4 ms·

“Chemical imbalance” antidepressants take weeks of ~100 milligram tablets to take effect. (Nobody can quite explain what the imbalance was to begin with, and wh

“Chemical imbalance” antidepressants take weeks of ~100 milligram tablets to take effect. (Nobody can quite explain what the imbalance was to begin with, and what the ideal levels are…) Psychedelics have an impact at the microgram range, with a single dose. They could be hundreds of thousands of times more potent, or, it could be the experience.

jrumbut 4y ago
With MDMA the doses studied aren't that different than the amounts needed for some SSRIs. Not sure what you're going for with the mass of the ingredient.
- deelowe 4y ago
  The point was that they need to be taken for weeks before there’s any improvement. Not so much the size of the dozes. They have a good point. The whole “chemical imbalance” thing has come under significant scrutiny as of late.
  - galangalalgol 4y ago
    could they give the control group other psychedelics in some of these studies to see if they are differently effective? That could be blinded right?
    - jrumbut 4y ago
      That would be further down the path. In this design, I have to imagine both groups' sessions were very much affected by thoughts of "am I about to trip or is this just allergy relief?" To be honest, I am uncomfortable with the thought of a participant being unsure if they had been given a psychedelic. Consider that a non-trivial number got it wrong! To me that signals some of the control group participants may have been quite agitated. I wouldn't mind seeing a self-controlled design where participants are randomized to receive either psilocybin with therapy or non-psilocybin therapy first, but ultimately end up receiving both. As others have noted it's not just the drug, it's the drug and the experience of therapy so I think the two ought to be packaged. Ultimately though, what I am most curious about is the long term sustenance (and/or repeatability) of any effects and also whether any negative effects appear later. The first wave of psychedelic research also showed some promise, but their utility faded. Have we gotten any better? Six months of alcohol use disorder or depression relief is great and useful, but the goal ultimately is long term relief.
rfrey 4y ago
It takes some tens of grams of sodium chloride to significantly alter my body chemistry. A few milligrams of cyanide will alter my body chemistry enough to be measured by the existence of a pulse.

jrumbut 4y ago

With MDMA the doses studied aren't that different than the amounts needed for some SSRIs. Not sure what you're going for with the mass of the ingredient.

deelowe 4y ago
The point was that they need to be taken for weeks before there’s any improvement. Not so much the size of the dozes. They have a good point. The whole “chemical imbalance” thing has come under significant scrutiny as of late.
- galangalalgol 4y ago
  could they give the control group other psychedelics in some of these studies to see if they are differently effective? That could be blinded right?
  - jrumbut 4y ago
    That would be further down the path. In this design, I have to imagine both groups' sessions were very much affected by thoughts of "am I about to trip or is this just allergy relief?" To be honest, I am uncomfortable with the thought of a participant being unsure if they had been given a psychedelic. Consider that a non-trivial number got it wrong! To me that signals some of the control group participants may have been quite agitated. I wouldn't mind seeing a self-controlled design where participants are randomized to receive either psilocybin with therapy or non-psilocybin therapy first, but ultimately end up receiving both. As others have noted it's not just the drug, it's the drug and the experience of therapy so I think the two ought to be packaged. Ultimately though, what I am most curious about is the long term sustenance (and/or repeatability) of any effects and also whether any negative effects appear later. The first wave of psychedelic research also showed some promise, but their utility faded. Have we gotten any better? Six months of alcohol use disorder or depression relief is great and useful, but the goal ultimately is long term relief.

rfrey 4y ago

It takes some tens of grams of sodium chloride to significantly alter my body chemistry. A few milligrams of cyanide will alter my body chemistry enough to be measured by the existence of a pulse.