Very much anecdotal but I can say that psychedelics helped me and several friends a lot with depression. They don't just magically make you feel better - at least not long-term - but they give you the neuroplasticity you need to adjust your internal filters and behaviour. As such, if the purpose is truly healing and recovery, they're best paired with professional therapy, preferably from somebody who's experienced with psychedelic-assisted therapy specifically.
Wonder how Adderall with its fourfold amphetamine recipe can fast-track to market, while psylocibin with all its ancestral approval had not yet been pilled AT ALL. How can a soldier designated pill make it to 60m prescriptions and amazing substantiated illegal use, while psylocibin is still rated as schedule-1 drug alongside heroine, which of course is major offense to possess.
This makes very little sense unless on purpose. I mean, like what, people been doing it for millenniums and still we got where we are now, and not because of downsides of its use, or what?
Modern drug laws came about in the 1970s, at the height of hippies on psychedelics trying to overthrow the government.
People in power fear losing their power, and they saw these drugs as a threat.
The weirdest part of the whole thing to me is that they outlawed Cannabis, Psilocybin, and LSD, but kept cocaine legal with a prescription under schedule 2.
You have to understand that drugs roughly break down into two categories IMO: the touchy-feely stuff that creates empathy and kindness and healing on the one hand. On the other hand you’ve got stuff that makes people “hard-charging” — going off and doing a thing without thinking it through, with a tinge of anger, fury, unstoppable raw power. Think: cocaine, booze, caffeine and any other stimulants. These reduce empathy and create problems for people.
These two camps are pretty wildly opposed! If I had to guess, I’d bet my money on the people in power liking and using the hard charging stuff while loathing the touchy feely stuff.
All this feels a bit trite, over-simplified, and maybe even a but concocted on my part. But after a lifetime of being around these drugs, it fits well with my experience.
I’d add, too, that the book “Chasing the Scream” gives a better perspective on drug laws & their origins, which really began much earlier than the 1970s.
It's oversimplified in terms of the drug landscape; fentanyl != meth != alcohol, and the reasons people use them are different. You could simplify it as escapism but you'd be incorrect. Or rather, where do people want to escape to? That has little to do with the racism of the 1970s when interracial marriage was literally illegal though which is when the original drug war and those laws date back to.
Definitely over-simplified for the drug landscape, but I still think that users roughly sort into these two categories.
I also think its incorrect to define this sort of escapism as escaping to something. IME people escape from something — the “to” doesn’t matter as long as the “from” ain’t there.
I’d further agree that it has nothing to do with interracial marriage — not sure where this point came from?
The “War on Drugs” as Nixon named it isn’t the beginning of the story.
it's not the beginning nor is it the end. To go back to the story, you said
> If I had to guess, I’d bet my money on the people in power liking and using the hard charging stuff while loathing the touchy feely stuff.
that some people liked the hard charging stuff and were white, and that some people liked the touchy feely stuff and who just so coincidentally some of them happened to be dark skinned, in an era that was racist to the point of having anti-miscegenation laws, isn't some minor coincidence.
> the “to” doesn’t matter as long as the “from” ain’t there.
The "to" matters because after you've gotten high you're there, but where's there? it's that the one where your kids are listening to you? where your wife never left, where your boyfriend wasn't beating you? In that "to", how is life?
Yeah it's a sad history that can't be separated from racism, unfortunately. I think "to" matters most to the sober folks, no? Perhaps I'm simply not getting it. When you're high the pain stops whatever it is. And you're there. In the euphoria. And nothing else matters.
But you eventually come down, and when you're sober again, it all matters! Particularly when you live in a society that criminalizes your escape. I've always thought it excessively cruel to criminalize substance abuse.
When you're high, where you are depends on the drug. They don't all cause the same incapacitating euphoria that fentanyl zombies experience. Alcoholics famously have a problem with driving while intoxicated, which is to say there's a state between sober and being blacked out. Some alcoholics just like a pleasant buzz and don't get to a point of euphoria and nothing else. Of course, cocaine addicts hash together elaborate business schemes while high to (to your point of stimulants being a gogogo drug), but then they're not in blissed out euphoria either, but actively thinking and planning and doing.
> “You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin. And then criminalizing both heavily, we could disrupt those communities,” Ehrlichman said. “We could arrest their leaders. raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
The initial war on drugs had nothing to do with the drugs themselves. But then successive governments had to keep running with it because letting the foot off the gas would let the opposition portray them as weak on drug abuse and crime. And then commercial interests got mixed into it too.
Research has proven that mushrooms and LSD are societally and personally the least damaging drug you can take. The top spots go to usual suspects like heroin and crack, and the subtop is alcohol and tobacco.
A family friend who was an ophthalmic surgeon once explained to me the cocaine was long the default anesthetic for eye surgery, and thus it had an accepted medical use (which was the criterion for Schedule 2). Sounds at least plausible to me.
But those modern drug laws picked up where the older drug laws petered out, and in both cases they were intended to punish their users, not protect them.
To bang a fairly weathered drum, this is largely a matter of conservative policy. Psychedelics were far more common in leftist circles (some might argue that this is cause as opposed to effect - mind-expanding experiences tend to shift politics towards that end of the spectrum).
This means that if you wanted to use the law as a political cudgel without being accused of thought-policing, you could outlaw psychedelics and be confident that the blast zone would exclude the politically faithful while locking up loads of political undesirables; like hippies, panthers, etc.
Of course, these days you have right-wing podcasters discussing DMT with billionaire CEOs, so it's a little trickier. Thus the tentative steps toward legalization.
This is an incredible take. The first SSRI was introduced in 1982 by a Swedish pharmaceutical company. The US congress passed the Controlled Substances Act in 1970. Not even Big SSRI has lobbyists who are time travelers.
sure, fair point but what is the reason mushrooms, which are factually and scientifically proven less harmful than say, ethanol on all measurable indices still scheduled? its all just money in the end. they need to get theirs in scam tax structures like say, colorado etc
I mean, the scheduling alone put research behind by decades, helping to stifle competition for more recent and less effective (in some cases ofc) pharmaceuticals
It's politics and optics. But as someone taking a schedule 3 medication that is really a schedule 1 in disguise (sodium oxybate) I wonder why they couldn't use the same tap dance for psylocibin or MDMA. Slight chemical modification to adjust absorption rate but same active ingredient. I think we only get away with this because it's prescribed so rarely and out of public consciousness. It's incredibly effective at treating a pernicious condition.
You'd think, yet I get it sent to me legally anyway. It is under a very restrictive REMS program, but it you're formally diagnosed with the very short list of applicable conditions, it's not that difficult to get.
Not enough money in it. It's not something that is taken regularly for long term like ADHD meds, or something that pretty much everyone uses at some point like antibiotics. If psilocybin came in a pill, it'd be targeted to a relatively small group of people for occasional use.
The simple answer seems sufficiently explanatory. Psilocybin is burended by its history as a recreational drug. That creates pockets of motivated advocates against it in a way that doesn't materialise for most drug candidates.
Adderall is just speed, which also has a long history of recreational usage. It was a widely used recreational drug decades before it began being used for ADHD.
Psychedelics sometimes makes people wake up to the abuses of government, so they are pretty scary to governments.
But there's also the issue that not everyone should take psychedelics. They can have lasting negative effects on certain people that may already be experiencing issues with mental stability, or they may trigger such effects in people that don't necessarily know about their own mental wellbeing or how the psychedelic will affect them. These, like every drug, should be used with caution.
Simple - there is no real lasting money in psylocibin as most people really only need 2 or 3 good sessions.
Whereas adderall is not technically addictive, but if you can function on it, you do become dependent on it.
You also really don't need it to become a prescription, shrooms just need to get legalized. The risks that come from overuse are far and few in between to the point where normal over the counter meds carry much more danger in abuse than shrooms do.
I don't think I've ever heard someone claim that Adderall isn't addictive.
> use of amphetamines and stimulants such as Adderall can result in tolerance and physiological dependence and can lead to the development of a substance use disorder. Misuse of prescription stimulants such as Adderall for any reason (e.g., to improve academic performance, reduce the effects of other drugs, etc.) is associated with both substance use disorders and use of other substances.
Through direct experience, I do not think 2 or 3 good sessions and you're done is really true. Maybe with experience even that goes - you learned what you needed to learn and there's nothing more to it.
But IMHO psilocin is a strong anti-inflammatory which may in and of itself be some (not all) of the mechanism for alleviating depression (the link between inflammation and depression is strong). That will almost never be lasting.
So we may be in the case where the real breakthroughs are, as you say, in the first two or three sessions. I think most people who took mushrooms out of desperation would agree with that - by the end of the third session many of the things they needed to accept are, in fact, front of mind for awhile. But ongoing maintenance is probably useful.
The parsimonious explanation is that amphetamine was basically grandfathered in over a historical period where shrooms/acid were cultural and political pariahs and they still have to overcome the residue of that a half century later.
Has nothing to do with being a one shot solution vs subscription.
Even economically the conspiracy theory against one shot cures makes no sense. As your shitty subscription solutions all go generic, I enter the market with my low risk one shot cure and eat all of your lunch.
That the guy that was on Adderall was able to pay attention to endless meetings and fill out forms and stick with it, while the guy on mushrooms was not, is surprising to you?
This is super unsubstantiated, even small children know amphet impairs creativity while shrooms do the opposite.
I can surely see great benefit in someone thinking out of the box at meetings. While I also see the benefit of zombies blindly following commands, which is where Adderall gets u.
Small children believe in a magic being that lives at the North Pole and brings them presents through the chimney every year o. Christmas, I'm not sure I'd base anything on their beliefs about "amphet" when they can't even describe its MoA. Thinking Adderall turns you into a zombie is fallacious thinking. No one's forcing you to take it, but unbridled creativity is great for getting nothing done. Pushing rope, as it were.
The traditional HN way is to make up some "It's Just That They Hate Us"[0] teenage conspiracy. The reality is this: amphetamine was widely used medically for decades by the time the Controlled Substances Act was passed. When these acts are passed, governments are usually under pressure to not remove access to things that people commonly use. Therefore, it was scheduled in a category that recognized medical use. This allowed the subsequent development of associated clinical trials and so on. It is much harder to work with Schedule I drugs than Schedule II drugs. So an accident of historical timing is what caused the difference.
0: This game is really tiresome. It's "capitalism". "They just don't want to lose power". "There's no money in it". Thought-terminating cliches. LLM-grade.
I don't have depression, but the first time I used psychedelics was so emotional helpful that I strongly suggested for depressed friends. I corrected that mistake hours later, after realizing that the risks are low, but life changing if it happens. However, I will never forget that feeling. I've used it again in the following years, but the results faded and it became boring for me.
Basically it hyper-connects your brain. When people talk about seeing shapes, its not that they are hallucinating, its that when they look at the random fuzz pattern on a rug, and pick out the particles of fuzz that make a creature face, its looks like someone purposefully put those pieces there to make that face.
As such, if you are "surfing" thoughts and find an association of something, that association can become very prominent. If you don't have the context to understand why you are making that association, especially after the trip, you can get stuck with beliefs about yourself that could be non optimal.
On the flip side this hyperconnectivity also allows you to see things like a completely different person would see them, which is where the true healing power lies. Its like you can be disugsted with a particular food when you are sober, but on shrooms you can truly feel what it would be like to enjoy that food. Once you have that context, you are able to move forward after the trip into right directions.
This is why set and setting are EXTREMELY important for significant trips. You want to be with someone who a) has done psychedelics, b) is in a very good mental state, and c) has a low ego not to project their own personality onto you. The best trip sitters are those that encourage exploration - they take everything you communicate to them and ask you questions about it without imparting any bias.
Exacerbation (and possibly development) of mental illness like psychosis, bipolar disorder, or schizophrenia is entirely possible.
Along with two other blokes, I got interested in psychedelics in high school. Took one medium high dose and wasn't right for a few months. Never in my life did i ever experienced paranoia, delusions, or hallucinations that are genuinely hard to separate from reality, but I did after that.
Intense psychedelic experiences can fracture what you once knew as "reality" allows all sorts of ideas to float into your mind, with equal possibility. This might be helpful and give you more flexible thinking (helpful for depression) but it also leaves you incredible vulnerable to all sorts of garbage ideas that you never would have considered otherwise. ie conspiracy theories or straight up delusions about the supernatural. Remember: It's not paranoia if you genuinely believe they really are out to get you!
Fighting these garbage ideas is a lot of work once they take hold, but you'll only know too late if you were vulnerable, and worse, if you can successfully align your understanding of reality with most other people.
I got extremely lucky that I stabilized. I'm convinced part of this was only doing it one time. My two co-experimenters took many trips with various doses are still in and out of mental hospitals years later. Psychedelics are incredibly potent and nobody really understands them very well. A lot of what is written on the internet ignores, downplays, or denies the very serious risks to your philosophy of mind and mental function. Its like playing with fire when you don't have heat sensation in your hands.
Several other comments on this page echo these warnings. One even claims there is an 18% chance you could go from depressed to schizophrenic. I have no idea where that figure came from, but the risk is certainly not 0%
Anectodically, this is pretty rare. I know quite a lot of people who used psychedelics, and they are fine.
I think some important safety points is to know family history of mental illness and not do then until later in life.
Anecdotally I know so many people thrashing their lives and this of loved ones with alcohol and antidepressants while I can’t immediately think up of even a single one, okay I know one guy who was doing everything altogether, who went so badly down the spiral thanks to acid. And this one guy actually had a horrendous childhood with lotta abuse so perhaps was already scheduled for a cathartic experience.
need another dose to take it to the next level: I found that love is an action not a feeling, perhaps I never loved my husband and I should now begin to
The risk is that it’s a false idea triggered by the psychedelic.
Maybe a better example would be my friend who took psychedelics and then believed he was in communication with Elon Musk. This one is more obviously a false idea, but nevertheless he was convinced it was real for a period after the psychedelic experience.
There’s a mystical concept that psychedelics open your third eye to see the world as it really is or something, but psychedelics are notorious for giving false ideas and making them seem like revelations. It’s obvious when it’s nonsense (like telepathy with Elon Musk) but it’s less obvious when the implanted idea is something like “your husband secretly doesn’t love you”. Another strangely common report is the belief that people around you have been replaced by clones, which can get scary very fast if the person can’t separate the idea from reality.
It sounds like your friend had a predilection for psychosis. I feel like the nice things about psychedelics is that they don't alter my processing too much (as compared with other drugs), moreso they just give me different 'inputs' into my senses / experiences, and then I process those.
> It sounds like your friend had a predilection for psychosis.
No prior history of any mental illness in him nor any of his family.
This is a common excuse: Blame some hidden susceptibility, not the drug. It doesn’t matter what it was, though. The drug caused it and there were no warning signs. Fine before the drug. Not fine after the drug.
> a common excuse: Blame some hidden susceptibility, not the drug
It's the interaction between that person and the drug.
I have a crustacean allergy. That doesn't mean crustaceans are bad, or other people shouldn't eat shrimp. It just means it's a bad mix for me.
One of the benefits of administering psychedelics in a clinical setting is that telepathic nonsense is more likely to be noticed early and corrected for, whether by reducing dosage or suspending treatement. (And treating it as medicine allows us to study those people who react negatively to it, further reducing harm.)
Yeah I agree with you 100%. it's interesting folks immediately taking the experience and result at face value when we understand so little about what's happening, even without psychedelics is most cases.
In the referenced anecdote it could be as simple as an excuse needed for someone who's been thinking about it for years. Though maybe that's enough to be a benefit
Anyway I like your example and look forward to what is learned about using psychedelics to help people :)
HPPD and .. honestly, some people have bad trips, and while it is popular in psychedelic circles to say "There is no such thing as a bad trip just the way you interpret it" that isn't really true. Even Terrence McKenna stopped taking mushrooms for a decade after a bad experience.
That said, I _do_ recommend mushrooms to everyone I know with depression or anger issues.
I had a panic attack one time, not sure how I should “interpret” that one. I’ve get anxiety since childhood for context. That said I’d love to do a session with a professional rather than by myself. Self medication for mental health issues is a bit of a gamble. I’ve also had good experiences even at higher doses so it’s a bit random
> after realizing that the risks are low, but life changing if it happens.
I think these risks are more common than was previously discussed on the internet. For a long time reports of very negative experiences were dismissed, laughed at, downplayed, waved away as symptoms of something else, or excused as something positive but mysterious.
It’s becoming more acceptable for people to discuss their negative experiences and not get downvoted or attacked for sharing them.
I just don't buy it, sorry. One thing that I learned about the internet is that most online opinions are from extremes: excellent or horrible experiences. Just search about any surgery. You will probably find a lot of bad experiences for anything. However, if you look at the data for the big picture, psilocybin is one of the safest drugs out there. There are risks, but they are nowhere near what you see in these conversations.
We don't have to rely on anecdotes, we have large amounts of empirical research. Just hop over to pubmed and search for yourself - the connection between psychedelics and psychosis is really weak, unless you have a known family history of schizophrenia etc. Yes, it exists, but it really isn't that common.
Not that rare, anyone with predisposition to psychosis/schizophrenia has a high risk of permanent effects, and that’s not that small of a segment of people, and nearly unknowable beforehand.
Many people say the first time they use Prozac that it was so helpful they recommended to their friends but then after a while it wore off.
How do you think psychedelics work? They activate the serotonin 2a receptor. It’s nothing but a different drug that effects serotonin. Except it does it more intensely but like all these drugs that act on receptors they wear off because of something what’s called receptor density changes.
For 70 years, we’ve been trying to manipulate receptors into making people feel good. It’s a losing proposition and it’s time to. We changed our thinking. For instance, if these people do have serotonin deficiencies, which is still possibly the case, what is it? That’s causing these deficiencies? Is it low, zinc, low B6, genetics, infection? There’s so many other things that we know that this could be, but we don’t try it.
I think this is naive. A mushroom trip is fully metabolized and cleared in approximately 6-12 hours. Despite the similar levels of reduction in depressive symptoms for the subsequent weeks, the psilocin has been cleared on the day of, unlike prozac, and hasn't been stimulating 5HT2* at all for that afterglow and post-exposure period.
Nobody other than crazy micro-dosers is taking mushrooms often enough to cause a change in receptor density and those people are putting themselves at risk of valvopathy due to 5HT2a restructuring of the heart valves (which, as an aside, is turning out to be a problem for people on prozac and other long-term SSRIs).
A drug that is very occasional, point use, with no ongoing use, which has long term treatment results, is absolutely, utterly unlike prozac.
That aside, let's say for the sake of argument that the mechanism is similar for prozac; I think that's wrong (one additional explanation may actually be: https://www.sciencedirect.com/science/article/abs/pii/S15675... ) but whatever. If so, then psilocin is vastly superior to prozac because you are not required to have continuous exposure for the benefits, as the corresponding cost, withdrawal, sexual dysfunction, weight gain, heart issues, etc. are removed.
> Nobody other than crazy micro-dosers is taking mushrooms often enough to cause a change in receptor density
This is so frustrating to me. Why not just google it before you think you know more about this than someone studying it for ten years? Two things can change receptor density: time and dose.
A Single Dose of Psilocybin Increases Synaptic Density and Decreases 5-HT2A Receptor Density in the Pig Brain
This is exactly why psychedelics last longer than prozac. It has less to do with half life and more to do with dose.
How is the mechanism not at least comparative to prozac since it is well know they both effect serotonin? The risk with psilocin is exactly the dose, as many people find out. And you thing there are not cardiac side effects from psychedelics?
A Case of Prolonged Mania, Psychosis, and Severe Depression After Psilocybin Use: Implications of Increased Psychedelic Drug Availability
Worsening suicidal ideation and prolonged adverse event following psilocybin administration in a clinical setting: case report and thematic analysis of one participant's experience
You've studied it for ten years and didn't notice that the pig brain receptor changes were only measured at +7 days and are replying to a comment about long term effectiveness vs. prozac (which takes weeks to really show impact)?
I have previously read that study. You should put it in context: for example, how quickly does the brain add A1 and A2 receptors for caffeine? (I already know the answer, but you might want to use it to contextualize that study).
The study about the woman co-administering venlafaxine (Effexor) which is an SNRI might be worth considering as non-representative.
Worsening suicidal ideation .. is not unique to _any_ antidepressant. Are you trying to suggest that this is somehow unique to psilocin? We were discussing prozac which is _well known to have this problem_. They got black box warnings for this reason.
To be clear they absolutely do regularly provide short to medium term depression relief (up to a few months). I also know someone who had severe treatment resistant depression that was cured long-term (at least years) from one dose.
Anecdotal, but about a year ago my wife participated in a psilocybin trial at a university here who were looking at patients with severe anxiety. It was her last hope after trying therapy, various supplements, as well as dietary and lifestyle changes, etc
It has been life changing for her, but one thing she tells people now is that what also helped was that it was facilitated with a trained therapist there during the session for guidance to make sure she didn’t “get stuck in a loop.” There was also many sessions pre dosing day to optimize the result.
She would highly recommend the treatment and hopes it becomes mainstream soon.
The point of music during a psychedelic experience is to provide a reference for the passing of time and to help with progression of thoughts. Music guides you through your thoughts, avoiding loops, by providing a changing texture, melody, rythm, and story.
This is on top of the other effects of music, such as emotional effects.
Yes, exactly - I should’ve added that she head a specific guided soundtrack as well, which the facilitators said was integral to optimal treatment, at least for this particular trial.
I haven’t yet. It’s not easy to find the place or time to do so. The trial was great because everything was meticulously organised, such as the dose and - I guess - quality? I’d be worried about sourcing myself and messing something up there.
Trial eligibility required someone with documented evidence of treatment-resistant depression, with at least two prescription regiments in recent history.
Correct, screening was pretty thorough and there were a lot of sessions with therapists, blood tests, etc before they made the decision to allow her into the trial.
It’s also possible that the effect is purely pharmacological/physiological and the things you think or don’t think during the trip are entirely immaterial to its effects on depression and/or anxiety (which last days or weeks, whereas the hallucinogenic effects last only hours).
If I understand what you wrote correctly,
Your wife did not try any traditional medication to treat her anxiety?
Or is that included under "supplements"?
If so the term "lost hope" is not in my opinion accurate.
I am quite happy that it worked and it is a better alternative than
medication, I certainly do not think that medication is the cure all,
or optimal.
You are right, there are many medications against anxiety disorder, and psilocybin not anyone's last hope if they haven't tried any of those other drugs.
> If so the term "lost hope" is not in my opinion accurate.
What an absolutely asshole statement, which also shows an absolutely profound misunderstanding of suicide prevention and care.
Edit: Core belief of suicide ideation is that hope is gone. This is often (but not always) a perception. There may always be more things to try - but that's irrelevant to the person that is dead because they could not see another way.
> If so the term "last hope" is not in my opinion accurate.
What an absolutely asshole statement, which also shows an absolutely profound misunderstanding of suicide prevention and care.
Edit: Core belief of suicide ideation is that hope is gone. This is often (but not always) a perception. There may always be more things to try - but that's irrelevant to the person that is dead because they could not see another way.
One way is using niacin in high doses, also known as vitamin B3, as an active placebo to induce a sensation of heat and cause the skin to flush red, which is a typical reaction to tryptamines.
The rest is a regular placebo. It can be a really strong thing when you are feeling hot.
I suppose different trials do it in various ways, for hers there was a placebo group that was given a strong antihistamine. Participants in the trial were allowed to opt in for the real dosing day once the trial concluded. I suppose this was to entice people to join, as otherwise it was basically 50/50 if you would get the trial treatment you were looking for. Post trial dosing was obviously omitted from the results.
Then again what if showing some funky hallucinogenic images/movies would have the same effect on some people? We surely know that people can go crazy (so have psychological effects) in cults and similar settings. What if intense visual/sonic/etc stimulation, visual distortions etc. together with messaging like "it will change your life and cure your anxieties" is the key in this therapy?
> intense visual/sonic/etc stimulation, visual distortions etc. together with messaging like "it will change your life and cure your anxieties" is the key in this therapy?
I sincerely hope this is not at all how any of this works. That sounds like a recipe for paranoia.
There are also studies that test against placebo. There have been lots and lots of trials on these things with different designs that make different cost/benefit tradeoffs.
A difficult one with psychedelics is as-mentioned: people can easily "break the blind". But if you want to eliminate that problem you can instead do a micro vs macro dose, in which case you're measuring a slightly different thing.
There was a placebo group that were given basically a very strong antihistamine which induced some drowsiness.
This particular trial, however, allowed participants who were in the placebo group to later opt in for the real dosing - obviously with those results omitted from the trial.
Anecdotally, I didn’t get severe anxiety and panic attacks until immediately after trying mushrooms. I didn’t even have a bad trip, but the next day something was off and I never truly recovered from that.
Thank you for posting this. While not everyone's experience is the same, after hearing all the hype I was inching closer to trying this... but this confirms that it's not a magic bullet and there are dangers. I don't have any specific mental issues right now, so there's also probably no reason to try it. The only thing I wish for, at 45 yo, is to have a faster to adapt mind like I had when I was younger.
I've did a bunch of recreational drugs growing up, but mushrooms were the only one that I swore off forever. It just didn't sit well with me and would lead to a ton of anxiety both during and after taking them.
I think it's too easy for people to get caught up in the idea that these are miracle cures and forget that, just like with any drug, the effects will be different for different people. I'd love for it to be available for people who are seeing benefits, but I don't think there's any shame in people saying, "that doesn't work for me"
Yes, the one time I've tried mushrooms it was a very unpleasant experience. For weeks I was left feeling like I had done some permanent damage to my mental health. I eventually got past that feeling and there might be a point I try them again, but not without professional guidance. Psilocybin is powerful and not a remotely recreational thing (for me at least.)
The first time I tried them, it was like I peaked behind the “curtain” in the Wizard of Oz, and knew even in that moment I’d never be able to unsee or forget it. It was the equivalent of being a child and realizing Santa didn’t actually exist.
Life as I had known it, the things that then animated me, were “shown” to be a pantomime - a joke. It was tremendously sad, and - for better or worse - I’ve never been the same since.
Maybe it was a coming of age experience - something I would have more painfully experienced later anyway. But it cost something significant. It changed me. Still, some 25 years later, I don’t know if it was for the better.
Ditto. They contributed to long-term trashing the psyche of a relative and we have a really strong history of such issues, stuff like schizophrenia that they can trigger. It’s an under appreciated risk.
In general, even with genetically inherited disorders your chances of developing most conditions drop from 54% to less than 18% in low stress environments.
Epigenetics are weird, but if you are past 35 without symptoms than you should be fine without medication (know several people that weren't as lucky.)
“18% chance you go from depressed to schizophrenic” (in reality this risk is going to vary across a distribution of risk) is still not favorable odds the way I see it.
I have a buddy that ended up in a ward, and still phones from time to time.
The 3rd generation medications keep his cycles under control fairly well. Note, prior to being processed by our medical system. These same a--hole sycophantic dealers would target vulnerable people with BS treatments all the time.
Talk with your doctor, get out for a walk every morning, and try out cognitive behavioral therapy when you are ready. =3
I have a family member who has never been alright due to moderate psychedelic and heavy marijuana use in college. Maybe some people are fine, sure, and maybe this is even a rare outcome, but the denialism bothers me when I personally know that they can, at some unknown rate, turn someone schizophrenic and ruin his life. I wish we could get him treatment but he's not high-grade enough to be involuntarily committed but paranoid schizophrenics who hate and distrust their family don't respond well to "hey we should get you treatment."
I have a friend from college who smoked too much marijuana during lockdown back in India. Thankfully the insanity cleared up after a few weeks to a month clean of it, but not all are so lucky.
The denialism and propaganda campaigns bother me. As pro-legalization as I am, I personally have never and will never use drugs. They are dangerous and unnecessary, and I resent those who would influence others' decisions to do something high-risk and potentially very damaging because they want to get high.
I will up front say that while I advocate taking mushrooms to depressed people, and said so elsewhere, I would not recommend them to _young people_.
But I think you might be missing the forest for the trees: unlike mushrooms, there is a _ton_ of research on pot specifically that illustrates that heavy use in the young is extremely detrimental to their mental health, especially young men. The studies on psilocybin/psilocin do not show this.
That said, Michael Pollan has a quote in one of his books that foes along these lines: coming to psychedelics in old age, when you are set in your ways and everything is locked in, helps you break out and reconsider things, but young people don't have those things, so the value is mostly absent.
While I respect your opinion, I disagree mostly by observing the people I've known for decades.
Folks with maladaptive coping strategies tend not to age well, and it is unrelated to the specific pharmacological recreational preferences they have chosen.
Some people refuse help, and will despise folks for trying. =3
> I have a friend from college who smoked too much marijuana during lockdown back in India. Thankfully the insanity cleared up after a few weeks to a month clean of it, but not all are so lucky.
I would love to meet one of these people that lose their minds in such a short time on drugs. I know they exist but I just want to see the reality of it.
Many people with psychiatric challenges (both acute or chronic disorders) will often seek self-medication options. Marijuana is indeed a mild hallucinogen, but you are correct in that many hard drugs can trigger a psychotic episode. Often illegal dealers lace the stuff with addictive compounds that cause severe problems during withdrawal.
Having a family member with active untreated disorders can tilt the odds out of ones favor, but those with intellectual gifts also tend to be more resilient to such situations.
>The denialism and propaganda campaigns bother me
Understandable, after a few years people see the same excuses, exploitive scams, and rhetoric. The Sackler family ruined a lot of lives to capture that money, and I guess a few psychopaths saw a business opportunity.
Exactly. This is why I hate it when psychonauts push the "there are no bad trips" angle. It's a lie, and psychedelics can have a long lasting negative impact on the brain in some cases.
I'd guess it falls in the category of "don't do that", along with things like using dd to overwrite your failing hard drive with a copy of your shiny new blank drive. You shouldn't take psychedelics therapeutically unless you're set up to have a good experience, I assume.
(I've heard that expectation of your experience actually influences your experience a lot, so it could even be self-fulfilling!)
I have a family member who participated in this trial and their life was utterly transformed, from top to bottom. And it resolved a lot of _other_ unrelated issues in a totally unexpected way.
They describe their participation as the most meaningful event of their lives, second to the birth of their children.
(Stage 4 metastatic lung cancer -- and still kicking nearly 10 years later ;)
I am more empathic for weeks after doses of psilocybin. Getting there doesn't rely on any hero trips, no fractals, just maybe to the point of seeing more vibrant lights for a few hours. They used to hurt my stomach which would throw off a trip while dealing with that, and I still avoid eating stems, but it looks like I have tolerance to that now.
Nothing supremely insightful, I mostly ignore my mind's attempts at epiphanies and the false feelings of clarity, I wait till music festivals to consume them and just enjoy the vibrant lights and echo-ing sounds. Just to the point where conversations and ambient noises from further away than expected are being amplified and spliced in to things happening much closer to me.
Recreationally, I like the people I attract when I'm feeling the effects of psilocybin. I'm far too analytical in default mode, not nearly as much as when I was a bit younger, but still a far cry from where I would prefer to be. Its like I "null route" all of that and am more present to how people feel or want to feel. Its kind of crazy and obvious when it wears off, I respond to stimuli differently, or ask about things I don't really want to ask about. Less "vibes" in the moment and more "analyze" like noticing incongruences in people's lives and asking about that as a form of smalltalk, when it would be better off ignored. People respond normally, but I can tell it doesn't give them a spark of warmth like the vibes version of me does. Wasn't a goal or something I was aiming to work on, just a side effect I noticed over time.
I also use other kinds of psychedelics but I didn't want to pollute this comment with more anecdotes.
The study design does try to mitigate blinding issues and expectancy effects, but with half of the participants reporting past use of hallucinogens, this is not going to be very effective blinding.
A majority of your low dose 1st group likely very much realizes that they're on the inactive dose.
There's an argument to be made that traditional blinding and placebo techniques are not really relevant for interventions targeting mood or personality. e.g. anything that makes you feel better is an effective mood intervention, by definition. "blinding" in these studies is really just going through the motions to make certain authorities happy.
I would be more interested in polling the close friends and family of study participants and asking them about perceived changes. Instruct participants not to tell anyone about their experience in the study (whether they think they got a drug or how much).
It looks like the study tried to do something like this with "session monitors" who interviewed the participants the day after. They call it double-blind, but it's more like single-blind because the 3rd person assessment is the outcome measure.
The issue with relying on placebo effects is not that they aren't real/don't work (everything you said also applies to e.g. a painkiller), but that they are very context-sensitive. Deploy that drug to an individual or population with a different belief framework or contextual information about the therapy or their condition, and you won't get the desired results.
The design you mention is really interesting! Have you seen this done anywhere?
Is it even possible to solve the issue of there being no convincing placebo? Would a different hallucinogen like 4-HO-MET work, where the visual experience component is similar, but the visceral effect on consciousness and thought patterns is less pronounced, almost sober like?
"Well everything looks exactly the same to me, and the guy over there is staring at the carpet and whispering about The Fractals, so I think I'm in the control group"
Seems that most hallucinogens have similar benefits, with “more powerful” drugs having a more profound effect. Here’s a study on social learning in mice [1]. TLDR: length of trip correlates strongly to duration of treatment effect (eg 6 hour trip -> 1 week effect, 36 hour trip -> 6+ month effect IIRC).
Psylocybin isn’t the most studied because it’s likely to be the most effective drug. It’s because the therapists/grad students can work an 8 hour day instead of providing 12+ hour care for LSD or multi-day treatment with Ibogaine.
Those can be "discontinuation effects" rather than lack of treatment. I'm not saying they aren't doing good for you, but it's important to bear in mind that acute symptoms from missing a dose can be a different thing.
The very apparent effect these things have makes you wonder if they do not (somehow) correct for what otherwise could be a built-in deficiency we carry with us, by "design" correcting some sort of built-in imbalance ...
Anecdotal, but I know someone who suffered major depression and was hospitalized multiple times. Their medication wasn't working and neither was therapy.
They discovered mindfulness meditation and in combination with becoming a more moral person, limiting music, eliminating social media and unwholesome entertainment, and practicing small acts of charity multiple times per week they were able to overcome their depression. It's been almost 15 years since they've had any symptoms.
The way they've explained it is that we listen to music because we have a desire for sensual pleasure. And constantly giving in to desires, in general, creates a dependence where we're never satisfied with what we have. This dissatisfaction, when it becomes strong enough, leads to depression.
They practiced something called guarding their senses where they limited the amount of sensual pleasures they exposed themselves to and this calmed down their mind down to the point where even small things like the taste of ordinary food or having a conversation with a friend felt really satisfying.
I hung out with some (Vietnamese Zen) buddhist monks at their monastery for a bit, and it was really interesting how they really strive to limit sensory indulgences that take their awareness away from what's happening right here, right now.
They didn't just cut out the obviously mindless things like television and social media, but music, small talk, and even books were considered things to be consumed in moderation, because they were striving to spend as much time as possible each day really focused on the present moment.
Music I like is a huge dissociative trigger for me. I definitely am 'better' the less I listen to it. Luckily, I'm not usually that fond of music of the type that plays in public areas.
I am referring to Buddhist ethics and this has nothing to do with Muslim Sharia law or the re-establishment of caliphates.
If you are genuinely interested in what I am referring to then you can search for pañcasīla (The Five Precepts) which form the foundation of Buddhist ethics/morality/virtue.
You added the "just". Becoming a better person is probably the best thing you can shoot for, though obviously it's not a trivial process and requires significant effort and intention. I mean, what else can you do? You're the one that has to live with yourself.
Even if the whole world is going to shit, if you desire the happiness and wellbeing of others, as a deep internal orientation, this itself is its own form of happiness which is not subject to anything external. Since this thread already has Buddhist vibes, you don't have to take my word for it and can refer to metta (loving-kindness) as its own practice in addition to mindfulness.
The really interesting part is they are Muslim. They said that learning about Buddhism helped them understand the core of Islam and helped everything click into place.
I think learning about different cultures and religions can unlock perspectives which enhance whatever we're currently practicing.
The native Muslim tradition akin to what mindfulness meditation is doing would be Sufism. There are still Sufi traditions extant, but in many places they're being attacked by militant Islamic fundamentalists.
The way they've explained it is that immorality is usually based on desire and aversion. And constantly giving in to these things creates a dependence where we're never satisfied with what we have. Having a structured moral code that allows for observing these mental qualities without giving in to them eventually leads to their reduction because we're breaking the habit pattern. Once your desires and aversions are reduced then you become more satisfied with what you have; ie eliminating depression in their case.
Welcome to year 30 of trying to prove psilocybin works for psychiatric illness. And still in the pilot stage.
Even taking the data at face value, the trial cannot disentangle the drug effect from expectancy, psychotherapy, and statistical noise. The enormous effect sizes are almost certainly inflated, multiple-comparison error is uncontrolled, and the participant pool is highly self-selected. Until a preregistered, parallel-group, active-placebo, adequately powered study with blinded independent raters replicates these findings, their practical value for routine cancer care remains minimal.
It’s so interesting to see how strong the drive to prove something works is, overriding everything. As a clinical psychologist, I would welcome this kind of therapy if it worked. But this is just sad. It’s just like listening to people claim that ivermectin can cure everything.
Show me one place where this therapy is conducted by people who haven’t "drunk the Kool-Aid," and I’ll be impressed. It’s so frustrating to work with actual patients and see how much these therapies really don’t work in reality. These kinds of biased studies pop up all the time without actually panning out. I’m starting to think that people promoting therapy, giving false hope, and spending money on research like this should be viewed as corrupt and evil.
I'm not saying you're wrong on the limitations of these studies, but I also don't think it's unreasonable for people to believe in the power of these drugs.
For many people (myself included) taking psychedelics was an immediately life altering experience. I don't need any more scientific validation that psychedelics helped me than I would need to prove that touching a hot stove burned me. It's an immediate and unmistakable effect that is wholly different from any other experience I've had.
Now, proving that these drugs would be beneficial at a population level may be an unanswered scientific question. But, to quote you: "trying to prove psilocybin works for psychiatric illness" - well, that's been done. The people who have been helped have all the proof they need. I think the issues you've raised are more properly targeted at the question "should we recommend psilocybin treatment to depression patients more broadly" which is in fact a much higher bar than "do they work?"
I can respect this view 100%. And your rephrasing, "Should we recommend psilocybin treatment to depression patients more broadly," is in perfect sync with my thinking, and the right question to ask.
I would only add that it's extremely hard to know if something actually works. There are seriously some medications that people claim don't work, but objectively they are healthier, happier, more social, more active, and "better" on almost every objective measure. An example of this is when you really have a good match with venlafaxine for co-morbid panic disorder and depression.
Then there are drugs everybody claims are good for them, but they almost never are, especially in the long run. Basically, all of the benzo sleeping aids (in the context of chronic use).
So I can't and won't say you are not right. But I hope you permit me my goal of finding "objective" markers for saying "something works." Because, to quote Murderbot, "Humans are idiots!" (me included). And self-report is a notoriously unreliable measure.
>Welcome to year 30 of trying to prove psilocybin works for psychiatric illness.
That is true, but it misses some important nuance: the war on drugs has effectively eliminated the ability for legitimate researchers to do significant research on these criminalized drugs.
For example, for me personally, a mild dose of marijuana is as effective as Zolpidem (Ambien) as a sleep aid, but without the lethargy and mental fog the next morning.
>the war on drugs has effectively eliminated the ability for legitimate researchers to do significant research on these criminalized drugs
That's not true any more. We have a substantial body of data already from clinical trials and a huge number of trials currently in the pipeline. The results from completed trials are quite equivocal - while psilocybin does appear to work as a treatment for depression, anxiety and other common psychological disorders, we have no evidence yet to suggest that it is meaningfully more effective than current treatments.
We have good reason to believe that psychedelics may be useful for some patients in some circumstances, but the widespread talk of a revolution in psychiatry is pure hype.
Thank you for this. I am neither an advocate nor against psychedelic use in therapy but as a person who has consumed these things in the past, my own experiences make me entirely skeptical of people who put on an advocacy hat around any particular chemical. Especially psychedelics like psilocybin which are extremely unpredictable.
When I was a teen a friend gave me an analogy that stuck with me. In much older computers (e.g. C64, Vic-20, etc), they'd behave "interestingly" when you mucked around with the physical circuit board or there was a fault. E.g. if something short circuited because a screw was loose in the board, or a cartridge was halfway in or a chip partially desocketed, etc. Characters would appear in random places, or the machine go through odd loops and so on. And to someone who didn't know how the machine worked, there could be a certain "magic" and a "pattern" to this. But clearly you'd be missing the point if you thought you had "enhanced" the machine this way.
LSD and psilocybin are kind of like that, but for your brain. They short circuit and alter pathways. In ways that can be entertaining but you're entirely missing the point if you try to assign a higher meaning to them.
Our brains are expert pattern-finding machines, and produce causes and reasons even when there are none. For some there may be value in the experience of altering the operation of your brain to get yourself out of a stuck pattern, I guess. But I am not sure the very random stochastic nature of the whole thing is ... medicinal.
Most people involved in it are aware at some level that this is at best suspect and at worst a deception designed to push legalization. Same as the “health benefits of marijuana” crowd who violently deny the risks, addictive nature, potential to induce schizophrenia (temporary or permanent), tendency to make people lazy and obese, etc.
Legalization has never been a question of “is this good for people?”
So am I, of both "hard" and "soft" drugs. I'm just pointing out the ridiculous approach some people choose to take rather than arguing from principled grounds. It's also a dangerous one: "we shouldn't use state violence against people who use X" is a moral position. "I'm going to spread lies that may lead more people to use dangerous substance X because I want to get high" is a very immoral one.
I think I agree. But I come at it from a different angle.
I only care if proposed therapies actually work, when people claim they do. I think the state has a horrendous track record of deciding what people are allowed to do with their own life. And I think drug enforcements are a waste of resources. I think almost all drugs are terrible and should never be taken. To me, all of these are simultaneously true.
It's really hard to answer without imposing values. For instance, I value productivity, progress, knowledge, the survival of humanity, and such things. In that sense, most substances referred to as "drugs" have a bad track record (heroin, cannabis, amphetamines, ethanol). I'm not sure if I think the world would suffer with regard to any of my values if all of them magically disappeared.
Then again, I think it's important that my views are never imposed on anybody. So it's perfectly fine to be a pure hedonist and use everything under the sun.
The dose makes the poison, though. So I think that limited use of alcohol, cannabis, shrooms, and LSD might be useful to gain new perspectives, serve as a social lubricant, or even provide some form of temporary relief.
The drug isn't really the problem; it's the pattern of use. So maybe I should have said that "most drugs are mostly used in a terrible way, to such an extent that they become terrible by default."
If I were to try anything, psilocybin would be high up the list of stuff I would like to try. Just to see what effect it would have on me. I suspect little (every life-changing, perspective-changing experience people yab on about never changed anything for me once they actually happened to me, and I am 100% immune to hypnosis and personality change when drunk), but it would be interesting to see.
Due to a small, self-selected sample, biased toward educated, prior hallucinogen users, inadequate blinding, p-hacking via uncorrected multiple tests on 17+ outcomes, and crossover design flaws that confound long-term effects with intensive therapy.
Similar psychedelic therapy claims—for LSD/psilocybin alleviating cancer-related anxiety/depression—have echoed since the 1950s-1970s, yet they've never panned out into practical, scalable clinical therapies. This alone should raise a MASSIVE Bayesian statistics red flag, due to prior discount: with decades of unfulfilled hype. At this point new evidence requires extraordinary proof to update our view.
If such massive effectiveness were true, it would blow what we already have out of the water, and I would be the first to promote it to my patients. But you know what they say when something sounds too good to be true.
Taking psychedelics allowed me to shed years of guilt and my own historic personality to become a more open and grateful person. I think some people have psychologies built on strong foundations that if shaken by psychedelics, cause more harm than good. The people who psychedelics help are those with more suggestible psyches that want change.
I meant to say historical personality. I thought I had heard about this type of ego-death when reading some of the early pioneer’s works but can’t find a mention. Basically it was the idea of who I was that had built up over time based on people’s assumptions, judgements, and the way they treated me. My built up idea of self was enforcing negative looping behavior patterns until tripping freed me from that past idea, my historical personality. This led to me feeling a more open and unburdened sense of identity, allowing my idea of self to be an unfolding story rather than someone else's half-telling
Anecdotally, I know several people who have tried mushrooms and/or ayahuasca for depression in recent years and their results are nothing like the glowing Internet reports.
The worst case is a friend who became disconnected from reality for a very long time. Went from atheistic to believing in mystical ideas. He thought he was able to see and sense things that we could not, like auras and secret messages. He was getting better last time we checked but he’s hard to get in contact with now. No prior hints of psychosis or family history, just a psychedelic induced mental illness.
The other anecdotes were not as dramatic, but also not as positive or free of side effects as studies like this one would make you think. Multiple stories of extended periods of derealization or anxiety attacks that started after the trip. There are similar comments here throughout this comment section.
There was a time when sharing these negative stories was met with disbelief and downvotes. I think as it’s becoming more common people are realizing that the interaction between psychedelics and depression isn’t as great as it seemed for a few years when they were virtually being promoted by podcasters and social media influencers as a novel cure for depression.
I think a lot of the negative reception to negative anecdotes were because they were often in the context of legalization. "I know someone who went crazy after trying $foo so we should still lock people into iron cages just for the crime of possessing it." Debate tends to get polarized when doors are being kicked down. Academic studies that are disconnected from culture wars don't tend to provoke such responses, probably because they don't tend to reach the general public in the first place.
> because they were often in the context of legalization. "I know someone who went crazy after trying $foo so we should still lock people into iron cages just for the crime of possessing it."
I think that’s what people thought when reading negative anecdotes, but I definitely didn’t see a lot of suggestions that we lock people up.
The same thing happened for marijuana: Any mention of negative effects would bring downvotes, scorn, and disbelief pre-legalization. Then once it was legal it became acceptable to say that marijuana wasn’t a panacea and using a lot of it was actually a problem.
Before this change, it was common to read highly upvoted anecdotes here and on Reddit claiming everything from medicinal properties to fixing depression to improving driving skills (an actual claim I saw here and on Reddit multiple times). Now it’s widely acceptable that frequent marijuana use is not good for mental health and wellbeing, but that was once a thing you could not say on the internet.
> definitely didn’t see a lot of suggestions that we lock people up.
Nobody had to suggest that, it was the law of the land already. Hyperbolic argument is hyperbolic ("iron cages" was a bit of a tip-off) but consequences short of imprisonment were typically some other state-run means of destroying one's career, family, and/or life. Pointing out that this isn't a good thing and isn't actually working somehow made you into The Enemy Of Decency. And while there's still lots of Drug Warriors out there who still think that way, I'm encouraged at the increasing avenues for actually productive discussion. Seems to be the one politically-charged topic that isn't getting more toxic these days.
Which is a terrible strategy actually. People did the same with marijuana. “Dude it’s medicine lol. Dude it can’t possibly contribute to schizophrenia. Dude weed lmao.”
All this does is create a credible argument that the pro legalization crowd are objectively lying to people and therefore untrustworthy.
When it comes to truthful arguments, the anti-legalization crowd historically hasn't stood on very firm ground either. I think we can agree that perhaps with the heat dialed down a bit, we're allowed to have grown-up conversations now.
I'm sure it's nothing like a panacea, but I've lost count of the times in which getting some context behind a report of a bad experience shows recklessness or just plain old bad decisions.
It also works the other way around, people even talk about how years of therapy didn't help but psilocybin did, and few seem to consider that maybe it was a combination of both? Perhaps all of that therapy that "didn't help" set the stage for something else.
I don't know if people have forgotten all the lessons from the 60s, but set and setting are still extremely important for what kind of experience you are going to have.
Does anyone know if any similar treatments are currently available or if there are any ongoing or pending such studies? Someone in my life is a cancer patient who could potentially benefit from this.
Oregon, Colorado and New Mexico have legalized psilocybin for supervised medical use. There are a number of clinical studies that might be relevant and are recruiting or soon to recruit participants.
Thank you so much. I have no familiarity with the appropriate search tools for this kind of thing. It's really great that we have a tool like this. Thank you for introducing me to it!
My dad is a boomer who's strongly (and I think uncritically) against non-medical use of all drugs except alcohol (and he himself doesn't drink). He would be hesitant to do this under medical supervision, but he definitely wouldn't just do it "on his own".
Besides, he's kind of a closed off person who has a lot of emotions he just avoids dealing with, even more so since the cancer diagnosis. He definitely needs a trip sitter, but he has few friends (certainly none who could do that competently), and no one in our family could fulfill such a role for him. Maybe I could for someone else, but my relationship with him is too complicated for me to do that job well, I think. :-\
To top it off, my dad's cancer is in his liver, even though he never drank much at all for dietary reasons (he was on a strict keto diet for ages). I would worry about the possibility of toxicity with introducing new drugs without medical supervision.
It indeed decreases. When my spouse was diagnosed, they prescribed her anti-depressants. We replaced them with psilocybin. Never taken any anti-depressants.
We had a very serious case with multiple surgeries, chemos, radiations. Not one, not two, and not ten or even twenty. MORE than that.
The treatment still goes on, soon it is gonna be 5 years. With ZERO anti-depressants. And I've learnt how to grow them, not buying them.
So we don't need studies, we tested it the hard way, and it works :) I can talk about it for hours.
Thanks! I just realized we're mostly feeling normal, maybe even a bit more happy than average non-cancer family. It's only the side effects that are uncomfortable: losing money, a couple of jobs down the road, affected childhood of our 11 y.o., dealing with jerks, etc. Mood-wise psilocybin brought us back to normal life, maybe even slightly better than it was before :)
This happens in every depression study: Placebo effect is extremely strong for depression.
You can even collect depressed people, do nothing at all, and when you survey them 6 months later the average scores will improve. This is because depression is, on average, an aberrant condition and the average patient will tend to revert toward the mean.
However, psychedelic studies have a bigger problem: Psychedelics trigger false feelings of amazement and wonder, feeling like something magical has happened. This is like turbo placebo when you tell people that it’s a depression treatment. Maybe that’s a valuable therapeutic effect, or maybe not. There’s a lot to explore, but from all the studies I’ve read I’m not as bullish on mushrooms for depression as the headlines would indicate.
I don't want to be patronized about the number of depression studies I have or have not read. Can you answer yes or no: does figure 3 support the study's conclusion?
Sure - but I don't see the authors mention group convergence anywhere.
While the first 5 week post treatment actually looks impressive, I don't think the treatment arms being essentially the same after 6 months supports the conclusions of the study. Unless we backpedal and say the inactive grouo was microdosing (which has its own baggage...)
Agreed. If I saw an SSRI with those curves I would doubt the efficacy of it. But this might be why I am not in charge of clinical trials. Just a layman taking pot shots.
I used to Microdose psylocibin, ever 4. Day. Since I didn't hold a job but did some daily routine, I knew it would be a slow day. It actually worked really well.
One day I had a little too much. That day I was really productive and obsessed with folds in clothing.
To be fair, so did a lobotomy. I believe close attention should be paid to any unintended outcomes of a therapy that the patient themselves would no longer be able to identify due to the nature of the treatment itself.
Psilocybin is about the 180-degree opposite of a lobotomy, just from a purely mechanical perspective. And it certainly feels that way qualitatively as well.
Yes, although—within a specific range—mild "hormetic" stress or departure from baseline can lead to adaptive and beneficial effects in organic systems.
Hormesis is characterized by a biphasic dose-response: low-level exposures to stressors (toxins, temperature, exercise, dietary restriction, etc.) are those which stimulate adaptive beneficial responses, eg exercise, ischemic preconditioning (short bouts of reduced blood flow improving tissue resilience), and dietary energy restriction.
Rather than negating homeostasis, we can say that hormesis "refines" it: mild, intermittent stress can make us resilient through larger future perturbations.
FWIW: Got me sober and I think: kept me sober. Psilocybin is some powerful stuff tho, do recommend if people want to try it for "issues" - you seek someone who knows what they are doing first.
The study mentions they administered 30 milligrams of psilocybin for 70 kg of body weight. Does anybody know how many grams of dried mushrooms that is equivalent to, roughly?
A good ballpark for dried shrooms is roughly 1% psilocybin by weight of dried shroom, so about 3g. That said, it's going to vary a lot shroom to shroom, genetic to genetics, and species to species. Could be as high as 6g for more mild strains and as low a 1g for something like pan cyans.
That is the problem with clandestine pharmacy by Florida man, as people may get the wrong dose or a mixture of various other poisons like arsenic (see dark web article.)
When ready, please talk with your doctor first. =3
I've been doing some recent research and testing, and here's what I have found: I'm talking about the "Penis Envy" strain, which is quoted as being ~30% more potent than typical. 2g is the edge of where I start getting visual artifacting, and only sometimes. 3g, which I have not tried, was quoted as being towards the upper end of a "theraputic dose", and 6g as the upper end of a recreational dose. Some friends with much more experience consider 1g to be microdosing, FWIW. 0.25g I can't feel at all. .5g I start to feel some euphoria and 1g to 1.5g I start to feel "high" but with no noticeable psychedelics or just minor visual artifacting when I'm reading.
I don't really have anxiety or depression. I do have a fairly high stress family life, wife and kiddos have lots of issues. A few weeks ago I had 2g on an empty stomach on a Sunday and I just listened to music for ~4 hours and it was like I had a vacation. I hadn't enjoyed listening to music so much for 20-30 years. Also, I seem to feel kind of sleepy when I'm trippy, but afterwards I'm wide awake for 4-5 hours. So evening dosing is best avoided.
It's kind of great, for me personally, living in a state where it has been decriminalized.
"[...] psilocybin converts to psilocin in the body at roughly a 1:1 ratio by active effect [...]
Psilocybe cubensis (most common): Contains about 0.5-1.0% psilocybin by dry weight. Since psilocybin converts to psilocin in the body at roughly a 1:1 ratio by active effect, 30mg of psilocin would be equivalent to roughly 3-6 grams of dried P. cubensis.
Psilocybe semilanceata (liberty caps): Much more potent at 1-2% psilocybin content, so you'd need only about 1.5-3 grams dried.
Psilocybe azurescens: Even more potent at 1.5-2.5% psilocybin, requiring roughly 1-2 grams dried.
Important caveats:
- Individual mushrooms within the same species can vary by 3-5x in potency
Growing conditions, harvesting time, and drying/storage methods all affect potency
- The caps are typically more potent than stems
- Fresh vs. dried makes a huge difference (fresh mushrooms are ~90% water)"
Have to note that the paper is from 2016; for those really interested, it's good to read recent review papers.
I learned from an episode of "The Studio" that by "an eighth" you are likely referring to an eighth of an ounce is around 3.5 grams. Dude thought he got really mild shroom laced chocolates ("an eighth of a gram") and much hilarity ensued.
Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial
Because usually the "euphoria" people feel is their biology failing due to mild poisoning. It is why most people will often upchuck within a few minutes of ingestion.
People may think they are finding enlightenment, but are no different from the local deranged squirrels aggressively howling at passerby after nibbling Amanita in the fall. Apparently the squirrels use the mushroom to help preserve food stores, and it doesn't poison them as severely (often fatal for humans.)
Paul Stamets is a weird dude, but his work contains some profoundly detailed observations.
People need to think about Fungi as closer to animals that don't move on their own, and acknowledge they rapidly adapt genetically to survive. Pretty to photograph, but often far more complex than people like to admit. =3
Let me guess, you’ve never tried them? This is the one substance no one should be talking about if you’ve never tried it. You can’t reason your way through it with first principles.
It's an entirely different class of hallucinogen. I don't have personal experience with it but I have done other dissociative hallucinogens and his take is likely largely true (though I wouldn't argue with someone saying they felt euphoria on it). The problem here is it's the entirely wrong mushroom.
I can assure any doubters that psilocybin on the other hand has legitimate euphoric effects.
The psilocybin containing variety also naturally grow in our yard, and the Amanita is an invasive variety. The "high" people feel is a chemical lobotomy from mild poisoning, and onset of renal failure. Hence why you feel nausea and often erupt out both ends if ingested (especially bad if allergic to a specific fungi.)
I asked for 5 citations not sponsored by dealers that he claimed were available, and my post was flagged. To be fair, I would also accept 3 double-blind medical citations of reasonable quality.
You can't argue with the irrational, as hitting yourself in the head with a brick also causes similar results. lol =3
These studies focused on combined therapy in psychiatry, and do not address the long-term health implications. They do confirm certain strata of the population benefit from the experience, but do not define the underlying mechanism (my concern.)
>That’s false and you aren’t going to find a single paper (funded by anyone) that would conclude this.
A brick may be too strong for some, but minor brain injury often causes euphoric experiences and personality changes... even if people hop up and down on the spot long enough. Native traditions in Africa have been getting concussion highs that way likely since history began.
Incidentally, getting hit with a brick would certainly cause someone to stop ruminating on existential angst for a little while, and euphoric concussions do cause cathartic experiences. lol =3
Notably, the age of surgical and chemical lobotomies were used to treat unruly patients in North America for several decades. Commonly, procedures were applied to treatment resistant criminal psychopaths and countless others with little long-term success.
We agree "something" happens (well documented with LSD), but disagree on the safety warnings in your own citations. Which do not clearly address long-term health effects due to the cocktail of other compounds in cancer patients.
I am not judging peoples life choices, but we must agree most people that do recreational drugs are not in cancer or psychiatric care.
Thank you for the citations, as it cleared up why we differ in opinion on this matter. Best of luck =3
>Why don't you show me 5 citations of renal failure from a confirmed psilocybe cubensis
Mostly, real doctors take "Primum non nocere" very seriously, and do not conflate therapeutic studies as proof organ damage isn't a risk. Fungal infection of those with compromised immune systems is harm.
People do experiment on the desperate, but it is rarely ethical gambling with someone's life. The squirrels seem to enjoy their trip, but also seem less invested in trying to justify its safety.
May you live an enjoyable life with authentic experiences. Have a glorious day. =3
Actually, the citations above already warn 40% of users have neutral to negative side effects, and doesn't get into the consequences of allergic or nausea related symptoms (about 2 of the 5 papers seem of reasonable quality.)
So to be clear, cancer patients have a lot of other problems that likely would confound which reported symptoms are related to which medication.
Someone with access to the PsycINFO database login could clarify things for sure. If I recall it was a few cases of micro-dosing related organ failure cases that caught my attention. No idea which specific psilocybe mushroom was responsible.
The Natives also used Datura, but rolling in your own excrement naked for 2 weeks with severe hallucinations isn't a popular recreational experience for some reason. A few kids die every so often trying to prepare the plant.
You cited the one case in recorded history which I already pointed out existed. It's not the data that's questionable but the circumstances. His two friends ate from the same batch and were fine.
I'd say that counts squarely as "no evidence". Besides, I asked for 5 citations.
Also, you can keep the off topic babbling to a minimum. We are talking about the lack of evidence of renal failure resulting from psilocybe cubensis.
Not really, the Proof burden falls on people to verify something poorly studied is safe, keeping their petulance in check, and acknowledging their BS when proven harmful.
What seems like a detractor is an allusion to some therapeutic psychiatric citations describing native shamanistic traditions as some sort of qualifying safety feature in compounds.
I really can't be bothered to pull more papers folks seem to simply ignore. The trivial counter-proof is there, and it is unethical to harm people for more data.
Best of luck, and please keep an eye open for early signs of renal failure like persistent excessive foaming in urine etc. =3
He was writing practical agricultural mycology books long before he advised the TV show.
First came across his work while modeling hermetic food and waste reclamation options. Paul looked at this area several decades prior, and documented everything in detail. He is weird, but a good scientist worthy of respect. =3
it only takes one bad trip (absolutely massive overdose in my case) to understand how badly south things can get. used to be a favourite consumable, haven't touched it in over a decade and extremely unlikely to again following that one experience. it also helped phrase 3 earlier experiences in terms of the new "peak", and made me understand how much incredible danger I had been in at all times even prior to the bad trip
This is from 2016, a lot has happened since then:
- The FDA recognized psilocybin as a breakthrough therapy for treatment-resistant depression: https://www.prnewswire.com/news-releases/compass-pathways-re...
- Some more studies, such as https://pubmed.ncbi.nlm.nih.gov/27909164/
- More widespread use in medical treatment, such as approval in Australia (https://www.bbc.com/news/world-australia-66072427) and limited approval in Switzerland
Very much anecdotal but I can say that psychedelics helped me and several friends a lot with depression. They don't just magically make you feel better - at least not long-term - but they give you the neuroplasticity you need to adjust your internal filters and behaviour. As such, if the purpose is truly healing and recovery, they're best paired with professional therapy, preferably from somebody who's experienced with psychedelic-assisted therapy specifically.
Wonder how Adderall with its fourfold amphetamine recipe can fast-track to market, while psylocibin with all its ancestral approval had not yet been pilled AT ALL. How can a soldier designated pill make it to 60m prescriptions and amazing substantiated illegal use, while psylocibin is still rated as schedule-1 drug alongside heroine, which of course is major offense to possess.
https://en.wikipedia.org/wiki/Adderall https://en.wikipedia.org/wiki/Psilocybin#History
This makes very little sense unless on purpose. I mean, like what, people been doing it for millenniums and still we got where we are now, and not because of downsides of its use, or what?
Modern drug laws came about in the 1970s, at the height of hippies on psychedelics trying to overthrow the government.
People in power fear losing their power, and they saw these drugs as a threat.
The weirdest part of the whole thing to me is that they outlawed Cannabis, Psilocybin, and LSD, but kept cocaine legal with a prescription under schedule 2.
You have to understand that drugs roughly break down into two categories IMO: the touchy-feely stuff that creates empathy and kindness and healing on the one hand. On the other hand you’ve got stuff that makes people “hard-charging” — going off and doing a thing without thinking it through, with a tinge of anger, fury, unstoppable raw power. Think: cocaine, booze, caffeine and any other stimulants. These reduce empathy and create problems for people.
These two camps are pretty wildly opposed! If I had to guess, I’d bet my money on the people in power liking and using the hard charging stuff while loathing the touchy feely stuff.
All this feels a bit trite, over-simplified, and maybe even a but concocted on my part. But after a lifetime of being around these drugs, it fits well with my experience.
I’d add, too, that the book “Chasing the Scream” gives a better perspective on drug laws & their origins, which really began much earlier than the 1970s.
It's oversimplified in terms of the drug landscape; fentanyl != meth != alcohol, and the reasons people use them are different. You could simplify it as escapism but you'd be incorrect. Or rather, where do people want to escape to? That has little to do with the racism of the 1970s when interracial marriage was literally illegal though which is when the original drug war and those laws date back to.
Definitely over-simplified for the drug landscape, but I still think that users roughly sort into these two categories.
I also think its incorrect to define this sort of escapism as escaping to something. IME people escape from something — the “to” doesn’t matter as long as the “from” ain’t there.
I’d further agree that it has nothing to do with interracial marriage — not sure where this point came from?
The “War on Drugs” as Nixon named it isn’t the beginning of the story.
it's not the beginning nor is it the end. To go back to the story, you said
> If I had to guess, I’d bet my money on the people in power liking and using the hard charging stuff while loathing the touchy feely stuff.
that some people liked the hard charging stuff and were white, and that some people liked the touchy feely stuff and who just so coincidentally some of them happened to be dark skinned, in an era that was racist to the point of having anti-miscegenation laws, isn't some minor coincidence.
> the “to” doesn’t matter as long as the “from” ain’t there.
The "to" matters because after you've gotten high you're there, but where's there? it's that the one where your kids are listening to you? where your wife never left, where your boyfriend wasn't beating you? In that "to", how is life?
As an aside, I enjoyed this conversation; thanks!!
Yeah it's a sad history that can't be separated from racism, unfortunately. I think "to" matters most to the sober folks, no? Perhaps I'm simply not getting it. When you're high the pain stops whatever it is. And you're there. In the euphoria. And nothing else matters.
But you eventually come down, and when you're sober again, it all matters! Particularly when you live in a society that criminalizes your escape. I've always thought it excessively cruel to criminalize substance abuse.
Truly, what kind of creatures are we? smfh
When you're high, where you are depends on the drug. They don't all cause the same incapacitating euphoria that fentanyl zombies experience. Alcoholics famously have a problem with driving while intoxicated, which is to say there's a state between sober and being blacked out. Some alcoholics just like a pleasant buzz and don't get to a point of euphoria and nothing else. Of course, cocaine addicts hash together elaborate business schemes while high to (to your point of stimulants being a gogogo drug), but then they're not in blissed out euphoria either, but actively thinking and planning and doing.
One of Nixon's advisors:
> “You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin. And then criminalizing both heavily, we could disrupt those communities,” Ehrlichman said. “We could arrest their leaders. raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
The initial war on drugs had nothing to do with the drugs themselves. But then successive governments had to keep running with it because letting the foot off the gas would let the opposition portray them as weak on drug abuse and crime. And then commercial interests got mixed into it too.
Research has proven that mushrooms and LSD are societally and personally the least damaging drug you can take. The top spots go to usual suspects like heroin and crack, and the subtop is alcohol and tobacco.
A family friend who was an ophthalmic surgeon once explained to me the cocaine was long the default anesthetic for eye surgery, and thus it had an accepted medical use (which was the criterion for Schedule 2). Sounds at least plausible to me.
Particularly considering this story about the cocaine extracted from coca for the coca cola products and where it supposedly goes to…
Besides, I’m not sure Timothy Leary and friends were more real about political party than Elon is today.
This absurd stigma of psychedelic substances need to stop now. This very moment.
But those modern drug laws picked up where the older drug laws petered out, and in both cases they were intended to punish their users, not protect them.
To bang a fairly weathered drum, this is largely a matter of conservative policy. Psychedelics were far more common in leftist circles (some might argue that this is cause as opposed to effect - mind-expanding experiences tend to shift politics towards that end of the spectrum).
This means that if you wanted to use the law as a political cudgel without being accused of thought-policing, you could outlaw psychedelics and be confident that the blast zone would exclude the politically faithful while locking up loads of political undesirables; like hippies, panthers, etc.
Of course, these days you have right-wing podcasters discussing DMT with billionaire CEOs, so it's a little trickier. Thus the tentative steps toward legalization.
the ssri industry would have collapsed, only reason
This is an incredible take. The first SSRI was introduced in 1982 by a Swedish pharmaceutical company. The US congress passed the Controlled Substances Act in 1970. Not even Big SSRI has lobbyists who are time travelers.
sure, fair point but what is the reason mushrooms, which are factually and scientifically proven less harmful than say, ethanol on all measurable indices still scheduled? its all just money in the end. they need to get theirs in scam tax structures like say, colorado etc
I mean, the scheduling alone put research behind by decades, helping to stifle competition for more recent and less effective (in some cases ofc) pharmaceuticals
Proof?
It's politics and optics. But as someone taking a schedule 3 medication that is really a schedule 1 in disguise (sodium oxybate) I wonder why they couldn't use the same tap dance for psylocibin or MDMA. Slight chemical modification to adjust absorption rate but same active ingredient. I think we only get away with this because it's prescribed so rarely and out of public consciousness. It's incredibly effective at treating a pernicious condition.
I think the Analogue Act covers stuff like that?
https://en.wikipedia.org/wiki/Federal_Analogue_Act
You'd think, yet I get it sent to me legally anyway. It is under a very restrictive REMS program, but it you're formally diagnosed with the very short list of applicable conditions, it's not that difficult to get.
Not enough money in it. It's not something that is taken regularly for long term like ADHD meds, or something that pretty much everyone uses at some point like antibiotics. If psilocybin came in a pill, it'd be targeted to a relatively small group of people for occasional use.
> Not enough money in it
Source?
The simple answer seems sufficiently explanatory. Psilocybin is burended by its history as a recreational drug. That creates pockets of motivated advocates against it in a way that doesn't materialise for most drug candidates.
Adderall is just speed, which also has a long history of recreational usage. It was a widely used recreational drug decades before it began being used for ADHD.
Is actually super high quality medical speed. Like - if u want the proper stuff, u get it from the licensed distributor. End of story.
There is so much anecdotal evidence that micro-dosing psylocibine actually relieves ADHD symptoms.
Note: my iPhone autocomplete does not even recognise psylocibine as a proper word.
it's also very easy to produce (grow) at home, further decreasing $$$ potential for big pharma.
Psychedelics sometimes makes people wake up to the abuses of government, so they are pretty scary to governments.
But there's also the issue that not everyone should take psychedelics. They can have lasting negative effects on certain people that may already be experiencing issues with mental stability, or they may trigger such effects in people that don't necessarily know about their own mental wellbeing or how the psychedelic will affect them. These, like every drug, should be used with caution.
Like alcohol mixed with benzodiazepines never does the same, is this what you imply?
>had not yet been pilled AT ALL
Simple - there is no real lasting money in psylocibin as most people really only need 2 or 3 good sessions.
Whereas adderall is not technically addictive, but if you can function on it, you do become dependent on it.
You also really don't need it to become a prescription, shrooms just need to get legalized. The risks that come from overuse are far and few in between to the point where normal over the counter meds carry much more danger in abuse than shrooms do.
> Whereas adderall is not technically addictive
I don't think I've ever heard someone claim that Adderall isn't addictive.
> use of amphetamines and stimulants such as Adderall can result in tolerance and physiological dependence and can lead to the development of a substance use disorder. Misuse of prescription stimulants such as Adderall for any reason (e.g., to improve academic performance, reduce the effects of other drugs, etc.) is associated with both substance use disorders and use of other substances.
https://americanaddictioncenters.org/stimulants/amphetamine/...
I agree with you, but ..
Through direct experience, I do not think 2 or 3 good sessions and you're done is really true. Maybe with experience even that goes - you learned what you needed to learn and there's nothing more to it.
But IMHO psilocin is a strong anti-inflammatory which may in and of itself be some (not all) of the mechanism for alleviating depression (the link between inflammation and depression is strong). That will almost never be lasting.
So we may be in the case where the real breakthroughs are, as you say, in the first two or three sessions. I think most people who took mushrooms out of desperation would agree with that - by the end of the third session many of the things they needed to accept are, in fact, front of mind for awhile. But ongoing maintenance is probably useful.
The parsimonious explanation is that amphetamine was basically grandfathered in over a historical period where shrooms/acid were cultural and political pariahs and they still have to overcome the residue of that a half century later.
Has nothing to do with being a one shot solution vs subscription.
Even economically the conspiracy theory against one shot cures makes no sense. As your shitty subscription solutions all go generic, I enter the market with my low risk one shot cure and eat all of your lunch.
That the guy that was on Adderall was able to pay attention to endless meetings and fill out forms and stick with it, while the guy on mushrooms was not, is surprising to you?
This is super unsubstantiated, even small children know amphet impairs creativity while shrooms do the opposite.
I can surely see great benefit in someone thinking out of the box at meetings. While I also see the benefit of zombies blindly following commands, which is where Adderall gets u.
Small children believe in a magic being that lives at the North Pole and brings them presents through the chimney every year o. Christmas, I'm not sure I'd base anything on their beliefs about "amphet" when they can't even describe its MoA. Thinking Adderall turns you into a zombie is fallacious thinking. No one's forcing you to take it, but unbridled creativity is great for getting nothing done. Pushing rope, as it were.
In one word- predictability. Psychotropics are not predictable and heavily situational.
The traditional HN way is to make up some "It's Just That They Hate Us"[0] teenage conspiracy. The reality is this: amphetamine was widely used medically for decades by the time the Controlled Substances Act was passed. When these acts are passed, governments are usually under pressure to not remove access to things that people commonly use. Therefore, it was scheduled in a category that recognized medical use. This allowed the subsequent development of associated clinical trials and so on. It is much harder to work with Schedule I drugs than Schedule II drugs. So an accident of historical timing is what caused the difference.
0: This game is really tiresome. It's "capitalism". "They just don't want to lose power". "There's no money in it". Thought-terminating cliches. LLM-grade.
I don't have depression, but the first time I used psychedelics was so emotional helpful that I strongly suggested for depressed friends. I corrected that mistake hours later, after realizing that the risks are low, but life changing if it happens. However, I will never forget that feeling. I've used it again in the following years, but the results faded and it became boring for me.
What are the low-but-life-changing risks?
Basically it hyper-connects your brain. When people talk about seeing shapes, its not that they are hallucinating, its that when they look at the random fuzz pattern on a rug, and pick out the particles of fuzz that make a creature face, its looks like someone purposefully put those pieces there to make that face.
As such, if you are "surfing" thoughts and find an association of something, that association can become very prominent. If you don't have the context to understand why you are making that association, especially after the trip, you can get stuck with beliefs about yourself that could be non optimal.
On the flip side this hyperconnectivity also allows you to see things like a completely different person would see them, which is where the true healing power lies. Its like you can be disugsted with a particular food when you are sober, but on shrooms you can truly feel what it would be like to enjoy that food. Once you have that context, you are able to move forward after the trip into right directions.
This is why set and setting are EXTREMELY important for significant trips. You want to be with someone who a) has done psychedelics, b) is in a very good mental state, and c) has a low ego not to project their own personality onto you. The best trip sitters are those that encourage exploration - they take everything you communicate to them and ask you questions about it without imparting any bias.
Exacerbation (and possibly development) of mental illness like psychosis, bipolar disorder, or schizophrenia is entirely possible.
Along with two other blokes, I got interested in psychedelics in high school. Took one medium high dose and wasn't right for a few months. Never in my life did i ever experienced paranoia, delusions, or hallucinations that are genuinely hard to separate from reality, but I did after that.
Intense psychedelic experiences can fracture what you once knew as "reality" allows all sorts of ideas to float into your mind, with equal possibility. This might be helpful and give you more flexible thinking (helpful for depression) but it also leaves you incredible vulnerable to all sorts of garbage ideas that you never would have considered otherwise. ie conspiracy theories or straight up delusions about the supernatural. Remember: It's not paranoia if you genuinely believe they really are out to get you!
Fighting these garbage ideas is a lot of work once they take hold, but you'll only know too late if you were vulnerable, and worse, if you can successfully align your understanding of reality with most other people.
I got extremely lucky that I stabilized. I'm convinced part of this was only doing it one time. My two co-experimenters took many trips with various doses are still in and out of mental hospitals years later. Psychedelics are incredibly potent and nobody really understands them very well. A lot of what is written on the internet ignores, downplays, or denies the very serious risks to your philosophy of mind and mental function. Its like playing with fire when you don't have heat sensation in your hands.
Several other comments on this page echo these warnings. One even claims there is an 18% chance you could go from depressed to schizophrenic. I have no idea where that figure came from, but the risk is certainly not 0%
Anectodically, this is pretty rare. I know quite a lot of people who used psychedelics, and they are fine. I think some important safety points is to know family history of mental illness and not do then until later in life.
And obviously, start low and see how it goes.
Anecdotally I know so many people thrashing their lives and this of loved ones with alcohol and antidepressants while I can’t immediately think up of even a single one, okay I know one guy who was doing everything altogether, who went so badly down the spiral thanks to acid. And this one guy actually had a horrendous childhood with lotta abuse so perhaps was already scheduled for a cathartic experience.
Just curious, which psychedelics were you guys experimenting with?
Some people report personality changes, some as radical as "I found I didn't love my husband anymore."
need another dose to take it to the next level: I found that love is an action not a feeling, perhaps I never loved my husband and I should now begin to
That's not a risk, that's a realization. You need those.
You may have saved 20 years in an unhappy marriage.
The risk is that it’s a false idea triggered by the psychedelic.
Maybe a better example would be my friend who took psychedelics and then believed he was in communication with Elon Musk. This one is more obviously a false idea, but nevertheless he was convinced it was real for a period after the psychedelic experience.
There’s a mystical concept that psychedelics open your third eye to see the world as it really is or something, but psychedelics are notorious for giving false ideas and making them seem like revelations. It’s obvious when it’s nonsense (like telepathy with Elon Musk) but it’s less obvious when the implanted idea is something like “your husband secretly doesn’t love you”. Another strangely common report is the belief that people around you have been replaced by clones, which can get scary very fast if the person can’t separate the idea from reality.
It sounds like your friend had a predilection for psychosis. I feel like the nice things about psychedelics is that they don't alter my processing too much (as compared with other drugs), moreso they just give me different 'inputs' into my senses / experiences, and then I process those.
> It sounds like your friend had a predilection for psychosis.
No prior history of any mental illness in him nor any of his family.
This is a common excuse: Blame some hidden susceptibility, not the drug. It doesn’t matter what it was, though. The drug caused it and there were no warning signs. Fine before the drug. Not fine after the drug.
> a common excuse: Blame some hidden susceptibility, not the drug
It's the interaction between that person and the drug.
I have a crustacean allergy. That doesn't mean crustaceans are bad, or other people shouldn't eat shrimp. It just means it's a bad mix for me.
One of the benefits of administering psychedelics in a clinical setting is that telepathic nonsense is more likely to be noticed early and corrected for, whether by reducing dosage or suspending treatement. (And treating it as medicine allows us to study those people who react negatively to it, further reducing harm.)
Yeah I agree with you 100%. it's interesting folks immediately taking the experience and result at face value when we understand so little about what's happening, even without psychedelics is most cases.
In the referenced anecdote it could be as simple as an excuse needed for someone who's been thinking about it for years. Though maybe that's enough to be a benefit
Anyway I like your example and look forward to what is learned about using psychedelics to help people :)
> then believed he was in communication with Elon Musk
Now that is scary.-
PS. We used to trip to contact our wise, the Spirit, spirits, our gods, the beyond, our higher selves ...
... now we just get ketamine kid.-
That's interesting, I've seen a few comments like this appearing. I was expecting more about HPPD or heart valve issues from extended use.
HPPD and .. honestly, some people have bad trips, and while it is popular in psychedelic circles to say "There is no such thing as a bad trip just the way you interpret it" that isn't really true. Even Terrence McKenna stopped taking mushrooms for a decade after a bad experience.
That said, I _do_ recommend mushrooms to everyone I know with depression or anger issues.
I had a panic attack one time, not sure how I should “interpret” that one. I’ve get anxiety since childhood for context. That said I’d love to do a session with a professional rather than by myself. Self medication for mental health issues is a bit of a gamble. I’ve also had good experiences even at higher doses so it’s a bit random
> after realizing that the risks are low, but life changing if it happens.
I think these risks are more common than was previously discussed on the internet. For a long time reports of very negative experiences were dismissed, laughed at, downplayed, waved away as symptoms of something else, or excused as something positive but mysterious.
It’s becoming more acceptable for people to discuss their negative experiences and not get downvoted or attacked for sharing them.
I just don't buy it, sorry. One thing that I learned about the internet is that most online opinions are from extremes: excellent or horrible experiences. Just search about any surgery. You will probably find a lot of bad experiences for anything. However, if you look at the data for the big picture, psilocybin is one of the safest drugs out there. There are risks, but they are nowhere near what you see in these conversations.
We don't have to rely on anecdotes, we have large amounts of empirical research. Just hop over to pubmed and search for yourself - the connection between psychedelics and psychosis is really weak, unless you have a known family history of schizophrenia etc. Yes, it exists, but it really isn't that common.
Negative experiences have always been a part of it. It's half the point. Negative also doesn't mean permanent, which is extremely rare.
> Negative experiences have always been a part of it. It's half the point.
This is the type of dismissal and downplaying I’m referring to.
My friend descended into psychosis after taking psychedelics. It was not “half the point” and not helpful to his life in any way.
Not that rare, anyone with predisposition to psychosis/schizophrenia has a high risk of permanent effects, and that’s not that small of a segment of people, and nearly unknowable beforehand.
That is the definition of rare.
Rarity isn’t a catch all, it’s a lot closer to winning $20 on a scratcher than 5k. When the game is Russian Roulette no one should call it rare.
Many people say the first time they use Prozac that it was so helpful they recommended to their friends but then after a while it wore off.
How do you think psychedelics work? They activate the serotonin 2a receptor. It’s nothing but a different drug that effects serotonin. Except it does it more intensely but like all these drugs that act on receptors they wear off because of something what’s called receptor density changes.
For 70 years, we’ve been trying to manipulate receptors into making people feel good. It’s a losing proposition and it’s time to. We changed our thinking. For instance, if these people do have serotonin deficiencies, which is still possibly the case, what is it? That’s causing these deficiencies? Is it low, zinc, low B6, genetics, infection? There’s so many other things that we know that this could be, but we don’t try it.
I think this is naive. A mushroom trip is fully metabolized and cleared in approximately 6-12 hours. Despite the similar levels of reduction in depressive symptoms for the subsequent weeks, the psilocin has been cleared on the day of, unlike prozac, and hasn't been stimulating 5HT2* at all for that afterglow and post-exposure period.
Nobody other than crazy micro-dosers is taking mushrooms often enough to cause a change in receptor density and those people are putting themselves at risk of valvopathy due to 5HT2a restructuring of the heart valves (which, as an aside, is turning out to be a problem for people on prozac and other long-term SSRIs).
A drug that is very occasional, point use, with no ongoing use, which has long term treatment results, is absolutely, utterly unlike prozac.
That aside, let's say for the sake of argument that the mechanism is similar for prozac; I think that's wrong (one additional explanation may actually be: https://www.sciencedirect.com/science/article/abs/pii/S15675... ) but whatever. If so, then psilocin is vastly superior to prozac because you are not required to have continuous exposure for the benefits, as the corresponding cost, withdrawal, sexual dysfunction, weight gain, heart issues, etc. are removed.
> Nobody other than crazy micro-dosers is taking mushrooms often enough to cause a change in receptor density
This is so frustrating to me. Why not just google it before you think you know more about this than someone studying it for ten years? Two things can change receptor density: time and dose.
A Single Dose of Psilocybin Increases Synaptic Density and Decreases 5-HT2A Receptor Density in the Pig Brain
https://pubmed.ncbi.nlm.nih.gov/33467676/
This is exactly why psychedelics last longer than prozac. It has less to do with half life and more to do with dose.
How is the mechanism not at least comparative to prozac since it is well know they both effect serotonin? The risk with psilocin is exactly the dose, as many people find out. And you thing there are not cardiac side effects from psychedelics?
A Case of Prolonged Mania, Psychosis, and Severe Depression After Psilocybin Use: Implications of Increased Psychedelic Drug Availability
https://psychiatryonline.org/doi/full/10.1176/appi.ajp.22010...
Worsening suicidal ideation and prolonged adverse event following psilocybin administration in a clinical setting: case report and thematic analysis of one participant's experience
https://pmc.ncbi.nlm.nih.gov/articles/PMC11698204/
Safety First: Potential Heart Health Risks of Microdosing
https://petrieflom.law.harvard.edu/2022/04/13/safety-first-p...
You've studied it for ten years and didn't notice that the pig brain receptor changes were only measured at +7 days and are replying to a comment about long term effectiveness vs. prozac (which takes weeks to really show impact)?
I have previously read that study. You should put it in context: for example, how quickly does the brain add A1 and A2 receptors for caffeine? (I already know the answer, but you might want to use it to contextualize that study).
The study about the woman co-administering venlafaxine (Effexor) which is an SNRI might be worth considering as non-representative.
Worsening suicidal ideation .. is not unique to _any_ antidepressant. Are you trying to suggest that this is somehow unique to psilocin? We were discussing prozac which is _well known to have this problem_. They got black box warnings for this reason.
As for the heart study, I mentioned this myself elsewhere, and SSRIs are showing the same issue: https://columbiasurgery.org/news/columbia-surgery-researcher... - much worse, however, because people take these drugs every day for decades.
Oh my, I can’t even SEE the goal posts anymore!
> at least not long-term
To be clear they absolutely do regularly provide short to medium term depression relief (up to a few months). I also know someone who had severe treatment resistant depression that was cured long-term (at least years) from one dose.
Oregon even started giving licenses for psilocybin therapy a year or two ago.
https://www.oregon.gov/oha/ph/preventionwellness/pages/psilo...
Anecdotal, but about a year ago my wife participated in a psilocybin trial at a university here who were looking at patients with severe anxiety. It was her last hope after trying therapy, various supplements, as well as dietary and lifestyle changes, etc
It has been life changing for her, but one thing she tells people now is that what also helped was that it was facilitated with a trained therapist there during the session for guidance to make sure she didn’t “get stuck in a loop.” There was also many sessions pre dosing day to optimize the result.
She would highly recommend the treatment and hopes it becomes mainstream soon.
The point of music during a psychedelic experience is to provide a reference for the passing of time and to help with progression of thoughts. Music guides you through your thoughts, avoiding loops, by providing a changing texture, melody, rythm, and story.
This is on top of the other effects of music, such as emotional effects.
For other readers, I would like to suggest no music, just a sunny day and quiet.
Music, television, people talking, etc. gives you an external clock and the timelessness of the experience, one of the greatest feelings, is lost.
I guess if you're just doing them for fun it's ok.
Yes, exactly - I should’ve added that she head a specific guided soundtrack as well, which the facilitators said was integral to optimal treatment, at least for this particular trial.
Taking mushrooms together with someone you love, who loves you, is possibly one of the most life changing experiences a couple can have.
Have you taken them with her?
I haven’t yet. It’s not easy to find the place or time to do so. The trial was great because everything was meticulously organised, such as the dose and - I guess - quality? I’d be worried about sourcing myself and messing something up there.
> "get stuck in a loop"
I feel that. Thought loops are scary and it takes someone to recognize them to get you out.
Trial eligibility required someone with documented evidence of treatment-resistant depression, with at least two prescription regiments in recent history.
Correct, screening was pretty thorough and there were a lot of sessions with therapists, blood tests, etc before they made the decision to allow her into the trial.
Technically, what is the approximate dosing regime?
How often, for how many days, how much (=how high?)?
Is this a therapy with an end or do you have to take mushrooms forever?
It’s also possible that the effect is purely pharmacological/physiological and the things you think or don’t think during the trip are entirely immaterial to its effects on depression and/or anxiety (which last days or weeks, whereas the hallucinogenic effects last only hours).
If I understand what you wrote correctly, Your wife did not try any traditional medication to treat her anxiety? Or is that included under "supplements"?
If so the term "lost hope" is not in my opinion accurate.
I am quite happy that it worked and it is a better alternative than medication, I certainly do not think that medication is the cure all, or optimal.
> It was her last hope after trying therapy, various supplements, as well as dietary and lifestyle changes, etc
Last vs Lost makes no difference. Therapy should be understood to include medication.
Your statement really rubs me the wrong way; incredibly judgmental and just… shitty. Sorry to say.
You are right, there are many medications against anxiety disorder, and psilocybin not anyone's last hope if they haven't tried any of those other drugs.
> If so the term "lost hope" is not in my opinion accurate.
What an absolutely asshole statement, which also shows an absolutely profound misunderstanding of suicide prevention and care.
Edit: Core belief of suicide ideation is that hope is gone. This is often (but not always) a perception. There may always be more things to try - but that's irrelevant to the person that is dead because they could not see another way.
He meant "last hope". That was the original phrase.
Ah, then I'll fix my statement!
> If so the term "last hope" is not in my opinion accurate.
What an absolutely asshole statement, which also shows an absolutely profound misunderstanding of suicide prevention and care.
Edit: Core belief of suicide ideation is that hope is gone. This is often (but not always) a perception. There may always be more things to try - but that's irrelevant to the person that is dead because they could not see another way.
Conventional anxiety medication is a lot easier to obtain than psilocybin.
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Was she in placebo group?
Is it possible to have a placebo group when doing a study on psilocybin? Would participants in the placebo not notice the lack of psychedelic effects?
EDIT: In the original link it says the placebo group received a much lower dose, so that seems to be one way of doing it.
One way is using niacin in high doses, also known as vitamin B3, as an active placebo to induce a sensation of heat and cause the skin to flush red, which is a typical reaction to tryptamines.
The rest is a regular placebo. It can be a really strong thing when you are feeling hot.
I suppose different trials do it in various ways, for hers there was a placebo group that was given a strong antihistamine. Participants in the trial were allowed to opt in for the real dosing day once the trial concluded. I suppose this was to entice people to join, as otherwise it was basically 50/50 if you would get the trial treatment you were looking for. Post trial dosing was obviously omitted from the results.
Then again what if showing some funky hallucinogenic images/movies would have the same effect on some people? We surely know that people can go crazy (so have psychological effects) in cults and similar settings. What if intense visual/sonic/etc stimulation, visual distortions etc. together with messaging like "it will change your life and cure your anxieties" is the key in this therapy?
> intense visual/sonic/etc stimulation, visual distortions etc. together with messaging like "it will change your life and cure your anxieties" is the key in this therapy?
I sincerely hope this is not at all how any of this works. That sounds like a recipe for paranoia.
That's not so much a placebo as a head to head test of different effects? I think you'd do it in a new study entirely
That isn't how these studies are being done... because yeah, it'd probably confound the results.
sounds like in that case you’re not testing the efficacy of high versus sober, you’re testing heroic dosing versus micro dosing.
There are also studies that test against placebo. There have been lots and lots of trials on these things with different designs that make different cost/benefit tradeoffs.
A difficult one with psychedelics is as-mentioned: people can easily "break the blind". But if you want to eliminate that problem you can instead do a micro vs macro dose, in which case you're measuring a slightly different thing.
There was a placebo group that were given basically a very strong antihistamine which induced some drowsiness.
This particular trial, however, allowed participants who were in the placebo group to later opt in for the real dosing - obviously with those results omitted from the trial.
Anecdotally, I didn’t get severe anxiety and panic attacks until immediately after trying mushrooms. I didn’t even have a bad trip, but the next day something was off and I never truly recovered from that.
Thank you for posting this. While not everyone's experience is the same, after hearing all the hype I was inching closer to trying this... but this confirms that it's not a magic bullet and there are dangers. I don't have any specific mental issues right now, so there's also probably no reason to try it. The only thing I wish for, at 45 yo, is to have a faster to adapt mind like I had when I was younger.
Yes, it’s a roll of the dice which is unfortunate because it was actually pretty fun and a quite profound experience.
I’m not saying people shouldn’t do it but just to proceed with caution and ideally under professional supervision.
I've did a bunch of recreational drugs growing up, but mushrooms were the only one that I swore off forever. It just didn't sit well with me and would lead to a ton of anxiety both during and after taking them.
I think it's too easy for people to get caught up in the idea that these are miracle cures and forget that, just like with any drug, the effects will be different for different people. I'd love for it to be available for people who are seeing benefits, but I don't think there's any shame in people saying, "that doesn't work for me"
Yes, the one time I've tried mushrooms it was a very unpleasant experience. For weeks I was left feeling like I had done some permanent damage to my mental health. I eventually got past that feeling and there might be a point I try them again, but not without professional guidance. Psilocybin is powerful and not a remotely recreational thing (for me at least.)
The first time I tried them, it was like I peaked behind the “curtain” in the Wizard of Oz, and knew even in that moment I’d never be able to unsee or forget it. It was the equivalent of being a child and realizing Santa didn’t actually exist.
Life as I had known it, the things that then animated me, were “shown” to be a pantomime - a joke. It was tremendously sad, and - for better or worse - I’ve never been the same since.
Maybe it was a coming of age experience - something I would have more painfully experienced later anyway. But it cost something significant. It changed me. Still, some 25 years later, I don’t know if it was for the better.
Similar. Was over a decade ago. Not easy, but gradually gets better. Sorry to hear about it, it's not something I'd wish on anyone.
I have way too much mental illness in my family to ever consider trying psychedelics.
Ditto. They contributed to long-term trashing the psyche of a relative and we have a really strong history of such issues, stuff like schizophrenia that they can trigger. It’s an under appreciated risk.
In general, even with genetically inherited disorders your chances of developing most conditions drop from 54% to less than 18% in low stress environments.
Epigenetics are weird, but if you are past 35 without symptoms than you should be fine without medication (know several people that weren't as lucky.)
Stay healthy friend =3
“18% chance you go from depressed to schizophrenic” (in reality this risk is going to vary across a distribution of risk) is still not favorable odds the way I see it.
I have a buddy that ended up in a ward, and still phones from time to time.
The 3rd generation medications keep his cycles under control fairly well. Note, prior to being processed by our medical system. These same a--hole sycophantic dealers would target vulnerable people with BS treatments all the time.
Talk with your doctor, get out for a walk every morning, and try out cognitive behavioral therapy when you are ready. =3
A funny post about what not to do:
https://www.youtube.com/watch?v=LO1mTELoj6o
I have a family member who has never been alright due to moderate psychedelic and heavy marijuana use in college. Maybe some people are fine, sure, and maybe this is even a rare outcome, but the denialism bothers me when I personally know that they can, at some unknown rate, turn someone schizophrenic and ruin his life. I wish we could get him treatment but he's not high-grade enough to be involuntarily committed but paranoid schizophrenics who hate and distrust their family don't respond well to "hey we should get you treatment."
I have a friend from college who smoked too much marijuana during lockdown back in India. Thankfully the insanity cleared up after a few weeks to a month clean of it, but not all are so lucky.
The denialism and propaganda campaigns bother me. As pro-legalization as I am, I personally have never and will never use drugs. They are dangerous and unnecessary, and I resent those who would influence others' decisions to do something high-risk and potentially very damaging because they want to get high.
I will up front say that while I advocate taking mushrooms to depressed people, and said so elsewhere, I would not recommend them to _young people_.
But I think you might be missing the forest for the trees: unlike mushrooms, there is a _ton_ of research on pot specifically that illustrates that heavy use in the young is extremely detrimental to their mental health, especially young men. The studies on psilocybin/psilocin do not show this.
That said, Michael Pollan has a quote in one of his books that foes along these lines: coming to psychedelics in old age, when you are set in your ways and everything is locked in, helps you break out and reconsider things, but young people don't have those things, so the value is mostly absent.
While I respect your opinion, I disagree mostly by observing the people I've known for decades.
Folks with maladaptive coping strategies tend not to age well, and it is unrelated to the specific pharmacological recreational preferences they have chosen.
Some people refuse help, and will despise folks for trying. =3
https://www.youtube.com/watch?v=jG4qp-2O3hs&list=RDjG4qp-2O3...
> I have a friend from college who smoked too much marijuana during lockdown back in India. Thankfully the insanity cleared up after a few weeks to a month clean of it, but not all are so lucky.
I would love to meet one of these people that lose their minds in such a short time on drugs. I know they exist but I just want to see the reality of it.
Some have genetic vulnerability to addictions, and others latent disorders do manifest.
Very common side-effect for people that try strong hallucinogens and or use malformed neurotransmitters.
The find-out part happens later =3
Many people with psychiatric challenges (both acute or chronic disorders) will often seek self-medication options. Marijuana is indeed a mild hallucinogen, but you are correct in that many hard drugs can trigger a psychotic episode. Often illegal dealers lace the stuff with addictive compounds that cause severe problems during withdrawal.
Having a family member with active untreated disorders can tilt the odds out of ones favor, but those with intellectual gifts also tend to be more resilient to such situations.
>The denialism and propaganda campaigns bother me
Understandable, after a few years people see the same excuses, exploitive scams, and rhetoric. The Sackler family ruined a lot of lives to capture that money, and I guess a few psychopaths saw a business opportunity.
Best of luck =3
> in low stress environments.
How many people live in low stress environments these days?
Even Elmo has changed:
https://www.youtube.com/watch?v=Rbk7leQdxbo
Go outside, stop watching media, and meet real people. lol =3
come on man, youre sat here posting on hacker news.... its all a bit jordan petersons 12-rules-for-someone-elses-life
waiting for the build... paid to wait... rather be golfing... lol =3
"there's an XKCD for everything"
https://xkcd.com/303/
Psychodelics allow brain to change, but the change is not guaranteed to be positive.
Exactly. This is why I hate it when psychonauts push the "there are no bad trips" angle. It's a lie, and psychedelics can have a long lasting negative impact on the brain in some cases.
Following the logic, though, it could be undone with a positive experience on psychedelics...
Or you could have further triggering experiences
I'd guess it falls in the category of "don't do that", along with things like using dd to overwrite your failing hard drive with a copy of your shiny new blank drive. You shouldn't take psychedelics therapeutically unless you're set up to have a good experience, I assume.
(I've heard that expectation of your experience actually influences your experience a lot, so it could even be self-fulfilling!)
I had this exact same experience. It felt like it opened the door to panic attacks, and I had a few of them in the years that followed.
And I've gotten far worse effects from weed than shrooms or LCD weirdly enough.
thanks for sharing that
I have a family member who participated in this trial and their life was utterly transformed, from top to bottom. And it resolved a lot of _other_ unrelated issues in a totally unexpected way.
They describe their participation as the most meaningful event of their lives, second to the birth of their children.
(Stage 4 metastatic lung cancer -- and still kicking nearly 10 years later ;)
Another positive anecdote for me
I am more empathic for weeks after doses of psilocybin. Getting there doesn't rely on any hero trips, no fractals, just maybe to the point of seeing more vibrant lights for a few hours. They used to hurt my stomach which would throw off a trip while dealing with that, and I still avoid eating stems, but it looks like I have tolerance to that now.
Nothing supremely insightful, I mostly ignore my mind's attempts at epiphanies and the false feelings of clarity, I wait till music festivals to consume them and just enjoy the vibrant lights and echo-ing sounds. Just to the point where conversations and ambient noises from further away than expected are being amplified and spliced in to things happening much closer to me.
Recreationally, I like the people I attract when I'm feeling the effects of psilocybin. I'm far too analytical in default mode, not nearly as much as when I was a bit younger, but still a far cry from where I would prefer to be. Its like I "null route" all of that and am more present to how people feel or want to feel. Its kind of crazy and obvious when it wears off, I respond to stimuli differently, or ask about things I don't really want to ask about. Less "vibes" in the moment and more "analyze" like noticing incongruences in people's lives and asking about that as a form of smalltalk, when it would be better off ignored. People respond normally, but I can tell it doesn't give them a spark of warmth like the vibes version of me does. Wasn't a goal or something I was aiming to work on, just a side effect I noticed over time.
I also use other kinds of psychedelics but I didn't want to pollute this comment with more anecdotes.
The study design does try to mitigate blinding issues and expectancy effects, but with half of the participants reporting past use of hallucinogens, this is not going to be very effective blinding.
A majority of your low dose 1st group likely very much realizes that they're on the inactive dose.
There's an argument to be made that traditional blinding and placebo techniques are not really relevant for interventions targeting mood or personality. e.g. anything that makes you feel better is an effective mood intervention, by definition. "blinding" in these studies is really just going through the motions to make certain authorities happy.
I would be more interested in polling the close friends and family of study participants and asking them about perceived changes. Instruct participants not to tell anyone about their experience in the study (whether they think they got a drug or how much).
It looks like the study tried to do something like this with "session monitors" who interviewed the participants the day after. They call it double-blind, but it's more like single-blind because the 3rd person assessment is the outcome measure.
The issue with relying on placebo effects is not that they aren't real/don't work (everything you said also applies to e.g. a painkiller), but that they are very context-sensitive. Deploy that drug to an individual or population with a different belief framework or contextual information about the therapy or their condition, and you won't get the desired results.
The design you mention is really interesting! Have you seen this done anywhere?
Is it even possible to solve the issue of there being no convincing placebo? Would a different hallucinogen like 4-HO-MET work, where the visual experience component is similar, but the visceral effect on consciousness and thought patterns is less pronounced, almost sober like?
"Well everything looks exactly the same to me, and the guy over there is staring at the carpet and whispering about The Fractals, so I think I'm in the control group"
Of course things get really complicated when this guy is messing with your control group https://xkcd.com/790/
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Or they could give them a different psychedelic to test the efficacy of psilocybin specifically would be my thought.
Seems that most hallucinogens have similar benefits, with “more powerful” drugs having a more profound effect. Here’s a study on social learning in mice [1]. TLDR: length of trip correlates strongly to duration of treatment effect (eg 6 hour trip -> 1 week effect, 36 hour trip -> 6+ month effect IIRC).
Psylocybin isn’t the most studied because it’s likely to be the most effective drug. It’s because the therapists/grad students can work an 8 hour day instead of providing 12+ hour care for LSD or multi-day treatment with Ibogaine.
[1]: https://www.nature.com/articles/s41586-023-06204-3
I think this says more about the usual psy drugs we're prescribed and use.
they don't do jack shit.
Mine have definitely helped me, as if I miss them for a day I get noticeably worse
Those can be "discontinuation effects" rather than lack of treatment. I'm not saying they aren't doing good for you, but it's important to bear in mind that acute symptoms from missing a dose can be a different thing.
Sorry, but I'd be dead without mine. I'm going to have to disagree with you.
The interesting thing with mushrooms is that you could eat a handful, realize you are already dead, and then maybe not need the other meds at all.
This could be interpreted as psychedelic ego death from psilocin, backdooring into some kind of personal revelation.
Or as clinical death from Amanita toxicity, with some meta commentary on religion.
+1. :)
The very apparent effect these things have makes you wonder if they do not (somehow) correct for what otherwise could be a built-in deficiency we carry with us, by "design" correcting some sort of built-in imbalance ...
Anecdotal, but I know someone who suffered major depression and was hospitalized multiple times. Their medication wasn't working and neither was therapy.
They discovered mindfulness meditation and in combination with becoming a more moral person, limiting music, eliminating social media and unwholesome entertainment, and practicing small acts of charity multiple times per week they were able to overcome their depression. It's been almost 15 years since they've had any symptoms.
That makes a lot of sense. May I ask, why "limiting music"? Was it just a specific type of music, or did music in general have a negative effect?
The way they've explained it is that we listen to music because we have a desire for sensual pleasure. And constantly giving in to desires, in general, creates a dependence where we're never satisfied with what we have. This dissatisfaction, when it becomes strong enough, leads to depression.
They practiced something called guarding their senses where they limited the amount of sensual pleasures they exposed themselves to and this calmed down their mind down to the point where even small things like the taste of ordinary food or having a conversation with a friend felt really satisfying.
Pali terms for anyone interested in the "source code" of the modern Mindfulness Movement that allows you to look up the original Pāli technical terms:
> guarding their senses
indriyasaṃvara
> calmed down their mind down
samādhi / samatha
In western/modern terms, dopamine fasting.
I hung out with some (Vietnamese Zen) buddhist monks at their monastery for a bit, and it was really interesting how they really strive to limit sensory indulgences that take their awareness away from what's happening right here, right now.
They didn't just cut out the obviously mindless things like television and social media, but music, small talk, and even books were considered things to be consumed in moderation, because they were striving to spend as much time as possible each day really focused on the present moment.
Music I like is a huge dissociative trigger for me. I definitely am 'better' the less I listen to it. Luckily, I'm not usually that fond of music of the type that plays in public areas.
Pali terms for anyone interested in the "source code" of the modern Mindfulness Movement that allows you to look up the original Pāli technical terms:
> becoming a more moral person
sīla
> mindfulness
sati
> acts of charity
caga / dana
> becoming a more moral person oh you mean like ISIS bringing back the caliphate?
I am referring to Buddhist ethics and this has nothing to do with Muslim Sharia law or the re-establishment of caliphates.
If you are genuinely interested in what I am referring to then you can search for pañcasīla (The Five Precepts) which form the foundation of Buddhist ethics/morality/virtue.
> pañcasīla (The Five Precepts) which form the foundation of Buddhist ethics/morality/virtue
Isn't it more accurate to call it an early commonality of Early Budhism than a foundation [1]?
[1] https://en.wikipedia.org/wiki/Five_precepts#History
"Just be a better person" is not real treatment advice lol.
You added the "just". Becoming a better person is probably the best thing you can shoot for, though obviously it's not a trivial process and requires significant effort and intention. I mean, what else can you do? You're the one that has to live with yourself.
Even if the whole world is going to shit, if you desire the happiness and wellbeing of others, as a deep internal orientation, this itself is its own form of happiness which is not subject to anything external. Since this thread already has Buddhist vibes, you don't have to take my word for it and can refer to metta (loving-kindness) as its own practice in addition to mindfulness.
The really interesting part is they are Muslim. They said that learning about Buddhism helped them understand the core of Islam and helped everything click into place.
I think learning about different cultures and religions can unlock perspectives which enhance whatever we're currently practicing.
The native Muslim tradition akin to what mindfulness meditation is doing would be Sufism. There are still Sufi traditions extant, but in many places they're being attacked by militant Islamic fundamentalists.
The way they've explained it is that immorality is usually based on desire and aversion. And constantly giving in to these things creates a dependence where we're never satisfied with what we have. Having a structured moral code that allows for observing these mental qualities without giving in to them eventually leads to their reduction because we're breaking the habit pattern. Once your desires and aversions are reduced then you become more satisfied with what you have; ie eliminating depression in their case.
Pali terms for anyone interested in the "source code" of the modern Mindfulness Movement that allows you to look up the original Pāli technical terms:
> [unskilful] desire
taṇhā (The second Noble Truth)
> aversion
dosa
> we're never satisfied
dukkha (The first Noble Truth)
> moral code
sīla
Actionable advice: be generous and notice how it feels. Then just be nice for the pleasant satisfaction it gives.
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Welcome to year 30 of trying to prove psilocybin works for psychiatric illness. And still in the pilot stage.
Even taking the data at face value, the trial cannot disentangle the drug effect from expectancy, psychotherapy, and statistical noise. The enormous effect sizes are almost certainly inflated, multiple-comparison error is uncontrolled, and the participant pool is highly self-selected. Until a preregistered, parallel-group, active-placebo, adequately powered study with blinded independent raters replicates these findings, their practical value for routine cancer care remains minimal.
It’s so interesting to see how strong the drive to prove something works is, overriding everything. As a clinical psychologist, I would welcome this kind of therapy if it worked. But this is just sad. It’s just like listening to people claim that ivermectin can cure everything.
Show me one place where this therapy is conducted by people who haven’t "drunk the Kool-Aid," and I’ll be impressed. It’s so frustrating to work with actual patients and see how much these therapies really don’t work in reality. These kinds of biased studies pop up all the time without actually panning out. I’m starting to think that people promoting therapy, giving false hope, and spending money on research like this should be viewed as corrupt and evil.
I'm not saying you're wrong on the limitations of these studies, but I also don't think it's unreasonable for people to believe in the power of these drugs.
For many people (myself included) taking psychedelics was an immediately life altering experience. I don't need any more scientific validation that psychedelics helped me than I would need to prove that touching a hot stove burned me. It's an immediate and unmistakable effect that is wholly different from any other experience I've had.
Now, proving that these drugs would be beneficial at a population level may be an unanswered scientific question. But, to quote you: "trying to prove psilocybin works for psychiatric illness" - well, that's been done. The people who have been helped have all the proof they need. I think the issues you've raised are more properly targeted at the question "should we recommend psilocybin treatment to depression patients more broadly" which is in fact a much higher bar than "do they work?"
I can respect this view 100%. And your rephrasing, "Should we recommend psilocybin treatment to depression patients more broadly," is in perfect sync with my thinking, and the right question to ask.
I would only add that it's extremely hard to know if something actually works. There are seriously some medications that people claim don't work, but objectively they are healthier, happier, more social, more active, and "better" on almost every objective measure. An example of this is when you really have a good match with venlafaxine for co-morbid panic disorder and depression.
Then there are drugs everybody claims are good for them, but they almost never are, especially in the long run. Basically, all of the benzo sleeping aids (in the context of chronic use).
So I can't and won't say you are not right. But I hope you permit me my goal of finding "objective" markers for saying "something works." Because, to quote Murderbot, "Humans are idiots!" (me included). And self-report is a notoriously unreliable measure.
> But I hope you permit me my goal of finding "objective" markers for saying "something works."
A very worthy goal!
FDA approved in 2018 for (treatment-resistant) depression?
https://www.prnewswire.com/news-releases/compass-pathways-re...
?
That’s not what that means.
Breakthrough Therapy designation means they can continue to study it with support.
It does not mean it’s approved for depression.
https://www.fda.gov/drugs/resources-information-approved-dru... !
>Welcome to year 30 of trying to prove psilocybin works for psychiatric illness.
That is true, but it misses some important nuance: the war on drugs has effectively eliminated the ability for legitimate researchers to do significant research on these criminalized drugs.
For example, for me personally, a mild dose of marijuana is as effective as Zolpidem (Ambien) as a sleep aid, but without the lethargy and mental fog the next morning.
>the war on drugs has effectively eliminated the ability for legitimate researchers to do significant research on these criminalized drugs
That's not true any more. We have a substantial body of data already from clinical trials and a huge number of trials currently in the pipeline. The results from completed trials are quite equivocal - while psilocybin does appear to work as a treatment for depression, anxiety and other common psychological disorders, we have no evidence yet to suggest that it is meaningfully more effective than current treatments.
We have good reason to believe that psychedelics may be useful for some patients in some circumstances, but the widespread talk of a revolution in psychiatry is pure hype.
https://pubmed.ncbi.nlm.nih.gov/?term=psilocybin&filter=pubt...
https://clinicaltrials.gov/search?intr=psilocybin&aggFilters...
Thank you for this. I am neither an advocate nor against psychedelic use in therapy but as a person who has consumed these things in the past, my own experiences make me entirely skeptical of people who put on an advocacy hat around any particular chemical. Especially psychedelics like psilocybin which are extremely unpredictable.
When I was a teen a friend gave me an analogy that stuck with me. In much older computers (e.g. C64, Vic-20, etc), they'd behave "interestingly" when you mucked around with the physical circuit board or there was a fault. E.g. if something short circuited because a screw was loose in the board, or a cartridge was halfway in or a chip partially desocketed, etc. Characters would appear in random places, or the machine go through odd loops and so on. And to someone who didn't know how the machine worked, there could be a certain "magic" and a "pattern" to this. But clearly you'd be missing the point if you thought you had "enhanced" the machine this way.
LSD and psilocybin are kind of like that, but for your brain. They short circuit and alter pathways. In ways that can be entertaining but you're entirely missing the point if you try to assign a higher meaning to them.
Our brains are expert pattern-finding machines, and produce causes and reasons even when there are none. For some there may be value in the experience of altering the operation of your brain to get yourself out of a stuck pattern, I guess. But I am not sure the very random stochastic nature of the whole thing is ... medicinal.
To better appreciate his point, read “The Control Group Is Out Of Control”: https://slatestarcodex.com/2014/04/28/the-control-group-is-o...
Most people involved in it are aware at some level that this is at best suspect and at worst a deception designed to push legalization. Same as the “health benefits of marijuana” crowd who violently deny the risks, addictive nature, potential to induce schizophrenia (temporary or permanent), tendency to make people lazy and obese, etc.
Legalization has never been a question of “is this good for people?”
Plot twist, I'm for full legalization.
So am I, of both "hard" and "soft" drugs. I'm just pointing out the ridiculous approach some people choose to take rather than arguing from principled grounds. It's also a dangerous one: "we shouldn't use state violence against people who use X" is a moral position. "I'm going to spread lies that may lead more people to use dangerous substance X because I want to get high" is a very immoral one.
I think I agree. But I come at it from a different angle. I only care if proposed therapies actually work, when people claim they do. I think the state has a horrendous track record of deciding what people are allowed to do with their own life. And I think drug enforcements are a waste of resources. I think almost all drugs are terrible and should never be taken. To me, all of these are simultaneously true.
Out of curiosity, which drugs do you consider to be the exception to the "almost all drugs are terrible" line?
It's really hard to answer without imposing values. For instance, I value productivity, progress, knowledge, the survival of humanity, and such things. In that sense, most substances referred to as "drugs" have a bad track record (heroin, cannabis, amphetamines, ethanol). I'm not sure if I think the world would suffer with regard to any of my values if all of them magically disappeared.
Then again, I think it's important that my views are never imposed on anybody. So it's perfectly fine to be a pure hedonist and use everything under the sun.
The dose makes the poison, though. So I think that limited use of alcohol, cannabis, shrooms, and LSD might be useful to gain new perspectives, serve as a social lubricant, or even provide some form of temporary relief.
The drug isn't really the problem; it's the pattern of use. So maybe I should have said that "most drugs are mostly used in a terrible way, to such an extent that they become terrible by default."
If I were to try anything, psilocybin would be high up the list of stuff I would like to try. Just to see what effect it would have on me. I suspect little (every life-changing, perspective-changing experience people yab on about never changed anything for me once they actually happened to me, and I am 100% immune to hypnosis and personality change when drunk), but it would be interesting to see.
Why do you say the effect sizes are inflated?
Due to a small, self-selected sample, biased toward educated, prior hallucinogen users, inadequate blinding, p-hacking via uncorrected multiple tests on 17+ outcomes, and crossover design flaws that confound long-term effects with intensive therapy.
Similar psychedelic therapy claims—for LSD/psilocybin alleviating cancer-related anxiety/depression—have echoed since the 1950s-1970s, yet they've never panned out into practical, scalable clinical therapies. This alone should raise a MASSIVE Bayesian statistics red flag, due to prior discount: with decades of unfulfilled hype. At this point new evidence requires extraordinary proof to update our view.
If such massive effectiveness were true, it would blow what we already have out of the water, and I would be the first to promote it to my patients. But you know what they say when something sounds too good to be true.
Taking psychedelics allowed me to shed years of guilt and my own historic personality to become a more open and grateful person. I think some people have psychologies built on strong foundations that if shaken by psychedelics, cause more harm than good. The people who psychedelics help are those with more suggestible psyches that want change.
> own historic personality
What do you mean by this?
I meant to say historical personality. I thought I had heard about this type of ego-death when reading some of the early pioneer’s works but can’t find a mention. Basically it was the idea of who I was that had built up over time based on people’s assumptions, judgements, and the way they treated me. My built up idea of self was enforcing negative looping behavior patterns until tripping freed me from that past idea, my historical personality. This led to me feeling a more open and unburdened sense of identity, allowing my idea of self to be an unfolding story rather than someone else's half-telling
Anecdotally, I know several people who have tried mushrooms and/or ayahuasca for depression in recent years and their results are nothing like the glowing Internet reports.
The worst case is a friend who became disconnected from reality for a very long time. Went from atheistic to believing in mystical ideas. He thought he was able to see and sense things that we could not, like auras and secret messages. He was getting better last time we checked but he’s hard to get in contact with now. No prior hints of psychosis or family history, just a psychedelic induced mental illness.
The other anecdotes were not as dramatic, but also not as positive or free of side effects as studies like this one would make you think. Multiple stories of extended periods of derealization or anxiety attacks that started after the trip. There are similar comments here throughout this comment section.
There was a time when sharing these negative stories was met with disbelief and downvotes. I think as it’s becoming more common people are realizing that the interaction between psychedelics and depression isn’t as great as it seemed for a few years when they were virtually being promoted by podcasters and social media influencers as a novel cure for depression.
I think a lot of the negative reception to negative anecdotes were because they were often in the context of legalization. "I know someone who went crazy after trying $foo so we should still lock people into iron cages just for the crime of possessing it." Debate tends to get polarized when doors are being kicked down. Academic studies that are disconnected from culture wars don't tend to provoke such responses, probably because they don't tend to reach the general public in the first place.
> because they were often in the context of legalization. "I know someone who went crazy after trying $foo so we should still lock people into iron cages just for the crime of possessing it."
I think that’s what people thought when reading negative anecdotes, but I definitely didn’t see a lot of suggestions that we lock people up.
The same thing happened for marijuana: Any mention of negative effects would bring downvotes, scorn, and disbelief pre-legalization. Then once it was legal it became acceptable to say that marijuana wasn’t a panacea and using a lot of it was actually a problem.
Before this change, it was common to read highly upvoted anecdotes here and on Reddit claiming everything from medicinal properties to fixing depression to improving driving skills (an actual claim I saw here and on Reddit multiple times). Now it’s widely acceptable that frequent marijuana use is not good for mental health and wellbeing, but that was once a thing you could not say on the internet.
> definitely didn’t see a lot of suggestions that we lock people up.
Nobody had to suggest that, it was the law of the land already. Hyperbolic argument is hyperbolic ("iron cages" was a bit of a tip-off) but consequences short of imprisonment were typically some other state-run means of destroying one's career, family, and/or life. Pointing out that this isn't a good thing and isn't actually working somehow made you into The Enemy Of Decency. And while there's still lots of Drug Warriors out there who still think that way, I'm encouraged at the increasing avenues for actually productive discussion. Seems to be the one politically-charged topic that isn't getting more toxic these days.
Which is a terrible strategy actually. People did the same with marijuana. “Dude it’s medicine lol. Dude it can’t possibly contribute to schizophrenia. Dude weed lmao.”
All this does is create a credible argument that the pro legalization crowd are objectively lying to people and therefore untrustworthy.
Its natural! therefore God made it for us to consume braaaaaaaaaahhhhhhhhhhhh
just ignore things like cyanide, and mercury
When it comes to truthful arguments, the anti-legalization crowd historically hasn't stood on very firm ground either. I think we can agree that perhaps with the heat dialed down a bit, we're allowed to have grown-up conversations now.
I'm sure it's nothing like a panacea, but I've lost count of the times in which getting some context behind a report of a bad experience shows recklessness or just plain old bad decisions.
It also works the other way around, people even talk about how years of therapy didn't help but psilocybin did, and few seem to consider that maybe it was a combination of both? Perhaps all of that therapy that "didn't help" set the stage for something else.
General problem with anecdata I guess.
I don't know if people have forgotten all the lessons from the 60s, but set and setting are still extremely important for what kind of experience you are going to have.
Psychedelics are basically like shock therapy.
The whole ketamine thing though is even crazier at least with psychedelics there is a forced introspection and very little addictive nature.
That's why use should be done in a controlled setting, with an experienced guide (ideally a therapist).
Does anyone know if any similar treatments are currently available or if there are any ongoing or pending such studies? Someone in my life is a cancer patient who could potentially benefit from this.
Oregon, Colorado and New Mexico have legalized psilocybin for supervised medical use. There are a number of clinical studies that might be relevant and are recruiting or soon to recruit participants.
https://clinicaltrials.gov/search?cond=cancer&aggFilters=sta...
Thank you so much. I have no familiarity with the appropriate search tools for this kind of thing. It's really great that we have a tool like this. Thank you for introducing me to it!
Just buy some mushrooms and turn on some Allman Brothers.
My dad is a boomer who's strongly (and I think uncritically) against non-medical use of all drugs except alcohol (and he himself doesn't drink). He would be hesitant to do this under medical supervision, but he definitely wouldn't just do it "on his own".
Besides, he's kind of a closed off person who has a lot of emotions he just avoids dealing with, even more so since the cancer diagnosis. He definitely needs a trip sitter, but he has few friends (certainly none who could do that competently), and no one in our family could fulfill such a role for him. Maybe I could for someone else, but my relationship with him is too complicated for me to do that job well, I think. :-\
To top it off, my dad's cancer is in his liver, even though he never drank much at all for dietary reasons (he was on a strict keto diet for ages). I would worry about the possibility of toxicity with introducing new drugs without medical supervision.
Hello from cancer family.
It indeed decreases. When my spouse was diagnosed, they prescribed her anti-depressants. We replaced them with psilocybin. Never taken any anti-depressants.
We had a very serious case with multiple surgeries, chemos, radiations. Not one, not two, and not ten or even twenty. MORE than that.
The treatment still goes on, soon it is gonna be 5 years. With ZERO anti-depressants. And I've learnt how to grow them, not buying them.
So we don't need studies, we tested it the hard way, and it works :) I can talk about it for hours.
I am sorry about the situation and hope it goes well. Hang in there.-
Thanks! I just realized we're mostly feeling normal, maybe even a bit more happy than average non-cancer family. It's only the side effects that are uncomfortable: losing money, a couple of jobs down the road, affected childhood of our 11 y.o., dealing with jerks, etc. Mood-wise psilocybin brought us back to normal life, maybe even slightly better than it was before :)
Happy to hear. Be well :)
Figure 3 is suspicious. Even the placebo arm has much better scores for depression and anxiety from baseline?
This happens in every depression study: Placebo effect is extremely strong for depression.
You can even collect depressed people, do nothing at all, and when you survey them 6 months later the average scores will improve. This is because depression is, on average, an aberrant condition and the average patient will tend to revert toward the mean.
However, psychedelic studies have a bigger problem: Psychedelics trigger false feelings of amazement and wonder, feeling like something magical has happened. This is like turbo placebo when you tell people that it’s a depression treatment. Maybe that’s a valuable therapeutic effect, or maybe not. There’s a lot to explore, but from all the studies I’ve read I’m not as bullish on mushrooms for depression as the headlines would indicate.
Thanks for this. Great insights.
Depression is a symptom, and for symptoms there are many causes.
Personalized medicine will fix this but that costs money and time and caring.
Setting aside the psychedlic aspect, do you think figure 3 supports the study's conclusion?
If this is your first time reading depression studies then it’s going to be surprising to see both groups improve. This is normal and expected.
The key indicator of efficacy is the difference between groups. In this case there is some difference between groups but it is small.
I don't want to be patronized about the number of depression studies I have or have not read. Can you answer yes or no: does figure 3 support the study's conclusion?
What do you mean by "false" feelings of wonder?
Not defending that - some times just knowing you are trying to better yourself helps make things seem better.
Sure - but I don't see the authors mention group convergence anywhere.
While the first 5 week post treatment actually looks impressive, I don't think the treatment arms being essentially the same after 6 months supports the conclusions of the study. Unless we backpedal and say the inactive grouo was microdosing (which has its own baggage...)
As far as I know antidepressants and even pain killers are the most susceptible to placebo effect.
Agreed. If I saw an SSRI with those curves I would doubt the efficacy of it. But this might be why I am not in charge of clinical trials. Just a layman taking pot shots.
I used to Microdose psylocibin, ever 4. Day. Since I didn't hold a job but did some daily routine, I knew it would be a slow day. It actually worked really well.
One day I had a little too much. That day I was really productive and obsessed with folds in clothing.
Being obsessed with folds in clothing has a long, noble history - check out Huxley's Doors of Perception
I did a medically supervised psilocybin treatment and it was a glorious adventure but had no lasting effect.
Ketamine was equally "experiential" but actually had lasting impact. It's a pity it's challenging to come by, as one can DIY the former.
And it might slow aging: https://x.com/bryan_johnson/status/1943824432419811437
To be fair, so did a lobotomy. I believe close attention should be paid to any unintended outcomes of a therapy that the patient themselves would no longer be able to identify due to the nature of the treatment itself.
Psilocybin is about the 180-degree opposite of a lobotomy, just from a purely mechanical perspective. And it certainly feels that way qualitatively as well.
organic systems seek points of equilibrium, with veering too much off in any axis being detrimental
Yes, although—within a specific range—mild "hormetic" stress or departure from baseline can lead to adaptive and beneficial effects in organic systems.
Hormesis is characterized by a biphasic dose-response: low-level exposures to stressors (toxins, temperature, exercise, dietary restriction, etc.) are those which stimulate adaptive beneficial responses, eg exercise, ischemic preconditioning (short bouts of reduced blood flow improving tissue resilience), and dietary energy restriction.
Rather than negating homeostasis, we can say that hormesis "refines" it: mild, intermittent stress can make us resilient through larger future perturbations.
A patient doesn’t metabolize a lobotomy.
they don't have to as there's no ingestion of the therapeutic agent
FWIW: Got me sober and I think: kept me sober. Psilocybin is some powerful stuff tho, do recommend if people want to try it for "issues" - you seek someone who knows what they are doing first.
(2016)
This. I saw the late Roland Griffiths as first author and thought the same.
The study mentions they administered 30 milligrams of psilocybin for 70 kg of body weight. Does anybody know how many grams of dried mushrooms that is equivalent to, roughly?
A good ballpark for dried shrooms is roughly 1% psilocybin by weight of dried shroom, so about 3g. That said, it's going to vary a lot shroom to shroom, genetic to genetics, and species to species. Could be as high as 6g for more mild strains and as low a 1g for something like pan cyans.
That is the problem with clandestine pharmacy by Florida man, as people may get the wrong dose or a mixture of various other poisons like arsenic (see dark web article.)
When ready, please talk with your doctor first. =3
2 to 5 grams dried psilocybe cubensis, per chatgpt.
You’ll be tripping balls on that amount. 5g is close to a heroic dose.
EDIT: Never mind, didn't see that it was cubensis - which might take more due to being weaker than regular wild semilanceata.
I've been doing some recent research and testing, and here's what I have found: I'm talking about the "Penis Envy" strain, which is quoted as being ~30% more potent than typical. 2g is the edge of where I start getting visual artifacting, and only sometimes. 3g, which I have not tried, was quoted as being towards the upper end of a "theraputic dose", and 6g as the upper end of a recreational dose. Some friends with much more experience consider 1g to be microdosing, FWIW. 0.25g I can't feel at all. .5g I start to feel some euphoria and 1g to 1.5g I start to feel "high" but with no noticeable psychedelics or just minor visual artifacting when I'm reading.
I don't really have anxiety or depression. I do have a fairly high stress family life, wife and kiddos have lots of issues. A few weeks ago I had 2g on an empty stomach on a Sunday and I just listened to music for ~4 hours and it was like I had a vacation. I hadn't enjoyed listening to music so much for 20-30 years. Also, I seem to feel kind of sleepy when I'm trippy, but afterwards I'm wide awake for 4-5 hours. So evening dosing is best avoided.
It's kind of great, for me personally, living in a state where it has been decriminalized.
Personal response may vary. At .15 grams of dried mushrooms I can definitely feel effects, while still be able to perform normal life functions.
I don't know if that's true or false, but I would certainly not trust chatgpt blindly in this case.
Here's a rough breakdown from Claude:
"[...] psilocybin converts to psilocin in the body at roughly a 1:1 ratio by active effect [...]
Psilocybe cubensis (most common): Contains about 0.5-1.0% psilocybin by dry weight. Since psilocybin converts to psilocin in the body at roughly a 1:1 ratio by active effect, 30mg of psilocin would be equivalent to roughly 3-6 grams of dried P. cubensis.
Psilocybe semilanceata (liberty caps): Much more potent at 1-2% psilocybin content, so you'd need only about 1.5-3 grams dried.
Psilocybe azurescens: Even more potent at 1.5-2.5% psilocybin, requiring roughly 1-2 grams dried.
Important caveats:
- Individual mushrooms within the same species can vary by 3-5x in potency Growing conditions, harvesting time, and drying/storage methods all affect potency
- The caps are typically more potent than stems
- Fresh vs. dried makes a huge difference (fresh mushrooms are ~90% water)"
Have to note that the paper is from 2016; for those really interested, it's good to read recent review papers.
@grok is this true????
lol
there was a study recently showing no difference in caps v stems
And I’d consider about an eighth to be a dose, so that sounds like it’s in the right neighborhood.
I learned from an episode of "The Studio" that by "an eighth" you are likely referring to an eighth of an ounce is around 3.5 grams. Dude thought he got really mild shroom laced chocolates ("an eighth of a gram") and much hilarity ensued.
full title
@dang, the OP title needs changing imo.
Psychedelics put me in Heaven… and in Hell. Use wisely.
> a high dose (22 or 30 mg/70 kg) of psilocybin
What is this compared to a recreational dose? Are these patients getting high as part of their treatment?
Why is there no more recent studies on that?
Because usually the "euphoria" people feel is their biology failing due to mild poisoning. It is why most people will often upchuck within a few minutes of ingestion.
People may think they are finding enlightenment, but are no different from the local deranged squirrels aggressively howling at passerby after nibbling Amanita in the fall. Apparently the squirrels use the mushroom to help preserve food stores, and it doesn't poison them as severely (often fatal for humans.)
Paul Stamets is a weird dude, but his work contains some profoundly detailed observations.
People need to think about Fungi as closer to animals that don't move on their own, and acknowledge they rapidly adapt genetically to survive. Pretty to photograph, but often far more complex than people like to admit. =3
the "euphoria" they feel is serotonin.
Indistinguishable from the stages of Death:
https://www.ted.com/talks/jill_bolte_taylor_my_stroke_of_ins...
Some do not choose wisely =3
Let me guess, you’ve never tried them? This is the one substance no one should be talking about if you’ve never tried it. You can’t reason your way through it with first principles.
> Because usually the "euphoria" people feel is their biology failing due to mild poisoning.
All the recent studies in the last decade have proven it's the opposite. What's your point exactly ?
>Amanita
It's an entirely different class of hallucinogen. I don't have personal experience with it but I have done other dissociative hallucinogens and his take is likely largely true (though I wouldn't argue with someone saying they felt euphoria on it). The problem here is it's the entirely wrong mushroom.
I can assure any doubters that psilocybin on the other hand has legitimate euphoric effects.
The psilocybin containing variety also naturally grow in our yard, and the Amanita is an invasive variety. The "high" people feel is a chemical lobotomy from mild poisoning, and onset of renal failure. Hence why you feel nausea and often erupt out both ends if ingested (especially bad if allergic to a specific fungi.)
I asked for 5 citations not sponsored by dealers that he claimed were available, and my post was flagged. To be fair, I would also accept 3 double-blind medical citations of reasonable quality.
You can't argue with the irrational, as hitting yourself in the head with a brick also causes similar results. lol =3
https://pubmed.ncbi.nlm.nih.gov/27909164/
https://pubmed.ncbi.nlm.nih.gov/35458717/
https://pmc.ncbi.nlm.nih.gov/articles/PMC12001667
https://pmc.ncbi.nlm.nih.gov/articles/PMC12030455/
None of those publications are sponsored by dealers.
There are multiple others which I’m not going to search but I hope now you have starting points, you’ll be curious enough to do further research.
> hitting yourself in the head with a brick also causes similar results.
That’s false and you aren’t going to find a single paper (funded by anyone) that would conclude this.
These studies focused on combined therapy in psychiatry, and do not address the long-term health implications. They do confirm certain strata of the population benefit from the experience, but do not define the underlying mechanism (my concern.)
>That’s false and you aren’t going to find a single paper (funded by anyone) that would conclude this.
A brick may be too strong for some, but minor brain injury often causes euphoric experiences and personality changes... even if people hop up and down on the spot long enough. Native traditions in Africa have been getting concussion highs that way likely since history began.
Incidentally, getting hit with a brick would certainly cause someone to stop ruminating on existential angst for a little while, and euphoric concussions do cause cathartic experiences. lol =3
Notably, the age of surgical and chemical lobotomies were used to treat unruly patients in North America for several decades. Commonly, procedures were applied to treatment resistant criminal psychopaths and countless others with little long-term success.
We agree "something" happens (well documented with LSD), but disagree on the safety warnings in your own citations. Which do not clearly address long-term health effects due to the cocktail of other compounds in cancer patients.
I am not judging peoples life choices, but we must agree most people that do recreational drugs are not in cancer or psychiatric care.
Thank you for the citations, as it cleared up why we differ in opinion on this matter. Best of luck =3
Why don't you show me 5 citations of renal failure from a confirmed psilocybe cubensis in the tens of thousands of years people have been eating them.
Or... don't bother, the one you will find is questionable at best if you read past the headline.
>Why don't you show me 5 citations of renal failure from a confirmed psilocybe cubensis
Mostly, real doctors take "Primum non nocere" very seriously, and do not conflate therapeutic studies as proof organ damage isn't a risk. Fungal infection of those with compromised immune systems is harm.
People do experiment on the desperate, but it is rarely ethical gambling with someone's life. The squirrels seem to enjoy their trip, but also seem less invested in trying to justify its safety.
May you live an enjoyable life with authentic experiences. Have a glorious day. =3
https://www.youtube.com/watch?v=aNSHZG9blQQ
So no citations then? Seems pretty trollish after making demands for citations just prior.
So, just to be clear, you have no evidence of renal failure from psilocybe cubensis?
Actually, the citations above already warn 40% of users have neutral to negative side effects, and doesn't get into the consequences of allergic or nausea related symptoms (about 2 of the 5 papers seem of reasonable quality.)
So to be clear, cancer patients have a lot of other problems that likely would confound which reported symptoms are related to which medication.
Someone with access to the PsycINFO database login could clarify things for sure. If I recall it was a few cases of micro-dosing related organ failure cases that caught my attention. No idea which specific psilocybe mushroom was responsible.
The Natives also used Datura, but rolling in your own excrement naked for 2 weeks with severe hallucinations isn't a popular recreational experience for some reason. A few kids die every so often trying to prepare the plant.
Have a great day, and stay healthy =3
I must apologize for the low quality data here:
https://www.sciencedirect.com/science/article/pii/S221175391...
You cited the one case in recorded history which I already pointed out existed. It's not the data that's questionable but the circumstances. His two friends ate from the same batch and were fine.
I'd say that counts squarely as "no evidence". Besides, I asked for 5 citations.
Also, you can keep the off topic babbling to a minimum. We are talking about the lack of evidence of renal failure resulting from psilocybe cubensis.
Not really, the Proof burden falls on people to verify something poorly studied is safe, keeping their petulance in check, and acknowledging their BS when proven harmful.
What seems like a detractor is an allusion to some therapeutic psychiatric citations describing native shamanistic traditions as some sort of qualifying safety feature in compounds.
I really can't be bothered to pull more papers folks seem to simply ignore. The trivial counter-proof is there, and it is unethical to harm people for more data.
Best of luck, and please keep an eye open for early signs of renal failure like persistent excessive foaming in urine etc. =3
So, you have zero examples and I have thousands of years of use with no evidence of what you claim. Burden of proof is definitely on you.
Except the physicians peer-reviewed published diagnostic data proving renal failure side-effects.
Good luck, most Dealers/Junkies engage in argumentum ad hominem when confronted with their exploitive/maladaptive coping behavior.
We will have to agree to disagree, =3
Which clearly exist only in your head. Disagree all you want, you failed to defend your point.
The very first one states the mushroom was misidentified.
I'll assume from there you failed to read any of it.
Edit:
lol, here's the paper he cited and deleted:
https://academic.oup.com/ndt/article-abstract/11/11/2324/190...
The 4th one is the one you already admitted had bad data.
At least one of the other two clearly states that the mushroom was unidentified. You will have to read or delete both.
too lazy... no longer care about your problems
https://www.medlink.com/articles/neurologic-presentations-of...
https://pmc.ncbi.nlm.nih.gov/articles/PMC1336442/
https://www.sciencedirect.com/science/article/pii/S221175391...
Ahhh, I can reply now!
Would you like to give up? It's a bad look my man.
See the other post for current status of this thread.
[flagged]
> Paul Stamets is a weird dude
A Star Trek reference?
The other way round. They named the Star Trek character after a real-world mycologist.
He was writing practical agricultural mycology books long before he advised the TV show.
First came across his work while modeling hermetic food and waste reclamation options. Paul looked at this area several decades prior, and documented everything in detail. He is weird, but a good scientist worthy of respect. =3
Do you really need to be a doctor to realize that this type of drugs makes someone’s mood better?
this stuff cured a lot of problems I had been trying for years to get rid of, overnight. (literally) mind-blowing
bonus, it made my buddy quit drinking
variance, it made my other buddy delusional and stupid. hasn't really recovered
it only takes one bad trip (absolutely massive overdose in my case) to understand how badly south things can get. used to be a favourite consumable, haven't touched it in over a decade and extremely unlikely to again following that one experience. it also helped phrase 3 earlier experiences in terms of the new "peak", and made me understand how much incredible danger I had been in at all times even prior to the bad trip
Did you ever reflect on why you had a bad trip? Did the drug change or did you change?
Was the setting different? Different people around, different location …
After all learning from mistakes can be just as helpful as the positives in life.
... In patients about to die from cancer. This title is disingenuous.
You think depression knows about cancer?
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For me it did the opposite, made me suicidal when I'd never felt that way before. I didn't even have particularly bad trips or anything.