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Environment and expectation play such a large role in psychedelic experience that placebo-controlled studies are not well-suited to measuring their effects. For

Environment and expectation play such a large role in psychedelic experience that placebo-controlled studies are not well-suited to measuring their effects. For instance, there's a huge experiential difference between hearing "you just ingested LSD" and "there's a 50% chance you just ingested LSD," and the resulting mindset (e.g. constantly wondering if you're in the control group) almost definitely affects the outcome.

skohan 4y ago
Is that how they do placebo controlled studies? I thought they would tell all participants they had received a genuine dose.
dahart 4y ago
Indeed, the article mentions they explicitly refrained from setting those expectation precisely because they affect the results. “We removed any expectations that this was a psychedelic drug,” de Wit explained. “Because in the real world, people’s expectations can strongly influence their responses.” The goal is to know whether the drug itself actually leads to improved mood & cognition, without any prior bias. I don’t know why you’d want to include expectational effects. Why is a placebo controlled study not well suited? If you don’t have a control group, you can’t know if the results are due to the drug, or due to hopes or “contact high” as they put it.
- superb-owl 4y ago
  I missed that! Good catch. Michael Pollan points out a few of the factors that make studying psychedelics hard in How to Change Your Mind. For macrodoses, there's the obvious problem that you probably know whether you got placebo (he mentions a control drug that gives people "chills" but even that is pretty obviously not LSD) But the bigger issue is that LSD has a huge dynamical set of effects that depend heavily on mindset, expectations, environment, and probably randomness. It's not as straightforward a casual mechanism as say, aspirin. The positive effects of psychs can't be isolated from the supportive environment, the coaching from staff, etc - doing those things wrong can easily negate - or even reverse! - the effect (i.e. bad trips)

skohan 4y ago

Is that how they do placebo controlled studies? I thought they would tell all participants they had received a genuine dose.

dahart 4y ago

Indeed, the article mentions they explicitly refrained from setting those expectation precisely because they affect the results. “We removed any expectations that this was a psychedelic drug,” de Wit explained. “Because in the real world, people’s expectations can strongly influence their responses.” The goal is to know whether the drug itself actually leads to improved mood & cognition, without any prior bias. I don’t know why you’d want to include expectational effects. Why is a placebo controlled study not well suited? If you don’t have a control group, you can’t know if the results are due to the drug, or due to hopes or “contact high” as they put it.

superb-owl 4y ago
I missed that! Good catch. Michael Pollan points out a few of the factors that make studying psychedelics hard in How to Change Your Mind. For macrodoses, there's the obvious problem that you probably know whether you got placebo (he mentions a control drug that gives people "chills" but even that is pretty obviously not LSD) But the bigger issue is that LSD has a huge dynamical set of effects that depend heavily on mindset, expectations, environment, and probably randomness. It's not as straightforward a casual mechanism as say, aspirin. The positive effects of psychs can't be isolated from the supportive environment, the coaching from staff, etc - doing those things wrong can easily negate - or even reverse! - the effect (i.e. bad trips)