I find the design and results somewhat underwhelming (weak significance in a N=800 sample with >50% dropout). The authors also mention that they lack power, but the only correct answer then is not to do the study, include more people, more data points, or reduce measurement variance.

That said, I think it's a refreshing perspective, and it seems like a good idea to look at effect heterogeneity in psychedelics use. Thinks like bayesian trees (BART) can help identify subgroups that react differently to stimuli along specific characteristics.

Reminder. Psychedelics can also lead to extremely traumatic experiences:


This doesn’t get mentioned in the current “psychedelics as a cure-all” hype wave.

It’s pretty scary to me that so many people seemingly on whim are willing to upgrade their brain firmware. I often hear stuff like “and then my whole view on reality changed”. Unless there’s an easy way to upload the previous “factory image” so to speak, it feels pretty risky to experiment with that.
N of one but my friend (who always saw the world as very black and white) killed herself not long after doing Ayahuasca. I’m pretty sure it contributed to her death, she became an extreme fantasist about judgement and god, not a formalised religion but a personified fantasy with crazed rules and vengeances. It was not good.
Interesting that OCD is the winning disorder, with zero negative responders.

Recalling my mushroom days.... Okay, I think I get it. Psychedelic experience is, in part, about embracing the beautiful chaos of the universe. Surrendering to the charms of free-flowing wild information at scale so huge there's no chance of imposing your own orderly corrections - as you might in normal every day life via OCD. That's my armchair take anyway.

  Psychiatric history | Negative responders (%) | Non-responders (%) | Positive responders (%) 

  OCD | 0.0 | 25.0 | 75.0
I am nearly 70 years old.

I have been taking psychedelics for 50 over years. I am retired psychotherapist and I do not have a predisposition to mental ill health. I was also a substance misuse worker and methadone dispenser for over 10 years. I gave up smoking hash when I was 40 years old.

I did notice that with the introduction of skunk and the increase of up to 20% more Tetrahydrocannabinol (THC), there were more and more people being sectioned under the mental health act with psychosis. Whereas prior to skunk when people generally smoked good old fashioned, Moroccan, Lebanese and Afghani hashish it was a rarity.

I know a range of people of different ages who partake in psychedelic use and have no trouble, like me, in holding down a professional job role and engaging fully in life.

As with all drugs there is a risk, however, the risks with Psyceedelics are very low in comparison with other drugs.

We must not use individual cases to determine the safety of any drug.

Here in the UK the media went wild over reports that a 18 year old girl (Leah Betts) had died from taking MDMA. Very rarely are the true facts given; The coroner said that "water intoxication", and not an allergic reaction to the drug, was the cause of death.

I have a great deal of respect for Professor David Nutt who is an English neuropsychopharmacologist specialising in the research of drugs that affect the brain and conditions such as addiction. His recommendations to the government to reclassify drugs were rejected and he was sacked.

heroin is top of the list - alcohol is 5th on the list - LSD is 14th on the list - Ecstacy is 18th on the list

> We find that 16% of the cohort falls into the “negative responder” subset.

“they should have known they had a family history of schizophrenia before using it!”

every dismissive psychedelic user that brags about increased empathy in the next breath

but in all seriousness, yes I would like to see more studies so we can at least have side effects printed on the side of the package, so the right people can take informed risks

Psychedelics are a force to be reckoned with. Plus people are conflating clinical trials with taking unknown substances, in unknown amounts without considering the proper set and setting.

Controlling for the substance and amount as well as having a professional, caring guide to help the patient through the experience will be a FAR different experience than eating a fist-full of shrooms at a party some stranger gave you while under the influence of other things...

This really just feels like fearmongering because this is a threat to big pharma. I mean, several commonly prescribed antidepressants have black box warnings about increased risk of suicide. When they trialed Prozac on people with no history of mental illness, someone committed suicide out of the blue. Fairly certain someone could cobble together a much more compelling meta analysis about even worse adverse effects of psych meds on similar populations, but due to NAMI and big pharma I think there's pressure not to draw those lines too clearly.

I think there's a clear bias in cases of big pharma approved meds to jump to "Oh, it wasn't the medication, the condition just worsened" and with psychedelics/weed to jump to "The substance use is causing this". Even when there is proof of RX medication worsening mental health conditions, it's common to have these relationships straight up denied by the prescribing doctor.

This isn't to say that there isn't a similar relationship in psychedelics, but it feels really disingenuous to me to be mentioning this outside of the wider context of psychiatric meds which somehow get a free pass for causing a much wider and dangerous range of side effects. If psychedelics cause less harm than commonly prescribed drugs in the same population, isn't that a good thing? We should understand these harms, but the bias of Big Pharma needs to be taken out of the picture.

We infer that the presence of a personality disorder may represent an elevated risk for psychedelic use and hypothesize that the importance of psychological support and good therapeutic alliance may be increased in this population.

Feels like another publish or perish paper.

You know when you see HN discussion on some subjects where you have significant background and it's hyper cringe? Psychology/neurology is one of those areas where the community's commentary is almost always extremely...factually challenged. Be very careful making health decisions based off of HN comments. Lots of people with strong agendas and weak subject matter knowledge. Also, be careful not to over-estimate your ability to interpret random study results. It's kinda like trying to get a project to build you downloaded from sourceforge.