There was a great interview between Peter Attia and David Nutt on the research and effectiveness of psychedelics on various disorders <a href="https://peterattiamd.com/davidnutt/" rel="nofollow">https://peterattiamd.com/davidnutt/</a><p>He touches on the history of governments banning various drugs through junk science and propaganda (mostly from the US which influences the rest of the world). The scheduling system for drugs is a joke.<p>Also interesting that the inventor of AA credited LSD for his ability to quit drinking.<p>Edit: David Nutt authored this study in the NEJM <a href="https://www.nejm.org/doi/full/10.1056/nejmoa2032994" rel="nofollow">https://www.nejm.org/doi/full/10.1056/nejmoa2032994</a> which pitted psilocybin against lexapro for the treatment of depression and it showed the same effectiveness (more nuanced than that but you'll have to read or listen). Peter talked about how he is very familiar with Lexapro and it's side effects (libido, a blunting effect on life) in his patients and remarked that what was most exciting about that study is that it showed it could be as effective as Lexapro with less side effects.
The shrooms community has known about this for a long time, and now it's just about recreating the knowledge in peer-reviewed studies. Although there is a lot of "woo woo" on shrooms usage in the online communities, I do hope that researchers can extract the useful bits.<p>This isn't like an SSRI. 25mg psilocybin isn't something you can just pop at the beginning of a workday. Your setting and "head space" matter a lot for how your "trip" (which we will now rebrand as "treatment") will go. This needs to be accounted for in future studies.
I am pretty prone to depression and I definitely feel it lifting for a while after microdosing or taking a larger dose. Unfortunately I have never experienced a life changing trip that solved all problems as you may want to believe when you read some of the latest articles about the miracle of psilocybin and other psychedelics. Same for Ayahuasca. It seems to help a lot of people but for me it was more just a very interesting experience.<p>For example I think a lot of film makers are/were taking psychedelics. During my trips I noticed so much more detail
in my environment and different light reflections which you often see in movies.
I’m a believer in the potential value but think placebo or blind studies of psychedelics are absurd. You know full well of you’ve eaten an eighth of cubensis.<p>I think to be fair, they should compare psychedelic treatment to other therapies like ECT or a weeklong vacation to Hawaii.
I had to look it up to put it in perspective. 25mg pure psilocybin could be around 5g of dried p. cubensis if they are .5% (which varies considerably...) point being this is no microdose. These patients are really tripping! So they are saying a psychedelic experience, which could reconstruct your entire ego, really can be a significant life-changing event.
As somebody who sometimes "treats" severe multi-decades-long depression with psychedelics, I'm not surprised that they'd have a positive impact but the news seems too unclear to my simple mind to make sense of a few things:<p>1- why is a private group on the stock market doing this, instead of public research & universities? vested interests in seizing a market of illegal drugs in a legal way worry me, because it's easy to completely forget the humans in the process when there's billions to be made<p>2- is 1mg declared a placebo with enough proof? I'm personally not receptive at all to any kind of "micro-dosing" but I've also seen equally anecdotal comments going exactly the opposite direction and loving that. Is there a study that thoroughly compares the 1mg dose to a fake product looking similar but with no psychoactive substance?<p>3- as someone keenly aware of an "afterglow" that can happen on psychedelics, I also don't see a proper discussion about (1) the potentially ephemeral nature of the benefits when taking a single dose, as well as (2) the difficulty of taking psychedelics along with pretty much any other treatment for mental health issues (SSRIs, MAOIs, anti-psychotics and so on, which all have their own counter-indications)<p>I very much love all the psychedelic experiences I've had in life, from simple doses to "heroic" and intensely crushing trips, and I've always tried to extract some long-term benefits from them during and post-trip, but even compared to a psychiatric treatment that doesn't help me quite enough (doesn't get rid of anhedonia, brain fog, suicidal ideation, etc etc), I have still come to see those trips as more of a targeted temporary relief for the soul that one should ideally leverage in the window of time post-trip - and not so much as an ongoing treatment in and of itself like what's offered by my meds.<p>At least from my limited perspective it hasn't been so much a treatment for a depression but a temporary relief from it, which offers a window of time to discuss anchoring constructive habits ("job search for an hour every morning", "clean up your house", ...) and having empathy for the self in pragmatic and measurable ways post-trip (cook yourself a meal, get a haircut, commit to physical activities again, etc). I'm not really convinced that we'll turn those substances into long-term treatments, but I could see them becoming a "shock therapy" of sorts.
Have a lot of experience with microdosing psilocybin, as well as with psychedelics like Ayahuasca. My experience with both as a means to remedy depression have been significant.<p>It is analagous to having a lamp in a dark forest. It won't get you through it itself, you need courage, and other tools like meditation (your machete), exercise (your provisions) and intention (your compass) to succeed. But with it, everything is easier.<p>Err -- AMA?
The trial tested psilocybin <i>combined with</i> therapy. This isn’t equivalent to ad-hoc self treatment with mushrooms.<p>They noticed a response to psilocybin+therapy in about 20-25% of patients depending on the criteria for “sustained response”:<p>> The protocol-defined sustained response* up to week 12 was double, with 20.3% of patients in the 25mg group<p>It’s also notable that about 5% of the psilocybin receivers experienced severe adverse events including suicidal ideation:<p>> There were 12 patients who reported treatment-emergent serious adverse events (TESAEs). These TESAEs included suicidal behaviour, intentional self-injury, and suicidal ideation
How does this get commercialized? I can't think of anything that's inherently cheap and easy to produce that you use for a few weeks and then never again that is also a financial cash cow the way most pharmaceuticals are. Disclaimer: I work for a pharma.
In Michael Pollan's fascinating history of psychedelics, "How to Change Your Mind", he explores this. It was interesting to see how governments appeared to have no issue with psychedelics until Timothy Leary came on the scene.
Having powerfully beneficial medications locked away is what happens when a law enforcement agency (DEA) decides national medical policy, instead of a qualified medical body.
Psilocybin has changed my life. It needs to be available to everyone in the world. Pharmaceutical companies will fuck it up (it's coming - very quickly) so learn to grow your own.
Ketamine also. It's already approved.<p>I would prefer all drugs were legalized as in Portugal and regulated because it's impossible for a consumer of illicit drugs to verify their contents and it would cut off criminal profiteering, violence, and the police-prison-industrial-complex from some funding too.
The thing that's not clear is, how often do you have to do this? It's definitely not an everyday pill like Prozac, but it's not very effective after 6 weeks. Would you trip every 2 months? Seems like that would rapidly run into diminishing returns. No one has even tested a second dose! How is this actually going to work?
Psilocybin changed my life. It threw off the wet blanket of depression, which allowed my antidepressant to fully do its job. I can’t really explain it, but imagine if your depression was a jacket, and one day you just took it off.
Some quick points:<p>> 233 patients<p>Very small, can't generalize results based on such a small number. Doesn't mean the study's trash or anything, but don't jump to any conclusions here - good or bad.<p>> "The trial, which had all patients stopping antidepressants before participating, compared two active doses of COMP360, 25mg and 10mg, against a comparator 1mg dose."<p>- COMP360 was, I assume, their therapeutic psilocybin but it's unknown if that differs from raw psilocybin or not, and if so in what way.<p>- Did they TEST and PROVE discontinuation of antidepressants at all stages of the trial? Which kinds of antidepressants did they test for? SSRI? TCA? MAOI? How did they test? Uranalysis? Blood? Or did they just take 233 people's word for it?<p>> "[...] 179 patients reported at least one adverse event — the most common being headaches, nausea, fatigue and insomnia."<p>- Likely unrelated to the medication itself, as those can be caused by hundreds (thousands) of factors. Literally included in every possible side effect list for nearly every medication known to exist. Doubtful that the medication caused any of these.<p>> "There were 12 patients who reported more serious adverse events, such as suicidal behavior, intentional self-injury, and suicidal ideation."<p>- Do we know how many experienced which specific "serious adverse event"? Was it 11 ideations and 1 behavior that could be interpreted as self-injury, for example?<p>- Do we know for certain that none of these 12 had any of those adverse events occur in the last few months prior to starting the medication?<p>---<p>Again, I'm not crapping on this at all here, but folks should take it with a grain of salt and realize there's more to this, that only 12 adverse events isn't a significant concern unless we can show with high confidence that it was caused by the therapy, and at only 5%, even then it sounds like manageable risk as long as a prescriber would know the patient's history before hand.<p>The announcement - not the study data itself just the press release - is here: <a href="https://ir.compasspathways.com/news-releases/news-release-details/compass-pathways-announces-positive-topline-results" rel="nofollow">https://ir.compasspathways.com/news-releases/news-release-de...</a>
For me, I get depressed when I feel "stuck" in my circumstances (mostly a directionless project, bad boss, or cancerous working environment, or all of the above). I suppose going on a "trip" would alleviate that significantly, at least for a while. Then you'll get used to it and you'll be back to square one you can't escape without fixing the root cause. So any enthusiasm for this is going to have to be tempered by long term studies and outcomes. Any significant change in one's circumstances can _tactically_ alleviate depression somewhat.