[tyu100]

This study, along with long-accepted clinical practice and the generic cheapness of most anti-depressants now, and the effectiveness of CBT/therapy if it's available to you, means you should really avoid self-medicating for major depression.

Why take risks with your health when there are lots of safe, cheap and efficacious treatments that can be monitored by your doctor?

[soundwave106]

The poster asked for "access to psychedelics (and analogues) in a safe, professional setting", which ideally (if the treatment is one that indeed works and isn't placebo) would be one that is monitored by your doctor. I agree that self-medication is not idea.

The issue here I think is that most current anti-depressants are currently of the SSRI / SNRI / tri-cyclic class. These treatments work great for some people, but do not work for everyone.

In one case (ketamine), this particular hallucinogenic drug has emerged as a candidate for anti-depression therapy (at least in mechanism) that works quite a bit different than the above (acts on glutamate). Non-hallucinogenic glutamatergic anti-depression drugs are being developed as a result, but as one is well aware, this takes time. Until one of these drugs emerges (rapastinel seems furthest along at this time), off-label ketamine clinics do exist where you can take the drug with some degree of clinical supervision.

I have not seen too much on the serotonin agonist hallucinogens in the past relieving depression, but Googling, there does seem to be a newish article on psilocybin (https://www.nature.com/articles/s41598-017-13282-7) that suggests it does offer a possible interesting anti-depression mechanism too. Possibly more exploration is needed here to confirm whether it works well (or not) and, if so, how.

I don't think we've even come close to exploring all routes to resolving depression, so I think exploring as many routes as possible is a good path. (And I do think scientists are doing this -- the parent article was for instance the first time I've heard of a melatonin receptor agonist as an anti-depressant candidate! https://en.wikipedia.org/wiki/Agomelatine )

[joncrane]

One issue worth mentioning is that psychiatrists are one of the hardest specialists to find that participate in health insurance. This is only anecdotal in my area, but many that take insurance have multiple month waiting periods for new patients. Or you can pay $200 to see one on your dime.

It's not the cost of the medication that's the problem. It's access to the professional to prescribe the medication that drives people to self-medicate, IMHO.

[PhasmaFelis]

Ditto. Also, at least for state-provided health insurance, there seem to be quite a few that accept it but aren't on the state's registry for some reason, so it's worth calling and asking.

[aianus]

Psychiatrists have a three month waiting list here in Canada and therapy is $100/h.

[markroseman]

Three months in some places. Here in Victoria, unless you're in crisis, it's actually almost impossible for most people to get in to see a psychiatrist, and if you can, the waiting list is well over a year.

[evincarofautumn]

I generally agree—I guess I just mean I wish there were a safer/tested way to take advantage of other serotonergics, after the first line of defense fails, for those who are less cavalier than I am about their neurochemistry.

Also in my case it wasn’t depression, so I can’t really speak to that, but SSRIs are also prescribed for anxiety disorders. I chose not to go on them when they were offered because I didn’t feel that the side effects were worth it, and they weren’t the correct treatment anyway because at the time I was mainly anxious due to alcohol withdrawal. (I’m lucky I didn’t have a seizure!)

[WalterSear]

Because they aren't safe, cheap or efficacious.