This is a very interesting piece of research. It needs to be put into context though - this isn't even a phase 1 trial, it's an observational study of veterans who decided to go to Mexico to take ibogaine. There is no control group
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
What's frustrating is that Ibogaine has been known about for a long time. I remember reading, 20 years ago, about how Ibogaine had cured some people of alcoholism. It was all anecdotal at the time, but clearly there's something worth studying.
I understand the hesitancy around drugs, but we've lost so much progress as a result of the bureaucratic red tape.
Remember that the bureaucratic red tape keeping these drugs from market has to do with moralism around psychoactive drugs.
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.
That and the War on Drugs™ is built on the foundation of oppressing "minorities".
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.
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.
I mean, substance abuse is a real problem. I’ve known people who have ruined their life because of it, all-the-while touting that it doesn’t affect 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 brother died from a heroin overdose. The fact that it was illegal didn't prevent it and might have been a small contributor in that the purity and strength of the drugs could not be known.'
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.
The way 'substance abuse' is framed and conceptualized deliberately obscures the fact that many if not most people with substance abuse problems are 'medicating' a psychological problem.
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.
> 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.
While I will always advocate for the legalization of all drugs, I think it's important to recognize the dangers and not downplay them.
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.
The red tape is actually hundreds of millions of dollars that some private party has to cough up to fund clinical trials, and with many of these drugs, there is no hope in recovering because they’re not patentable. And we don’t really have any mechanism for publicly funding clinical trials for unpatentable but public-benefitting drugs.
Has to cough up millions under the current system. A rule change to make that process easier would be helpful, but an agency which receives over half its funding directly from the industry it oversees is not likely to make policy which damages those same companies.
Not really. Clinical trials are expensive because clinical trials are expensive. Especially when you’re looking for weaker and weaker effects in more specific populations.
There are a number of things that can be done that can fix the broken system while retaining the things that work in our existing system.
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.
As an alternative to some of these, do you think that compulsory patent licensing could work? This would allow for day one generics while still ensuring that the parent holders get paid.
For what it's worth, ibogaine in particular is more dangerous than more common psychedelics. There have been many fatal overdoses which isn't true of, for instance, LSD.
Totally. But nearly every pharmaceutical on the market has a lethal dose, some of which are rather close to their effective dose (and some really painful deaths).
We should find what the safe and effective dosage is, if there is one, the same way we do for other drugs.
People have flat out done stupid, lethal things on psychedelics such as LSD and psilocybin. I'm one of them. I did a small dosage first time, and took a bath. Fell asleep and almost drowned.
> 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.
Probably money is the issue. None of these compounds can be patented now.
In general you're correct, but not about Ibogaine, which is actually cardiotoxic and prolongs the QT interval, sending the odd man out into the next life.
You're painting an unfairly one-sided picture here, as so many pro-psychedelic people do. These are highly potent chemicals that also have negative physical and psychological effects. It's not as simple as "these substances cure a condition and the fear of psychedelics keep them repressed". You are saying the equivalent of the college stoner friend saying "you can't get addicted!" about weed. Even this article points to fatal heartbeat irregularities as a dangerous side effect that has limited ibogaine's study.
Look at the analogs act, and the banning of salvia in many US states, and tell me that such things as negative externalities are actually weighted in the decision to ban things. Look at 2CB. It was banned for having chemical proximity to DOB, which is banned for having chemical proximity to DOM. 2CB was banned for the entire justification of "posing a risk to the public health." Where? How? I've never found data published to justify this scheduling, other than chemical proximity. Why was DOM banned? Posing a risk to the public health. Again, I can find no data.
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.
Ibogaine's safety profile is pretty good, there is a reason it is legal in other countries. The cardiac risk factors can be mitigated with appropriate screening, and of course, it should not be consumed with other substances with unsafe drug interactions. To the extent that Ibogaine fatalities have occurred, they are largely attributable to these two factors. In this respect, it is not especially different from plenty of other OTC and prescription drugs.
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.
This would be a great rebuttal if I said “this is why ibogaine isn’t approved and used broadly!” but I didn’t. I said this is why we don’t really understand Ibogaine.
The action proposed in the article is: more trials
I read bureaucratic red tape, and I imagine a group of people gathering actual information on how this goes down including input from hospitals and law enforcement where problems occur. As opposed to word of mouth, which is whatever you want it to be.
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.
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 pesky red tape surrounding drugs where people died during clinical studies?
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.
You mention curing alcoholism, but my casual observation is that there is almost always a history of psychosocial trauma, likely with residual PTSD, that leads to substance abuse.
The ibogaine treatment very likely allowed individuals to move past their traumatic experience and no longer had a reason to self-medicate.
Something I’ve read in a few ibogaine trip reports is the experience of something scaring them out of their addiction. “If you ever do heroin again, I will personally rip your soul in half” kinda shit. Certainly a different mechanism than resolving underlying trauma.
That might still be more comforting emotionally than whatever painful uncertainty about something they didn't feel control over from the past which led to the self-medicating in the first place.
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.
My reading through the history of this drug is that there has always been a significant risk of cardiac events. It's a promising drug, but until we find out what causes some people to die shortly after taking it, it's not safe for common medical use.
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.
There are hundreds of anecdotes about people with near-impossible to conquer opiate addictions that have managed to quit using ibogaine. I personally know someone who tried and failed on three occasions with traditional rehab, but she has been 10 years clean after ibogaine.
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.
+1. Erowid had plenty of self-reported but for some reason believable accounts of people kicking opioid addiction with ibogaine. Having never had experience with either can’t confirm the efficacy but definitely can confirm the fact that it was talked about.
When I first learned of it I researched it and it seemed like the risks to heart health are significant with ibogaine, but I’m unaware of mitigation efforts that could make research ethical and safe.
Oh sure, I guess that. I think when I researched it the articles just said the heart risks were high and this limited research possibility. I hadn’t seen anything previously about magnesium for this.
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.
Chocolate from all kinds of produces has high levels of heavy metals, yet it's still sold everywhere. It's not hard to control the quality, and safety, but it's easier to look the other way and profit.
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.
The Pharmacopoia shows that it's easy to control quality of natural drugs - maximum acceptable level of contaminants or adulterants, minimum level of active principle (nowadays with HPLC). It's just that the feeble government can't rouse itself to enforce truth-in-advertising standards.
When it comes to natural medicine, the FDA loves to capitalize on instances of adulteration and mislabeling. This enables them to trumpet the allegedly unsafe nature of anything they don't regulate, and lets them spread F.U.D. about those products, until finally they can yank it all from the market.
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.
You don't even need to resort to racism or jingoism. You can visit your local GNC or Target and find products made right here in America that contain adulterated medicine or misleading claims.
In fact I have made some orders from vendors of natural medicine, and I believe they may be legally bound to lie and falsify instructions for use, lest they run afoul of the FDA.
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.
Research has long been held up by legal obstacles, but articles like this are promoting an entirely false optimism about psychedelics. I live with a treatment-resistant mental illness, I have participated in clinical trials for psychedelics and I follow the field closely. Sadly, what we are seeing is almost certainly a hype bubble rather than a genuine breakthrough.
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.
It’s also worth noting the study size was only 30 veterans. All of them special forces apparently, which probably introduces a lot of other factors. Plus several participants failed to complete baseline or follow up work.
Regardless, hopefully studied further in the future (legally)!
You don't need a control group at this stage to see there's something there that's worth further investigation. What's the control look like here? Do some elaborate ceremony, sit around in a circle, pretend to get high and see if the PTSD goes away? In the name of science, sure let's do that.
> Actually, you do, as the placebo effect is very strong for depression.
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.
It was 50% reduction. Presumably a trip and not being anaethsetised would result in an even greater placebo effect.
>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.
> 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.
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.
> 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.
"small study finds" has happened before, in the context of mental health cures, for everything from LSD to yoga to going 48 hours without sleep. Many other things that can induce altered states of consciousness have probably been studied at small scale too (like you say, Psilocybin). For each one, there's always some subgroup that responds to it.
"small study finds" is also how we landed ourselves with a replication crisis, so your comment about putting it into context is very appropriate.
Propofol is a useful, well-tested anesthetic. Michael Jackson abused it and discovered the consequences, but that doesn't make it any less legitimate of a drug.
Actually Michael Jackson's every dose was prescribed, overseen and administered by a professional physician in good standing. Was it Michael Jackson's fault that the good doctor actually didn't care about his well-being?
I'm confused because it seems like you're actually agreeing with the person you're replying to. Namely that improper administration of a drug by a "doctor [who doesn't] care for ... well-being" is an issue. Logically, that doesn't say anything about the appropriateness of the drug for others. Eg. You wouldn't say people shouldn't ever use opiates in hospital settings because opiates are abused elsewhere.
Do you think the current clinical ketamine protocol is to hand the patient a little baggie and tell em good luck? Ketamine is prescribed, overseen, and administered by a professional physician in good standing. You don't just get a bottle and take a bump every morning lmao. It's a monthly or less, supervised administration, with the possible addition of active therapy to my understanding. You can't just go walk into a doctors office and say, "doc I'm real sad, i want ketamine". The whole thing is extremely careful. Why is it different for propofol and ketamine?
I get ads for ketamine on instagram btw. They send you a care package and do the whole thing over video chat. Sounds abominable to me but hey that's healthcare for you.
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.
It is 100% stupid quackery to believe that people with serious mental disorders will find their answer in the bottom of a pill bottle.
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!!!
That certainly explains why various different chemicals are actually incredibly effective at treating various serious mental disorders.
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
Bro here is what psychotropics are: they function as restraints. Chemical restraints. This was the overt aim of the original creators of psychiatric drugs, so that they could remove actual shackles and leg irons and replace them with the drugs.
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 think something is wrong with me, I keep getting into these kinds of conversations on HN instead of the insightful and intelligent conversations I used to have on here. I think I need to reassess the way I am engaging with this site.
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.
The whole Matthew Perry situation has a lot of odd behaviour to it, and I'd make a bet and put odds on ketamine being a cover story to detract from the likely culprit.
Indeed, big pharma loves how well this fear mongering tactic works - and they'd love a renaissance of "the war on drugs" to ban all cheap-relatively natural, highly effective medicines, so their patented drugs can make mega profits for them.
There was also no control group, which is a fatal flaw in any depression related study.
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.
PTSD is a dramatically different disorder to MDD though, no? It has pretty acute effects, and I don't know, but I would imagine it's less susceptible to placebo.
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.
It is not the medicine by itself but the whole experience around it. Practitioners feel deeply that the medicine is an essential part of the experience. This raises the question, which I think is a very good one, of what a valid control would even look like.
Fyi, while PTSD is commonly associated with soldiers and the experiances of war, it is far more common in many civilian trades. Top of the list: train drivers. Also, certain types of doctors such as pediatric oncologists. But we never hear about PTSD treatment studies involving anyone other than vets.
There's a reason for that. If civilian PTSD were more widely acknowledged, insurance would be paying out more and people would want employers to do something about high-stress jobs.
> 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.
To add to the chorus, I've had multiple kids waking up in the middle of the night screaming "Don't hit me mommy!" for months or more after moving in. I promise those kids will meet any definition you can find in a textbook.
Yes, and it's also worth noting that DSM5 has some pretty loose wording with PTSD diagnostic criteria. Not even saying that as a bad thing, more to say that a lot more people (diagnostically) likely have PTSD without realizing it.
PTSD can be caused by any trauma, like a car crash or abuse. PTSD is actually a fear of a traumatic memory. A person experiences flashbacks (pieces of the traumatic memory) and fears that the traumatic event will reoccur. The most effective treatment is exposure therapy - in a nutshell, you eventually write down the traumatic memory in full (not just pieces of it) and read it until it becomes boring/you understand that for example it wasn't your fault. Here is a recent meta analysis https://www.sciencedirect.com/science/article/abs/pii/S02727...
I think it's for society buy-in and relatability - that we can assume, because we see in entertainment (or real-life footage) the horrors that happen during war, but other professions may be harder to relate to.
Also one of the easier groups to target research on, since they are easier to systematically identify and are more likely to have similar underlying experiences.
Right. Who has the money to pay for a study to be done? The VA, for all its faults, can. Battered women and abused IT help desk employees can't, so we don't hear stories of big expensive studies being done with them.
It's hard to find good or consistent stats on this but I believe most cases are not from work at all. IIRC the most common causes are sexual assault, car crashes, and child abuse.
Doesn't even have to be a profession. I've got (actual legit, not "trying to be hip") PTSD from my experiences getting bullied. I'm lucky that my symptoms are fairly mild, but at this point I don't expect them ever to go away. Turns out getting called ugly about a hundred times a day by almost everyone you know does things to a kids psyche.
Suicide by train, but also a great many more animals that are killed. What makes is especially bad is that drivers see the accident coming many seconds in advance. One you've seen one person throw themselves in front of your train, every time you see another person near the track you relive the scenario.
Not only that, but the driver of a train will often see an impending collision, but will have no way to prevent it -- it takes a freight train over a mile to stop. The combination of being in control of the train, but unable to stop an accident, is a recipe for trauma.
All of the early research on. PTSD was done at the Trauma Center in Brookline, Massachusetts, I believe. The affliction was first seen in this group before being better understood.
If everyone has ptsd then no one has ptsd. It’s too loose as it is. Sorry but people who got bombed and shot at deserve a little more priority in terms of mental health.
PTSD is generally indicated for people experiencing situations that involve say trauma rather than distressing. However, enough exposure to distressing might be considered trauma.
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".
To add, it’s worth noting that what gives Person A trauma may not give Person B trauma. The situation is not a prescription for mental trauma. Two combat vets who fought side by side in the same battle can walk away with wildly different effects. Someone working a help desk may feel immense stress, even trauma over time, while another thrives under the same circumstances. Trivializing PTSD to “I worked a shitty help desk job before, I get it” is not a great take.
Emotional abuse can cause more severe PTSD than other forms[1] and help desk (really any call center) occupations deal with far too much of it. Sure you can be pedantic around the phrasing, but do not hand wave how crushing these kinds of jobs are.
I'm not sure what you consider to be the source(s) of "emotional abuse" for a Help Desk or call center employee, but nobody who works on the phones for customers is required to endure any sort of egregious verbal abuse from them. Such a worker should be free to warn them, and then hang up or refer the to management as appropriate.
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.
Considering that 1 in 9 girls and 1 in 20 boys are sexually assaulted, yeah I can buy someone in GenZ having PTSD requiring being accompanied by a service animal everywhere. :(
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.
It's not kind to say, but one must wonder if after you kill people, rip their bodies asunder, send them into the afterlife... if PTSD doesn't have a spiritual or karmic purpose. We're not meant to be doing this to each other.
I'm as about as big a hippie as you can get, however we live in a cold world and sometimes killing is the right thing to do. Look no further than the war in Ukraine. My family left there from pogroms over 100 years ago and again Russian aggression is causing innocent people to have to kill to defend. We're not meant to do this, you're right. However, sometimes you have to so I don't believe PTSD to be 'karmic'.
Though i do wonder if there's any difference in ptsd between the invading and defending forces. Especially if those invading either actively don't want to, or eventually come to realize they were being used for political squabbles and not the true defense of the empire and way of life.
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.
Ill be honest most of what youve said here is gibberish to me. Maybe vaguely anti-Semitic based on the whole khazaria thing? I am not sure its all kind of unhinged, but your whole attitude and approach to conversation seems like it might not be cut out for this message board. Try r/worldnews or something it might be a better fit for you. Anyways this thread is buried so many fewer people will ever have to read your drivel, so im gonna disengage now.
Ibogaine is a very odd duck in the category of psychedelics. Unlike most psychedelics, which bind principally to the 5-ht2a receptor, ibogaine's affinity for this receptor is 16 micromolar, which should make it irrelevant. Its metabolite noribogaine does bind to the kappa-opioid receptor, the primary target of Salvia divinorum, but still with a weak affinity of around 600 nanomolar. The strongest binding site is actually at the nicotine receptor, and the strongest binding site of noribogaine is at the serotonin transporter. These activities usually would not confer psychedelic action.
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.
Fyi, while PTSD is commonly associated with the experiences of war, it can be caused by any trauma, like a car crash or abuse. PTSD is actually a fear of a traumatic memory. A person experiences flashbacks (pieces of the traumatic memory) and fears that the traumatic event will reoccur. The most effective treatment is exposure therapy - in a nutshell, you eventually write down the traumatic memory in full (not just pieces of it) and read it until it becomes boring/you understand that for example it wasn't your fault. Here is a recent meta analysis https://www.sciencedirect.com/science/article/abs/pii/S02727...
From the abstract: "Exposure therapy showed... a negligible effect relative to other trauma-focused treatments or medication."
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.
The writing they used in abstract is confusing, the full quote: “Exposure therapy showed large effects relative to waitlist and treatment-as-usual, a small effect relative to non-trauma-focused comparators and a negligible effect relative to other trauma-focused treatments or medication. At follow-up most effects sizes were stable, except for a medium effect favoring exposure over medication.”
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
I hesitate to write this, but PTSD is a bit more complex than that.
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.
You try propranolol yet? Worked like a slow miracle for me. It completely neutered the negative physical symptoms after some time using it combined with carefully controlled exposure to triggers.
Nitpicking, but for a technical audience it's worth noting that ibogaine is not at all a 'potent' psychedelic in the pharmacological sense of the term. A typical therapeutic dose is on the order of 500mg, which makes ibogaine something like 20 times less potent than psilocybin (typical dose ~25mg), which itself is 100 times less potent than LSD (typical doses less than 250ug).
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.
sort of an interesting dichotomy in the meaning of potency. The poison that kills you with the smallest dose is the most potent, but the (hypothetical) drug that cures cancer most effectively is the most potent cancer cure, regardless of dose.
One definition of potency is how little mass it takes to do its thing, whatever that is. Fentanyl is a potent drug, LSD is a potent psychedelic. That resolves the dichotomy.
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.
all the poisons kill you, one of the poisons is most potent
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
> 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.
Geoff Rickly, who some might know as the singer of Thursday, recently published a fantastic novel called "Soneone Who Isn't Me," which is a lightly fictionalized account of his experience using Ibogaine to kick a heroin habit. It's an artful, stream of consciousness book, and contains fascinating details about his experience at an addiction clinic in Mexico that offers the treatment.
I hadn't heard about the drug before reading the book and found it very fascinating.
One thing I don't understand is how targeted we can expect this to be.
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.
>Could it be consistent with the data that potent psychedelic drugs banishes all prior strong feelings?
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.
I suppose all I'm asking if there is consensus that is universally good or not. In the goal of eliminating PTSD it clearly seems worth it, but do we think that something that can very quickly "make people re-evaluate their feelings about everything" has zero negative consequences?
Right, got you now. Universally good seems like an impossible bar but it's a good question and I don't think there is such consensus.
>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.
Like many things, I think it's important to tread carefully, both in engaging in mind-altering actions, but also in how we think about and frame questions like this.
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.
The article here isn't about how psychedelics can help with ptsd, which is a well understood fact.
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."
It hasn't "been known", as there have never been any RCTs (and this is just a very small open-label trial). So we still have no idea whether or not this drug is actually of any use for PTSD or depression. We certainly can't that it "banishes PTSD" like the overhyped headline here says.
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].
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.
Umm, did you read about this study? It was widely criticized for a very good reason. They administered a dose of ketamine/placebo when the participants were in surgery and under general anesthesia. Not what's commonly done, and it tells us approximately nothing about its effects when administered normally.
Crazy that your first assumption is a conspiracy. Ibogaine would never represent any kind of competition to FDA approved pharmaceuticals, because of its cardiotoxicity: it can cause sudden cardiac arrest and death. There are many case studies of sudden death from ibogaine recorded in the literature.
You're thinking of Anslinger and Hearst. Big pharma would be the first to jump on this stuff - most of the experimentation is already done for them, they can just stick to what they know which is running clinical trials.
Most psychedelics like MDMA or LSD are synthetic; there are only a few naturally occurring ones like psylocibin or LSA (the natural precursor to LSD) and most of them already have synthetic analogues. Many of them were made by pharma companies: Merck first synthesized MDMA over a century ago and patented several variants, long before anyone realized what it was good for.
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.
thats like asking when do we lynch hackernews for banning the majority of people who would otherwise post here? sorry but theres a lot of money invested in particular agendas
I don’t see the international hackernews conspiracy. 99.9% of the world has not heard of hacker news. The pharma industry doesn’t own the US, any more than big fast food, lawyers in general, US automobile dealerships, the petroleum industrial complex, etc.
I’d say they all want to continue to make big profits and push for things that help them.
Governments are made of people. People who like money and are more loyal to money than the voters. Voter can't buy politician a nice beach front property or placement at prestigious school for children. Big pharma can do that easily.
They just need to make enough theatre for general public to believe they serve them and just let that cash roll in, while they make lives of millions a misery.
I’m no fan of big pharma I’m just saying the government had a big role in fighting against research in to these drugs. I don’t know if lobbying would have been successful against Reagan or Bush for example.
The pharma industry spends more money lobbying US politicians than any other, almost twice as much as the next largest spender; 64% of pharma lobbyists are former government employees
The researcher was interviewed in a recent Tim Ferris Show, including discussion of why the results are being taken seriously despite the lack of control group.
The radio program This American Life did a program on ibogaine a long time ago. A former addict kicked heroin through ibogaine and made it his mission to help others do the same. Great listen.
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).
my friend is currently in prison in Canada for administering Ibogaine for opioid addiction, which caused a person's death
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
Seems weird to me that firefighters, police officers, paramedics, content moderators, abuse victims, and so on who struggle with PTSD and get caught taking ibogaine become felons for possessing a Schedule I substance, but not contract killers
Ibogaine is the drug Hunter S. Thompson rumoured Muskie had taken, which caused a bit of a ruckus during the 72 election campaign. Its in "fear and loathing on the campaign trail"
> "About half way through the campaign, I suddenly realized that all these poor bastards out there reading the Rolling Stone believed this madness," he said.
> "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."
This study also saw an improvement in an age weighted brain scan measurement of almost 1.5 years after a single ibogaine treatment session. Ibogaine was already a medicine over 100 years ago, and has what is apparently generations of seemingly safe use in Gabon. The concept of a 'blind' placebo falls apart with these types of medicines as it is obvious if you got an active medicine or not. There is a proposal to do the treatments under a normal blind situation and then offer the placebo ones treatment too, that was the proposal for narcotic detox for which it was felt there was an ethical dilemma to having them go through such hoops and not get treatment. The normal outcomes of long term substance abuse and conventional treatments are already well documented. Theoretically one can work out the statistics also against normal matched PTSD patients under conventional treatment. Double blind is the gold standard in western medicine, but the two issues are repurposing a natural medicine with centuries of use and the blind issue with obvious mental activity.
You are a bit biased with that nickname... that said, I have family from that neck of the woods and I know it's been used since time immemorial for shamanistic and medicinal purposes. I'm personally looking forward to the age of psychedelics when we're able to integrate tribalistic medicine with modern psychiatry... 70 years too late because of idiotic and corrupt bureaucrats.
I don't see it mentioned anywhere in the article but there has been some research on the therapeutic benefits of non-hallucinogenic ibogaine analog, tabernathelog (TBG) which is also supposed remove negative cardiovascular side effects.
Hunter S. Thompson once spread a rumor of a presidential candidate’s drug addiction and it was taken seriously
“Not much has been written about the Ibogaine Effect as a serious factor in the presidential campaign,” Thompson wrote in an article he later claimed was never meant to be taken at face value. In it, he declares, “word leaked out that some of Muskie’s top advisers called in a Brazilian doctor who was said to be treating the candidate with ‘some kind of strange drug.”
For those with an interest in politics, I strongly recommend reading “fear and loathing on the campaign trail” and “better than sex (confessions of a political junkie). Both of course by HST
i cannot express how hopeful i am that this class of medicines and therapy are going to help so many people. i do think treating vets/first responders will break the dam open. i'm very keen to see where the novel psychs go - those without "the trip" but with the healing factor. i believe that will be key for the masses, i'm not sure 'normies' want to trip for 8-12 hours or more. i know this is a bit controversial to say in the psych community. the psych biotech sector is set to get quite interesting this year i reckon. i expect FDA approval for MDMA at a minimum. much love to anyone struggling mentally. exciting times IMO.
I work at a large Canadian law firm helping founders and it's great how much inbound we have for people looking at entheogen-based therapy startups. I think the regulatory environment will keep up, but unfortunately, a lot of folks got burnt on cannabis investments so I'm concerned it's going to be hard to get something going in Canada with venture investment.
For those interested in taking dissociative drugs, or any recreational drugs in general, please take a look at this disorder called Depersonalization-derealization disorder (DPDR).
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.
Ibogaine can be tricky as a therapeutic because it carries cardiac risk and because it lasts extremely long (>20h)
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.
There's more research on this drug for treating addiction.
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?
I don't like the unscientific nature of these articles. It "treats" PTSD but they don't define what PSTD is. Idk how PTSD could be quantified since it seems very personal and relative to what a person considered normal for them.
Maybe, maybe not. But what is true is that the experience is supposed to be the most brutal. Some desperate people will always do what is necessary. A lot won't do this no matter what.
it is tightly regulated in many countries and can cause fatal heartbeat irregularities
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.
I'm not opposed to psychedelics in any way (in fact very supportive), but not having a control group seems non-scientific to me.
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.
Where do you get 80% success from? Reducing the score on an assessment by 80% on average is not what most would infer from “80% success [rate]”, two very different measures.
The headline author also has a very liberal definition of “banishes”
As a close friend of Gabonese people, I confirm: don't take iboga lightly. It's traditional use is a serious ritual and none who undertook it, under shamanic supervision, are less than shaken by the experience.
Imagine it as a soft reset for your brain, it's the best way I can describe it.
Ibogaine technically is not a psychedelic but an '"oneirogen", which means "dream inducing". The trip comes in stages, but at the peak, some enter a state where deep lucid dreams can be acheived by merely closing one's eyes and out of it just by opening one's eyes if it gets too intense; with common trip reports of people physically coexisting with their deceased family and literal demons, as was my case.
There's also the notion that it aids in unlocking memories. In my experience, it did though they appeared to be inconsequential ones from my toddler years.
The morning following the experience, I bit into an apple, and it tasted as if it were the first apple I'd tasted in my life: my senses appeared to have undergone a literal reset. This might explain why many people turn to it as a means of overcoming opioid dependence.
It is a deep deep rabbit-hole and I can't do it justice here, there's a whole religion based on it in Gabon Africa.
I had never heard of this substance. Some quick googling found this for reference.
> 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.
You should go read that paper. I read it a while ago, but all the cases are extreme circumstances if my memory serves. Ibogaine is fairly safe and used as a treatment for opioid addiction in Australia and New Zealand. (I am not a doctor and "fairly safe" is not meant to be a recommendation).
I took way more ibogaine/iboga root than I needed to in my younger dumber days, and couldn't really recommend it in good conscious. Heart issues aside, it has the potential to seriously twist up your mind, and not just short term. I always think of the trip report I read where the narrator is raving about how good his life is now that he has the voice of an African god in his head, guiding him down the right path. Thankfully I never reached those 'heights'.
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.
Just a warning for anyone considering self-treating: Ibogaine is not as harmless as other psychedelic drugs. There are a number of well-documented cases and studies of Ibogaine causing cardiac problems in people who previously had no heart issues. Some of these cardiac problems result in sudden death.
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.
Speaking as a person who is healing their own intense childhood traumas, I'd try everything safer first, but I'd absolutely accept a 1/150 chance of death if there was even a 1/10 chance of being truly free of the hellish inner prison that such trauma creates.
I hate to be the bearer of bad news, but psychedelics occasionally create traumatic experiences for people. They can also worsen or trigger depressive episodes.
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.
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