Psychedelics, placebo, and anesthetic dreams | Boris Heifets (part 1)
05/02/24 • 30 min
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:
Episode credits
This episode was produced by Michael Osbor
Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience.
Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.
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:
Episode credits
This episode was produced by Michael Osbor
Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience.
Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.
Previous Episode
Why our brains are bad at climate change | Nik Sawe
This week on From Our Neurons to Yours, we're talking about the neuroscience of climate change with neuroeconomist Nik Sawe.
If you follow the science or the news, you know how big of a risk climate change is. Storms, coastal flooding, heat waves, extinctions, mass migration — the list goes on.
But — as you can probably also appreciate — it’s really hard to properly perceive that risk. It’s much easier to focus on today’s emergency, this week’s looming deadline, this quarter’s economic forecast — where the risks are objectively much smaller, but feel more pressing.
This is where neuroscience comes in: Why are our brains so bad at perceiving this existential, long-term risk to our society and our planet? And are there ways we could work with our brains' limitations to improve our decision-making around environmental issues and the future more broadly?
To answer this question, we spoke with Nik Sawe, a neuro-economist who uses brain imaging to study environmental decision making in the lab of Brian Knutson in the Stanford Department of Psychology. Nik is also a policy analyst at the think tank Energy Innovation, where he is working on policy avenues to reduce carbon emissions in the industrial sector.
References
- Parks donation FMRI study
- Ecolabeling/energy-efficient purchasing FMRI study
- "Price of your soul" study by Greg Berns
- Dan Kahan science literacy/numeracy and climate change risk study
- Brain stimulation for perspective-taking of future generations
Episode Credits
This episode was produced by Michael Osborne at 14th Street Studios, with production assistance by Morgan Honaker. Our logo is by Aimee Garza. The show is hosted by Nicholas Weiler at Stanford's Wu Tsai Neurosciences Institute and the Knight Initiative for Brain Resilience.
Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience.
Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.
Next Episode
Psychedelics Part 2: How do drugs alter our perceptions? | Boris Heifets
Today, we're going to talk about how psychedelics alter our perception of reality and what that says about... reality!
Welcome to part two of our conversation with Stanford anesthesiologist and psychedelics researcher Boris Heifets!
Last time, we talked with Boris about the question of why psychedelics help people with mental health disorders.
This week, we're going to dive into a different question, which is to explore how psychedelics work in the brain. How are they able to alter something as fundamental as our perceptions of reality — and could understanding these effects teach us about the nature of our everyday perceptions?
Learn more:
- Review: Therapeutic mechanisms of psychedelics and entactogens (Heifets and Olsen, 2024)
- As psychedelics near approval, there’s no consensus on how they work (STAT News, 2023)
- How do psychedelics work? (Carhart-Harris, 2019)
- Heifets Lab website
Episode credits
This episode was produced by Michael Osborne at 14th Street Studios, with production assistance by Morgan Honaker. Our logo is by Aimee Garza. The show is hosted by Nicholas Weiler at Stanford's Wu Tsai Neurosciences Institute.
Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience.
Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.
From Our Neurons to Yours - Psychedelics, placebo, and anesthetic dreams | Boris Heifets (part 1)
Transcript
Nicholas Weiler:
Psychedelics are an incredibly hot topic in psychiatry today. They're producing dramatic reversals for patients with severe depression, PTSD, and other mental health conditions, but scientists are still debating why they work. Part of the problem, of course, is historical. Research on these substances was banned for decades and is really just getting started again.
On top of that, there are aspects of psychedelics that make them particularly hard t
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