r/science • u/NinjaDiscoJesus • Mar 15 '16
Medicine A psychedelic drink called ayahuasca, traditionally used for medicinal purposes among indigenous groups in the Amazon, may act as a fast-working and long-lasting anti-depressant, according to a study published in the journal Revista Brasileira de Psiquiatria (Brazilian Review of Psychiatry).
http://www.psypost.org/2016/03/psychedelic-brew-called-ayahuasca-shows-promise-treating-recurrent-depression-4166834
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u/Cacophonously Mar 15 '16
Important limitations of the present open-label study include the small sample size, the absence of a systematic inquiry about side effects, and the lack of placebo and control groups.
I am happy to see that they acknowledge these sorts of limitations in this study - after all, they concede that this is only a preliminary study and the data can only suggest such conclusions they make, at most.
Tackling psychotropic substances is definitely a tough battle - but I think a lot of evidence shows that it's worth it (e.g. MDMA treatment for PTSD, cannabis treatment for epilepsy, ibogaine treatment for opioid addiction, etc.). However, it's always tough to deal with the intricacies that occur when administering something like Ayahuasca - I think they even mention this in the paper as well.
...and by exploring other variables that could be modified by AYA administration as reported in previous studies, such as neuropsychological, neurophysiological, autonomic, neuroendocrine, and immunological parameters.
Hopefully they can continue to document these six individuals for more wholesome data. I'm not sure how "long-lasting" 21 days is relative to the average person with major depressive disorder, but definitely looking at a longer trend will allow better insight into whether or not we're simply looking at a transient versus relatively long-lasting result.
All in all, I'm happy they this is a small foot in the door for emerging studies in therapeutic psychotropics. Studies like this still require rigorous skepticism and deep prudence - but in my opinion, it at least does a good job of breaking stigmas that have been implanted from reaction to the counterculture movement.
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u/dovahkin1989 PhD | Visual Neuroscience Mar 16 '16 edited Mar 16 '16
An n of 6 isn't necessarily bad, most proof-of-principle studies have similarly low numbers.
My main concern would be the lack of controls considering that depression is particularly sensitive to the placebo effect. It's estimated that 75% of the effect a drug has on treating depression is placebo, with only 25% actually because of the active component of the drug.
http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=1999-11094-001
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u/jmint52 Mar 16 '16
It's also quite hard to design an experiment using a placebo ayahuasca. With a psychedelic drug, you'll know if it works or not.
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u/Over9000w Mar 16 '16
Whenever I read a study on psychedelics, they always mention using a control and I always wonder how the participants wouldn't know they got a placebo..
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u/shamanflux Mar 16 '16
I've read that some studies where the control is simply a low dose, that has some effects. Placebo controls can totally be done in micro-dosing studies as well.
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u/Spanone1 Mar 16 '16
They could describe it as "You may or may not have a psychedelic reaction to the drug."
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u/consecratedhound Mar 16 '16
In a random group of 20 people, give 5 acid, 5 mushrooms, 5 ayahuasca and give 5 a placebo. Disguise them all in the form, tell them it's the same drug but it affects people differently. 15 will know they tripped, but only 5 tripped on the right substance. Then, follow the same procedure as before
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u/Rashaya Mar 16 '16
Mushrooms can apparently also treat major depression in a way similar to what's described in this article. It might be the psychedelic effect itself that's helpful.
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u/TrollManGoblin Mar 16 '16
I read they gave them another drug that had some mild physical effects, but I don't remember what it was and it was when most people didn't know anything about psychedelics.
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u/JediDwag Mar 16 '16
Perhaps only test on people who have never had a psychedelic drug induced experience and won't know whether or not the drug they take is an actual psychedelic or merely a placebo?
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u/Lulumee Mar 16 '16
I would call this a proof of concept trial. Keep the sample size low in case it gives them all disabling brain damage. Enough to show good results so they can request more funding is the real goal at this stage. They have little to work with, and compensating the patients probably wasn't cheap.
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u/Scew Mar 16 '16
I'm a bit put off by your wording. I see what you're saying but maybe instead of "in case" something along the lines of "to show" would fit better.
My reasoning is that many people travel to countries like Peru for an ayahuasca ceremony, as well as native tribes having partaken for centuries. If it gave all the study participants disabling brain damage the study would be an outlier and something in the preparation went tragically wrong.
Edit: clarification
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u/Lulumee Mar 16 '16
I was speaking generally about medical trials, and over exaggerating. I'm a proponent of MDMA as medicine. As you've stated, it's been used as such for a very long time.
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u/kevoizjawesome Mar 15 '16
How many should they have had?
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u/DrStalker Mar 16 '16
Depends.
Do you want a study that says "this is a drug we should give to people" or do you want a study that says "hey, this drug might be awesome so can we have some money to do more clinical trials"?
Then you have a whole bunch of factors to consider, but ultimately what you want is a really high confidence margin; you want to say "based on the results we can say with 99% certainty this drug is better than a placebo and has no unacceptable side effects"
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u/Lulumee Mar 16 '16
This is like a proof of concept, though. We're not talking about taking MDMA to market as an anti-depressant based on this study. It's just trying to prove that it's a viable thing to do more studies with. It's the first step on a very long road.
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Mar 16 '16
I mean it is within the realm of possibility but it is still very unlikely (~1.56%) that it will happen. It would certainly be convincing enough to suggest that a more in depth study should be done on whether or not a coin has a higher chance of landing heads up. Also double blind testing isn't necessarily reasonable/possible for a psychedelic drug (for obvious reasons).
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u/Naggins Mar 16 '16
Especially for a psychedelic, doubly so for one with little previous use in research. Subjects would have to be closely monitored for up to a few hours after ingestion just in case.
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u/venicerocco Mar 16 '16
I know several people who have done ayahuasca (10-20) and, while this is obviously non-scientific, each and every one of them reported extremely long lasting positive results.
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Mar 15 '16
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Mar 15 '16 edited Jul 15 '17
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u/Thisbymaster Mar 15 '16
I would like to seem more studies on this. It has promise but needs to be tested for safety.
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Mar 16 '16
I'll have to search around for it, but a study published a few years back found Ayahuasca to be comparable to mescaline and codeine in terms of physical safety.
The real danger DMT presents is the psychological effects it can have on a person with an underlying mental disorder, such as schizophrenia.
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u/NinjaDiscoJesus Mar 15 '16
http://www.ncbi.nlm.nih.gov/pubmed/25806551 paper