To someone who has done mushrooms before, sure, they can tell. But for people with no psychedelic experience, niacin (a common stand-in) causes flushing and some other effects which a patient can tell "is doing something."

IIRC, the famous "Good Friday" psilocybin experiment had some people from the control group believe they were not in the control group.

> IIRC, the famous "Good Friday" psilocybin experiment had some people from the control group believe they were not in the control group.

I can find a few people right now that believe that Lord of the Rings is a historical account of medieval Europe.

Right but when it comes to questions of placebo, the belief is what matters.

There is a specific belief here around something which changes under these substances, around memory, recall, ideation, I'd use the word "plasticity" but thats not what I mean. Taking these drugs (or MDMA) and undergoing some kind of guided psychological engagement, appears to have lasting effects on how mood is mapped over experience, for people suffering negative ideation/PTSD.

I'd love to poo-poo this because I believe in (and do) CBT and have a continuing high level engagement with somebody which is strongly anti-drug: the SSRI are a weapon for a problem which are being over-used. Its classic hammer/nail analogy stuff.

There was interesting, good science being done on these drugs before the "war on dope" took everything offline.

Consider the work on its effect on timor mortis. If we can ease people's passage into an inevitable end, Isn't that net-beneficial overall?

9 weeks of TMS should be tried before ECT. ECT is just one away from a lobotomy in terms of brutality and risk.

ECT is not as brutal or risky as it used to be. You can now opt for unilateral treatment (only shocking one hemisphere) rather than bilateral for the same outcome with lessened side effects. I agree TMS should come first, but I think the comparison of ECT to lobotomy is misguided.

That's your opinion. The point of ECT is to induce a seizure. Seems damn barbaric.

This does at least show a difference between 10 mg and 25 mg dosage.

One way to do this — and I don’t know why it isn’t done — is to use a general anesthetic and then administer drug/placebo and record effects.

Not clear that it works when not conscious

Then run that experiment, too:

Psilocybin + anesthetic

Psilocybin + nothing

Control + anesthetic

Control + nothing