New study finds psilocybin greatly and quickly relieves depression
psychnewsdaily.com
psychnewsdaily.com
I've felt depressed before, but I've probably never had it as bad as many people. But generally I've felt depressed when my life felt too narrow. When I've felt like there was only one or two things holding me up. When I felt like nobody really understood what I was going through or I couldn't open up to others.
From what I understand, tripping on psilocybin inhibits your DMN, which apparently is the part of your brain most responsible for your sense of self and makes you feel less like there is a barrier between you and the rest of the universe.
If certain medicines help people cope with depression, I definitely don't want to detract from the progress those medicines have provided to those people. But does it go against prevailing wisdom to think the only cure to depression is other people? And that, if psilocybin gets people to connect more, it can be part of the cure. But that no drug, in and of itself, can "cure" depression?
Just thinking out loud. Please go easy on me. I'm just curious and want to know more.
I imagine this drug can uncover the problem and help the person solve it.
Bang on the money there, speaking from experience with exactly this.
Maybe the easiest way to think of it is an electrochemical circumstance in the brain. This circumstance could come about as a result of external stimuli (or lack thereof), or through some imbalance or other more internal issue. I think the technical terms are something like situational depression vs clinical depression.
Even with situational depression, a fresh perspective can often give people the bit of confidence and hope that they need to proactively break depressive cycles.
In general, the boundaries of what people call "depression" is very fuzzy and usually far wider than what doctors would call "depression". I can certainly agree that there are a lot of "what-people-call-depression" cases which could in fact be helped by a change of company and habits and literally connecting more with other people. But there are also a lot of people for whom suggesting "connect more with people" is the literal equivalent of telling a person with broken legs to "walk more", as their current ability to connect with people in a functional and rewarding way is simply not working properly right now. Unhappiness is not depression; depression can involve things like feeling subjectively unhappy or even suicidally miserable during experiences that the depressed person agrees are really rewarding and positive, it's just that their happiness/reward system is broken currently.
I don't know what the cure for my own case of depression is, and I'm sure if I were isolated/disconnected my condition would be worse, but the evidence available to me indicates that simply connecting with people is not what's going to fix me.
My wife and mother-in-law are both counselors, and routinely successfully treat people with depression. They have never indicated that level of social connection is either a dominant cause or reliable treatment for depression.
If you want something to read up on, a very popular treatment methodology for depression is CBT (Cognitive Behavioral Therapy). The premise is that depression is often caused by harmful thought patterns about yourself or your life, and CBT trains you to arrest those thoughts and replace them with thoughts that are constructive or more accurate (less exaggerated, etc.). It's not the treatment I need, but it works for an awful lot of people, and its solution isn't built around social connections (though it may reveal social connections as a problem in individual cases).
>but it works for an awful lot of people
I know CBT is awfully popular on HN. But it is worth reading into the stats on CBT. Even if you take them at face value, it certainly does not work for everyone. It is of course, most effective when there is a clear cause and effect, very effective with anxiety, and also generally with children in particular. But has been shown to be ineffective or even dangerous when used with certain cohorts, ie. significant trauma background, clinical mental illness including depression, psychosis etc.
There have been more studies on CBT than any other form of therapy, and those studies suffer from the same replication crisis that the rest of social science research does.
So if it is your first exposure to getting help (and don't get me wrong, it is good to try as a first response) and it doesn't work for you, it is not your fault. You are not 'treatment resistant', more just at a 'treatment deficit'. Generally speaking, if your counsellor says you are treatment resistant, it is time to get a new counsellor and maybe if it is warranted a referral in combination with other medical expert like a psychiatrist. Each case is different though, and you are always your own best expert in yourself.
*like pop psychology, but it burns your mouth.
More studies showing the same results means they aren't suffering from the replication crisis, even if the exact same study isn't being replicated.
CBT isn't for everyone, that is true. And you shouldn't worry or blame yourself if it didn't work, there are more options available. But I wouldn't cast doubt's on it's overall efficacy or claim it's junk science.
Truth is, some CBT studies have repeatedly passed replication and others yet have failed. CBT studies in lots of areas where it is used have shown relatively low efficacy, but close to alternative options. Even across anxiety disorders, where is it most effective, it is with an average-ish 70-80% success, and often only a few points different with alternative options. Meta studies have shown it to be ineffective within certain sub-cohorts, even in general areas where it is shown to be effective. Lots of CBT studies are performed differently or with different cohorts to how or with whom they are instituted in practice.
None of this means it is junk science, it just means you have to be very careful to understand the precise limitations of the science. You cannot separate the outcomes you like from the replication issue, you have to test it all. You also cannot generalise the very real successes of CBT across areas where they have not been shown to be effective, or shown to be ineffective. It is worth keeping these things in mind.
This information is almost never shown to clients. Clients are told 'CBT works', with the implication (or outright claim) that if it doesn't work for you it is your fault. It is popular with clients and it is popular with the profession, because it sets expectations early, it is cheap, it is targeted, and it works for the majority of people with the majority of issues people seek counselling for (ie. anxiety and depression). If this doesn't work for you, and this is all your counsellor offers, they are doing a massive disservice.
Not specific to CBT, but as a general point, replication crises are behind the scenes. Publication bias means only positive results get published, even if it's only the occasional lucky studies (or ones with overt cheating or innocent bad statistics) which come out positive. Researchers know about it and grumble privately, because they wasted months or years of effort before figuring out it's largely false. But this knowledge isn't generally what goes into archival publications.
This part is useful to everyone well beyond the scope of depression. Simply becoming aware of one's thoughts is a revelation. Our ability to ride a stream of thoughts without being actively conscious to them is unfortunate; it must have some evolutionary reason, but it also means we can repeat and experience many bad feelings and thought patterns without recognizing that we have some choice in whether to allow them to run free or to shut them down/replace them.
I suspect that the evolutionary reason is rather mundane; introspection (thinking about thinking and feeling) is expensive, and while it may confer some small epistemic benefit toward constructing and maintaining a theory of mind, the main benefit is in masking the downsides of other traits (like neuroticism, depression, anxiety, paranoia), which, to be frank, don't usually have much in the way of an upside. Historically (and likely prehistorically) it is simpler on a population basis to select against the traits that introspection would mask, which leaves introspectiveness as a trait that isn't strongly selected for, and at least slightly selected against in most situations.
This calculation flips in any situation where neuroticism, paranoia, etc. confer an advantage, which probably happens often enough to keep those traits (and introspectiveness) from dying out, and of course much of the stress of modern living exacerbates any neurotic etc. tendencies, which may give introspectiveness a boost even as those tendencies are selected against more strongly. But on an evolutionary timescale, I'd place a bigger bet on human culture(s) becoming less stressful, rather than on people evolving to better withstand stress.
Much of this speculation, TBH, is a handwavy just-so story. And since a theory isn't much use unless it has predictive power, here is a prediction: low-trust societies are where you would expect to find some minor advantage to neuroticism associated traits and a corresponding greater advantage to an even marginally better theory of mind, so we might find a correlation to greater introspectiveness. I am not aware of any research that addresses that question (although on an individual basis, neuroticism is by definition negatively correlated with trust, since trust is a facet of agreeableness)
The reason people treat depression as an individual problem to be addressed by individual means (medication) is that we are totally unwilling to acknowledge the complete emptiness of modern life. And also because modern life teaches us to treat everything as an individual problem. The symptom is itself the mechanism.
On an individual basis, the specific treatment matters, but statistically the human connection matters more. Your standard “what did you do on the weekend” friendship won’t cut it.
And there are plenty of therapists (and researchers) who would definitely say that the quality of the relationship with a depressed patient makes or breaks treatment, in many cases it actually is the distinguishing factor. At the very least, it's a necessary one.
"The literature" isn't even clear on what major depressive disorder is. Well, the clinical definition is clear: literally sadness/low mood for at least 2 weeks. But what does that mean?
I guess what I really mean to say here is that we have essentially created a situation where people are pushed toward being alone. Then when a whole bunch of them feel empty about their state of being, we assign the label of "depressed" on them and give them drugs that are only barely effective. The lucky ones can afford to buy someone who basically takes the place of a close friend or parent. We have no framework to describe this state of affairs because every single one of us only has our permanently modern society as a point of reference.
It's easy to forget that the human brain is not designed to live the way we live. It's designed to spend every waking moment together with a very small group/family, always outdoors together, always doing something entirely tangible and physical together. Seeing a stranger was a rare occurrence. Imagine that!
"Sadness" happens when someone close dies. "Depression" happens when a huge number of human relationships that the brain needs get replaced by vastly inferior alternatives -- coworkers, social media, video game friends, service workers, etc. Nothing else but modern society creates this.
(Clinical) depression isn't the same as unhappiness.
The lack of energy to do anything and the general hopelessness are quite different to feeling unhappy or sad.
You can't just toggle some biochemical switches and restore normal function.
But if you can rewire the software in just the right way then maybe
I bet you have the 3 scenarios:
- "hardware" only
- "software" only
- both
But even though there are common scenarios, each computer can also be broken in a different way.
It could as easily not stem from it.
Drugs like MDMA are being evaluated as a potential treatment as well: https://www.medicalnewstoday.com/articles/mdma-depression
Anecdotally, I've heard it usually takes several tries to find an antidepressant that works for any given patient. But once you've found a drug that works, that helps a lot.
... eh, being with people is the most reliable way to trigger a depressive episode. It makes me realize how much of traditional "This will make you happy" advice just doesn't click with me. Groups of friends make me feel lonely and disconnected.
I feel my best when I'm on my own. Or with 1 or 2 very close friends for short periods followed by lots of recovery time.
And since so few people result in positive experiences (and since solitude doesn't usually cause feelings of sadness, but rather freedom), I would usually choose to be alone.
Given a choice, I would like 60% total solitude, 10-20% general human interaction, and the rest ideally the good meaningful, connective relationships.
I'm an amateur mycophile, if you couldn't tell.
note: they're taking far less than a recreational dose.
As far as the default mode network, I've seen research that claims hyperactivity of the DMN causes rumination, which puts you in a downward spiral. So perhaps a bit of inhibition is good.
There can be, but only for some people and not others. I've seen esketamine make a night & day difference. Sadly, it has horrible side-effects as well, as in someone nearly died from that and had to discontinue the trial.
There's some hope that a particular metabolite of ketamine that works on AMPA may offer relief without the side-effects, but I haven't seen it actually in a medical trial yet and even if it was, I don't know if our doctor would go for it or not, though it allegedly does avoid the psychosis.
You're right that it can basically turn off depression, though. I just want a version with that and not the rest.
After three decades of trying different therapeutic treatment avenues, including many pharma and non-pharma options, I think that refractory (treatment resistant) depression is a phenomenon rooted in biochemistry. At least for me, disconnect from other people/society doesn’t play a role (plenty of connections, happily married, etc.).
In my case, pharma pretty much works, non-pharma hasn’t. This doesn’t exclude non-pharma therapies’ being effective - for example, they may modulate underlying biochem to good effect in some- but only that such treatments haven’t worked for me.
I’m following the pscilocybin work closely. So far, it’s encouraging. I plan to experiment in 2021.
However, medication is very effective especially as short term treatment or for major depression.
In terms of non-pharmaceutical medication, there is evidence supporting the use of St John's Wort:
A 2008 review of 29 international studies suggested that St. John’s wort may be better than a placebo and as effective as different standard prescription antidepressants for major depression of mild to moderate severity.
However:
St. John’s wort was no more effective than placebo in treating major depression of moderate severity, an NCCIH- and NIMH-funded study of 340 participants reported in 2002.
https://www.nccih.nih.gov/health/st-johns-wort-and-depressio...
So yeah, tell me how depression has no neurological root, and is purely a result of a dysfunctional relationship to society, when it can affect someone effectively from birth.
She is watching the emerging study of psychedelics for mental illness with great anticipation and hope. Nothing else has done more than reduce the frequency of symptoms. (She actually started trying IV ketamine a few years ago, when it became available, and it has helped to reduce both the frequency and severity of symptoms, but not eliminate them entirely.)
Depression, on the other hand, is feeling down without any adequate reason to do so. If your life is objectively quite okay, save for depression itself, but you constantly feel as if you've lost a loved one, then it's a medical condition. It's like feeling physical pain when you're not actually getting hurt.
"Before you go on any powerful psychoactive medication, just do a quick head count of all the people around you. Are most of them assholes? You may want to just take a nice long vacation, permanently"
P.S. If anyone has the link to that part of whatever stand-up it was, that would be really great to see!
Multiple comments here have asked for double blind placebo trials. But you can't really do that with something psycho active, at least not ethically. I can appreciate wanting high standards, but that doesn't mean banning everything that doesn't fit the neat mold we use in other cases.
Also, suicide is the leading cause of death for multiple age/sex demographic groups in most of the western world. Literally number 1 killer. Current anti depressants are about the least effective medicines used in the Western world. So there is a good public health arguement to accept that we're in an emergency and try things without necessarily having 10 years of statistically significant results and followup and debate.
There are no ethical barriers to including a control group.
The idea that double-blind, placebo-controlled trials are impossible with psychoactive medication is a strawman argument, because obviously we can still have a control group.
The control group doesn't even need to receive placebo. In a study like this one, they could have easily and ethically had one group receive therapy and a second group receive therapy plus mushrooms. Or the first group could have received therapy plus traditional SSRIs.
The placebo response rate in antidepressant studies is extraordinarily high. There is no good reason to omit a control group in studies like these, other than perhaps if the researchers were too underfunded to make it work.
The moment anyone knows it's no longer double blind.
I'm happy to be corrected if there is some clever way around this. I have heard people suggest you give "control" group members so other psychoactive substance (MDMA was suggested). But that doesn't have the same effect as mushrooms. And also, it's ethically merky to give people other drugs they're not expecting/consenting to. Plus then you don't really have a control group, you have Mushrooms vs Other Drugs...
I'd be careful with that - waiting lists may have a nocebo effect, exaggerating the benefits of the treatment under test.
Maybe it requires a different kind of experimental structure that still allows for single-blind follow-ups. Imagine the subjects talking a different set of therapists or researchers after 1 month, 3 months, 6 months. The patients/subjects would have to be instructed not to talk about whatever they experienced during the psilocybin/placebo phase, only about their personal development since then: outlook on life, lifestyle changes, etc. The therapists would have to self-invalidate if anything was divulged by a patient. It would probably have to be a large group, since with 1000 people you might only get 300 therapist-blind reports.
For comparison, AIDS kills about 13k. About 16k people died from (non suicide) handgun injuries. Even All Cancers caused 600k deaths. Curing depression would be the same as curing 1/12th of all cancers...
My point is, you can't associate a rising number of suicide cases and believe there's a definite cause and solution.
It is not a black and white problem, and for that matter imho nether is "suicide and depression." Those two things are caused by so many infinite externalities in life, we cannot point to a solution with any sort of confident conviction.
In essence I see that and hear this:
"Oh look, that suicide statistic is caused by "XXX", and "YYY" is the solution.
It's more like...
"Oh look, that suicide statistic is caused by problems "X&$Y#", "DLKJER)(", "DOEKDHT&", "$%&DHTJ" ETC., and there are a ton of solutions for each problem.
TLDR: we should legalize psychedelics for recreational use, not limited to medical purposes
Back in my teenage years I took pretty much every psychedelic I could access, and trip-sat (like babysitting) for about two dozen of my friends over the course of a few years. I found in tripsitting that psilocybin was among the more difficult to manage psychedelics, especially for first-timers. I found that 2C-B/E, DOC and LSD were the best-tolerated substances among people that weren't "psychonaut veterans."
This is purely anecdotal and in no way meant to imply that I know what the hell I'm talking about. I only bring it up as a thought that popped into my head relating to the use of psychedelic drugs in therapy.
Also, no. I do not know where to get any of this stuff anymore. Haven't known for over a decade.
This study is not the same as taking psilocybin or other psychedelic drugs in an ad-hoc manner.
To be fair, considering the importance of set and setting, my opinions on the subject may be entirely informed by what I was going through during my trips personally, and what my friends were going through during theirs! Again, not an expert haha
Looks like a potentially interesting study here: https://jme.bmj.com/content/45/5/299
Once I was able to feel and confront those emotions and discover what had me so wound up, upset and sad - I was finally able to start the process of healing.
The theory is that psilocybin increases suggestibility and openness to new ideas, making the therapy easier to integrate.
Note that increasing suggestibility isn't a universally positive trait, especially for people doing ad-hoc dosing alone without therapy. In fact, it's uncommon to hear "bad trip" stories where people end up in prolonged depressive or anxious episodes following a trip.
There is no evidence here that taking psychedelics without therapy is positive for patients, so it's extremely unlikely that dosing someone who is sedated or in a coma would have any effect.
Many people only read the headlines and assume that psilocybin is treating depression. The reality is that these studies psilocybin as an adjunct to 11 hours of traditional therapy.
These studies aren't showing that psilocybin is a promising treatment for depression. They're showing that psilocybin-assisted therapy is a promising treatment for depression.
As many studies indicate, it temporarily disables/decreases DMN (among other effects) which is exactly what a depressed person would need: break the vicious self-destructive circle. Only then I could start making hard but necessary decisions and change my life completely. Depression is nowhere to be seen but that's because I actually changed things and didn't become complacent.
I'd not recommend to do it without spending a good time doing research. The aforementioned book is a great resource.
Ultimately, the research results (and anecdotal evidence) for psilocybin are too great to ignore. The next question is - How does it get legalized (which we're seeing the stirrings of) and who gets access to it and how when it is?
Permits licensed service providers to administer psilocybin-producing mushroom and fungi products to individuals 21 years of age or older.
Who are the service providers of the treatment and what training have they taken to do so? There is some available through folks who did original research (eg: John Hopkins) and now do talk and demo circuits but otherwise it's all largely undefined.
I'm paranoid of what this might lead to without strong community standards and ethics. A good first step, but lets hope it doesn't ruin it for others.
I'd have assumed it meant a tolerance would kick in after a few rounds.
1 reset day out of every 100 does sound achievable/possible even with clinical administration, but needing it every 3 days wouldn't be.
Consider normal SSRIs where you feel like crap for a month, try N more (which could mean many more months) until you find one that suits you, then have side-effects, then try to get off them so that's another couple of months of misery.
That's countless doses, money, time spent in misery vs one day of mushrooms every 3 months.
Normal psych meds are to be avoided at all costs and only be used if absolutely necessary, after you have tried everything else; atleast in my opinion.
Psilocybin is an intense acute experience. People can have negative effects. I hope we do studies to find how to use it most safely, or isolate the beneficial aspect without the intoxicating effects.
Though some take greater dosages, many people are finding relief from sub-perceptual doses: indicating that the typical hallucinations and disorientation associated with recreational psilocybe use is likely not necessary for achieving anti-depressive effect.
I've also read of some interesting work being done creating "anti-abuse" formulations, where the active ingredients are compounded with Niacin or other drugs that cause unpleasant physical side effects at high doses to discourage overdose/abuse/recreational use. "Stamet's stack" seems to be the most common of these.
Definitely needs much more research into these compounds, but seems a very promising frontier for antidepressant pharmacology.
Of course they can’t just let us use the natural substance that has existed for most, of not all, of human history.
Psilocybin works great, and almost everyone I know with depression can attest to that- but without changing the circumstances that cause the depression it will likely always return.
Anecdotal example: My sister is in disability care and is routinely abused by patients with severe disabilities (to no fault of their own) and she will slip into a severe depression that usually lasts a long period of time. Tripping helps her substantially deal with this, but psilocybin is for treating the effect and not for fixing the cause... If you kick a dead horse it (probably) won't wake up.
Repeated again roughly yearly. After 4 difficult and unpleasant trips I'm fine. Never reached the sense of utter well-being I have for the few months after a trip but I'm fine.
I will say that drinking any alcohol basically negates the positive effects for me for a while. As in, I'll have a cocktail and then won't feel "right" again for a month or so.
I've had a very bad experience w/anesthesia so am always nervous while dealing with anything of that nature. Wonder if that predisposes me to a bad trip.
Not sure that would be worth it for just 2 weeks of relief.
Also not sure I'd be able to find any such doctor near me. Probably health care providers are much more open minded out West than it is here.
As to monoideism's question: I'm not a doctor, but ketamine is more benign than many other anesthetics especially at the lower doses used in treating depression. Do your homework, but don't rule it out based upon prior experiences with other anesthetics.
It’s a shame too. I had the best health care option from one of the largest public tech companies and I had to pay $450 out of pocket, twice a week for four weeks, and then moving down to every other week. This is on top of $6k they took out of my salary over the year.
It is extremely frustrating the amount of basic mental health care needs, which I believe depression is, that are simply out of reach for most of Americans.
Maybe vaccines or antibiotics (depending on how you define 'permanent'), but I don't think any psychopharmaceuticals fit this description.
And I will never, ever take Psilocybin again.
Instead I will say those that struggle, first get your sleep, diet, work and community/relationships in order. Wellness is comprehensive and this tool is better viewed as a spirit guide than a magical cure.
If your issue is negative thinking it doesn't necessarily help .. I guess without a guide.
I mean alcohol will greatly and quickly relieve depression while you are drunk too. That is not solving anything though.
The obvious problem with this kind of study is it is hard to see this being done by objective researchers who are not quite biased towards finding benefits of psychedelic use.
Curious if that's enough for the patients to have a psychedelic experience.
"The concentrations of psilocin and psilocybin, as determined by high-performance liquid chromatography, are in the range of 0.14–0.42% and 0.37–1.30% (dry weight) in the whole mushroom"
My napkin math: 20mg is equivalent to roughly between 1.1g to 3.9g of dry weight (lots of variance in potency). This weight range is roughly equivalent to typical recreational dosages.
Notice that therapy is required. What are the odds people will look for the convenience of a pill while completely ignoring any required therapy and then blame everything else but themselves?
there are grow kits you can buy to ensure you're getting the real deal. shroomery.org probably can help you out
I think the therapy portion of this is crucial. I've heard stories of "underground" psilocybin therapists, but finding them would take some sleuthing.
Nope, it doesn't. The study wasn't placebo controlled. The placebo effect will have a large effect in a study like this, so we have no idea what effect the psilocybin had.
The lack of good placebo options seems to be why they chose not to have a placebo. The paper mentions:
> Although placebo and active treatment controlled designs are widely used in therapeutic trials, they too have limitations owing to the highly discriminable effects of psilocybin.
If you have found a protocol where (according to the study author) "the magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market", if it's just a placebo, that sounds like a great placebo to be giving!
As noted above I seriously doubt the concept of a placebo is even well-formed for psychedelics.
I quite like Scott Alexander's take on this issue:
> Actual carefully-researched psychiatric drugs are exquisitely selected for having few side effects. The goal is something like an SSRI – mild stomach discomfort, some problems having sex, but overall you can be on them forever and barely notice their existence. In the grand scheme of things their side effects are tiny – in most placebo-controlled studies, people have a really hard time telling whether they’re in the experimental or the placebo group.
> Nobody has a hard time telling whether they’re in the experimental or placebo group of a trial of high-dose MDMA. I think this might be the difference. If you go for large effects – even if you don’t really care what direction the effect is in – you’ll get them. And if you go for small, barely perceptible effects, then you’ll get those too.
https://slatestarcodex.com/2017/06/05/is-pharma-research-wor...
Also see https://slatestarcodex.com/2018/01/31/powerless-placebos/
> All three looked at studies comparing a real drug, a placebo drug, and no drug (by the third, over 200 such studies) – and, in general, found little benefit of the placebo drug over no drug at all. There were some possible minor placebo effects in a few isolated conditions – mostly pain – but overall H&G concluded that the placebo effect was clinically insignificant.
> What happened? Probably placebo effects rode on the coattails of a more important issue, regression to the mean. That is, most sick people get better eventually. This is true both for diseases like colds that naturally go away, and for diseases like depression that come in episodes which remit for a few months or years until the next relapse.
Even for antidepressants, the placebo effect makes up 67.6% of the effectiveness [1], so the placebo is always much more effective than antidepressants.
>Also see https://slatestarcodex.com/2018/01/31/powerless-placebos/
Hmmm, that seems to be a review from 2004. Newer data [2] shows that placebos can affect autonomic, neuroendocrine and immune responses and pain responses.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130402/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6013051/
The other way (which is close to what they have done) is to compare and contrast the therapeutic effects of different dosages - if the patient feels the expected sideeffects in both cases, but the normal dose achieves measurably better results than a minimally low dose, then that's some evidence about the effectiveness of the active ingredient.
https://www.discovermagazine.com/mind/do-magic-mushrooms-mak...
They could have used an active control group that received traditional antidepressants.
This study wasn't actually about psilocybin, it was about psilocybin-assisted therapy. So they could have simply had one group receive only therapy and the other group receive therapy plus psilocybin.
Traditional antidepressants take days or weeks to have an effect, and the effect is very different from psilocybin.
>So they could have simply had one group receive only therapy and the other group receive therapy plus psilocybin.
That still wouldn't tell you if the psilocybin itself had any effect over and above the placebo effect.
Which is fine. Double-blind is great when you can pull it off, but it's fallacious to dismiss control groups just because they can't be perfectly blinded.
Active control groups and non-blinded studies are still used frequently in these situations. There's no excuse for discarding control groups completely.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
Findings In this randomized clinical trial of 24 participants with major depressive disorder, participants who received immediate psilocybin-assisted therapy compared with delayed treatment showed improvement in blinded clinician rater–assessed depression severity and in self-reported secondary outcomes through the 1-month follow-up.
Meaning This randomized clinical trial found that psilocybin-assisted therapy was efficacious in producing large, rapid, and sustained antidepressant effects in patients with major depressive disorder.
> Please don't comment on whether someone read an article. "Did you even read the article? It mentions that" can be shortened to "The article mentions that."
From the paper:
> Strengths and Limitations ... Further research with ... a placebo control is needed to better ascertain the ... efficacy of this intervention among patients with MDD.
> Conclusions ... Further studies are needed with active treatment or placebo controls
The paper explicitly mentions that there's no placebo control, so I'm not sure what you're trying to point out with your comment.
How is this anything intellectual? It’s just conspiracy theory level pseudoscience like the fecal transplant stuff and the diet / vitamin stuff.
Caffeine is a mind altering experience. Eating too much sugar is a mind altering experience. Drinking alcohol is a mind altering experience. I have had extremely pleasant and also terrifying psilocybin trips. They have all been constructive experiences for me.
Asking depressed people whether they're depressed in four weeks during which they've had two good, safe, legal drug sessions, and considering it meaningful, is moronic.
edit: I've been reading lately about saying things directly. Of course drugs feel good, that's why people do them.
Drugs can feel good, but that isn't universal and that isn't the goal of these drug-assisted therapies.
Often psychedelics can be scary and anxiety producing. An introspective trip often isn't "fun" but can lead to personal insight -- the internet is littered with such testimonials. That is the hope of these therapies, not to give the person a joy ride for a few hours.
Of course, it's a very small sample size (as seems to be true with many of these studies) and appears to have lacked a control, although maybe I missed it.
So these substances aren't like coke or heroin where it's bliss and euphoria while on them (though that can happen, too)
- Not been enjoyable, as I was much less capable of feeling pleasure/joy
- Been way to difficult for me to accomplish, given that getting out of bed and showering was often too difficult for me to accomplish
- Would have had a negative effect on my depression
Drugs only 'feel good' for that purpose in the few hours after they are consumed. If people's psychological state is influenced (either way) several weeks after the experience, then something else is at work.
People's experience will vary of course, and if you have a bad or unpleasant trip you won't feel good afterwards. However, in my experience, the majority of people don't experience comedown after taking psychedelics.
If you're interested in experimentation, I recommend a series (say, 5 to 10) of mid-level-dosage psychedelic sessions, going in with the intent to study the nature of human consciousness and perception, keeping a journal of your experiences and thoughts. I would be surprised if you would still hold the opinions you've expressed here, but then mileage can vary quite significantly in some cases.
> Of course drugs feel good, that's why people do them.
Technically, that is only one of the reasons. Psychedelics seem to usually feel good, but from time to time you can get the exact opposite effect, sometimes in very large quantities. Yet, anecdotes seem to suggest that even after extremely unpleasant trips, most people seem to consider the experience valuable and continue to use them.
There has been substantial research recently showing that in some ways that I, at least, don't yet fully understand, various different psychedelics have the ability to "reset" the brain. This appears to be an effective long-term treatment for depression and anxiety—much, much longer-term than the direct effects of the drug—the trip, or any euphoria associated with it; in some cases, on the order of months, or even, for some lucky people, permanently.
So take your "this is pretend science" and shove it. Just because you don't approve of drugs that have been deemed illegal and immoral in the past doesn't change their very real benefits to some people—or the fact that depression is not, and has never been, something that can be cured by "an all expenses paid weeklong camping trip" or any other pleasant experience. Mental illness is serious and debilitating, and if psilocybin and other psychedelics can be more effective treatments than what we have now—which very real science indicates is highly likely—then that's going to be amazing for millions of people all over the world.
You're welcome to go take your camping trip and ignore the news about it.