I remember all the studies on Ketamine that were posted to the front page of HN, and then we finally had a proper RCT which showed that, while ketamine was very effective in treating depression, the placebo was equally effective. Essentially it was hope that was resulting in the remission [1].

[1] https://news.ycombinator.com/item?id=37948938

It might not be as clear cut as that: https://www.astralcodexten.com/p/does-anaesthesia-prove-keta...

The thing with trials is chicken and egg. Big pharma ensures certain drugs are illegal and scientists cannot or have limited ways to study them. Some corrupt government departments even only permit studies if they are going to find out that those drugs are bad.

It's quite a dissonance that people pretend they don't see. Like with cannabis. Millions of chronic pain sufferers say it helps them and then you can look at studies, you can cherry-pick plenty that say it's a placebo.

Let's face it. Scientists, politicians are all corrupt and honest ones can easily get cast out or made fall out of the window.

The term you're looking for is defenestrated.

The FDA grants forms of exclusivity other than patents which would apply and pharma has developed plenty of ways to modify molecules to repatent them like turning them into salts or hydrides, adding amino acid caps, creating alternative methods of application like nasal sprays, etc. It's actually really easy to do which is what led to the proliferation of "research chemicals" over the last twenty years.

I’d say they all want to continue to make big profits and push for things that help them.

The pharma industry spends more money on lobbying US politicians than any other, almost 2x more than the next biggest spender

https://www.opensecrets.org/federal-lobbying/industries

https://www.opensecrets.org/federal-lobbying/industries

Next you'll be telling me that car owners run the DMV.

The US government is about power and influence, not chains of command and technical appointments and elections. You should have learned this by now.

Who would want to destroy people's lives and community for them doing what they want with their own body?

Except both mainstream political parties of course. Thank first past the post voting for our lack of competition in the electoral system.

I hadn't heard about the drug before reading the book and found it very fascinating.

https://www.npr.org/2023/07/25/1189278437/someone-who-isnt-m...

Other psychodelics, such as psilocybin, are further down the road to validated treatment. I'm not quite sure what stage they are at for PTSD but there are various groups doing RCTs for depression etc

I understand the hesitancy around drugs, but we've lost so much progress as a result of the bureaucratic red tape.

Plenty of other safe and effective treatments have made it through the “excessive” red tape because actually the red tape isn’t the issue. Dismissiveness and fear of psychoactivity is.

https://erowid.org/experiences/subs/exp_Ibogaine.shtml

That is not true

There is (usually) no law against atropine and other Deliriants because they are not fun. No fun at all for most people

Drug users generally try those drugs once

Even true for some psychedelics. Few people take Salvia Divinorum twice.

The public has now been so conditioned by this bullshit that most people think that they're being protected by these stupid laws, when in fact they're either directly or indirectly suffering because of them.

Yes, drugs affect you. It also ends up affecting those around you.

That being said, the current state of laws, enforcement and culture is definitely not aligned for success in this arena.

My mother died as an alcoholic. Totally legal drug that's socially acceptable.

I'm well aware of the abuse potential. But a lot of this (including the current fent epidemic) could be addressed by legalizing and regulating these drugs (including the aforementioned ibogaine).

So yes, the current state of laws, enforcement and culture are definitely aligned for the clusterfuck of what we have today (by virtue of that's what we have).

There will always be risks, but society has shown that it's ok with risks in that alcohol and tobacco are legal. They've just been brainwashed by the drug war propoganda.

Of course anyone can get in trouble with drugs, so I agree with you too!

But I want to just try and shake up the "Drugs affect you. They affect those around you" point a bit because often the drug use is a symptom, the consequences of hopelessness, neglect, depression, abuse etc is whats actually making its presence felt, and even teetotalers have bad life outcomes when they're carrying that around.

Except, they can cause these problems in the first place. I agree that when those problems exist, drugs can make them worse too.

But a lot of those dangers can be mitigated by having them legal and regulated.

A lot of abuse is about self-medicating from pain, so if they're going to do that let's at least make it safer to do so and have support to transition off when ready.

Wealthy people have access to doctors to get prescribed speed, ludes, opiates, whatever they want.

It's specifically the targeting of minorities using criminalization of street drugs that led to modern media and academic misperception of "overpolicing" in minority areas for all crime.

Sometimes I get a bit overzealous on quoting, and sometimes, on commas, too. But in the case of the Nixon years it was anti-war hippies too.

But yes, it's well documented that the war has always been about targeting "others". It's bad enough that the laws exist, what is crazy-making is that a large portion of the population has been brainwashed into thinking they're a good thing.

We should find what the safe and effective dosage is, if there is one, the same way we do for other drugs.

1. Public funding for approval for public interest drugs that immediately are available at generic-level prices.

2. Public funding for patent early buyouts so that they can be available at generic-level prices sooner.

3. Public drug bounty systems: award non-trivial payouts to companies that discover and perform all clinical trials, and immediately make the drugs available to the public at generic-level prices.

4. Broad cooperation and alignment on approval trial requirements across drug regulators in Canada and the EU, such that drug trials don't need to be duplicated 3 different times in 3 different jurisdictions with slightly varying rulesets. This would benefit both public interest ideas above as well as existing private interests.

5. Add price controls to drugs which have benefited from publicly funded research. I'm not a fan of price controls in general as I think there is a risk that good drugs won't be researched if they're too risky, but in the case of a private company taking some compound that public research discovered, patenting the chiral[0], and funding the clinical trials for it...the public has already done all the hard work and you're just

6. Allowing for risk-assumed early approval drugs which are regulated for content purity, but which do not do full testing for drug interaction/benefit/risk assessments. Users could explicitly opt out of the guarantees that come with full FCC approval. This is actually how the much of the developing world treats drug regulation: sure you can buy it and it will be what it says on the label, but there is no guarantee that it will fix your problem or that it wont harm you. While that sounds potentially troublesome, there is a reason why rich people sometimes travel to poor countries for medical care, and this is a huge part it. If you've got 9 months to live, you don't care that the FDA is trying to determine if it might kill you...you are already on your death bed. Holding back a potential cure is inhumane.

[0] https://en.wikipedia.org/wiki/Chirality_(chemistry) Chirality is an extremely common loophole that allows drug companies to patent drugs that work exactly the same as an unpatentable drug, so that they have price protection for it.

Probably money is the issue. None of these compounds can be patented now.

But it's also important to recognize medical risk alone is not what has stopped the serious evaluation of entheogenic or hallucinogenic substances.

Salvia is even more clowning. Republican legislators heard that it's a more potent psychedelic than LSD and rushed to ban it without even knowing what "potency" means for such a comparison. This has led to such beautiful pieces of law as Florida (I believe) banning salvia divinorum and all chemical derivatives thereof. Salvia divinorum is a plant. There are no chemical derivatives. They should have specified its principle component, salvinorin A, and its derivatives. These banning were made entirely out of moral panic, with not even a modicum of pharmacological or chemical understanding.

This is not to say that Ibogaine has zero risk for either physical or psychological harm---this cannot be said about very many perscription drugs either. However, given its efficacy for treating opiod use disorders alone, along with its safety profile, there is no logical reason that it should be out of reach for mental health professionals, let alone a schedule 1 substance.

The action proposed in the article is: more trials

FTFY. The amount of psychoactive pharmaceutical drugs cooked up by big companies is immense. It seems to be a slow process for natural substances, because there's no money in that and it can't really be patented to maximize profits.

There are plenty of reputable manufacturers who wouldn't think of adulterating medicine or misleading their customers, but all it takes is a couple sleazy Chinese vendors on Amazon to spoil the entire apple-barrel.

For example, my potassium iodide specifically instructs the user to consume it orally, which is dangerously incorrect. I believe that if they put the correct instructions on the bottle, the product would be so efficacious that it'd demand removal from the market.

https://www.asyousow.org/environmental-health/toxic-enforcem...

And many pharmaceuticals start from natural substances that had to be refined. There's nothing humans don't understand about refining and purifying, we've done it for a very, very long time. It's a solved problem. Greed is not.

Some people have committed homicides while on LSD [1], that they would unlikely have committed otherwise. Here's a crazy story a New Zealand friend of mine told me. She knew a guy who had gotten high on LSD while vacationing in France, and wandered into some stranger's backyard. The homeowner came out and they stabbed them with a pitchfork and killed them. They went to French prison for life, but were released as part of a deal France made with New Zealand for the bombing of the Rainbow Warrior by the French Secret Service. They released all New Zealanders and repatriated them, and this guy, lucky SOB he is, was set free.

[1] - https://www.vice.com/en/article/7k9pmz/acid-lsd-fuelled-murd...

I also am aware that it’s a fallacy to say “X is worse than Y, so don’t worry about Y”. Both X and Y can be bad at the same time! We definitely need more harm reduction education about psychedelics.

The ibogaine treatment very likely allowed individuals to move past their traumatic experience and no longer had a reason to self-medicate.

Knowing what you can avoid to stay safe is a lot more tolerable than never knowing when you're going to get pummeled. Just that sense of control is huge.

Psychoactive drugs also seem to have a tendency to expose/accelerate symptoms for diseases like schizophrenia for people who are not (yet) suffering, while at the same time showing promising results for treating such illnesses.

The outright ban because of the fear of hallucinogenics is ridiculous, but a lot of the red tape is also warranted, especially for drugs that have a long-lasting (sometimes even lifelong!) effect after a single dose.

It’s really frustrating how much our drug approval process biases towards patentability. There are probably hundreds of extremely beneficial drugs out there that have no chance of approval simply because no drug company is willing to do trials for an unpatentable drug.

E.g. https://erowid.org/experiences/exp.php?ID=86136

This thread has everyone suggesting there's been a a miracle drug that doctors have been ignoring.

Doctors have not been ignoring it. This drug fucks with your heart rhythm, people died taking it. Doctors are also still researching it, addiction is a serious affliction and there's loads of research done on possible solutions.

Not just Ibogaine - pretty much all of the "psychedelics".

And it's just big pharma doing their evil deeds. Should have been obvious by now.

We now have a useful body of research on psychedelics as a treatment for psychiatric disorders. We can be reasonably confident that they do indeed work, but the effect size in depression and anxiety appears to be very similar to SSRI antidepressants or cognitive behavioural therapy. Research into addiction is more limited, but plausible effect sizes are again comparable to existing treatments. We're much less confident about the risk profile (especially in real-world clinical settings), so any marginal benefits in efficacy might be outweighed by safety risks.

Psychedelics might still prove useful as a second- or third-line treatment for a minority of patients, which I don't want to underplay - severe mental illness is truly awful and each additional patient in remission is a person given a second chance at life. They might provide insights that guide us towards better treatments in the future, but in this respect the NMDAR-agonists (ketamine etc) look far more promising. Unfortunately, the promise of psychedelics as a revolution in psychiatry is a busted flush.

I wish I wasn't saying this, but the data doesn't care what my wishes are. We have reached the point in the curve where decent, well-meaning researchers are tinkering with the analysis post-hoc to try and make psychedelics look marginally more effective than existing treatments. A lot of money has been committed to research, the results are deeply disappointing, serious researchers are trying to salvage something useful, but all the while there's a steady drumbeat of deluded quacks and uninformed journalists continuing to peddle a narrative that has been thoroughly demolished.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399008/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10278160/

Which is why researchers are looking at Psilocybin and LSD

particularly Psilocybin as it is short acting making everything easier and cheaper

I think they should look more at DMT. Businessman's acid.

Regardless, hopefully studied further in the future (legally)!

Actually, you do, as the placebo effect is very strong for depression.

>What's the control look like here?

You can give the drug during anaesthesia, like in the recent Ketamine trial.

https://news.ycombinator.com/item?id=37948938

Is it an 80% reduction in symptoms?

The trip may very well be an essential part of the experience. Giving it during anesthesia would be very different.

Psychedelics just aren’t amenable to placebo controls. That doesn’t mean throw the whole science out, you just need to… control for that. You could have a non-placebo control of similar effort (talk therapy?) to control for drop outs. You could have alternative therapy as baseline.

>You could have a non-placebo control of similar effort (talk therapy?) to control for drop outs. You could have alternative therapy as baseline.

But that would have a much smaller placebo effect, and there would be no blinding to treatment. Comparing the two treatments wouldn't tell us anything.

>The trip may very well be an essential part of the experience.

Yes, I think it is, even if it is a very effective placebo. My point is that you don't need a psychedelic to cure depression of PTSD.

That’s quite the standard. Obviously there’s some depression and PTSD treated in other ways. But maybe this treatment does better in some cases over alternatives. That makes it valuable.

Have you taken into consideration the important distinction between abstract reality and object level reality?

Some fires can be put out with a fire extinguisher, but not all fires can be. Yet, it is objectively true (though misinformative, an extremely popular meme ~2 years ago) to say that "fire can be extinguished with a fire extinguisher".

Or if that's too poorly stated: "you don't need a psychedelic to cure depression of PTSD" is only true to the degree that it is true, and it is not possible for you to know that degree - thus, your mind fills the gaps of the unknown, and you take it as true, as you have been conditioned for decades to do. "It is unknown" is not an option available, to you.

But then that's ~~just~~ my opinion, I could be wrong.

Now, as in the past, the stigma surrounding mind-altering chemicals overshadows any scientific evidence or testing supporting their therapeutic use.

It is a shame that we as a society allowed puritan ethics and drug alarmism to do such a number on our cultural relationships surrounding mind altering chemicals.

This is selling false hope, but hey, it's OK to sell false hope, because insurance happily pays for false hope. What insurance doesn't pay for is real solutions.

So why not sell this idiotic drug-based bullshit. For God's sake, I am a child of the 80s. When Mrs. Nancy Reagan said "Just Say No" she meant "Just Say No" to drugs!!!

Clearly years of study and scientific evidence are "100% stupid quackery".

Believe you me, it is clear that this attitude and perspective comes from the Reagan era moralizing that did (and continues to do) a real number on our society.

I am so hopeful that some of the stigma is seeming to dissolve and the war on drugs is starting to be recognized for the farce that it is. This will enable real research to be done about mind altering chemicals and the profound effects they have. From dissociative experiences to psychedelic experiences there is an entire frontier of new research to be done now that we are beginning to free ourselves from the hand-wringing of the last century

This is what enabled Reagan to close the asylums, because the victims, er um patients, would theoretically no longer require physical restraint in institutions, but could be chemically restrained wherever they lived. And it's true: the mentally ill are now turned out onto the street by the thousands, and restrained by use of drugs. They keep coming back for refills and new prescriptions. It's almost as good as a physical tether or leash.

Psychotropics do nothing to heal or cure mental illness. They place the user in an altered state of consciousness. They dull the intellect, they blunt the affect, they banish the wit. A person under the influence will seldom fight back or think for themselves. They become pliant and malleable to whatever suggestion is foisted upon them. It's quite effective in that regard.

I am not even going to bother linking the research about the actual observable effects of various medications on various mental illnesses because clearly youre an elder and if you were interested in the truth on this matter you would have sought it out by now.

For the second time in as many days I am disengaging from this exchange

I am so sorry to hear that. Have you discussed these thoughts with your psychiatrist? I am sure that she has an arsenal of prescriptions to treat you with.

On second thought, during your weekly runs to the pharmacy for a stack of frozen pizzas and a fistful of prescriptions, your 16-hour workdays and 12 hours on social media consuming rage, fear, and paranoia, did you ever stop to think that there's a better way?

Have you considered eating an organic apple once in a while? 30 minutes of meditation, clearing your mind and listening to your Higher Power? What about disconnecting from the Internet and your phone for a few hours a week, at least? Getting outside, taking a walk, making some Vitamin D?

Sometimes the best cures are perhaps not as easy as popping a few pills; they're not subsidized by your insurance company, and they require forming better habits, but they are truly efficacious and have long-lasting, proven effects. Those are effects that are proven by science, by knowledge, by experience.

Edit: here it is, https://www.mindbloom.com/program

"small study finds" is also how we landed ourselves with a replication crisis, so your comment about putting it into context is very appropriate.

If you're not aware: Depression studies have a very high placebo response rate. It's often hard to get new antidepressants to demonstrate improvements in studies not because the patients don't get better, but because the placebo group improves so much that the difference between the groups is small.

This doesn't mean that antidepressants are placebo, it just means that if you take depressed people and tell them they're going to get better, then give them a lot of attention and activity from clinicians, they start to improve.

This study definitely needs a control group, as the patients went all the way to Mexico on a small vacation to receive the drug. I guarantee that if you take a cohort of depressed patients, send them to Mexico for a short vacation and hand them a placebo pill that you tell them is an antidepressant, many of them will improve substantially on various measures upon return.

This is why placebo control groups are critical for any depression study. I don't think it's a coincidence that so many of these psychedelics-for-depression studies omit control groups. Including a control group increases the cost, but it also is guaranteed to reduce the "wow factor" of a depression study. Therefore, they get omitted any time someone wants to make an antidepressant look effective.

If this was a study for a new SSRI that didn't have a control group, people would be tearing it apart. For some reason people love stories about psychedelics doing magical things, though, so a lot of people are willing to overlook the most glaring fault of this study.

Not to say this trial is any higher quality than it is, or that your sidebar on MDD wasn't interesting, but I'm not sure it's that effective of a comparison.

But psychedelic studies are impossible with double blind

It is important to be rigorous in your study, but cannot expect too much

Psychedelic therapies are not like antibiotic therapies, they interact in complex and confounding ways with set and setting

Edit: When the chilling effect's no longer working... Now, go jump on a mine for Khazaria.

Anyway I find your original statement about people incurring PTSD as somehow justified an absolutely despicable point of view and everything you said after that is colored in that light for me.

Edit: I come on HN so I can participate in an online discussion board without having to see this garbage. At least grandparent got flagged but its still frustrating.

Now stay away or I shall taunt you a third time, then call my Congressman and Senators and demand we shut off the war bucks and investigate where they went. Capiche? smack

How many roubles you get per post man?

Anyway, this is all arse backwards: You start off with a diagnosis of PTSD based on symptoms and try to work out causation, through diagnosis. You don't start off with: "I worked on a helpdesk for attorneys and therefore I have PTSD".

1 - https://www.talkspace.com/mental-health/conditions/articles/...

It is certainly a good skill to be able to defuse situations where the customer is angry and ranting, but there is hopefully no personal or intimate connection with said customers, and that's really the key to effective emotional abuse. Likewise, the worker is hopefully not enduring emotional abuse from coworkers or management in the course of their jobs, although this is also a possible thing.

> Top of the list: train drivers.

I rather suspect front-line in Trust and Safety at any major social media outfit is up there, too.

I know this might be quite shocking but in my experience, sexual abuse to children is unfortunately common. Remember the olympic gymnastics doctor that (convictedly) sexually abused "at least" 265 women and minor girls, with the overall scandal being (allegedly) over 500 women primarily under 18? How about the thousands of child sex abuse cases in the Boy Scouts? These are just the high profile cases. Literally "creepy uncle" jokes have been common crass comedy for decades.

> Fatalities Temporally Associated with the Ingestion of Ibogaine

> Abstract: Ibogaine is a naturally occurring psychoactive plant alkaloid that is used globally in medical and nonmedical settings for opioid detoxification and other substance use indications. All available autopsy, toxicological, and investigative reports were systematically reviewed for the consecutive series of all known fatalities outside of West Central Africa temporally related to the use of ibogaine from 1990 through 2008. Nineteen individuals (15 men, four women between 24 and 54 years old) are known to have died within 1.5–76 h of taking ibogaine. The clinical and postmortem evidence did not suggest a characteristic syndrome of neurotoxicity. Advanced preexisting medical comorbidities, which were mainly cardiovascular, and/or one or more commonly abused substances explained or contributed to the death in 12 of the 14 cases for which adequate postmortem data were available. Other apparent risk factors include seizures associated with withdrawal from alcohol and benzodiazepines and the uninformed use of ethnopharmacological forms of ibogaine.

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1556-4029....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874389/

It's about the results of a new treatment. "One month after ibogaine treatment, the veterans reported that TBI symptoms such as post-traumatic stress disorder (PTSD) and depression had decreased by more than 80%, on average."

https://pca.st/episode/349b6543-1b80-4076-9d0e-94e7f2061c0b

> "I never said he was [taking Ibogaine]," he continued, "I said there was a rumor in Milwaukee that he was, which was true when I started the rumor in Milwaukee."

-- https://theplaidzebra.com/hunter-s-thompson-spread-rumor-pre...

or Fox news: start the rumour in the morning, report breathlessly on the "some people say" in the evening.

https://www.thisamericanlife.org/321/sink-or-swim/act-two

I have heard many stories of people being cured via ibogaine but the experience is not for the faint of heart. To me it sounds a lot like you die and are reborn again (you don’t literally die of course).

I do worry that some treatments (both this and standard pharmaceutical products) could be doing things that truly change what we can measure in positive ways but also have different side effects that we don't measure. Could it be consistent with the data that potent psychedelic drugs banishes all prior strong feelings? If so, is that a good trade off in all situations?

It is a very different type of drug, and very anecdotal, but in a previous relationship I came to the conclusion while high on edibles I didn't truly love my girlfriend. Intense feelings (both good and bad) I had for many months disappeared and I became very indifferent to the idea we had a special connection. Perhaps if I had PTSD marijuana edibles would have been positive as they would have made my negative feelings towards my past closer to indifferent, but I'm always curious the boundaries of when then is good or bad.

That's not how psychedelic drugs work. If anything I would say it's more the opposite. We tend to naturally suppress a lot of feelings and memories when in regular everyday-life mode. A psychedelic experience can make people dig all those up, open all the mental closets and make people re-evaluate their feelings about everything.

>do we think that something that can very quickly "make people re-evaluate their feelings about everything" has zero negative consequences?

How many negative consequences does sticking with the status quo have, over potential alternatives?

To be clear, I'm critical of the hype around psychedelics for treating people's mental issues, like PTSD. It has cultish undertones where the drug is the miracle savior that will fix all your problems. There also seems to be an industry developing of groups and companies trying to push this idea for profit, because they see the potential. There's always good money to be made with religious believers.

That said though, used in the right way, with the right intentions and realistic expectations, psychedelic drugs can be a very useful tool.

PTSD is for many people incalculably and incomprehensibly life-ruining. The smallest things, like someone casually saying just "hey, what'cha doing?", that anyone else thinks nothing of, lead to explosive aggression or crushing panic or explosive aggressive crushing panic. It's not good, and it's not worthwhile, and nobody should ever be made to feel like erasing the pain would be bad. IMO, as much as it maybe sucked to conclude that you didn't love your girlfriend, there isn't a good feeling on earth that feels better than not being in anguish anymore.

I really hope this drug helps. But, it's possible that selecting high-intention patients played into the results.

Maybe this is the scientific method hardliner / rationalist in me, but to me, without a control group and proper statistical controls, there's no difference between this and say, alternative medicine, such as homeopathy or acupuncture, where people claim there are benefits without a true comparison.

A couple of decent docs:

Iboga: Africa's Miracle Cure For Addiction?: https://www.youtube.com/watch?v=Cb7k2-STmmg

IBOGAINE - Rite of Passage: https://www.youtube.com/watch?v=vt0E8N4FRFY

Total Synth also covered it in depth, very very good: https://www.youtube.com/watch?v=W3xuJ0TQQ-w

I have a high school buddy who used ibogaine for a heroin addiction. Still a "weirdo", still can't get a job, still has few "normal" friends, is single, etc... but.. clean as a whistle.

It's possible the nicotine-like (nicotinic acetylcholine receptors) and antidepressant-like effects of ibogaine act to moderate and stabilize the typically wild and dysphoric effects of the kappa-opioid activity that is characteristic of salvia intoxication. This might be a combination that could be mimicked by hopefully less toxic synthetic analogues. For its part, salvia demonstrates similar anti-addictive effects to ibogaine in animal trials, but people tend to recall a salvia experience as though they had been run over by a car.

The headline author also has a very liberal definition of “banishes”

Point being, there's a reason we study these things at trial in a scientific manner and consider long term effects.

Of course, this isn't really relevant to the subjective experience of taking ibogaine at its typical dose, which by all accounts is strange in ways that go beyond the classical psychedelics.

And lasts quite a bit longer!

There’s a second, softer connotation, of how strong it is in light of whatever other limits may exist. Mescaline is less potent in this way, not just because of the larger mass, but because a dose that’s going to blast you into another realm is going to be much harder on you than some other psychedelics.

Ibogaine (haven’t done it) is very potent by this meaning. Very long, intense trips are possible.

only one of the cancer cures cures you, but you have to drink a swimming pool of it; thankfully, it's potent enough in that dose to kill the cancer where the other choices only slow it down

from what I understand, the person had done some other drug, lied about it, and the combination was lethal. and my friend didn't follow all the precautions necessary either

Just think, we could have been doing this sort of thing fifty years ago.

https://www.thedailybeast.com/the-big-money-behind-kentucky-...

https://www.thedailybeast.com/kentuckys-risky-bet-to-fight-t...

Trauma/PTSD is said to be a driver behind alot of addiction . I wonder if the way this substance works is by fixing the root problem (trauma), would that then mean the drug addict no longer needs to use the drugs as a means of escape?

There was a pilot programme in my city to treat severe addiction with ibogaine but afaik the idea was abandoned because of the cardiac risk and the patients need supervision for such a long period.

page 271

This is almost certainly the definition they are using as it is the standard definition when dealing with psychological illness in any serious context

Participants received a magnesium supplement alongside the psychedelic to lower the risk of cardiac side effects.

I'm impressed. Came here to ask if anyone knew how it worked and was going to say the fatal heartbeat irregularities suggest it interacts with magnesium.

Noteworthy comments:

https://news.ycombinator.com/item?id=38934501

https://news.ycombinator.com/item?id=38934828

https://news.ycombinator.com/item?id=38934517

I'm not trying to scare you, but it can be a potential side effect, so it's good to know if you're curious. https://en.wikipedia.org/wiki/Depersonalization-derealizatio...

This study tried using magnesium to offset those effects, but it's not a proven antidote. Don't treat this one like people treat LSD or mushrooms. The risk profiles are not the same.

We had a herion addiction treatment service using ibogain in my country try

Worked well, as well as any addiction service

Till someone died

I learnt it is statistically about one in one hundred and fifty people will have their heart stop, and die, taking ibogain (I do not have a reference)

Knocks it out of consideration

The stories you read online are largely the result of selection bias from psychedelic enthusiasts. The idea that psychedelics can only produce improvements or good experiences is an internet myth.

I'm also curious why 'flood dosing' is so often recommended. A large dose is necessary for interrupting opiate addiction, but I don't see why it should be for PTSD or major depression. Micro dosing over a long period of time, complemented by talk therapy, seems like a much safer bet to me.

In some cases there's damage to the hippocampus, which doesn't get better. I've had 40 years to make peace with the crappy accident I was in. But the things like an exaggerated startle reflex, an aversion to chaotic or unplanned sounds and other triggers remain. I always carry a pair of noise-cancelling headphones if I think I might need to be in a noisy environment.

Anyway, from my understanding, medications for treating PTSD are less effective than medications for other mental disorders. I'm waiting for the day that PTSD medications catch up, because therapeutic treatment for PTSD is currently centered on reducing discomfort, without much hope for remission, which feels like a dim outlook.

They mean exposure is much better than doing nothing, a bit better than “non-trauma-focused comparators“ and on par or negligibly better then the most effective approaches, for example, exposure is often used as a part of a larger therapy like trauma focused CBT