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Gastronomicus t1_j2ew7fz wrote

I see two issues here. Firstly, why BMI and not mass? BMI is a ratio that scales with mass, so a 50 kg 1.45 m tall person could has the same BMI (25) as a 100 kg 2.0 m tall person. But the 100 kg person is larger and almost certainly requires more of the same drug to achieve the same blood concentration.

Secondly, only one dosage was tested (25 mg). It might just be that at that dosage a biochemical process is initiated that is similar for all. It is likely that the minimum dose to achieve this effect varies by mass.

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Weaselpanties t1_j2fhceq wrote

It's explained in the source paper:

> Background:

> Psilocybin is a serotonin type 2A (5-HT2A) receptor agonist and naturally occurring psychedelic. 5-HT2A receptor density is known to be associated with body mass index (BMI), however, the impact of this on psilocybin therapy has not been explored. While body weight-adjusted dosing is widely used, this imposes a practical and financial strain on the scalability of psychedelic therapy. This gap between evidence and practice is caused by the absence of studies clarifying the relationship between BMI, the acute psychedelic experience and long-term psychological outcomes.

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Gastronomicus t1_j2fjdhd wrote

>While body weight-adjusted dosing is widely used, this imposes a practical and financial strain on the scalability of psychedelic therapy

That just doesn't make sense. I don't see how they can claim that since the effect does not scale with BMI this somehow mitigates the need to dose according to body mass, for which dosage almost certainly scales.

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Weaselpanties t1_j2fl9hv wrote

That isn't what it says they're claiming at all. "this imposes a practical and financial strain on the scalability" is just a way of saying that it gets more expensive for bigger people.

They did the study in part to determine if it's actually necessary to scale up for people whose additional size is mostly fat, or if they can take the same (smaller, cheaper) dose as someone who is their height but has less body fat.

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SoylentRox t1_j2faik3 wrote

That's what I was thinking. For example if it stimulates synapses at some minimum dose, the type of synapses it acts on will saturate the ability of their target axon to carry any more signals. So doses above the minimum won't have a stronger effect.

For example, an injection of lidocaine has a minimum dose, but doses above the minimum don't make the nerves in the region any more numb.

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SwansonHOPS t1_j2fdzus wrote

>It is likely that the minimum dose to achieve this effect varies by mass.

Why do you say this is likely?

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Gastronomicus t1_j2fjt6b wrote

For the same reason I gave here:

>But the 100 kg person is larger and almost certainly requires more of the same drug to achieve the same blood concentration.

More mass = higher necessary dosage. A greater volume of blood/body fluids means a more diluted product in the bloodstream. Beyond a certain dosage the effect might be similar because you've saturated the receptors. Not sure that applies here or not, probably not since higher dosages are linked to more intense experiences.

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SwansonHOPS t1_j2flbeq wrote

The only two drugs I know of that are mass-dependent are DXM and alcohol. Where are you getting that, in general, more mass = higher necessary dosage?

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