You can't really do a double blind trial.

The therapy in question isn't replacing your prozac with magic mushrooms, it is a series of brief intense therapy sessions where the patient is given a dose and talked to while they are under the influence of the drug.

It's just really obvious to everyone involved whether the patent got psilocybin, LSD, or whatever else. Double blinds would work to an extent with dosages, but still limited.

You can't do a double blind study of the effects of lighting someone's hair on fire on their ability to solve math problems, that's about the realm of the situation here.

Sure, but that's missing the point.

Researchers need to study therapy sessions compared to therapy sessions with psychedelics. If they have enough people, include a third arm with traditional antidepressant medication.

It's not blinded, but at least we would have data to compare to existing treatments. Double-blind isn't the only way to run a trial.

I wouldn't think it's missing the point, you have a different topic there.

And the A/B comparison doesn't have much room for common ground to control for. Perhaps not a single study comparing both, but separate studies (many) of different treatment methods and replications of those treatment methods and then meta-analysis studies on the whole lot. (and much of this already exists)

My understanding is that they achieve "double-blind" by giving everybody either a low dose or high dose. So everybody gets mushrooms, and the effect is based on the difference between a low dose and high dose. Experimenters don't know the dose that a subject gets, and subjects don't know that there is a difference in the dose they could get, so they can't try to guess what dose they got. It does tend to be obvious to the experimenters who got which dose when it kicks in though.

> subjects don't know that there is a difference in the dose they could get, so they can't try to guess what dose they got.

Do subjects really believe this?

"Even though most trials are done with placebo groups I'm sure this one will be different"

Both groups are told that they will get psilocybin and they do. Maybe they guess there's a placebo group, but when it starts to kick in, they figure it wasn't them.

at least sometimes they've done blind experiments with an "active placebo" - give the subject something like Ritalin that makes you feel like you've taken a drug, but no psychedelic effect

My understanding is that niacin is often used. It is a high enough dose to cause noticeable changes and flushing, but of course isn't psychoactive.

I mean haven't you ever had/heard about that guy who would describe what an amazing experience he had on drug X when someone gave him fake drugs.

It's easy to distinguish if you tried it, otherwise autosuggestion etc. could play it's part of you actually tell the placebo group you are giving them pshychodelics (not disclosing/mentioning placebo)

There are lots of psychedelic drugs, so you could at least compare them to each other.

Not that the FDA would allow that.

Michael Pollan writes in "How to change your Mind" that the placebo often is some drug which causes some mild dizziness - can't find the name of it.

My understanding is none of this research is double-blind, and by the nature of what is studied it is impossible to conduct a double-blind study.