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Huberman Lab
Dr. Nolan Williams: Psychedelics & Neurostimulation for Brain Rewiring
Oct 10, 2022
02:44:46
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Quick takeaways
- Dr. Nolan Williams and his team at Stanford combine transcranial magnetic stimulation (TMS) with other cutting-edge treatments like Ibogaine, Silasuybin, MDMA, Cannabis, and DMT to treat depression and mood disorders.
- The left dorsolateral prefrontal cortex (DLPFC) plays a crucial role in mood regulation.
- Depression involves a network dysfunction between the dorsolateral prefrontal cortex (DLPFC) and the anterior cingulate cortex (ACC).
- Dissociation and opioid receptors may play a role in depression treatment.
- Ibogaine is a powerful psychedelic derived from the root bark of the Iboga tree in Gabon, Africa.
- During a psychedelic journey, the concept of 'letting go' is seen as a key variable for relief from depression and trauma-related symptomology.
Deep dives
The Role of Transcranial Magnetic Stimulation (TMS) in Treating Depression
Dr. Nolan Williams and his team at Stanford combine transcranial magnetic stimulation (TMS) with other cutting-edge treatments like Ibogaine, Silasuybin, MDMA, Cannabis, and DMT to treat depression and mood disorders. While other clinics use TMS, Dr. Williams' approach stands out for its combination of multiple treatments. They also focus on modifying psychedelics to remove hallucinogenic properties while maintaining anti-depressant effects. The future of psychedelic research and clinical use looks promising, as more studies explore the neural circuitry underlying depression and positive moods.
The Importance of the Dorsolateral Prefrontal Cortex in Mood Regulation
The left dorsolateral prefrontal cortex (DLPFC) plays a crucial role in mood regulation. Stimulation of this brain region can decelerate heart rate and show promising anti-depressant effects. The DLPFC is associated with cognitive control, governing rules, and cognitive task performance. It also influences traits like hypnotizability and can restore balance to brain networks implicated in depression. When stimulated, the DLPFC can retime and regulate the anterior cingulate cortex, impacting mood and emotional processing.
Understanding Depression as a Network Dysfunction
Depression involves a network dysfunction between the dorsolateral prefrontal cortex (DLPFC) and the anterior cingulate cortex (ACC). In depression, the hyperactive ACC overwhelms the regulation from the DLPFC, resulting in spontaneous and semi-volitional negative thoughts and a lack of control. Therapies like TMS aim to restore the balance by exogenously stimulating the DLPFC and re-timing its regulation over the ACC. Cognitive-behavioral therapy can also help individuals identify negative beliefs and incorporate alternative explanations to improve depressive symptoms.
The Role of Dissociation and Opioid Receptors in Depression Treatment
Dissociation and opioid receptors may play a role in depression treatment. Ketamine, a dissociative anesthetic, shows antidepressant effects, and the level of dissociation during ketamine treatment correlates with therapeutic outcomes. The opioid system, particularly the mu-opioid receptor, appears to contribute to ketamine's antidepressant effects. On the other hand, blocking opioid receptors with medications like naloxone or naltrexone can reduce the antidepressant effects of ketamine. Additionally, the role of the opioid system is evident in pain management, where depression can triple the required oral opioid dose.
Ibogaine: A Potent and Non-Recreational Psychedelic
Ibogaine is a powerful psychedelic derived from the root bark of the Iboga tree in Gabon, Africa. It is traditionally used as a sacrament by the Boiti religious group. The effects of Ibogaine differ from classic psychedelics, as it does not produce visual perceptual changes but rather induces a life review experience. Preliminary studies have shown promising therapeutic effects in treating conditions such as PTSD and depression. A recent study focused on Navy SEALs undergoing Ibogaine treatment in Mexico has reported significant improvements in mental health. Further research is needed to fully understand the potential therapeutic benefits of Ibogaine.
Letting Go and the Therapeutic Effects of Psychedelics
During a psychedelic journey, the concept of "letting go" is seen as a key variable for relief from depression and trauma-related symptomology. This idea is related to the concept of exposure and response prevention therapy, which involves exposing individuals to triggers and preventing them from engaging in compulsive behaviors. By allowing individuals to let go and experience their thoughts, emotions, and memories without the need for control or avoidance, psychedelics may provide a unique opportunity for reevaluation, empathy, and the reconsolidation of memories. This process can lead to significant improvements in mental health and a sense of personal growth and self-forgiveness.
The Potential of Ayahuasca as a Sacrament and Therapeutic Agent
Ayahuasca is a psychedelic brew used as a sacrament in South American countries such as Brazil, Peru, Ecuador, and Colombia. It is made by combining two plants in specific proportions to create a powerful psychedelic effect. Ayahuasca contains dimethyltryptamine (DMT) and a reversible monoamine oxidase inhibitor (MAOI), which allows the DMT to cross the blood-brain barrier and produce its psychoactive effects. Ayahuasca has been explored for its potential therapeutic benefits, particularly in the treatment of depression and other mental health conditions. However, more research is needed to fully understand its effects and ensure safe and responsible use.
Exploring the Therapeutic Power of Psychedelics in Clinical Settings
Psychedelics, such as psilocybin and MDMA, have shown promising therapeutic effects in the treatment of trauma-related symptoms, depression, and other mental health conditions. Studies have demonstrated that these substances can induce profound changes in brain activity and connectivity. They can help individuals reevaluate and reconsolidate memories, leading to significant improvements in mental health outcomes. While more research is needed to fully understand the mechanisms and potential applications of these substances, their therapeutic potential is garnering attention from both medical professionals and individuals seeking alternative treatments. It is crucial to conduct further research and ensure appropriate medical supervision to harness the therapeutic power of psychedelics.
The potential therapeutic effects of psychedelics
Psychedelics like ayahuasca have been found to have potential therapeutic effects with limited neurocognitive side effects. Studies have shown that ayahuasca sessions could lower recidivism rates in prisoners.
The risks and benefits of cannabis use
Cannabis has both potential medical benefits and risks. Early use of potent cannabis, particularly during adolescence, may increase the risk of exacerbating psychosis later in life. However, CBD, a component of cannabis, has shown promise in treating certain conditions, such as epilepsy and schizophrenia.
The efficacy of neuromodulation therapy for depression
Neuromodulation therapy, specifically transcranial magnetic stimulation (TMS), has shown promise as a treatment for depression. The therapy involves reorganizing the stimulation approach using space learning theory to optimize learning and memory signals. Clinical trials have demonstrated significant remission rates for depression with minimal side effects.
In this episode, my guest is Nolan Williams, M.D., a triple board-certified psychiatrist, neurologist and professor of psychiatry and behavioral sciences at Stanford School of Medicine. He is also the Director of the Stanford Brain Stimulation Lab. We discuss clinical applications for brain stimulation, behavioral protocols and novel drug treatments to halt and reverse mental health disorders, including depression and post-traumatic stress disorder (PTSD). We first discuss the neural circuits for self-identity and mood and stress control. We discuss Dr. Williams’ work using transcranial magnetic stimulation (TMS) to depression, trauma, PTSD, and other mood disorders. We then dive deep into the history, biology, modern use, and safety margins of the various psychedelics, including MDMA, LSD, ketamine, ibogaine, ayahuasca, and psilocybin, as well as cannabis and the use of SSRIs in both adults and children. Finally, we discuss behavioral treatments for mental health disorders, including sleep and sleep deprivation, light exposure, exercise, and training to control the brain-heart-rate pathways. Regardless of age, all those interested in mental health should benefit from the incredible breadth and depth of Dr. Williams’ knowledge and the clarity with which he conveys that information.
For the full show notes, visit hubermanlab.com.
Thank you to our sponsors
AG1 (Athletic Greens): https://athleticgreens.com/huberman
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Supplements from Momentous
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Timestamps
(00:00:00) Dr. Nolan Williams, Brain Stimulation & Depression Treatment
(00:03:48) Sponsors: LMNT
(00:09:16) Depression, Risk Factors, Emergency Psychiatric Treatments
(00:15:11) The Brain-Heart Connection, Vagus Nerve, Prefrontal Cortex
(00:17:51) Right vs. Left Brain Hemispheres & Mood Balance, Connectome
(00:22:34) Heart Rate & Depression, Behavioral Interventions, Transcranial Magnetic Stimulation (TMS)
(00:33:02) Prefrontal Cortex & Cognitive Control, TMS
(00:35:30) Sponsor: AG1
(00:39:00) Belief/Identity “Rules”, Re-scripting, TMS & Talk Therapy
(00:45:49) Dorsolateral Prefrontal Cortex, TMS & Depression Treatment
(00:48:36) Cingulate Cortex & Emotion, Dissociation & Catatonia
(00:54:27) Ketamine, the Opioid System & Depression; Psychedelic Experience or Biology?
(01:03:42) SSRIs, Serotonin & Depression; Childhood, Chemical Imbalance or Circuit?
(01:13:58) Memories & “Rule” Creation; Psilocybin & “Rule” Resolution
(01:21:00) MDMA & Post-Traumatic Stress Disorder (PTSD) Treatment, Psilocybin & Depression Treatment
(01:24:12) Is MDMA Neurotoxic?, Drug Purity, Dopamine Surges, Post-MDMA Prolactin
(01:30:38) Psilocybin, Brain Connectivity & Depression Treatment
(01:34:53) Exposure Response Prevention: “Letting Go” & Depression Treatment
(01:41:23) Normal Spectrums for Mental Health Disorders
(01:45:35) Ibogaine & “Life Review”; PTSD, Depression & Clinical Trials
(01:57:16) Clinical Use of Psychedelics
(02:01:59) Ayahuasca, Brazilian Prisoner Study
(02:06:55) Cannabis: THC, CBD & Psychosis, Clinical Uses
(02:14:52) Personal Relative Drug Risk & Alcohol
(02:20:42) Circadian Reset for Depression, Sleep Deprivation, Light
(02:28:43) Stanford Neuromodulation Therapy (SNT) Study
(02:34:25) Space Learning Theory & TMS Stimulation
(02:45:35) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Huberman Lab Premium, Neural Network Newsletter, Social Media
Title Card Photo Credit: Mike Blabac
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