4 ms·

Yeah an unregulated and uncontrolled consumption of a poorly dosed hallucinogenic is totally better than a double-blind study of SSRI/SNRI. I swear, I do not r

Yeah an unregulated and uncontrolled consumption of a poorly dosed hallucinogenic is totally better than a double-blind study of SSRI/SNRI. I swear, I do not reject the possibility that hallucinogenics can cure depression better than existing meds, but the almost religious enthusiasm for such a poorly studied chemical is deeply concerning. And yes, before you accuse me of being a pharma shill, I know that the lack of serious study is due to legal restrictions and not scientific evidence. But that doesn’t change the fact that they’ve not been studied rigorously. In my State, they are being actively studied, let us hold back the praise until the results are in.

ornornor 4y ago
You do you of course. You can grow your own mushrooms at home fairly easily and then you have more control over quality/contamination etc.
- grenoire 4y ago
  Correct, in theory. However, if you are just starting out growing you won't have the knowledge to assess quality or control contamination.
- mellavora 4y ago
  Ok, so you have some control over quality. I'll also be generous and assume you have good estimate of dosages and/or some way to maintain consistency of dosages (anyone else reading this, the standard advice is to take less than you think you want and wait 45 min or so, then take more if needed to reach planned cruising altitude. This works if you have enough prior experience to calibrate by, otherwise is very difficult). How do you know which dosage is best for treating depression? Assuming the best treatment is a series of sessions, how do you know the optimal spacing of sessions, and the optimal dosing per session? You are correct that the trips should be intentional. Who sets these intentions, which intentions are the most helpful, how do you guide the session along the lines of the intentions (recalling that the session might include full ego death and conviction that both your mind and reality are distinct and permanently broken) and most importantly how do you structure the post-session therapy to integrate the learnings and actually get some personal growth out of this? Are there age-related differences in this? What is the protocol for a early 20s vs a mid-50s vs 70s/80? Also, to look at your own advice ("if you have anything else than extreme depression and no other mental health conditions") how do you actively screen for this? These are concerns which are well addressed within shamanic circles-- so I'm not speaking with the voice of pharma here. Psychedelics are powerful tools. Like any other power tool, they can be a great help and also fairly risky if not used carefully. Insert your own woodshop analogies here. And if you are going to use them anyway, without working with someone who knows what they are doing, please please please: 1) start with small doses 2) do some reading BEFORE. Minimal list: Hudson Smith, "Cleansing the Doors of Perception" and James Fadiman The Psychedelic Explorer's Guide: Safe, Therapeutic, and Sacred Journeys
  - ornornor 4y ago
    Yes I kinda assumed that if someone was considering giving this a shot, they’d research the subject very thoroughly before to get a good understanding of the effects, preparation, effects, doses, etc. The genera consensus seems to be that mushrooms (psilocybin) can’t kill you. You can’t OD on them. There is no known LD50 (that’s “practical” to achieve anyway), they dont cause addiction, and if you take them too often they actually stop having an effect until you take a break and use again. There are risks if you have other mental health conditions like schizophrenia etc, but (according to my research), the only risk if you’re otherwise healthy is to have a “bad trip” where you’re basically experiencing negative feelings. By reading about the experience, you also learn that if you resist the bad trip it gets worse but if you look at it with curiosity (what is my brain trying to tell me?) then you’ll have an easier time. About assessing te severity of your depression, there is a standard test (of which I forget the name) that is also used in the studies submitted to the FDA for approval of antidepressants that ask questions, you then add the points up, and anything above a certain number is severe depression. Although this is yet another flaw of the studies, the people running the studies don’t even agree on the score that give you mild vs severe depression. Again, I have no medical training so this is just a random stranger’s opinion on the internet. To anyone reading: educate yourself about the whole thing, see if you’re willing to try, and make your own decisions.
    - bowsamic 4y ago
      There are four main risks for most people: - PTSD caused by bad trip. Bad trips are not uncommon, and it's not easy to let go. Part of the reason why psychedelics are so effective is that they basically force you to let go, otherwise you will have a bad trip. But some people can't do that, I couldn't, and you can end up causing long lasting psychological damage due to this. I had an existential crisis and became pretty suicidal for a few months after I had a couple of trips. I actually had to take up a religion to cope with it. The therapy services in the UK had no idea what to do to help me and made me feel alienated - DP/DR (depersonalisation/derealisation). Can be short lasting, can be long lasting, can be flashbacks, can be constant - HPPD (Hallucinogen persisting perception disorder). Described as anywhere between "visual snow" and "you never came down from the trip". No one knows why this happens or who it happens to, if it occurs differently with different psychs. Many people commit suicide over this one, since it can basically cause psychosis as some people never stop having intense hallucinatory effects for months or even years. If they can't come to terms with it it can be extremely disorientating and alienating. Andrew Callaghan of Channel 5 news / All Gas No Brakes has this. Kind of frightening since it's most trippers' worst nightmare to never come down from the trip, but that's actually a thing that happens to some people - Flashbacks, which I would say are different to the other three, in that they are a sudden return to the tripping state of mind randomly, but not necessarily visual or DP/DR. I think this one is the least explored and least well known about
taurath 4y ago
> Yeah an unregulated and uncontrolled consumption of a poorly dosed hallucinogenic is totally better than a double-blind study of SSRI/SNRI. Frankly, it could be and we’d have no way of knowing with the “rigor” we put through pharmacological stories, if your goal is effectiveness. That the entire field of psychology is sort of In conflict over the mechanisms, validity, and treatment models of trauma and dissociation, which frequently underly depression and anxiety symptoms.
LatteLazy 4y ago
Careful: whether SSRIs and SNRIs work is unrelated to whether hallucinogenics do or don't. hallucinogenics being shit doesn't make SSRI/SNRIs a good bet. Also, those exact studies you refer to show that SNRIs work very poorly and are very limited. Usually studies have fewer than 100 participants: * people are dropped from the study arbitrarily * they are not double blind * they are not representative of the population (overwhelmingly participants are white, male, well off or young with no other health complaints and few serious problems) * studies are usually very short (<100 days) for medicines that are prescribed for years They then find drugs are less than 15%ppts more effective than placebos. In exchange you get quite extreme side effects for a significant number of users from impotence to suicide... The lancet picked this up and did. meta-study. Their conclusions: >We identified 28 552 citations and of these included 522 trials comprising 116 477 participants. In terms of efficacy, all antidepressants were more effective than placebo, with ORs ranging between 2·13 (95% credible interval [CrI] 1·89–2·41) for amitriptyline and 1·37 (1·16–1·63) for reboxetine. For acceptability, only agomelatine (OR 0·84, 95% CrI 0·72–0·97) and fluoxetine (0·88, 0·80–0·96) were associated with fewer dropouts than placebo, whereas clomipramine was worse than placebo (1·30, 1·01–1·68). When all trials were considered, differences in ORs between antidepressants ranged from 1·15 to 1·55 for efficacy and from 0·64 to 0·83 for acceptability, with wide CrIs on most of the comparative analyses. In head-to-head studies, agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and vortioxetine were more effective than other antidepressants (range of ORs 1·19–1·96), whereas fluoxetine, fluvoxamine, reboxetine, and trazodone were the least efficacious drugs (0·51–0·84). For acceptability, agomelatine, citalopram, escitalopram, fluoxetine, sertraline, and vortioxetine were more tolerable than other antidepressants (range of ORs 0·43–0·77), whereas amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone, and venlafaxine had the highest dropout rates (1·30–2·32). 46 (9%) of 522 trials were rated as high risk of bias, 380 (73%) trials as moderate, and 96 (18%) as low; and the certainty of evidence was moderate to very low. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32802-7/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... I think even assuming good faith for all those studies, those are poor results when you include the low acceptability. If you don't assume good faith you're left wondering if these drugs work at all. It should go without saying that NO ONE should stop or change their medication (especially highly addictive ones like these) based on a HN comment. Please speak to your doctors dear readers.
hirvi74 4y ago
It's almost a self-fulfilling prophecy. If anti-depressants were so effective, people wouldn't be flocking to psychedelics for treatment. Stimulants are the most useful medication we have found for ADHD. Without access to them, what do people with ADHD flock to? Caffeine, Nicotine, Alcohol, Cannabis, etc. Substances that are stimulants or can have stimulating effects. I am no woo-woo person, but perhaps our bodies when flocking to something are trying to tell us something? Alcohol also works great for anxiety (and super dangerous), so we created benzos in alcohol's image (though I think benzos can be just as dangerous for some).

ornornor 4y ago

You do you of course. You can grow your own mushrooms at home fairly easily and then you have more control over quality/contamination etc.

grenoire 4y ago
Correct, in theory. However, if you are just starting out growing you won't have the knowledge to assess quality or control contamination.
mellavora 4y ago
Ok, so you have some control over quality. I'll also be generous and assume you have good estimate of dosages and/or some way to maintain consistency of dosages (anyone else reading this, the standard advice is to take less than you think you want and wait 45 min or so, then take more if needed to reach planned cruising altitude. This works if you have enough prior experience to calibrate by, otherwise is very difficult). How do you know which dosage is best for treating depression? Assuming the best treatment is a series of sessions, how do you know the optimal spacing of sessions, and the optimal dosing per session? You are correct that the trips should be intentional. Who sets these intentions, which intentions are the most helpful, how do you guide the session along the lines of the intentions (recalling that the session might include full ego death and conviction that both your mind and reality are distinct and permanently broken) and most importantly how do you structure the post-session therapy to integrate the learnings and actually get some personal growth out of this? Are there age-related differences in this? What is the protocol for a early 20s vs a mid-50s vs 70s/80? Also, to look at your own advice ("if you have anything else than extreme depression and no other mental health conditions") how do you actively screen for this? These are concerns which are well addressed within shamanic circles-- so I'm not speaking with the voice of pharma here. Psychedelics are powerful tools. Like any other power tool, they can be a great help and also fairly risky if not used carefully. Insert your own woodshop analogies here. And if you are going to use them anyway, without working with someone who knows what they are doing, please please please: 1) start with small doses 2) do some reading BEFORE. Minimal list: Hudson Smith, "Cleansing the Doors of Perception" and James Fadiman The Psychedelic Explorer's Guide: Safe, Therapeutic, and Sacred Journeys
- ornornor 4y ago
  Yes I kinda assumed that if someone was considering giving this a shot, they’d research the subject very thoroughly before to get a good understanding of the effects, preparation, effects, doses, etc. The genera consensus seems to be that mushrooms (psilocybin) can’t kill you. You can’t OD on them. There is no known LD50 (that’s “practical” to achieve anyway), they dont cause addiction, and if you take them too often they actually stop having an effect until you take a break and use again. There are risks if you have other mental health conditions like schizophrenia etc, but (according to my research), the only risk if you’re otherwise healthy is to have a “bad trip” where you’re basically experiencing negative feelings. By reading about the experience, you also learn that if you resist the bad trip it gets worse but if you look at it with curiosity (what is my brain trying to tell me?) then you’ll have an easier time. About assessing te severity of your depression, there is a standard test (of which I forget the name) that is also used in the studies submitted to the FDA for approval of antidepressants that ask questions, you then add the points up, and anything above a certain number is severe depression. Although this is yet another flaw of the studies, the people running the studies don’t even agree on the score that give you mild vs severe depression. Again, I have no medical training so this is just a random stranger’s opinion on the internet. To anyone reading: educate yourself about the whole thing, see if you’re willing to try, and make your own decisions.
  - bowsamic 4y ago
    There are four main risks for most people: - PTSD caused by bad trip. Bad trips are not uncommon, and it's not easy to let go. Part of the reason why psychedelics are so effective is that they basically force you to let go, otherwise you will have a bad trip. But some people can't do that, I couldn't, and you can end up causing long lasting psychological damage due to this. I had an existential crisis and became pretty suicidal for a few months after I had a couple of trips. I actually had to take up a religion to cope with it. The therapy services in the UK had no idea what to do to help me and made me feel alienated - DP/DR (depersonalisation/derealisation). Can be short lasting, can be long lasting, can be flashbacks, can be constant - HPPD (Hallucinogen persisting perception disorder). Described as anywhere between "visual snow" and "you never came down from the trip". No one knows why this happens or who it happens to, if it occurs differently with different psychs. Many people commit suicide over this one, since it can basically cause psychosis as some people never stop having intense hallucinatory effects for months or even years. If they can't come to terms with it it can be extremely disorientating and alienating. Andrew Callaghan of Channel 5 news / All Gas No Brakes has this. Kind of frightening since it's most trippers' worst nightmare to never come down from the trip, but that's actually a thing that happens to some people - Flashbacks, which I would say are different to the other three, in that they are a sudden return to the tripping state of mind randomly, but not necessarily visual or DP/DR. I think this one is the least explored and least well known about

taurath 4y ago

> Yeah an unregulated and uncontrolled consumption of a poorly dosed hallucinogenic is totally better than a double-blind study of SSRI/SNRI. Frankly, it could be and we’d have no way of knowing with the “rigor” we put through pharmacological stories, if your goal is effectiveness. That the entire field of psychology is sort of In conflict over the mechanisms, validity, and treatment models of trauma and dissociation, which frequently underly depression and anxiety symptoms.

LatteLazy 4y ago

Careful: whether SSRIs and SNRIs work is unrelated to whether hallucinogenics do or don't. hallucinogenics being shit doesn't make SSRI/SNRIs a good bet. Also, those exact studies you refer to show that SNRIs work very poorly and are very limited. Usually studies have fewer than 100 participants: * people are dropped from the study arbitrarily * they are not double blind * they are not representative of the population (overwhelmingly participants are white, male, well off or young with no other health complaints and few serious problems) * studies are usually very short (<100 days) for medicines that are prescribed for years They then find drugs are less than 15%ppts more effective than placebos. In exchange you get quite extreme side effects for a significant number of users from impotence to suicide... The lancet picked this up and did. meta-study. Their conclusions: >We identified 28 552 citations and of these included 522 trials comprising 116 477 participants. In terms of efficacy, all antidepressants were more effective than placebo, with ORs ranging between 2·13 (95% credible interval [CrI] 1·89–2·41) for amitriptyline and 1·37 (1·16–1·63) for reboxetine. For acceptability, only agomelatine (OR 0·84, 95% CrI 0·72–0·97) and fluoxetine (0·88, 0·80–0·96) were associated with fewer dropouts than placebo, whereas clomipramine was worse than placebo (1·30, 1·01–1·68). When all trials were considered, differences in ORs between antidepressants ranged from 1·15 to 1·55 for efficacy and from 0·64 to 0·83 for acceptability, with wide CrIs on most of the comparative analyses. In head-to-head studies, agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and vortioxetine were more effective than other antidepressants (range of ORs 1·19–1·96), whereas fluoxetine, fluvoxamine, reboxetine, and trazodone were the least efficacious drugs (0·51–0·84). For acceptability, agomelatine, citalopram, escitalopram, fluoxetine, sertraline, and vortioxetine were more tolerable than other antidepressants (range of ORs 0·43–0·77), whereas amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone, and venlafaxine had the highest dropout rates (1·30–2·32). 46 (9%) of 522 trials were rated as high risk of bias, 380 (73%) trials as moderate, and 96 (18%) as low; and the certainty of evidence was moderate to very low. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32802-7/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... I think even assuming good faith for all those studies, those are poor results when you include the low acceptability. If you don't assume good faith you're left wondering if these drugs work at all. It should go without saying that NO ONE should stop or change their medication (especially highly addictive ones like these) based on a HN comment. Please speak to your doctors dear readers.

hirvi74 4y ago

It's almost a self-fulfilling prophecy. If anti-depressants were so effective, people wouldn't be flocking to psychedelics for treatment. Stimulants are the most useful medication we have found for ADHD. Without access to them, what do people with ADHD flock to? Caffeine, Nicotine, Alcohol, Cannabis, etc. Substances that are stimulants or can have stimulating effects. I am no woo-woo person, but perhaps our bodies when flocking to something are trying to tell us something? Alcohol also works great for anxiety (and super dangerous), so we created benzos in alcohol's image (though I think benzos can be just as dangerous for some).