[jvandyke]

I recommend reading "How to Change Your Mind" by Michael Pollan if you're all interested in the history and details of psychedelics. https://www.goodreads.com/book/show/36613747-how-to-change-y...

Based my reading of that, what these researchers are doing is not prescribing psychedelics to patients with mental disorders and giving the whole "take one time a day with food". What these researchers are finding is that the drugs can be very effective in a therapeutic setting with a guide (trained therapist or otherwise) to coach and conform the experience to reach a goal. In other words to those familiar with these drugs, set and setting. That is, mindset and surroundings are at least as important as the drug itself to achieving anything. Without that, it's just a drug experience. This is very unique compared to the drugs we're used to.

No medication will ever be a miracle drug, and most drugs show a significant decline in effectiveness once they're out of small trials and methods have standardized. However, any drug or therapy that sees orders of magnitude of improvement over existing drugs and therapies is promising and not worth dismissing simply because of a moral panic from the 60s or the Puritan ideals of our Western culture. Given time and the leeway to experiment, hopefully we will find uses for this class of drugs that have gone shunned for decades for no reason other than someone's moral qualms.

[scythe]

The trouble is that talk therapy is already too expensive for most patients, and unless you plan to have people tripping with a therapist who is a complete stranger (not advised!) you're going to need to charge for some preliminary sessions. If a typical therapist charges $100 per hour -- and that's optimistic, in fact I've never paid less than $125 -- then the cost of treatment quickly runs into four figures.

That's already more expensive than a year on SSRIs, as crazy as that might sound. Human interaction is shockingly expensive.

[jvandyke]

The cost is something to consider, but let that not dissuade us from exploring the opportunity. There are many therapies that are covered by insurance due to their medical backing. Insurance companies would rather pay for life-saving procedures that are hundreds of dollars rather than trauma, end of life care, or life insurance payouts. The evidence needs to be persuasive, though.

[aurbano]

I've always been curious about talk therapy, and as someone who hasn't tried it - or knows someone who has - what would you say are the perceived benefits?

How does it compare to an intelligent friend/partner?

[pmoriarty]

"The trouble is that talk therapy is already too expensive for most patients"

Not necessarily. Under some insurance plans under Medi-Cal (the California Medicaid program), you get unlimited therapy (once a week) for free.

I strongly recommend that anyone who qualifies for Medi-Cal (ie. if your income is low enough) investigate this option, if you are looking for therapy. You actually get your own choice of therapists, as long as they accept your insurance plan.

Also, when choosing health insurance plans, make sure to take a look at how much therapy they cover. You might be surprised. Some plans definitely cover much more than others.

[eip]

It would be much cheaper and much more effective to talk to trees.

[shittyadmin]

Minor correction, the name is Michael Pollan

If you'd like an introduction to his work I'd recommend his post on planting the opium poppy, I really enjoyed it.

https://michaelpollan.com/articles-archive/opium-made-easy/

[vole]

For further reading, LSD: My problem child by Albert Hofmann is also interesting

[JamesBarney]

What is the effect size of the randomized controlled trial for psychedelic therapy?

[jvandyke]

I'm not sure (you can look it up as well as anyone), but from what I've heard (again, Pollan's book), controlled, randomized trials are very difficult if not impossible with psychedelics. It's obvious to both the patient and the observer who has received a placebo and who has not. That's part of the problem with studying this class of drugs, what we have considered the gold standard for clinical trials isn't effective here. So do we trust what results we do see or dismiss them because of their nature?

When a small study shows that 80% of smokers stop cold-turkey after a single session and 60% of them are still abstinent a year later (versus 30% for therapy), it's hard to discount the results so long as other trusted methods are used.

Study using psilocybin for smoking cessation: https://www.ncbi.nlm.nih.gov/pubmed/27441452 Study using CBT for smoking cessation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119230/

[jdietrich]

>Study using psilocybin for smoking cessation: https://www.ncbi.nlm.nih.gov/pubmed/27441452

N = 15. I understand that there are a lot of regulatory obstacles to performing large-scale clinical trials into psychedelics, but the overall quality of the research so far is indifferent. A great number of ineffective and mediocre interventions have been made to look miraculous by a handful of small open-label trials. The homeopathy community has produced a mountain of similar trials.

Psychedelics do indeed look promising and have a plausible mechanism for providing very large effect sizes, but it really is too early to draw any firm conclusions. The authors have registered a larger comparative efficacy trial, so I look forward to seeing their results if and when they are published.

[DenisM]

> N = 15

Can you even judge the sample size separate from effect size?

If 15 out of 15 people register an improvement it's a lot more meaningful than 3 out of a 100 sample, despite the much larger sample size in the latter case.

[tpm]

Those are pilot studies.

There is one psilocybin study by Compass Pathways starting this year in 8 EU countries with I think about 800 participants which if successful will pave the way for legal use of psilocybin therapy of depression. MAPS is doing another one for MDMA for PTSD, that's FDA Phase 3 in 14 international sites.