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Invisiblexbrandnewxsnowx
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Clinical Trial Finds Substantial Antidepressant Effects From Psilocybin-Assisted Therapy
    #27023115 - 11/05/20 11:42 AM (3 years, 4 months ago)

Clinical Trial Finds Substantial Antidepressant Effects From Psilocybin-Assisted Therapy

5 November 2020

When psylocybin - the hallucinogenic compound in magic mushrooms - is used during supportive psychotherapy, there appear to be rapid, substantial and enduring antidepressant effects, according to a new clinical trial.

The randomised study is small and there was no traditional control group, but lead researcher Alan Davis from Johns Hopkins University says he and his team are "really excited about the results."

"We found a statistically significant and very large effect," Davis said in a recent podcast.

Among 24 volunteers with major depressive disorder, researchers found psilocybin-assisted therapy was at least twice as effective as psychotherapy on its own, and more than four times as effective as available antidepressant drugs.

The drug also doesn't require taking a pill every single day, nor does it come with nearly as many side effects as antidepressants or ketamine. Apart from occasional mild to moderate headaches and a few emotional moments, volunteers in the study tolerated psilocybin quite well and there were no serious dangers.

The research included two therapy sessions on the drug with 8 hours of prep and 2 hours of follow-up with a therapist. During the sessions, a pill of psilocybin was administered and participants stretched out on a couch in a living room-like space with headphones on for musical stimulation and eyeshades on to spur inward reflection.

During the trial, roughly half the volunteers began psilocybin therapy straight away, while the other half was put on a 'waiting list' for eight weeks with regular mental health check ups.

This served as a sort of control group, with the immediate treatment group faring significantly better than those in the delayed group who weren't receiving any other forms of treatment.

By the point of four weeks into the trial, 71 percent of the volunteers showed improvement, with a 50 percent drop in depressive symptoms.

A month later, more than half the group were considered 'in remission', and the average depression score dropped from 23 to 8.

"The present trial showed that psilocybin administered in the context of supportive psychotherapy (approximately 11 hours) produced large, rapid, and sustained antidepressant effects," the authors conclude.

Up to a year after the trial, patients were still being checked up on, and researchers plan to publish those results in the future.

Even what we've got so far looks promising. The findings support other recent studies, which suggest psilocybin-assisted therapy can produce significant and lasting antidepressant effects in just one or two sessions.

One prior clinical trial found a high-dose and a low-dose session decreased depression and anxiety in patients with life-threatening cancer. Six months later, 80 percent of the patients were still reaping the benefits.

Another trial among those who weren't responding to other depression and anxiety treatments found similar benefits with two doses that lasted for up to three months.

While it's still not clear how psilocybin improves depressive symptoms, the hallucinogen has been tied to many of the same neural networks as current antidepressant drugs, although it appears to act in a different way.

Brain imaging studies on those with treatment-resistant depression suggest psilocybin has the opposite effect of selective serotonin reuptake inhibitors (SSRIs), increasing emotional connection instead of blunting it like SSRIs tend to do.

In the current trial, for instance, researchers say their volunteers reported mystical, personally meaningful and insightful experiences that were associated with a decrease in depression at 4 weeks.

Major depressive disorder impacts over 300 million people worldwide, and many of them don't respond easily to existing forms of treatment. Finding better ways to treat this mental illness could bring relief to so many.

Twice last year, the United States' Food and Drug Advisory (FDA) designated psilocybin a "breakthrough therapy" in the hopes it would speed up research, and one of these clinical trials is looking specifically at major depression.

The results are just starting to come in, and we will need to verify them amongst much larger cohorts and with stronger control groups, but the findings thus far are strong and researchers remain optimistic.

"This is the first of what is going to be, over the next couple of years, many clinical trials on this topic in depressed populations," says Davis.

"It's looking like in the next four to six years that it's possible the FDA might have enough evidence to determine if this treatment can be made available to the public."

In some areas, the therapy might arrive even sooner. Just recently, Oregon became the first state in the US to legalise psilocybin therapy, given it's promising results among those with PTSD, addiction and also depression.

You might be hearing about psychedelic therapy a lot more in the future.

The study was published in JAMA Psychiatry.

Original study here.
News article here.


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Invisiblexbrandnewxsnowx
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Re: Clinical Trial Finds Substantial Antidepressant Effects From Psilocybin-Assisted Therapy [Re: xbrandnewxsnowx]
    #27023117 - 11/05/20 11:44 AM (3 years, 4 months ago)

Related question for folks: what would be a comparable dose of raw mushrooms to 20mg/kg of psilocybin (lets assume 1000mg for a 50kg human)? Any ideas?

In the study they use 20mg/kg for moderate dose and 30mg/kg for the high dose. I'm assuming this isn't ground up dried mushrooms in capsules, because I wouldn't classify 1 gram of raw mushrooms as a moderate dose (or 1.5g as a high dose).


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OfflineFailboat
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Re: Clinical Trial Finds Substantial Antidepressant Effects From Psilocybin-Assisted Therapy [Re: xbrandnewxsnowx] * 1
    #27023159 - 11/05/20 12:09 PM (3 years, 4 months ago)

Read closer...

"Two psilocybin sessions (session 1: 20 mg/70 kg; session 2: 30 mg/70 kg) were given (administered in opaque gelatin capsules with approximately 100 mL of water) in the context of supportive psychotherapy (approximately 11 hours). Participants were randomized to begin treatment immediately or after an 8-week delay."

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Invisiblexbrandnewxsnowx
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Re: Clinical Trial Finds Substantial Antidepressant Effects From Psilocybin-Assisted Therapy [Re: Failboat]
    #27023210 - 11/05/20 12:39 PM (3 years, 4 months ago)

I read that. I think you're missing my question - or perhaps I've phrased it poorly.

I'm wondering what the relationship between raw mushrooms and psilocybin extract is? For example, does it take 10 grams of raw mushrooms to produce 1 gram of psilocybin?

How much exactly is 20mg/70kg of psilocybin in terms of raw mushrooms/kg?


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Edited by xbrandnewxsnowx (11/05/20 12:40 PM)

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OfflineLosTresOjos
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Re: Clinical Trial Finds Substantial Antidepressant Effects From Psilocybin-Assisted Therapy [Re: xbrandnewxsnowx]
    #27023316 - 11/05/20 01:41 PM (3 years, 4 months ago)

bro, there is no answer to your question. The potency varies to greatly to answer that.

There are rough ranges but they are rough at best. At BEST.

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OfflineVP123
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Re: Clinical Trial Finds Substantial Antidepressant Effects From Psilocybin-Assisted Therapy [Re: xbrandnewxsnowx]
    #27023379 - 11/05/20 02:29 PM (3 years, 4 months ago)

Quote:

xbrandnewxsnowx said:
I read that. I think you're missing my question - or perhaps I've phrased it poorly.

I'm wondering what the relationship between raw mushrooms and psilocybin extract is? For example, does it take 10 grams of raw mushrooms to produce 1 gram of psilocybin?

How much exactly is 20mg/70kg of psilocybin in terms of raw mushrooms/kg?




Look at this link.

https://www.erowid.org/plants/mushrooms/mushrooms_info4.shtml

Data is based on dry mushroom weight. Raw mushrooms can vary widely in their water content. Thus, raw mushroom weight is not a reliable way to do your calculations. Furthermore, those values in that page are just some old measurements and the psilocybin content can vary widely even within the same species.

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Invisiblexbrandnewxsnowx
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Re: Clinical Trial Finds Substantial Antidepressant Effects From Psilocybin-Assisted Therapy [Re: LosTresOjos]
    #27023497 - 11/05/20 03:41 PM (3 years, 4 months ago)

Looks like good old chemistry it is then.


DOI: 10.1055/s-2006-960970


P.S. Not a bro. :facepalm3:


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Edited by xbrandnewxsnowx (11/05/20 03:42 PM)

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InvisibleHolybullshit
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Re: Clinical Trial Finds Substantial Antidepressant Effects From Psilocybin-Assisted Therapy [Re: xbrandnewxsnowx]
    #27023817 - 11/05/20 06:49 PM (3 years, 4 months ago)

Psilocybin content can vary from 0.25 - 1.75% or even more, without even accounting for other compounds. Water weight in raw mushrooms also has an inexact range.

Answering that question with any accuracy for dried mushrooms would already be difficult and only result in an approximation. For raw mushrooms its almost pointless.

But, let's assume raw mushrooms are 10x the weight of dry mushrooms, so 10g fresh = 1 g dry. Again, this will vary based on a plethora of factors such as age, environment, maturity, etc.

And then assume cubensis have an average potency of ~1%(NOT a safe assumption)....that would mean 1 g dry = 10mg, so 10 grams fresh.

I would hope you could figure out the dose/body weight from there.

But, like others have tried to say, you are never going to be able to ascertain active content of mushrooms with any accuracy at the specificity you are looking for.

And if you try to do this mushroom by mushroom you are going to have much more variance than if you dried, powdered, and mixed a batch of them.

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Invisiblexbrandnewxsnowx
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Re: Clinical Trial Finds Substantial Antidepressant Effects From Psilocybin-Assisted Therapy [Re: Holybullshit]
    #27024135 - 11/05/20 10:29 PM (3 years, 4 months ago)

Pardon, I did say raw, I should've specified dried (raw as in uncooked). I recognize psilocybin/cin are more stable in dried tissue (preferably in oxygen-free environments).

I've now read a bit of literature that estimates P. cubensis between 0.5-1% and P. cyanescens a smidge higher (than wild P. cubensis).

I'm now convinced a MEOH AcN extraction -> HILIC is probably necessary for precise quantification/identification. Of course, don't eat MeOH. You'll go blind or die with as little as 10 ml.

For everyone else's sake (and because I like math), I'll ballpark the math.

For weaker mushrooms:

~0.5% psilocybin/gram dried mushroom,
0.005 g/g -> 5 mg/1 g dried mushroom
Assuming a 154 lb human (70kg), 20 mg/70 kg would be 4 grams of dried mushrooms.

For stronger mushrooms:

~1% psilocybin/gram dried mushroom,
0.01g/g -> 10 mg/1 gram (as you said); the moderate dose they refer to would be 2 grams of dried mushrooms for a 154 lb human. The high dose would be 3 grams of strong dried mushrooms.


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InvisibleHolybullshit
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Re: Clinical Trial Finds Substantial Antidepressant Effects From Psilocybin-Assisted Therapy [Re: xbrandnewxsnowx]
    #27024616 - 11/06/20 08:48 AM (3 years, 4 months ago)

Remember that psilocybin is not the only active in mushrooms, and that range is not perfect, there are examples of even cubensis samples being more potent than 1%.

I can't say for sure what the participants were feeling, but my gut says you are overshooting the mark. 3-4 grams, even of "weaker" mushrooms, is a pretty high dose even for a 200lb man(let alone 70kg), and probably more than needed for therapeutic purposes.

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