What's missing from this article is that people are reaching for this because the standard medical treatment for these disorders, SSRIs, are pretty terrible. In the mild case, the common side effects are blunting of your emotions and sexual dysfunction. So you don't have panic attacks, but you live in a gray fog and your relationships suffer. In the worst case, they cause suicidal ideation. Psychedelics also have psychiatric risks that can be severe and unpredictable, but they don't require prolonged, daily dosages to be effective.
Counterpoint: SSRIs were transformative for my depression. Side effects were minor and manageable (eg, Wellbutrin worked well to prevent any sexual dysfunction). I was on them for several years and had no problem tapering off. My understanding is that this is a pretty typical experience. Rhetoric like this was actively harmful in dissuading me for years from trying what ended up being by far the most effective treatment for me.
(yes, I've tried psychedelics; they're fascinating and super promising, but at least for me, not transformative in the way that fluoxetine was)
No individual depression treatment works for everyone. SSRIs are not a magic bullet. Neither are psychedelics. But if you're depressed and haven't tried SSRIs, you owe it to yourself and everyone in your life to at least test the hypothesis that they might help.
Scott Alexander's page on SSRIs is a great, relatively objective resource, from a psychiatrist who regularly prescribes them:
https://lorienpsych.com/2020/10/25/ssris/
Same. I'm a big time psychedelic advocate, and relatively frequent consumer.
Prozac actually saved my life. Psychedelics since have certainly enhanced it, but they could not accomplish what prozac did. I can go into more detail if interested.
Fully agree SSRI:s probably saved my life. SSRI:s are supposed to be used as part of therapeutic regimen with therapy and regular checkups with doctor, not as over-the-counter remedy like aspirin. I’m guessing that using them detached from any therapeutic context increases the prevalence of negative experiences.
I think in my part my negative reaction is, like many people, having observed the effects of SSRIs on young people. It's well known that risks like suicidal ideation are actually higher among those under 25, and in general it is awful to see the mental health crisis among young people dealt with primarily via instantly reaching toward semi-permanent medication, rather than considering other treatments.
A lot of medical treatment is like this. Everything has side effects, but at least with regulated, approved treatments, they're well-known side effects with a large-sampled quantified probability profile, thanks to decades of use following years of clinical trials. If you just heed the Internet for anecdotes, though, all you ever hear are the horror stories and your personal risk assessment becomes biased away from statistics and toward compelling stories.
For what it's worth, synthetic opioids and spinal fusion saved my life. If I'd listened to the Internet, I'd have likely never pursued treatment or maybe just taken Kratom and gotten massages or something, fearing I'd end up a drug addict with a worse spine than I started with.
How did you decide to stop? I’ve been on Escitalopram for a few months now after suffering depression and anxiety that affected (and was affected by) my work relationship. My GP tried to get me down from 10mg to 5mg but I felt terrible again. I’m now on 7.5mg and feel ok. But I can’t imagine stopping. Like ever. I wonder how I could stop. Or perhaps just accept and take them forever?
Prozac is my fun drug. It makes me hypo manic with one 20mg dose.
I have schizoaffective disorder, bipolar type So I am prone to being more sensitive to SSRI. This is mostly to do with my genetically odd 5HT2A receptors.
Depression is no longer really a part of my life anymore after I found I was zinc deficient. But now I do tend towards the manic and have issues with psychosis still so I need to be careful with my serotonin.
Same for me. It's hard to say exactly what SSRI's are doing for me but I definitely feel better.
The bad sides of of SSRI's are as overblown as the good sides of psychedelics are. It's easy to form an opinion from reading personal experiences online but that doesn't reflect the real world imho.
I don't think Scott Alexander's page is a 'relatively objective resource'. He is, as you point out, a 'psychiatrist who regularly prescribes them' and also used to take them. It is full of special pleading where he relitigates extremely high quality meta-analyses to overlay his own opinion:
> That is, there are a bunch of tests that ask you a bunch of questions about your feelings and symptoms, and you can add them up and call that a “depression score”, and if you do that, antidepressants have an effect size of 0.3. Or you can ask patients “how depressed do you feel on a scale of 1-10”, and if you do that, antidepressants have an effect size of 0.5. I think the latter is better, because it’s what we actually care about (how patients are doing), and the tests are kind of dumb and ask about a lot of symptoms most people realistically aren’t experiencing.
(In other words, if you ask a patient with depression how they are feeling, and they say 'great', and then you ask them questions like "are you managing to shower every day", or "did you think about suicide a lot this week" and they give the same answers as a depressed person, they are cured!)
Does weird napkin math which clearly can't be justified:
> For those people, they will have a large real effect size of 1.0, plus a large placebo effect size of 0.9, for a very large total effect size of 1.9.
(How do you get to add the placebo effect back on to the postulated 'large real effect size'??)
Says that extremely common side effects are 'very unusual':
> It can be any or all of decreased libido, difficulty orgasming, difficulty getting an erection, difficulty enjoying sex, or decreased sensation in the genitals. These usually go away a few weeks to months after stopping the medication, but in rare cases they might linger for months or years, and there are a few people who say their sexual side effects never went away. These cases are very unusual and still not well understood.
(Note that in the same article he points out that, in general, the medication only improves mood or anxiety while you keep taking it, when you stop taking it you still have the depression or other conditions. So the fact that sexual disfunction usually gets resolved after stopping taking the medication isn't much relief. For most people SSRIs will never lead to a steady state where you are stable with regards to your mental health issue and also are able to enjoy sex.)
Makes armchair psych connection between well-studied things which are not the same:
> When everything goes right, SSRIs blunt negative but not positive emotions. But many people even at reasonable doses will notice that their most extreme positive emotions become a little less extreme (this may be part of the problem with sex).
(Difficulty getting aroused or orgasming or feeling in the mood for sex is not the same as "most extreme positive emotions becoming a little less extreme")
Wellbutrin also excarcbates OCD symptoms with typical responses including paranoia, hallucinations, eventually inducing psychosis. The article you post the author admits they don't really understand how SSRIs work. Why should putting such things in your body be any different than psychedelics or heroin or eating chocolate when you are sad? Simply put, it's not. This kind of science is based on collecting the minimum number of people to establish a p value and effect size larger than 0. You do that enough times then you can give your pills to whoever you want. Psychiatry provides a physiological change, i.e. they give you pills, based on a diagnostic criteria that removes all physiological reasons for the presented symptoms. This all seems rather backwards to me. Especially when modern psychology has developed therapies like cognitive behaviour therapy, schema therapy, dialectical behaviour therapy, which all basically can be summed up to state "your thoughts and feelings don't matter and probably get in your way. What matters is how you organise your mind and actions." So modern psychology has arrived at stoicism as the answer to a variety of problems such as depression, post traumatic stress disorder, obsessive compulsive disorder, and personality disorders. This isn't to say that pills don't help. It's just that they are not a panacea nor are they well understood by the psychiatrists who are motivated to give you pills since their training as a medical doctor teaches them peoples problems have physiological solutions.
As far as the risks, I have a friend who's been "microdosing" acid and shrooms for a while, and recently had a legitimate psychotic break, thinking all of her life-long friends were in some kind of Truman Show-esque grand conspiracy against her. She ditched town and cut us all off for over a month.
I can't say the drug use caused it, but I and the rest of her friends are of the opinion that it contributed (we all have experience with psychedelics, mostly in our younger days). We know that the microdosing also turned into macrodosing on a lot of occasions. She's in a group of friends who follow Phish around, and it's basically part of their identity.
She's doing better now, but still thinks she's in some kind of a stimulation, and has described feeling like she's on a never-ending acid trip. She's always been one of my most solid friends, and this came completely out of left field.
We can't get her to see any psychiatrists who would want to put her on anti-psychotics (which is basically all of them). So we just tell her we love her, and try to convince her that if this is all a big simulation, we're not in on it either.
Well, it is a big simulation. She's discovered Plato's cave firsthand; no way could any brain handle the constant barrage from the senses. Once you start tripping you see that we are tripping all the time but we filter most of it out, thank goodness. Feeling like time is looping is pretty freaky regardless; once your mind starts short circuiting and you start heavily believing in symbols, patterns, alignment etc., it gets pretty scary.
I think the best you can do is be a calm friend and imagine you're dealing with a two year old without being condescending.
There are organisations that work with people who have had challanging psychedelic experiences, but without taking the psychiatric approach. One such project is: https://zendoproject.org/
There are also therapists who work with people before and after psychedelic experiences, called psychedelic integration therapists. They usually have legit mainstream psychotherapy qualifications.
There are also integration circles where people support each other. For example, https://acerintegration.com/ This was set up by a researcher in psychedelics. Not sure if it would be appropriate for someone experiencing psychosis though. You could also try contacting the researcher directly for recommendations: https://www.drrosalindwatts.com/
> We know that the microdosing also turned into macrodosing on a lot of occasions.
It's pretty easy to slip into this. I don't have a good answer for solving this but criminalization is definitely a bad answer, so we will have to find a way to discourage such tendencies. It may be that it is mostly or entirely a cultural thing in which case public understanding of the drug is a prerequisite, so I'm glad more are starting to learn about it as a result of decriminalization and legalization.
I hope she can find some way to be comfortable again.
My experience is that I’ve seen this happen a lot to people who take psychedelics frequently (say, multiple times a month over a prolonged period). Whereas this seems to be rare with infrequent use at moderate dosages.
is she bipolar by any chance? if not, does she have a family history of bipolar or schizophrenia? or, does she have any cluster-b personality disorders?
> We know that the microdosing also turned into macrodosing on a lot of occasions
Do you know how frequent the macrodosing became? I have never seen or heard (anecdotal) of microdosing leading to a psychotic break. But frequent use (more than once every three weeks) of large quantities will almost certainly harm you in the long run.
Honest Q: How much weed does she smoke? Because if she smokes a considerable amount then that is certainly more likely than the psychedelics to be a factor.
I can't say the drug use caused it, but I and the rest of her friends are of the opinion that it contributed (we all have experience with psychedelics, mostly in our younger days)
I mean a cup of coffee might push the wrong person over the edge if they’re already in the midst or about to enter a serious mental health crisis?
Of course you’d have to assume a psychoactive substance might contribute but maybe not?
I’ve had serious depressive stints of existential crisis where the world felt like it was telling me I don’t need to exist anymore and I’ve had them before and I’ve had them before and after smoking pot, did it contribute maybe ? Maybe not. I’ve smoked pot since and never had the same symptoms.
> the standard medical treatment for these disorders, SSRIs, are pretty terrible. In the mild case, the common side effects are blunting of your emotions and sexual dysfunction. So you don't have panic attacks, but you live in a gray fog and your relationships suffer. In the worst case, they cause suicidal ideation.
As others have stated in this thread, this overt generalization is harmful. SSRIs and psychedelics have both been studied, and both have outcomes that we don't really understand. To say one is better or worse than the other in most cases is pure ignorance.
We all have roughly the same physical properties to our brains but how they develop is truly unique to every individual, which leads some methods of treatment for mental health disorders more or less effective than others. I am 100% onboard with pursuing psychs for treatment if you want, but its not for everyone and neither are SSRIs.
I'd downvote this if the responses weren't so full of instructive counterpoints.
They're terrible for some people, but they work well for others. I don't think they should automatically be disregarded.
> In the worst case, they cause suicidal ideation
Is this actually true? My understanding is that people in severe depression can have suicidal ideation but not actually be able to put in the effort/energy needed to go through with it. SSRIs initially give you a little more boost in energy before the mood-lifting effects kick in. During that middle phase, we observer higher suicide rates because you've now enabled them to have effort to follow through with their suicidal ideas.
GlaxoSmithKline paid the Department of Justice $3 billion for covering up evidence of this while promoting their SSRI to under-18s. They paid the fine in 2012, 11 years ago. The medical trial was done in 1994-1998.
In 2003, the (UK medicines regulator) MHRA obtained full clinical data from Glaxo, and based on that data forming robust evidence of significant increase in suicidality, both the MHRA and the FDA immediately said that paroxetine couldn't be prescribed to under-18s.
The UK govt rules on how to report medical trials were changed in relation to what happened with the publication of the Glaxo Paxil trials.
GSK paid around $1 billion in the 2000-2010s to settle several hundred lawsuits, including many many suicides and several family annihilations.
The main investigative news TV show in the UK, Panorama, reported on this in 4 shows between 2002 and 2007.
The Boston Globe did significant investigative work on this around 2005, including a book published by their reporter.
In view of that, your question comes across as at best, uninformed and naive.
I took Sertraline (one kind of SSRI) to treat anxiety, never had depression.
No panic attacks anymore, sexual drive was still good, after 3 months I felt superhuman and like my life changed, 3 months after that the suicidal ideation started.
I thought it was something I could power through, so I gave it another three months before it became unbearable, and I couldn't book an appointment with my treating doctor for another two months so I quit cold turkey.
The withdrawals were so terrible, I was basically a zombie for two weeks.
Took me a few months until I felt like myself again.
I no longer experience anxiety to the same degree I did back then, no use of other SSRIs or any other drugs.
This isn't meant to scare people into not trying SSRIs, just sharing my experience.
I think had I been more informed of the potential risks and changed my attitude of toughing it out, it could've probably been more beneficial.
> Is this actually true? My understanding is that people in severe depression can have suicidal ideation but not actually be able to put in the effort/energy needed to go through with it.
It seems like you forgot the word "ideation" is in the original claim you're disputing, based on your description. Yes it is true that SSRIs can cause suicidal _ideation_. And the first step to suicide is suicidal ideation.
> SSRIs, are pretty terrible ... you don't have panic attacks, but you live in a gray fog and your relationships suffer
Comments like this -- and there are an awful lot of them online -- dissuaded me for a very long time from taking SSRIs. And that was a terrible mistake: SSRIs have been a life-changing good for me. I am on a high dose of Lexapro, and in no way do I live in a gray fog, and my relationships are markedly better. My GAD is gone, completely.
A few years ago, a doctor tried to convince me that they were causing sleep apnea, so I came off them, slowly, over many months. I didn't have cessation symptoms. My anxiety slowly returned, in proportion to the dosage, my sleep apnea didn't improve, and I was glad to start them again.
This comment is dangerous and incorrect. Many people have exceptional responses on SSRIs - myself included. I went from having regular panic attacks to living a very normal life with absolutely zero side effects, just from taking the lowest dose of Zoloft (25mg generic sertraline). I don't live in a gray fog, my relationships do not suffer, and I have not had any suicidal ideation. You're cherry picking very rare/extreme instances and noting them to be commonplace.
It took me MONTHS to even consider SSRIs because of rhetoric like this that is online and pervasive in our culture.
Psilocybin works in sort of the same way as SSRI. SSRIs will keep around the serotonin we make, but the problem is, if we’re not making enough serotonin in the first place they won’t be effective.
Psilocybin on the other hand acts kind of like the serotonin molecule itself. It attaches to most of the serotonin receptors, including the two receptor. The reason why it works for so long is you get such a huge and strong attachment to the serotonin receptors that the body ends up, reducing the serotonin receptors in response. It’s this lack of serotonin receptors that make us more sensitive to what little serotonin we make.
There’s nothing non-pharmacological about the effects of mushrooms.
I don't think poor performance of SSRIs is really a common reason. People just love magic bullets and shortcuts. It's basically a variant of drinking bleach for COVID, except safer and more fun.
(Not a prohibitionist, just against self-medication)
You are correct about (1), but "citation needed" for (2).
Psychedelic therapies are most definitely not based on hype -- there's real research being conducted by real doctors, and it's only becoming more prevalent.
If you don’t quantify these things and perform cost-benefit analysis, it’s like saying we shouldn’t drive cars , because in the worst case you burn alive.
SSRI side effect prevalence is a hard thing to measure for a large variety of reasons. But in [1] only 1/4 patients report the side effects as ”very bothersome.” Given that 100% of patients are so anxious/depressed that they want to try psych meds, it seems like SSRIs are a great treatment option for many.
Gotta love the language there. "Very bothersome" sounds so much less problematic than other potential phrasings. Like, "oh dear, I get brain zaps, feel like a zombie, and am having persistent intrusive thoughts that interfere with my ability to think and perform during the day. Gee golly, what a nuisance."
A quarter of patients reporting very troubling side effects is not great for a class of drugs with an effect size around 0.3, or about 10% more reduction in depression symptom scores compared to placebo. If you have run out of options and are desperate for relief, it may be an appealing risk/reward equation for some people. But the notion that 100% of patients believe they need these meds, rather than had the drug recommended by a doctor/psychiatrist (who maybe didn't go into great detail about the potential risks vs tempering expectations about how likely they are to help), is absurd. It totally ignores how our medical system operates in most cases. Many times, the doctors prescribing will be informed by drug company PR literature moreso than careful reading of scientific research.
As someone with Depression that has tried both SSRIs and Shrooms, my experience was badically: SSRIs keep you alive with a host of side effects or you take a shroom trip once a year and feel better without side effects.
To add to this, I think the toxic part about this is that SSRIs are the first line treatment, and are handed out like candy when they are not magic cure-alls for whichever ailment. In fact there’s a risk of SSRIs activating self-destructive mania, even in people who do not typically fall under the “bipolar” umbrella. (which, the interactions of SSRIs with undiagnosed disorders is also unsafe given their track record of being handed out like candy).
> In the mild case, the common side effects are blunting of your emotions
Isn't this the primary effect, more than a side effect?
Atleast in my case, it's been super helpful, going from jumping between a 1 to 7 in mood, to just lie around 4-5-6.
I'm a fairly drug-averse person. I have no qualms about other people using them, but it took us over 30 years to really understand the implications of legalized opioids. And that was after a lengthy and expensive FDA process.
So respect to all of the early adopters who have nothing to lose and are willing to put their own sanity at risk. I just don't understand people who in one breath curse the Sackler family but then line up to try the first batch of industrialized psilocybin from Rose City Laboratories.
Do you understand what happened in the opioid crisis, and why people are mad at the Sacklers? They weren’t hapless naive actors that didn’t fully understand “the implications” of the drugs they were selling. The effects of opioid addiction were WELL known when oxycontin was introduced, and Purdue Pharmaceuticals deliberately misrepresented critical information about the drugs they sold and had salespeople lie in a wholesale fashion on a massive scale.
It’s reasonable to have suspicion about companies and regulators in this area, but the opioid crisis is such a different situation in context.
> Dr. Janis Phelps, director of the Center for Psychedelic Therapies and Research at the California Institute of Integral Studies, said she and other researchers had been wary of the decriminalization movement. Many in the field had worked for years to remain strictly scientific, hoping to avoid government crackdowns, and to give the U.S. Food and Drug Administration time to fully review the effects of psilocybin before pressing ahead with efforts to make it legal.
> “I have changed my mind,” she said. While she remains concerned that bad actors could try to enter the industry strictly for profit, or try to take advantage of vulnerable people, she has come to believe that the open door in Oregon could advance the use of psychedelics in ways that methodical approaches cannot.
> Dr. Charles Nemeroff, the chair of the department of psychiatry and behavioral sciences at the University of Texas at Austin, said he continues to be wary. Psilocybin is powerful, with immediate effects lasting for hours, and uncertain outcomes for patients, he said, recalling one patient of his who has experienced protracted psychosis, losing partial connection to reality, after taking doses of mushrooms. The treatments ruined her life, said Dr. Nemeroff, who said he worried about the lack of required medical oversight in Oregon’s program.
Just like the Sacklers, people pursuing psilocybin are fully aware of all of these warnings and problems. And just like Purdue, anyone selling psilocybin right now are willfully misrepresenting the evidence and ignoring medical opinion. Again, Purdue did all of the things they did because they believed they were ultimately helping treat people's suffering.
I am fully aware that time may tell and the concerns may be unfounded. And I get that we are dealing with a completely different drug/mechanism. But one is right and one is wrong only through the benefit of hindsight.
I too am fairly drug-averse. And after 40 years of avoiding all drugs but caffeine and alcohol, I dipped my toe into psilocybin and found not only was it profoundly therapeutic in terms of self-acceptence, self-love, and anxiety-reduction, I found after 3 or 4 uses, I had no further interest in it whatsoever.
Is my experience universal? Of course not, but an anecdote to consider alongside yours.
Same here. Did it once and it saved my life. Point is it was only legally accessible to rich people. I.e. I had to fly to amsterdam pay for pre and post psychotherapy and multi day care. This is so wildly different to recreational use.
And like caffeine and alcohol, you can make practical use of psychedelic mushrooms in low doses with far less potential of unpredictable/problematic results. The dose makes the poison.
Same experience here. I did psychedelics maybe 10 times and then simply stopped having the desire. I don't have an aversion to it either. Just kind of got what I wanted out of it.
I think an important difference is that "legal" / manufactured drugs are patented, their formulation a trade secret, production fully in the hands of one party, etc. Weed and mushrooms can be grown by anyone; likewise, alcohol can be produced by anyone, but because of the risks in distilling it's illegal in most places to do so yourself.
My point is that the vilification of 'soft' drugs like mushrooms and weed is because the powers-that-be can't make a profit off of it. Or they could, but they would have to compete with home grown.
That doesn't stop the industry though; in the past few years in my country (Netherlands, famously tolerant but in a weird way to weed) you can get CBD oils and products off-the-shelf, alongside things like melatonin and whatnot. They've made it a consumer product and much more socially acceptable.
At the moment there's trials going on for the legal production of weed in greenhouses; up until then, all production was done illegaly in people's basements / attics, or via skirting the rules: legally you can have... I forgot, 1, 2 or 3 plants in your house (it used to be 7 but then the plants got bigger). There's "companies" now (they call themselves a foundation, charity or private club) that will offer to put a grow tent in your house if you have a spare room, just needs some electricity and water, they'll come and harvest it once it's done and you get a share of it and / or paid for it.
We've had thousands of years experience with psilocybin. We've already synthesized more potent psychedelics for 75ish years. I'd argue that the safety is well understood, but of course effective dosage in clinical trial are not. However, there's plenty of information from psychonauts out there on how to consume shrooms safely.
But neither of these chemicals are magic. A lot of people are looking for magic pills. A lot of companies want to sell you magic pills. Take a couple pills and your problems go away; that's just not achievable anytime soon. We have to get better as a Western society of supporting people on their various, multifaceted journeys through life.
I mean, we could be saying the same thing about psychedelics in 30 years time. "Wow, everyone knew psychedelics were bad for hundreds of years! What were medical professionals doing recommending them in the 2020s?"
I understand that we are not talking about the same specific mechanism (addiction), but I also want to keep my eyes open and not blindly stumble into the same broader category of problem all over again.
>but it took us over 30 years to really understand the implications of legalized opioids.
It took the EU all of ten seconds to reject opiates for minor use -- the opioid crisis is very much manufactured and endured in North America and is a regulatory failing of the FDA. The most crucial distinction here is the addictiveness of psilocybin vs opioids, mushrooms are not remotely addictive relative to opioids.
Up until the mid 2000s, psychedelic mushrooms in their natural state were completely legal in the UK. They were banned based on virtual no evidence of harm or widespread abuse despite being used recreationally for decades, just because the government decided that they didn't seem like the kind of thing that should be legal.
That's not quite right, sadly. They banned them because careless traders in places like Camden could buy them cheap from Holland and sell them with zero responsibility to anyone who wanted, including minors.
I know this because I was in part responsible for opening up the gates, with a company that sold them very responsibly, starting in Camden.
Opiods are only legal in some circumstances: We've known about opium addiction for centuries. Heck, we had the Opium Wars.
That's not really what happened with the current pills, though. They were touted as not being addictive in the same way as opium.
And then we prescribed them, didn't (and don't) offer realistic talks about how addiction starts with them, aren't giving people sick time so they are less likely to need them, putting folks in jail for using things like pot instead, and aren't giving folks affordable and medicine-based help if they do happen to get addicted. And then, if they do happen to get addicted, we treat them like a pill-seeking addict for many years, if not for life.
We know other things cause dependency - it isn't just opioids - but we are better at having conversations around them and better at making sure to taper folks (and so on).
> They were touted as not being addictive in the same way as opium
Oxycotin was never touted as "not being addictive".
Hell they had (and still have) a big "WARNING: OxyContin is an opioid agonist and a Schedule II controlled substance with an abuse liability similar to morphine." in their label.
It was a confluence of medical professionals being taught "pain is the 5th vital sign", "pain is routinely undertreated" and "controlled release opioids have a reduced abuse potential".
This was not necessarily bad because many of those things were true and the pendulum had swung back from "just tough it out", "Tylenol is enough for most people", "just one dose of opioids will make you an addict".
Then layer on top pill mill clinics popping up where doctors were dispensing scripts for 120 sixty milligram Oxycotin without so much as a physical examination, the DEA doing nothing despite having ample data in front of them that some doctors were dispensing milions of pills each year and the massive amounts of money doctors made writing the scripts by charging addicts cash.
Sure. But there are all sorts of negative side effects we should also be worrying about besides just dependence.
And we've also known about problems from psychedelic abuse for centuries. And we're talking about dumping them on the market with way less oversight than we did opioids!
It's like that truism about the military always fighting past wars...
At least "natural" psilocybin can't be compared with opiods at all, other that both are controlled substances. Psilocybin is not addictive, it's way to exhausting and also physiologically not possible.
However, there is still a lot of potential for harm. The biggest one is triggering latent psychosis and other psychological issues followed by possibly dangerous actions under the influence of high doses.
I also believe the "recreational" potential is low but it will probably be very interesting for many people to try at least once.
This is what was said about THC until it was legal and now we know there are physical withdrawal side effects in a decent percentage of people. So I don’t trust advocates pushing this narrative at all
> I also believe the "recreational" potential is low
Laughable. Most people doing magic mushrooms are doing so recreationally. That’s what it’s known for, that’s why there has to be entire talks given about the mental health benefits. Because it’s widely used exclusively as a recreational drug
speaking as someone who has done a fair amount of recreational drug use, including shrooms -
you can totally use shrooms too much, because you're bored on summer break so you eat a bunch to spice up your day. It's honestly not the smartest use of it, but 'overuse'/spending too much time tripping is totally a thing.
We do have some understanding of the safety profile of psilocybin, even if its Schedule I status makes it hard to research. At the very least, it doesn’t have physical dependency like opioids.
However, the lack of significant safety research does make it hard to determine the incidence of development of disorders like HPPD but, unlike opioids, I can’t imagine someone wanting to continue taking psilocybin after developing HPPD.
They said the same thing about weed - that you don’t have any physical dependency.
A quick search on Reddit would show you countless people who say they’re physically unable to function without weed anymore. Withdrawal symptoms include insomnia, depression, brain fog, lack of appetite, lack of energy, shaking, etc.
This is especially true of people who started using it when they were young and people who use high THC products.
Aside from the other comments, opioids are much more addictive than psilocybin. All drugs have risks, but the risk of death or serious issues (whether psychosis or addiction) are a fraction of what they are with opioids.
This is one of the things I love about America. Each state can run their own experiments and everyone else can watch. We don't have to wonder what would happen now.
One issue is that SSRI treatment has to be stopped before starting psychedelic therapy (interactions). This means tapering off until you're not being treated anymore, which takes weeks if not months, can be difficult and put the patient in a less than ideal state of mind, possibly even worse than when they started off.
And this is a very bad state of mind to be in when starting psychedelics. I wonder how people usually deal with that.
While nobody should do this, the interaction risk between an SSRI and a classical psychedelic is low. The primary concerns are serotonin syndrome, which requires a dose far outside the level that a responsible practitioner would administer. That said, this does mean that if an error is made, the consequence is far more severe (ie: miligrams as opposed to micrograms in dosing LSD).
I have heard second-hand reports of users who tapered their SSRI treatment, and on first exposure to psychedelics, had a severe negative response (to the point of re-traumatisation). So you're correct, this is exceptionally difficult to do correctly.
Yeah, which is why maybe these treatments are ok for people with relatively "mild" symptoms / disorders (like the guy in the article with "lingering ptsd"), people who aren't being aggressively treated with SSRIs.
That's the sad thing about those pills I guess, it's that you stay on them or you get better.
My own success with battling depression had so much to do with controlling the adhd that we've talked about tapering off the SSRI's. I wouldn't be surprised if they become dramatically less prescribed over time.
Mindfulness, communication, learning how to rest and better time management techniques have more than likely done more for my mental health than the SSRIs. I'd love to taper off with them one day but we'll see.
Which pharmaceutical is going to back this clinical trial though??
Here's hoping more accurate dosing will be a side effect of this. Going by rough weight of a plant that includes a lot of water always seemed kind of sketchy to me.
I've heard of tinctures made by dissolving them in alcohol, but I don't think even those are measured objectively. No idea what sort of titration/measurement you'd do to determine the mg amount of psilocybin, or if that's even well documented.
Potency can still vary drastically from batch to batch (and even within the same batch), let alone between distinct strains. Standardization and accurate testing are still quite important when we are talking therapeutic use.
It's not the water weight, since they're always dried. Not every mushroom has the same % of active ingredients vs the rest of the dry weight. You could have one big weak shroom or a tiny potent one.
> Here's hoping more accurate dosing will be a side effect of this. Going by rough weight of a plant that includes a lot of water always seemed kind of sketchy to me.
> I've heard of tinctures made by dissolving them in alcohol, but I don't think even those are measured objectively. No idea what sort of titration/measurement you'd do to determine the mg amount of psilocybin, or if that's even well documented.
You could create a tincture and test it. And like the other person who replied said, the doses will be consistent.
Personally I took magic mushrooms once. I've always been an anxious person. For at least 2 or 3 months after. My anxiety was gone like never before, I was not scared of anything or talking to anyone. I was the most free I ever was. Ive been wanting to take another dose soon, I think I should... 1g.
I make full spectrum CBD oil for myself and family. It has a very real effect too. Much more powerful than most CBD products you can purchase, because it will contain more than pure CBD. Its the same process as a tincture with a few steps after. I turn 4 ounces (112g) into 60ml. ~300+ mg/g, take 0.05-0.1g. I think the benefits should be experienced without expectations, because they can vary. Helps with stress, anxiety, blood pressure, inflammation and some pain, arthritis, and others. There are some other compounds in this plant that can help with other things. CBG/A CBN, CBDA. A tiny bit of THC, which is naturally found in tiny amounts in most CBD containing plants, increases the effects of the others greatly. Too much THC alone has a negative impact if you continue long term use, at least on me. These compounds effect the endocannabinoid system, but have some off target activity which is why a variety of similar compounds can have a lot of different effects. Those other compounds can help with different issues-digestion, sleep. Keeping a decent amount of CBD/G(A) (by not cooking/heating it) is important too.
I am a very scientific person, and I understand some people are weary of this type of medicine. But what is your alternative? Eat the pills by big pharma filled with lies to sell drugs and make money? Take an SSRI so you can kill your sex drive and feel like a zombie? Maybe that won't happen to you, and I understand that they help some or many people. But if you understood the potential negative effects, and that some of them can be permanent, would you still be okay with starting it yourself? Perhaps something that has grown in nature with us can be beneficial, we came from the same planet, we evolved together. We consider other plants and vegetables from this earth to be healthy for us, why? Coffee, tea, in moderation, are good for you too. Tea is more than just caffeine.
I find it odd that most states legalize pot before they legalize/decriminalize shrooms. Psilocybin mushrooms are native to a lot more states than cannabis. It's an odd experience to walk down the streets of NJ and see a patch of Psilocybe Ovoideocystidiata growing in a mulch bed and to think, "Wow! A natural fungal felony with freewill and a means to reproduce, turning other people's mulch beds into felonies!"
The captcha on that is ridiculous. I couldn't pass until changing to another network (from fixed residential to mobile). Tapped a checkbox a dozen times and solved a half dozen rounds identifying objects in photos before giving up. Android Chrome, PiHole, nothing else.
If the PiHole is to blame (haven't checked yet), I guess it sort of makes sense that I can't expect to read TFA when offering neither tracking nor dollars in return.
Readit News
(yes, I've tried psychedelics; they're fascinating and super promising, but at least for me, not transformative in the way that fluoxetine was)
No individual depression treatment works for everyone. SSRIs are not a magic bullet. Neither are psychedelics. But if you're depressed and haven't tried SSRIs, you owe it to yourself and everyone in your life to at least test the hypothesis that they might help.
Scott Alexander's page on SSRIs is a great, relatively objective resource, from a psychiatrist who regularly prescribes them: https://lorienpsych.com/2020/10/25/ssris/
Prozac actually saved my life. Psychedelics since have certainly enhanced it, but they could not accomplish what prozac did. I can go into more detail if interested.
I think in my part my negative reaction is, like many people, having observed the effects of SSRIs on young people. It's well known that risks like suicidal ideation are actually higher among those under 25, and in general it is awful to see the mental health crisis among young people dealt with primarily via instantly reaching toward semi-permanent medication, rather than considering other treatments.
For what it's worth, synthetic opioids and spinal fusion saved my life. If I'd listened to the Internet, I'd have likely never pursued treatment or maybe just taken Kratom and gotten massages or something, fearing I'd end up a drug addict with a worse spine than I started with.
I have schizoaffective disorder, bipolar type So I am prone to being more sensitive to SSRI. This is mostly to do with my genetically odd 5HT2A receptors.
Depression is no longer really a part of my life anymore after I found I was zinc deficient. But now I do tend towards the manic and have issues with psychosis still so I need to be careful with my serotonin.
The bad sides of of SSRI's are as overblown as the good sides of psychedelics are. It's easy to form an opinion from reading personal experiences online but that doesn't reflect the real world imho.
> That is, there are a bunch of tests that ask you a bunch of questions about your feelings and symptoms, and you can add them up and call that a “depression score”, and if you do that, antidepressants have an effect size of 0.3. Or you can ask patients “how depressed do you feel on a scale of 1-10”, and if you do that, antidepressants have an effect size of 0.5. I think the latter is better, because it’s what we actually care about (how patients are doing), and the tests are kind of dumb and ask about a lot of symptoms most people realistically aren’t experiencing.
(In other words, if you ask a patient with depression how they are feeling, and they say 'great', and then you ask them questions like "are you managing to shower every day", or "did you think about suicide a lot this week" and they give the same answers as a depressed person, they are cured!)
Does weird napkin math which clearly can't be justified:
> For those people, they will have a large real effect size of 1.0, plus a large placebo effect size of 0.9, for a very large total effect size of 1.9.
(How do you get to add the placebo effect back on to the postulated 'large real effect size'??)
Says that extremely common side effects are 'very unusual':
> It can be any or all of decreased libido, difficulty orgasming, difficulty getting an erection, difficulty enjoying sex, or decreased sensation in the genitals. These usually go away a few weeks to months after stopping the medication, but in rare cases they might linger for months or years, and there are a few people who say their sexual side effects never went away. These cases are very unusual and still not well understood.
(Note that in the same article he points out that, in general, the medication only improves mood or anxiety while you keep taking it, when you stop taking it you still have the depression or other conditions. So the fact that sexual disfunction usually gets resolved after stopping taking the medication isn't much relief. For most people SSRIs will never lead to a steady state where you are stable with regards to your mental health issue and also are able to enjoy sex.)
Makes armchair psych connection between well-studied things which are not the same:
> When everything goes right, SSRIs blunt negative but not positive emotions. But many people even at reasonable doses will notice that their most extreme positive emotions become a little less extreme (this may be part of the problem with sex).
(Difficulty getting aroused or orgasming or feeling in the mood for sex is not the same as "most extreme positive emotions becoming a little less extreme")
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I can't say the drug use caused it, but I and the rest of her friends are of the opinion that it contributed (we all have experience with psychedelics, mostly in our younger days). We know that the microdosing also turned into macrodosing on a lot of occasions. She's in a group of friends who follow Phish around, and it's basically part of their identity.
She's doing better now, but still thinks she's in some kind of a stimulation, and has described feeling like she's on a never-ending acid trip. She's always been one of my most solid friends, and this came completely out of left field.
We can't get her to see any psychiatrists who would want to put her on anti-psychotics (which is basically all of them). So we just tell her we love her, and try to convince her that if this is all a big simulation, we're not in on it either.
I think the best you can do is be a calm friend and imagine you're dealing with a two year old without being condescending.
You could also try contacting https://challengingpsychedelicexperiences.com/
There are also therapists who work with people before and after psychedelic experiences, called psychedelic integration therapists. They usually have legit mainstream psychotherapy qualifications.
There are also integration circles where people support each other. For example, https://acerintegration.com/ This was set up by a researcher in psychedelics. Not sure if it would be appropriate for someone experiencing psychosis though. You could also try contacting the researcher directly for recommendations: https://www.drrosalindwatts.com/
There are also forums where you could ask for advice, e.g. https://old.reddit.com/r/RationalPsychonaut/
They might be able to point you to other resources like this in your area.
It's pretty easy to slip into this. I don't have a good answer for solving this but criminalization is definitely a bad answer, so we will have to find a way to discourage such tendencies. It may be that it is mostly or entirely a cultural thing in which case public understanding of the drug is a prerequisite, so I'm glad more are starting to learn about it as a result of decriminalization and legalization.
I hope she can find some way to be comfortable again.
Do you know how frequent the macrodosing became? I have never seen or heard (anecdotal) of microdosing leading to a psychotic break. But frequent use (more than once every three weeks) of large quantities will almost certainly harm you in the long run.
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I mean a cup of coffee might push the wrong person over the edge if they’re already in the midst or about to enter a serious mental health crisis?
Of course you’d have to assume a psychoactive substance might contribute but maybe not?
I’ve had serious depressive stints of existential crisis where the world felt like it was telling me I don’t need to exist anymore and I’ve had them before and I’ve had them before and after smoking pot, did it contribute maybe ? Maybe not. I’ve smoked pot since and never had the same symptoms.
As others have stated in this thread, this overt generalization is harmful. SSRIs and psychedelics have both been studied, and both have outcomes that we don't really understand. To say one is better or worse than the other in most cases is pure ignorance.
We all have roughly the same physical properties to our brains but how they develop is truly unique to every individual, which leads some methods of treatment for mental health disorders more or less effective than others. I am 100% onboard with pursuing psychs for treatment if you want, but its not for everyone and neither are SSRIs.
I'd downvote this if the responses weren't so full of instructive counterpoints.
They're terrible for some people, but they work well for others. I don't think they should automatically be disregarded.
> In the worst case, they cause suicidal ideation
Is this actually true? My understanding is that people in severe depression can have suicidal ideation but not actually be able to put in the effort/energy needed to go through with it. SSRIs initially give you a little more boost in energy before the mood-lifting effects kick in. During that middle phase, we observer higher suicide rates because you've now enabled them to have effort to follow through with their suicidal ideas.
GlaxoSmithKline paid the Department of Justice $3 billion for covering up evidence of this while promoting their SSRI to under-18s. They paid the fine in 2012, 11 years ago. The medical trial was done in 1994-1998.
In 2003, the (UK medicines regulator) MHRA obtained full clinical data from Glaxo, and based on that data forming robust evidence of significant increase in suicidality, both the MHRA and the FDA immediately said that paroxetine couldn't be prescribed to under-18s.
The UK govt rules on how to report medical trials were changed in relation to what happened with the publication of the Glaxo Paxil trials.
GSK paid around $1 billion in the 2000-2010s to settle several hundred lawsuits, including many many suicides and several family annihilations.
The main investigative news TV show in the UK, Panorama, reported on this in 4 shows between 2002 and 2007.
The Boston Globe did significant investigative work on this around 2005, including a book published by their reporter.
In view of that, your question comes across as at best, uninformed and naive.
I no longer experience anxiety to the same degree I did back then, no use of other SSRIs or any other drugs.
This isn't meant to scare people into not trying SSRIs, just sharing my experience. I think had I been more informed of the potential risks and changed my attitude of toughing it out, it could've probably been more beneficial.
It seems like you forgot the word "ideation" is in the original claim you're disputing, based on your description. Yes it is true that SSRIs can cause suicidal _ideation_. And the first step to suicide is suicidal ideation.
Comments like this -- and there are an awful lot of them online -- dissuaded me for a very long time from taking SSRIs. And that was a terrible mistake: SSRIs have been a life-changing good for me. I am on a high dose of Lexapro, and in no way do I live in a gray fog, and my relationships are markedly better. My GAD is gone, completely.
A few years ago, a doctor tried to convince me that they were causing sleep apnea, so I came off them, slowly, over many months. I didn't have cessation symptoms. My anxiety slowly returned, in proportion to the dosage, my sleep apnea didn't improve, and I was glad to start them again.
It took me MONTHS to even consider SSRIs because of rhetoric like this that is online and pervasive in our culture.
Psilocybin on the other hand acts kind of like the serotonin molecule itself. It attaches to most of the serotonin receptors, including the two receptor. The reason why it works for so long is you get such a huge and strong attachment to the serotonin receptors that the body ends up, reducing the serotonin receptors in response. It’s this lack of serotonin receptors that make us more sensitive to what little serotonin we make.
There’s nothing non-pharmacological about the effects of mushrooms.
2/ there is increasing evidence that psychedelic therapies for mental illness were all based on hype and don’t actually perform any better or at all
Psychedelic therapies are most definitely not based on hype -- there's real research being conducted by real doctors, and it's only becoming more prevalent.
[1] https://www.hopkinsmedicine.org/psychiatry/research/psychede... [2] https://www.nejm.org/doi/full/10.1056/NEJMoa2206443
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SSRI side effect prevalence is a hard thing to measure for a large variety of reasons. But in [1] only 1/4 patients report the side effects as ”very bothersome.” Given that 100% of patients are so anxious/depressed that they want to try psych meds, it seems like SSRIs are a great treatment option for many.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719451/
A quarter of patients reporting very troubling side effects is not great for a class of drugs with an effect size around 0.3, or about 10% more reduction in depression symptom scores compared to placebo. If you have run out of options and are desperate for relief, it may be an appealing risk/reward equation for some people. But the notion that 100% of patients believe they need these meds, rather than had the drug recommended by a doctor/psychiatrist (who maybe didn't go into great detail about the potential risks vs tempering expectations about how likely they are to help), is absurd. It totally ignores how our medical system operates in most cases. Many times, the doctors prescribing will be informed by drug company PR literature moreso than careful reading of scientific research.
Isn't this the primary effect, more than a side effect? Atleast in my case, it's been super helpful, going from jumping between a 1 to 7 in mood, to just lie around 4-5-6.
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But you do you, I won't judge foreign exotic cultures.
So respect to all of the early adopters who have nothing to lose and are willing to put their own sanity at risk. I just don't understand people who in one breath curse the Sackler family but then line up to try the first batch of industrialized psilocybin from Rose City Laboratories.
It’s reasonable to have suspicion about companies and regulators in this area, but the opioid crisis is such a different situation in context.
> Dr. Janis Phelps, director of the Center for Psychedelic Therapies and Research at the California Institute of Integral Studies, said she and other researchers had been wary of the decriminalization movement. Many in the field had worked for years to remain strictly scientific, hoping to avoid government crackdowns, and to give the U.S. Food and Drug Administration time to fully review the effects of psilocybin before pressing ahead with efforts to make it legal.
> “I have changed my mind,” she said. While she remains concerned that bad actors could try to enter the industry strictly for profit, or try to take advantage of vulnerable people, she has come to believe that the open door in Oregon could advance the use of psychedelics in ways that methodical approaches cannot.
> Dr. Charles Nemeroff, the chair of the department of psychiatry and behavioral sciences at the University of Texas at Austin, said he continues to be wary. Psilocybin is powerful, with immediate effects lasting for hours, and uncertain outcomes for patients, he said, recalling one patient of his who has experienced protracted psychosis, losing partial connection to reality, after taking doses of mushrooms. The treatments ruined her life, said Dr. Nemeroff, who said he worried about the lack of required medical oversight in Oregon’s program.
Just like the Sacklers, people pursuing psilocybin are fully aware of all of these warnings and problems. And just like Purdue, anyone selling psilocybin right now are willfully misrepresenting the evidence and ignoring medical opinion. Again, Purdue did all of the things they did because they believed they were ultimately helping treat people's suffering.
I am fully aware that time may tell and the concerns may be unfounded. And I get that we are dealing with a completely different drug/mechanism. But one is right and one is wrong only through the benefit of hindsight.
My point is that the vilification of 'soft' drugs like mushrooms and weed is because the powers-that-be can't make a profit off of it. Or they could, but they would have to compete with home grown.
That doesn't stop the industry though; in the past few years in my country (Netherlands, famously tolerant but in a weird way to weed) you can get CBD oils and products off-the-shelf, alongside things like melatonin and whatnot. They've made it a consumer product and much more socially acceptable.
At the moment there's trials going on for the legal production of weed in greenhouses; up until then, all production was done illegaly in people's basements / attics, or via skirting the rules: legally you can have... I forgot, 1, 2 or 3 plants in your house (it used to be 7 but then the plants got bigger). There's "companies" now (they call themselves a foundation, charity or private club) that will offer to put a grow tent in your house if you have a spare room, just needs some electricity and water, they'll come and harvest it once it's done and you get a share of it and / or paid for it.
But neither of these chemicals are magic. A lot of people are looking for magic pills. A lot of companies want to sell you magic pills. Take a couple pills and your problems go away; that's just not achievable anytime soon. We have to get better as a Western society of supporting people on their various, multifaceted journeys through life.
People have been using these drugs for a very long time. Their affects are fairly well known.
Opioids are addictive, mushrooms are not. That singular fact makes them very very different.
I understand that we are not talking about the same specific mechanism (addiction), but I also want to keep my eyes open and not blindly stumble into the same broader category of problem all over again.
It took the EU all of ten seconds to reject opiates for minor use -- the opioid crisis is very much manufactured and endured in North America and is a regulatory failing of the FDA. The most crucial distinction here is the addictiveness of psilocybin vs opioids, mushrooms are not remotely addictive relative to opioids.
I know this because I was in part responsible for opening up the gates, with a company that sold them very responsibly, starting in Camden.
That's not really what happened with the current pills, though. They were touted as not being addictive in the same way as opium.
And then we prescribed them, didn't (and don't) offer realistic talks about how addiction starts with them, aren't giving people sick time so they are less likely to need them, putting folks in jail for using things like pot instead, and aren't giving folks affordable and medicine-based help if they do happen to get addicted. And then, if they do happen to get addicted, we treat them like a pill-seeking addict for many years, if not for life.
We know other things cause dependency - it isn't just opioids - but we are better at having conversations around them and better at making sure to taper folks (and so on).
Oxycotin was never touted as "not being addictive".
Hell they had (and still have) a big "WARNING: OxyContin is an opioid agonist and a Schedule II controlled substance with an abuse liability similar to morphine." in their label.
It was a confluence of medical professionals being taught "pain is the 5th vital sign", "pain is routinely undertreated" and "controlled release opioids have a reduced abuse potential".
This was not necessarily bad because many of those things were true and the pendulum had swung back from "just tough it out", "Tylenol is enough for most people", "just one dose of opioids will make you an addict".
Then layer on top pill mill clinics popping up where doctors were dispensing scripts for 120 sixty milligram Oxycotin without so much as a physical examination, the DEA doing nothing despite having ample data in front of them that some doctors were dispensing milions of pills each year and the massive amounts of money doctors made writing the scripts by charging addicts cash.
And we've also known about problems from psychedelic abuse for centuries. And we're talking about dumping them on the market with way less oversight than we did opioids!
It's like that truism about the military always fighting past wars...
However, there is still a lot of potential for harm. The biggest one is triggering latent psychosis and other psychological issues followed by possibly dangerous actions under the influence of high doses.
I also believe the "recreational" potential is low but it will probably be very interesting for many people to try at least once.
This is what was said about THC until it was legal and now we know there are physical withdrawal side effects in a decent percentage of people. So I don’t trust advocates pushing this narrative at all
> I also believe the "recreational" potential is low
Laughable. Most people doing magic mushrooms are doing so recreationally. That’s what it’s known for, that’s why there has to be entire talks given about the mental health benefits. Because it’s widely used exclusively as a recreational drug
you can totally use shrooms too much, because you're bored on summer break so you eat a bunch to spice up your day. It's honestly not the smartest use of it, but 'overuse'/spending too much time tripping is totally a thing.
However, the lack of significant safety research does make it hard to determine the incidence of development of disorders like HPPD but, unlike opioids, I can’t imagine someone wanting to continue taking psilocybin after developing HPPD.
A quick search on Reddit would show you countless people who say they’re physically unable to function without weed anymore. Withdrawal symptoms include insomnia, depression, brain fog, lack of appetite, lack of energy, shaking, etc.
This is especially true of people who started using it when they were young and people who use high THC products.
There are also no known cases of psilocybin overdosing (same for LSD and Ketamine).
And this is a very bad state of mind to be in when starting psychedelics. I wonder how people usually deal with that.
I have heard second-hand reports of users who tapered their SSRI treatment, and on first exposure to psychedelics, had a severe negative response (to the point of re-traumatisation). So you're correct, this is exceptionally difficult to do correctly.
That's the sad thing about those pills I guess, it's that you stay on them or you get better.
Mindfulness, communication, learning how to rest and better time management techniques have more than likely done more for my mental health than the SSRIs. I'd love to taper off with them one day but we'll see.
Which pharmaceutical is going to back this clinical trial though??
I've heard of tinctures made by dissolving them in alcohol, but I don't think even those are measured objectively. No idea what sort of titration/measurement you'd do to determine the mg amount of psilocybin, or if that's even well documented.
Weights you read are dry weights.
> tincture
Tinctures at least homogenize. So a “0.05g” dose of a tincture is consistent within the batch, and more consistent between batches.
This is how medicine worked up to the 19th century.
> I've heard of tinctures made by dissolving them in alcohol, but I don't think even those are measured objectively. No idea what sort of titration/measurement you'd do to determine the mg amount of psilocybin, or if that's even well documented.
You could create a tincture and test it. And like the other person who replied said, the doses will be consistent.
Personally I took magic mushrooms once. I've always been an anxious person. For at least 2 or 3 months after. My anxiety was gone like never before, I was not scared of anything or talking to anyone. I was the most free I ever was. Ive been wanting to take another dose soon, I think I should... 1g.
I make full spectrum CBD oil for myself and family. It has a very real effect too. Much more powerful than most CBD products you can purchase, because it will contain more than pure CBD. Its the same process as a tincture with a few steps after. I turn 4 ounces (112g) into 60ml. ~300+ mg/g, take 0.05-0.1g. I think the benefits should be experienced without expectations, because they can vary. Helps with stress, anxiety, blood pressure, inflammation and some pain, arthritis, and others. There are some other compounds in this plant that can help with other things. CBG/A CBN, CBDA. A tiny bit of THC, which is naturally found in tiny amounts in most CBD containing plants, increases the effects of the others greatly. Too much THC alone has a negative impact if you continue long term use, at least on me. These compounds effect the endocannabinoid system, but have some off target activity which is why a variety of similar compounds can have a lot of different effects. Those other compounds can help with different issues-digestion, sleep. Keeping a decent amount of CBD/G(A) (by not cooking/heating it) is important too.
I am a very scientific person, and I understand some people are weary of this type of medicine. But what is your alternative? Eat the pills by big pharma filled with lies to sell drugs and make money? Take an SSRI so you can kill your sex drive and feel like a zombie? Maybe that won't happen to you, and I understand that they help some or many people. But if you understood the potential negative effects, and that some of them can be permanent, would you still be okay with starting it yourself? Perhaps something that has grown in nature with us can be beneficial, we came from the same planet, we evolved together. We consider other plants and vegetables from this earth to be healthy for us, why? Coffee, tea, in moderation, are good for you too. Tea is more than just caffeine.
But taking those mushrooms, one can see that there is something real in that direction, just obscured by millennia of deceit and misdirection.
If the PiHole is to blame (haven't checked yet), I guess it sort of makes sense that I can't expect to read TFA when offering neither tracking nor dollars in return.