It wasn't a *bad* episode - I didn't want to stop watching or find my mind wandering to multi-task. But I think we have all come to expect more from Supernatural at this point. Even episodes that are essentially stand alones should have an emotional punch, or have some emotional resonance to bigger story/character arcs.
For me, they didn't explore any new ground with the psychological reveals for Dean or Sam. Sam especially should have had a big unload of emotions if he's a ragey bomb about to explode inside like Lucifer needs/wants. Or some big dump of his guilt and self-loathing about how he was tricked by Ruby, how worried he is that maybe is IS angry enough to be tricked by Lucifer. Or tell me something new that indicates Sam's losing control and could be provoked some way to say Yes to Lucifer.
They didn't confuse me at all about whether they truly *were* insane from being hunters either. (unlike say the Buffy episode where part of the story was to question if Buffy had a hero complex gone completely wrong)
The scene where Sam's altered by the drugs and talking to Dean and says Dean should be half crazy after hell, etc, was a total wasted opportunity to me too. He tells Dean he loves him, and even that didn't turn into a high point, because they played it all for the surface humour. The "boop!" wasn't in character either - that was Jared Padalecki and not Sam - it's funny... but out of character.
The end scene was just wrong/rushed. If Sam thought he needed to stay in the looney bin to work out his anger issues, then he should have actually said that. Otherwise, him stopping to share while escaping made no sense to the character. And they didn't do a good enough job of clarifying that Dean's speech was an "on your feet soldier" moment - he wasn't ignoring Sam's feelings, but saying 'look, we have to deal with that later."
The performances were good. The writers just wasted a big opportunity (imho) to instead do something rather formulaic and surface. I think Brent said this was like an appetizer (maybe potato skins) instead of an actual meal of some original meat and potatoes and dessert. I think that's an apt anology.