3 ms·

The reason you cannot have a double blind study is that you can tell you've been given mushrooms. So, I expect, can the therapist and the researcher etc. The m

The reason you cannot have a double blind study is that you can tell you've been given mushrooms. So, I expect, can the therapist and the researcher etc. The moment anyone knows it's no longer double blind. I'm happy to be corrected if there is some clever way around this. I have heard people suggest you give "control" group members so other psychoactive substance (MDMA was suggested). But that doesn't have the same effect as mushrooms. And also, it's ethically merky to give people other drugs they're not expecting/consenting to. Plus then you don't really have a control group, you have Mushrooms vs Other Drugs...

tasty_freeze 6y ago
People have attempted controls in the past, and often it is a high dose of niacin. It causes flushing and increased HR. To someone who has experience with mushrooms they won't be fooled. To someone naive, they can think they got the real deal.
- LatteLazy 6y ago
  I guess (I'm no expert) we would want a little of both: A blind, Niacin trial that is not placebo controlled AND a Placebo controlled but not blind trial? I wonder what Tim Ferriss has gotten up to recently on this...
- esperent 6y ago
  But how can you tell if someone has been fooled or is just saying they've been fooled? When a drug has a very clear and obvious psychoactive effect, double blind simply doesn't work.
meetups323 6y ago
Perhaps at low doses in total darkness?
- raunakdag 6y ago
  Darkness won’t affect it. You’ll probably be able to tell either way. Microdosing probably wouldn’t make for an effective study, as it’s currently being touted as a way to increase “productivity”.
austinjp 6y ago
Indeed. Other trial designs may also be appropriate such as crossover or waiting lists. Depends on the aims of the study. Double blind RCT simply isn't feasible or appropriate in every circumstance.
- jdietrich 6y ago
  >waiting lists I'd be careful with that - waiting lists may have a nocebo effect, exaggerating the benefits of the treatment under test. https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.12275 https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.12275
filoeleven 6y ago
Yeah, it’s a weird thing to test for. Sort of like trying to double-blind broken bone procedures with a hard cast for the experimental group, and an Ace bandage for placebo. All parties can tell the difference while it’s being applied. Maybe it requires a different kind of experimental structure that still allows for single-blind follow-ups. Imagine the subjects talking a different set of therapists or researchers after 1 month, 3 months, 6 months. The patients/subjects would have to be instructed not to talk about whatever they experienced during the psilocybin/placebo phase, only about their personal development since then: outlook on life, lifestyle changes, etc. The therapists would have to self-invalidate if anything was divulged by a patient. It would probably have to be a large group, since with 1000 people you might only get 300 therapist-blind reports.

tasty_freeze 6y ago

People have attempted controls in the past, and often it is a high dose of niacin. It causes flushing and increased HR. To someone who has experience with mushrooms they won't be fooled. To someone naive, they can think they got the real deal.

LatteLazy 6y ago
I guess (I'm no expert) we would want a little of both: A blind, Niacin trial that is not placebo controlled AND a Placebo controlled but not blind trial? I wonder what Tim Ferriss has gotten up to recently on this...
esperent 6y ago
But how can you tell if someone has been fooled or is just saying they've been fooled? When a drug has a very clear and obvious psychoactive effect, double blind simply doesn't work.

meetups323 6y ago

Perhaps at low doses in total darkness?

raunakdag 6y ago
Darkness won’t affect it. You’ll probably be able to tell either way. Microdosing probably wouldn’t make for an effective study, as it’s currently being touted as a way to increase “productivity”.

austinjp 6y ago

Indeed. Other trial designs may also be appropriate such as crossover or waiting lists. Depends on the aims of the study. Double blind RCT simply isn't feasible or appropriate in every circumstance.

jdietrich 6y ago
>waiting lists I'd be careful with that - waiting lists may have a nocebo effect, exaggerating the benefits of the treatment under test. https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.12275 https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.12275

filoeleven 6y ago

Yeah, it’s a weird thing to test for. Sort of like trying to double-blind broken bone procedures with a hard cast for the experimental group, and an Ace bandage for placebo. All parties can tell the difference while it’s being applied. Maybe it requires a different kind of experimental structure that still allows for single-blind follow-ups. Imagine the subjects talking a different set of therapists or researchers after 1 month, 3 months, 6 months. The patients/subjects would have to be instructed not to talk about whatever they experienced during the psilocybin/placebo phase, only about their personal development since then: outlook on life, lifestyle changes, etc. The therapists would have to self-invalidate if anything was divulged by a patient. It would probably have to be a large group, since with 1000 people you might only get 300 therapist-blind reports.