5 ms·

> because outcomes vary widely, it's hard to call them "medicine" Is that so different from any other psychiatric medicine?

galangalalgol 4y ago
No kidding! Might help, but won't cause harm, and you probably won't have to take it forever, matbe even just once? I know LSD has been attributed some harmful effects, does psilocybin have no chance of psychotic breaks or ???
- tempsy 4y ago
  recreational doses are not necessarily therapeutic doses if you are taking a psychedelic as part of some therapy regime it is not a tripping balls level dose
  - Ingaz 4y ago
    It's actually could be other way. There is an anecdotic evidence that bad trips on first intake are more frequent with lower doses of psychedelics than higher. So it's very possible that those therapeutic sessions will be mind-shattering experiences and not like going to discotheque with friends.
  - TaylorAlexander 4y ago
    Everything I've learned about therapeutic psilocybin treatment is that the doses involved are actually quite a bit higher than I've ever done on a trip at home. For example for psychedelic therapy with psilocybin, you would see a therapist a few times with no psilocybin, then you would have a session where you take something like the equivalent of 1 gram of dried mushrooms, and go through that session with the therapist. Then come back 1-2 weeks later and take something like a "heroic" dose or about 5 grams dried mushroom equivalent and go through that session with the therapist. Then you come back again two weeks later and have a sober session again to talk about all of it. My understanding is that this is generally how the well respected research studies have gone. The most I have ever done myself is 2 grams dried mushroom equivalent, and I usually stay under 1.
    - sterlind 4y ago
      Jesus. five grams would scare me. does it just not work to use an eighth?
      - TaylorAlexander 4y ago
        So in a clinical setting they actually give 20-30mg of psilocybin directly. This works out to approximately 3-5g of dried cubensis depending on their potency.
    - azinman2 4y ago
      I can’t imagine being completely detached from reality, and using that to work through really tough shit. Talk about a bad trip.
      - geertj 4y ago
        From my limited understanding, when a trip is used in a therapy session, it allows a patient to observe past trauma from an (emotional) distance, allowing them to process it. I can see how that would work. If trauma is so severe that you can’t even think of it, you’d push it away to the back of your mind where it would fester.
    - dntrkv 4y ago
      5 grams? Most people would absolutely lose their shit on that. Even an eighth of good mushrooms is enough to obliterate most people. Like complete ego death. How long do these sessions last? What are the logistics? I’m very curious.
      - mathgladiator 4y ago
        9 hours on a heroic dose
      - batty_alex 4y ago
        An eighth won’t give you ego death. 5 grams is about where you start getting kaleidoscopic visuals and good hallucinations In all, the whole trip usually lasts a solid 4 hours. You’re going to be ready to pass out at the end
  - naasking 4y ago
    A therapeutic MDMA dose is basically equivalent to a recreational dose from the literature I've read. Not sure about psilocybin. Ketamine dosage definitely leads to tripping balls.
    - Overtonwindow 4y ago
      Not at all actually. I underwent 11 weeks of ketamine therapy. No hallucinations whatsoever, and I checked with others because I thought I was missing out! I felt physically drunk, but mentally absolutely clear. You may be thinking of a higher dose taken recreationally.
      - naasking 4y ago
        Or the reports I read were before they dialed in the dose.
- Alex3917 4y ago
  > I know LSD has been attributed some harmful effects, does psilocybin have no chance of psychotic breaks or ??? Psilocybin has that risk, but it’s lower because the molecule binds to your receptors much less tightly.
aeturnum 4y ago
It's a fair question - but I would say yes? I know lots of people who have taken antidepressants and psychedelics and while both have been helpful the antidepressants have much more consistent effects (both person to person and dose to dose).
tdehnel 4y ago
This is rationalizing rhetoric. Full-on psychedelic drugs are very different from any other psychiatric medicine. Users should know this difference and be prepared to mitigate the risks. With psych drugs, the most common experience is that user takes them for a few weeks, and reports or doesn’t report some subtle change in their psyche. A bad experience is mostly limited to “didn’t work”. If the drug “doesn’t work” they stop using it and try something else. With psychedelic drugs, the effect is 100% going to be felt within less than an hour, the effect will be very strong and is guaranteed to be one of the most memorable experiences of the user’s life. A bad experience could easily consist of being rapidly confronted with some deep truths about the user’s self and ego. There is a reason psychedelics have been linked to schizophrenia: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/493118 https://jamanetwork.com/journals/jamapsychiatry/article-abst...
- pas 4y ago
  recreational dose is easily 10-20x more than therapeutic dose for most drugs. comparison has to take this into account, so they are not different, the dose is the real difference.

galangalalgol 4y ago

No kidding! Might help, but won't cause harm, and you probably won't have to take it forever, matbe even just once? I know LSD has been attributed some harmful effects, does psilocybin have no chance of psychotic breaks or ???

tempsy 4y ago
recreational doses are not necessarily therapeutic doses if you are taking a psychedelic as part of some therapy regime it is not a tripping balls level dose
- Ingaz 4y ago
  It's actually could be other way. There is an anecdotic evidence that bad trips on first intake are more frequent with lower doses of psychedelics than higher. So it's very possible that those therapeutic sessions will be mind-shattering experiences and not like going to discotheque with friends.
- TaylorAlexander 4y ago
  Everything I've learned about therapeutic psilocybin treatment is that the doses involved are actually quite a bit higher than I've ever done on a trip at home. For example for psychedelic therapy with psilocybin, you would see a therapist a few times with no psilocybin, then you would have a session where you take something like the equivalent of 1 gram of dried mushrooms, and go through that session with the therapist. Then come back 1-2 weeks later and take something like a "heroic" dose or about 5 grams dried mushroom equivalent and go through that session with the therapist. Then you come back again two weeks later and have a sober session again to talk about all of it. My understanding is that this is generally how the well respected research studies have gone. The most I have ever done myself is 2 grams dried mushroom equivalent, and I usually stay under 1.
  - sterlind 4y ago
    Jesus. five grams would scare me. does it just not work to use an eighth?
    - TaylorAlexander 4y ago
      So in a clinical setting they actually give 20-30mg of psilocybin directly. This works out to approximately 3-5g of dried cubensis depending on their potency.
  - azinman2 4y ago
    I can’t imagine being completely detached from reality, and using that to work through really tough shit. Talk about a bad trip.
    - geertj 4y ago
      From my limited understanding, when a trip is used in a therapy session, it allows a patient to observe past trauma from an (emotional) distance, allowing them to process it. I can see how that would work. If trauma is so severe that you can’t even think of it, you’d push it away to the back of your mind where it would fester.
  - dntrkv 4y ago
    5 grams? Most people would absolutely lose their shit on that. Even an eighth of good mushrooms is enough to obliterate most people. Like complete ego death. How long do these sessions last? What are the logistics? I’m very curious.
    - mathgladiator 4y ago
      9 hours on a heroic dose
    - batty_alex 4y ago
      An eighth won’t give you ego death. 5 grams is about where you start getting kaleidoscopic visuals and good hallucinations In all, the whole trip usually lasts a solid 4 hours. You’re going to be ready to pass out at the end
- naasking 4y ago
  A therapeutic MDMA dose is basically equivalent to a recreational dose from the literature I've read. Not sure about psilocybin. Ketamine dosage definitely leads to tripping balls.
  - Overtonwindow 4y ago
    Not at all actually. I underwent 11 weeks of ketamine therapy. No hallucinations whatsoever, and I checked with others because I thought I was missing out! I felt physically drunk, but mentally absolutely clear. You may be thinking of a higher dose taken recreationally.
    - naasking 4y ago
      Or the reports I read were before they dialed in the dose.
Alex3917 4y ago
> I know LSD has been attributed some harmful effects, does psilocybin have no chance of psychotic breaks or ??? Psilocybin has that risk, but it’s lower because the molecule binds to your receptors much less tightly.

aeturnum 4y ago

It's a fair question - but I would say yes? I know lots of people who have taken antidepressants and psychedelics and while both have been helpful the antidepressants have much more consistent effects (both person to person and dose to dose).

tdehnel 4y ago

This is rationalizing rhetoric. Full-on psychedelic drugs are very different from any other psychiatric medicine. Users should know this difference and be prepared to mitigate the risks. With psych drugs, the most common experience is that user takes them for a few weeks, and reports or doesn’t report some subtle change in their psyche. A bad experience is mostly limited to “didn’t work”. If the drug “doesn’t work” they stop using it and try something else. With psychedelic drugs, the effect is 100% going to be felt within less than an hour, the effect will be very strong and is guaranteed to be one of the most memorable experiences of the user’s life. A bad experience could easily consist of being rapidly confronted with some deep truths about the user’s self and ego. There is a reason psychedelics have been linked to schizophrenia: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/493118 https://jamanetwork.com/journals/jamapsychiatry/article-abst...

pas 4y ago
recreational dose is easily 10-20x more than therapeutic dose for most drugs. comparison has to take this into account, so they are not different, the dose is the real difference.