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PragmaticPulp Apr 13, 2022 | on: Study suggests mechanism through which psychedelics may… | context
> Considering how often antidepressants tend to be a hit-or-miss game (not to speak of side effects), I am a bit annoyed psychedelics don't get more attention for medical use. Psychedelics are actually extremely hit-or-miss as well. Anecdotally, psychedelics don't always send someone in the right direction post-trip. If you scroll the comments in any popular psychedelics-for-depression post on Reddit, there are almost as many negative experience reports (including some long-lasting) as there are positive reports. The positive reports receive the bulk of upvotes, though, so you have to scroll down to see them. Perhaps less anecdotally, any medical professional will see a non-trivial number of people with significant negative effects of psychedelics, from worsening depression to HPPD to existential crises or psychoses. An actual doctor had a great comment on the previous discussion: https://news.ycombinator.com/item?id=30995831 |
As a physician with a practice in the realm of behavioral health it's been fascinating to witness the development of approaches to treatment-resistant depression using hallucinogenic agents.
First out of the gate was ketamine (now on the market as esketamine), and currently psilocybin is being studied. It's showing promising results, however, the details re: dosing and adverse effects are still being worked out.
It's an inescapable fact: ALL drugs produce side effects (at least in some recipients). Who will or won't tolerate a given drug is mostly hard to predict beyond the overall odds.
Everyone in my field has seen individuals who have experienced serious harm due to use of hallucinogens including psilocybin. IMO using this class of drugs shouldn't be considered trivial. Sure, a lot of people have taken such "illicit" drugs without lasting problems, but response is a stochastic function. Odds of harm are no doubt small but as use spreads to a larger pool odds are adverse reactions will emerge.
Of course people with serious depression already have major brain dysfunction and likely vulnerable to exacerbated adverse effects. Compared to normal functioning there's sharply decreased room for error.
In medicine the primary rule is "above all do no harm". Absent sufficient data backing particular practices, choosing to step into new territory requires moving forward with great caution and care.