Newsworthy Science

Might, actually.
The problem is that the other drugs might just do exactly the same.

If they do exactly the same, this is probably evidence for a placebo effect. If the psychoactive substances had effects beyond placebo it would be very unlikely that they had exactly the same effect.
 
My point is about the definition of working. If we define working as having better outcomes then working via the placebo effect is still working. If we were talking about say Malaria, and we knew we could clear the parasite from the body if we could convince the patient that they were getting an effective drug and could not without that (perhaps via cortisol levels or something), would it be wrong to use a placebo?

I think this really depends on the side effects and costs.
If that drug costs a million, leads to permanent taste loss, and a 1000% increased change of a heart attack.... while in practice doing nothing besides encouraging the user to be more positive... is that worth it?
(that is an extreme example, obviously)

If they do exactly the same, this is probably evidence for a placebo effect. If the psychoactive substances had effects beyond placebo it would be very unlikely that they had exactly the same effect.

A bunch of these substances work on the same receptors, triggering the same effect (the psychoactive part). I would not be too surprised if this was actually case, that most of them have some effect in this area.
 
If they do exactly the same, this is probably evidence for a placebo effect. If the psychoactive substances had effects beyond placebo it would be very unlikely that they had exactly the same effect.
You need to be a bit careful saying things like that, given this work (summarised by the image below). I do think using a wide range of psychoactive substances, including the opiates, cocaine like ones, amphetamines and the hallucinogens would be valuable data.
I think this really depends on the side effects and costs.
If that drug costs a million, leads to permanent taste loss, and a 1000% increased change of a heart attack.... while in practice doing nothing besides encouraging the user to be more positive... is that worth it?
I agree. That is true for all drugs though, they are all poisons to some extent.

Spoiler The durations of acute subjective effects in humans are proportional to the durations of the critical period open state in mice :
41586_2023_6204_Fig3_HTML.png

a, Durations of the acute subjective effects of psychedelics in humans. b, Durations of the critical period open state induced by psychedelics in mice.
 
No, the problem is that we can't say that it works so obviously, because it might be purely placebo effect.
You must've misread.

The point is the drug effect is so obvious it's clear they didn't get a placebo.

If you have to ask you didn't get it.

I think this really depends on the side effects and costs.
If that drug costs a million, leads to permanent taste loss, and a 1000% increased change of a heart attack.... while in practice doing nothing besides encouraging the user to be more positive... is that worth it?
Are you talking about mdma?

There's no permanent taste loss. Where'd you get that?

And 10x increased risk of hard attack? Sounds pretty bollocks as well.

And regarding price, if a person can get therapy and take two or three doses as done in the trails of 100-125mg the wholesale cost of that would be maybe $10-15 (assuming $5 per dose) not $1,000,000.

$15 vs ptsd, I think I'd drop the $15 (now the therapy and supervisor would probably cost over $10,000 but the cost to society of taking people with PTSD who can't work and might be antisocial/criminal and helping them work again would make even that cost well worth it.

And the point isn't to "be more positive" it's more of a lifting of chronic stress and tension that pervades the life of people w depression and PTSD.

That stress and tension will probably return on some level but just knowing you don't have to feel that way (that your brain has the capacity to feel differently) if you have for months upon months is a relief in and of itself.

Re : heart health, I'm n of 1 and oura ring is primitive tech (and who knows how they calculate this stuff) but if this drug were gonna give me 10x increased risk of heart attack I don't think I'd have heart of a 30yo.

Spoiler for large image :
Screenshot_20240814-075146.png


Obviously mdma and other potentially beneficial drugs could have some cardiac risk (especially if overdosed or used too frequently) but let's not pretend the government is concerned about our heart health when heart disease is the #1 cause of death and the #1 contributor food (often subdizied foods)
 
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You must've misread.

The point is the drug effect is so obvious it's clear they didn't get a placebo.

If you have to ask you didn't get it.
Yes, that is why we cannot rule out that the therapeutic effect is actually there.
People get hallucinations. Therefore they know they got the drug, and the placebo effect will make them feel better. Or maybe it's the drug. Without a comparison, there is no way to say.
Without entangling the hallucinogenic effects from the therapeutic ones there is probably no way to figure it out.
That might be possible though, depending on if they can figure out which part leads to the hallucinations and if that one can be deactivated.
Are you talking about mdma?

There's no permanent taste loss. Where'd you get that?

And 10x increased risk of hard attack? Sounds pretty bollocks as well.

And regarding price, if a person can get therapy and take two or three doses as done in the trails of 100-125mg the wholesale cost of that would be maybe $10-15 (assuming $5 per dose) not $1,000,000.

$15 vs ptsd, I think I'd drop the $15 (now the therapy and supervisor would probably cost over $10,000 but the cost to society of taking people with PTSD who can't work and might be antisocial/criminal and helping them work again would make even that cost well worth it.
That was a hypothetical example to show that we cannot just let everything on the market without having it properly tested. There are negative effects, and we need to make sure that the positive ones outweigh the negative ones.
 
Mdma isn't hallucinogenic.

Regarding testing it's a bit of a catch 22 to arbitrarily make a bunch of drugs illegal and hard to study and then say we need to spend decades studying them for them to be legal.

The bar for drugs like mdma and psyilocibin is orders of magnitude higher than for other drugs.

We've known they can have therapeutic effects for at least fifty years.
 
We can't prove it. That is the problem.
That they're illegal is less of an issue. You can do science with anything, if you have a good enough reason.
Our organic chemistry department had a bunch of cocaine in their safe. Don't ask me for what :lol:.
 
One-quarter of unresponsive people with brain injuries are conscious

At least one-quarter of people who have severe brain injuries and cannot respond physically to commands are actually conscious, according to the first international study of its kind1.

Although these people could not, say, give a thumbs-up when prompted, they nevertheless repeatedly showed brain activity when asked to imagine themselves moving or exercising.

“This is one of the very big landmark studies” in the field of coma and other consciousness disorders, says Daniel Kondziella, a neurologist at Rigshospitalet, the teaching hospital for Copenhagen University.

The study included 353 people with brain injuries caused by events such as physical trauma, heart attacks or strokes. Of these, 241 could not react to any of a battery of standard bedside tests for responsiveness, including one that asks for a thumbs-up; the other 112 could.

Everyone enrolled in the study underwent one or both of two types of brain scan. The first was functional magnetic resonance imaging (fMRI), which measures mental activity indirectly by detecting the oxygenation of blood in the brain. The second was electroencephalography (EEG), which uses an electrode-covered cap on a person’s scalp to measure brain-wave activity directly. During each scan, people were told to imagine themselves playing tennis or opening and closing their hand. The commands were repeated continuously for 15–30 seconds, then there was a pause; the exercise was then repeated for six to eight command sessions.

Of the physically unresponsive people, about 25% showed brain activity across the entire exam for either EEG or fMRI. The medical name for being able to respond mentally but not physically is cognitive motor dissociation. The 112 people in the study who were classified as responsive did a bit better on the brain-activity tests, but not much: only about 38% showed consistent activity. This is probably because the tests set a high bar, Schiff says. “I’ve been in the MRI, and I’ve done this experiment, and it’s hard,” he adds.
 
Peoples Pharmacy has a short bit on MDMA

 
No, the problem is that we can't say that it works so obviously, because it might be purely placebo effect.
A couple of papers came out last month examining the mechanics of the placebo effect. I have not read either further than the abstract, and I do not think their content actually adds to the discussion, but the fact that the placebo effect is a real measurable effect localised to specific cells in both human brain scans and model organisms indicates it could be an effector mechanism in medical treatment.

Also, you said before you do not trust correlations with low R values? What about these lines for highly significant low effect size correlations? You certainly have to be careful, but in messy environments like the brain sometimes you can get information from clouds of dots like the last chart.

Neural circuit basis of placebo pain relief

Here we show that analgesia from the expectation of pain relief is mediated by rostral anterior cingulate cortex (rACC) neurons that project to the pontine nucleus (rACC→Pn)—a precerebellar nucleus with no established function in pain. We created a behavioural assay that generates placebo-like anticipatory pain relief in mice.

Placebo treatment affects brain systems related to affective and cognitive processes, but not nociceptive pain

In a large-scale fMRI study (N = 392) with pre-registered analyses, we tested whether placebo analgesic treatment modulates nociceptive processes, and whether its effects generalize from conditioned to unconditioned pain modalities. Placebo treatment caused robust analgesia in conditioned thermal pain that generalized to unconditioned mechanical pain. However, placebo did not decrease pain-related fMRI activity in brain measures linked to nociceptive pain, including the Neurologic Pain Signature (NPS) and spinothalamic pathway regions

Correlations between behavioral and neural placebo-induced reductions.

41467_2024_50103_Fig6_HTML.png

Spoiler Legend: ***p < 0.001 :
Placebo-induced neural reductions (Control - Placebo) in the (A) NPS or (B) SIIPS, as a function of the behavioral analgesia (pain ratings Control - Placebo) for each stimulus intensity level (color) and modality. Each dot is a participant. Lines represent linear smoother, with the 95% confidence interval shaded in gray. Asterisks represent significance of the correlation (mixed-effects model, uncorrected): *p < 0.05, **p < 0.01, ***p < 0.001 (Thermal: N = 367 participants; Mechanical: N = 368 participants).
 
Also, you said before you do not trust correlations with low R values? What about these lines for highly significant low effect size correlations? You certainly have to be careful, but in messy environments like the brain sometimes you can get information from clouds of dots like the last chart.
While that really depends on the research field, my general opinion on that is still that I don't care about significant, but practially irrelevant results 😬.
Any correlation also gets significant, if the sample size is just big enough (apparently), see https://stats.stackexchange.com/que...-with-sufficiently-large-samples-unless-the-p
 
While that really depends on the research field, my general opinion on that is still that I don't care about significant, but practially irrelevant results 😬.
Any correlation also gets significant, if the sample size is just big enough (apparently), see https://stats.stackexchange.com/que...-with-sufficiently-large-samples-unless-the-p
You understand that "unless the population effect is exactly zero" means "unless the null hypothesis is true", aka. there is nothing there to find? This is why you spend money on doing more samples, so you have a higher chance of detecting smaller effects with greater confidence.

If you are trying to achieve an outcome, say if you are doing actual clinical medicine, then It is important to consider if the magnitude of the effect is large enough to produce a positive effect. When you are trying to find out about how the world works, there are many cases where even the smallest effect provides information about the underlying mechanism.
 
I'm right now working in an area of clinical medicine, so... ^^.
Yes, it's different when it's basic science, but with these results it then needs to be considered if this is worth further pursuing, or if this is practically negligible.
 
I'm right now working in an area of clinical medicine, so... ^^.
Yes, it's different when it's basic science, but with these results it then needs to be considered if this is worth further pursuing, or if this is practically negligible.
These results are nothing to do with the hallucinogens for PTSD. I think they are trying to understand the effect, that second one with particular emphasis on excluding the effect when doing clinical studies.
 
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