 'nuts' - no-one gets this excited over peanut allergies - we've replaced this fear with education, drugs should be the same.
  - joeberon 5y ago
- spacemanmatt 5y ago
  Inertia is the worst justification for alcohol I have heard yet. If I could wave a wand and remove the most dangerous drug on the planet it would probably be alcohol.
nudpiedo 5y ago
Every few weeks articles like this one on the topic of depression and psychedelics keep coming. They repeat themselves. I wonder whether someone wants to promote the topic or just get upvotes for later lobbying some other posts on HN.
Uptrenda 5y ago
I can't imagine they would be able to 'blind' their experiments for participants though? I mean, when you start tripping balls it becomes clear you got given the LSD and not something else... Unless they use like sub-threshold / micro-doses.
john-doe 5y ago
Who would have thought that the compounds probably responsible for our consciousness are also beneficial to our mental health. https://www.inverse.com/article/34186-stoned-ape-hypothesis https://www.inverse.com/article/34186-stoned-ape-hypothesis
- idiotsecant 5y ago
  I think your use of the word probably might be described as wildly overconfident.
jrapdx3 5y ago
As a physician with a practice in the realm of behavioral health it's been fascinating to witness the development of approaches to treatment-resistant depression using hallucinogenic agents. 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.
- cersei 5y ago
  "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." Is there actual evidence showing that depressed individuals are more likely to suffer adverse effects?
- ProjectArcturis 5y ago
  Yes, fascinating to watch, but as usual the hype outpaces the science. Two major issues not discussed in the article: 1. How do you do a placebo-controlled trial? All subjects will know the difference between psilocybin and placebo. And there are often huge placebo effects in depression trials. 2. No one has done a controlled trial with more than one dose. The best RCT so far, done by Compass, only followed patients up for 12 weeks. By that time there was still a numerical difference between drug and placebo, but it was narrowing and no longer significant. Extrapolating from the available data, the drug and placebo groups would have converged after 6 months. So what does that look like for a treatment? Do you have people trip every 3-6 months? How do you structure a Phase 3 trial to test the efficacy of, say, the 4th dose?

127 points by bencollier49 5y ago

deepsun 5y ago

> drug could treat depression Weren't researches done way back in 60-70s?

marc_io 5y ago
Yes, but they became illegal in 1971, before researchers had a chance to further explore the action of psychedelics.
grenoire 5y ago
As this area was gaining legitimacy in the late 70s, Reagan and the War on Drugs happened, which made legally obtaining the substances difficult, and research funding dried out.
- flente 5y ago
  The backlash actually started sooner than that, and largely due to the excesses of Tim Leary, et al. Michael Pollan's book "How To Change Your Mind" covers it in detail. 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.
  - deepsun 5y ago
    I read "it changed my life" so many times on internet, but from personal experiences and many friends I don't know anyone who'd noticeably changed their life for better. 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.
after_care 5y ago
60s and 70s research does not meet modern standards. The validity of almost all medical and psychological research done in the era is very questionable. Some research done in this time was very good, but with psychedelics we are really starting back from square 1 because we've just begun researching it in earnest. 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.

causi 5y ago

Patients with depression are warned not to take psilocybin on their own. 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.

system16 5y ago
The possibility of a bad trip in someone who is not prepared for the experience should not be understated. When reality crumbles around you for the first time, you may not make the best decisions and could hurt yourself or others. Novice users should definitely start with a low dose, and be in the company of someone they trust in an environment where they feel safe.
- eldenwrong 5y ago
  Furthermore not everyone can deal with the aftermath of a bad trip. I've seen people get messed up for a long time because they believed the delusions they had.
  - titoasty 5y ago
    Yep. 15 years later, still messed up. Not with delusions, but with the constant fear of being in that state again. The descent (is it the correct translation?) was more than particularly rough. I was kinda anxious before, but after it's been a constant hell of anxiety/depression/stress, avoiding anything that can trigger these feelings (yeah, I'm looking at you, sugar). So be extreeemely careful with this.
- after_care 5y ago
  I agree with everything you said, but would also advise caution for more experienced users as well.
- ne0flex 5y ago
  Definately agree. Two years ago, the death of a close friend lead me to try psilocybin as a means gaining a different perspective / coping with the loss. I don't think my scale was calibrated properly and ended up taking a fairly large dose. I wasn't at all prepared for the come up, where my body felt like it was overheating and I kept drinking chugging water feeling as though I was going to pass out. It scared the hell out of me. Luckily, I was able to call my friend who was experienced with this type of stuff and he guided me through it. If it wasn't for him, I definitely would've freaked out and done something stupid. The experience scared me that I wouldn't touch the stuff outside of micro doses. 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.

AnthonBerg 5y ago

Psychedelics are profoundly immunomodulatory – 5-HT2A agonists are psychedelics are antiinflammatory: https://www.frontiersin.org/articles/10.3389/fimmu.2015.00358/full https://www.frontiersin.org/articles/10.3389/fimmu.2015.0035...

huachimingo 5y ago

They should test induced psychedelic-like experiencies without substances too, like meditiation or trance with music...

petesergeant 5y ago

> In the first, everyone received psilocybin; and in the second - a randomised controlled trial - some were given the drug while others were given a different antidepressant 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

zapataband1 5y ago
The second trial was to compare escitalophram with psylocibin. Both groups were given psilocybin -> then brain scan. Then after a few weeks one group given escitalophram and one group given the placebo -> then brain scan. From what I can tell briefly reading the abstract.
fsckboy 5y ago
How does a control group work here? It's (presumably?) pretty clear to the people who got the mushrooms 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.
- obscur 5y ago
  You mean that blinding is not meant to be able to separate the effect from placebo? If so, I don't agree. I often hear it mentioned in the context of psychedelic research that it is a problem that psychedelics result in unblinding. E.g. Carhart-Harris the other day https://twitter.com/RCarhartHarris/status/1513906164639023108 https://twitter.com/RCarhartHarris/status/151390616463902310...
moistly 5y ago
> nobody gets that kind of jazz from anti-depressants Ever been prescribed Effexor®? I assure you, some anti-depressants in some people are an acid trip.

tomatowurst 5y ago

in another thread I mentioned psilocybin mushrooms and how it helped depression in a lasting way I was downvoted to oblivion because it was "shaman and not based on science". 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.

whalesalad 5y ago
I’ve been surprised by the negative opinion of self medicating held by a vocal group here. I can honestly say this medicine saved my life. I put my hands in the care of “the system” for too long and it never got me anywhere. A few months of microdosing, occasional tripping, and meditation/breathwork has completely changed the trajectory of my life.
- tomatowurst 5y ago
  happy to hear that brother, I also note that this might be geographically related, I saw at one point (posting outside west coast 9~5pm) rise to 20 upvotes, and then downvoted (during work hours in west coast). 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.

zwieback 5y ago

I've heard this many times now: psilocybin and related drugs anecdotally are breakthrough treatments for some patients. Does that mean the "brain gets rewired" or is the experience so profound that it changes the patient's outlook? 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?

neves 5y ago
Michael Pollan book "How to change your mind" is excellent. He give very good explanations about it.
whalesalad 5y ago
Both. Neurogenesis occurs at the physical layer but there can also be a shift in userland based on your experience.

daenz 5y ago

Speaking from personal experience, psychedelics can have a very emotionally cathartic effect. At the end of it, you feel like you were a sponge full of emotion that has just been wrung out. I can definitely see how if you're "stuck" in some kind of pattern, exercising those emotions can help get you "unstuck." I would probably recommend someone do this once every other year.

ta8645 5y ago
My personal experience is decades old, but different. I never had an emotional release provided by LSD. Instead, there were enjoyable visual hallucinations, ability to concentrate, and a heightened appreciation of beauty. 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.
- daenz 5y ago
  Thanks for sharing. I should have clarified that my experience was with psilocybin
- emmanuel_1234 5y ago
  This is fascinating, my experience is quite the opposite. The coming up is a very uncomfortable experience, both physically and mentally, but the coming down is the best thing ever: everything is at piece, in its right place, the world has a beautiful glistening aspect to it. I truly bite the bullet of the up phase to bask in the comfort of the coming down phase.

jotm 5y ago

Psilocybin has been in the news lately, but I'd say many drugs that cause a significant, immediate and forceful shift in thinking can work for depression. 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.

mwattsun 5y ago

> Patients with depression are warned not to take psilocybin on their own. 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

derevaunseraun 5y ago

Psychedelics are weird: some people will speak very positively about them. Other people get fucked up for life. It's like rolling a dice. Imho that's not a risk any person with sound judgement would take. 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

AnonCoward4 5y ago
As far as I know you can't sensibly OD on LSD for example. It doesn't really cause addiction and to OD you need to take something like 100x the effective dose.However the psychosis danger would still be a valid concern ("rolling a dice" puts it quite nicely)
- derevaunseraun 5y ago
  the OD part wasn't with respect to LSD but towards drugs in general. I've known people who got started with psychedelics, then moved on to molly (not real MDMA, like the dangerous synthetic street shit), and onto other stuff after that. It makes people more susceptible to drug culture 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
mudcrab 5y ago
Humans can be allergic to anything - re-read your post replacing 'Psychedelics' with 'nuts' - no-one gets this excited over peanut allergies - we've replaced this fear with education, drugs should be the same.
- joeberon 5y ago
spacemanmatt 5y ago
Inertia is the worst justification for alcohol I have heard yet. If I could wave a wand and remove the most dangerous drug on the planet it would probably be alcohol.

nudpiedo 5y ago

Every few weeks articles like this one on the topic of depression and psychedelics keep coming. They repeat themselves. I wonder whether someone wants to promote the topic or just get upvotes for later lobbying some other posts on HN.

Uptrenda 5y ago

I can't imagine they would be able to 'blind' their experiments for participants though? I mean, when you start tripping balls it becomes clear you got given the LSD and not something else... Unless they use like sub-threshold / micro-doses.

john-doe 5y ago

Who would have thought that the compounds probably responsible for our consciousness are also beneficial to our mental health. https://www.inverse.com/article/34186-stoned-ape-hypothesis https://www.inverse.com/article/34186-stoned-ape-hypothesis

idiotsecant 5y ago
I think your use of the word probably might be described as wildly overconfident.

jrapdx3 5y ago

As a physician with a practice in the realm of behavioral health it's been fascinating to witness the development of approaches to treatment-resistant depression using hallucinogenic agents. 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.

cersei 5y ago
"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." Is there actual evidence showing that depressed individuals are more likely to suffer adverse effects?
ProjectArcturis 5y ago
Yes, fascinating to watch, but as usual the hype outpaces the science. Two major issues not discussed in the article: 1. How do you do a placebo-controlled trial? All subjects will know the difference between psilocybin and placebo. And there are often huge placebo effects in depression trials. 2. No one has done a controlled trial with more than one dose. The best RCT so far, done by Compass, only followed patients up for 12 weeks. By that time there was still a numerical difference between drug and placebo, but it was narrowing and no longer significant. Extrapolating from the available data, the drug and placebo groups would have converged after 6 months. So what does that look like for a treatment? Do you have people trip every 3-6 months? How do you structure a Phase 3 trial to test the efficacy of, say, the 4th dose?