Psychedelics, placebo, and anesthetic dreams | Boris Heifets (part 1)

Psychedelics are a hot topic in psychiatry today.  They’re producing dramatic reversals for patients with severe depression, PTSD, and other mental health conditions. But scientists still have fundamental questions about why these drugs are so effective.

For example, is the "trip" even necessary? Some think it is not and are working to design drugs with similar brain chemistry but no psychoactive effects — “Taking the trip out of the drug.”

Others suspect that many of the benefits of psychedelics can be attributed to hype and expectation: People expect to get better, so they do.

Normally scientists control for placebo using a blinded study where patients don't know if they're getting the real treatment or a sugar pill. But how are you going to do this with mind-altering substances? Patients are probably going to figure out pretty quickly whether they got a sugar cube with or without LSD.

Today's guest, Stanford anesthesiologist Boris Heifets, has come up with a particularly clever strategy to tease apart the psychedelic experience, biochemistry, hype and placebo. 

Listen for the whole story!

Learn more:

• The Heifets Lab at Stanford Medicine
• The Early Days of a Psychedelic Resurgence? (Stanford Medicine Magazine, 2024)

Depression, ketamine & anesthesia:

• Randomized trial of ketamine masked by surgical anesthesia in patients with depression (Nature 2023 - paywall)
• Ketamine’s effect on depression may hinge on hope (Stanford Medicine, 2023)

Anesthetic dreams and trauma recovery:

• Case report 1: dreaming & knife attack (A & A Practice, 2022 - paywall)
• Case report 2: dreaming & PTSD (American Journal of Psychiatry, 2024)
• Could anesthesia-induced dreams wipe away trauma? (Stanford Medicine, 2024)
• Video: Mothers with PTSD following their sons' deaths talk about dreaming of their sons under anesthesia (Heifets Lab, 2024 — content advisory)

Related episodes:

• S1 E1: Psychedelics and Empathy
• S3 E3: OCD and Ketamine

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