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by lindsaywaterman
1689 days ago
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1. Pharmaceutical studies are extremely expensive so usually done through private sector. In this case compass has a patent for a certain way to synthesize psilocybin, but not a patent on psilocybin itself. However, the results of the study will generalize to psilocybin of all sources. Win win in my view. 2. There are many studies in the literature that compare "psycholytic" (which tend to accentuate pre-existing mental states) to "psychedelic" (which can trigger mystical/insight experiences) doses of psilocybin. I'd say it's reasonable to treat 1 mg as placebo. 3.i. The study followup is ongoing. One of the remarkable aspects of psilocybin treatment is that one dose can lead to lasting (ie >6 mo) effects on mood. See the john hopkins studies. 3.ii. Although the studies all have folks weaning off, concurrent SSRI, MAOI, and anti-psychotic use is not an absolute contraindication. They do not cause serotonin syndrome with psilocybin. But clinically I think this won't be a huge issue as most patients will only be trying psilocyin if 1. their ssri has failed or 2. they are opposed to trying ssris. cheers! |
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I agree that all news is in principle good news for psychedelics, but the private interests still have a bigger reason to exaggerate the positives for any treatment for financial benefit. We even see this with how prevalent the "latest" SSRIs are vs. treatments that have existed for a long time. New research with fancy articles isn't always better than old research, especially when the people prescribing it to you fall prey to the market pressure of prescribing the costly solution to you vs. older solutions for a tenth of the price, for which on the other hand we'll exaggerate the side effects...
Do you happen to have any interesting link regarding what you mention as being psycholitic and how it relates to a placebo? Because from every page I've been finding on the subject, none seems to indicate that the substance acts specifically as a placebo but only that noticeable psychedelic effects aren't present, which is slightly different. I've done some digging to find something[1] supporting the idea that "microdosing == placebo" but given that there's pretty much only studies that have self-reported data in that domain, I'm not sure I've ever seen anything conclusive regarding microdosing being a placebo, nor at what dosage one can consider each psychedelic substance as microdosing/placebo. I might have very much missed something big in the domain and you seem to know your stuff, so if you happen to know something to link I would happily take a look :)
As for long-term positive effects, are you referring to this study [2] ? It certainly looks interesting for significance over long periods of time, but not necessarily to alleviate depression. I have a few DMT trips in my life that are amongst the most significant moments of my existence, yet I'm into my third decade of debilitating depression - those things don't necessarily have to overlap.
I also agree about concurrent treatments not being absolutely contra-indications, but I think we're being particularly kind to whatever is the new kid on the block and unfairly harsh to old treatments in comparison. I had the chance to meet a psychiatrist who's been doing their job since the 60s, and they were the first to offer trying a RIMA (moclobemide) which significantly helped compared to multiple SSRIs, and had less negative side effects than SSRIs and even some positive ones (libido) - despite a truly horrible reputation everywhere you look, and in young psychiatrists' minds.
I believe there's a good place for psychedelic treatments to contribute to the well-being of a suffering person, but as a pretty experienced "psychonaut" I've always remained keenly aware of the potential for these substances to induce a certain degree of collective delusions too -- even more so if we're talking about a multi-billion dollar new market opening up.
[1] https://www.imperial.ac.uk/news/216134/citizen-scientists-sh... [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050654/