Tim Ferriss

January 5, 2024

A Glimpse of the Future: Electroceuticals for 70%–90% Remission of Depression, Brain Stimulation for Sports Performance, and De-risking Ibogaine for TBI/PTSD (#714)

“What’s so hard about this scientifically, and to get the scientific community fully on board with these ideas, is that we’re likely going to figure out this works before we have any idea on how it works.”
— Dr. Nolan Williams

Welcome to a very special episode of The Tim Ferriss Show, an episode that might be an example of peeking around corners and catching a glimpse of the future of mental health treatments in the next five to ten years.

My guest is Nolan Williams, MD (@NolanRyWilliams). Nolan is an associate professor within the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine and director of the Stanford Brain Stimulation Lab. He has a broad background in clinical neuroscience and is triple board certified in general neurology, general psychiatry, and behavioral neurology and neuropsychiatry. Themes of his work include examining spaced learning theory and neurostimulation techniques, development and mechanistic understanding of rapid-acting antidepressants, and identifying objective biomarkers that predict neuromodulation responses in treatment-resistant neuropsychiatric conditions.

Nolan specializes in looking at cutting-edge treatments and new technologies that can be applied to treatment-resistant psychiatric disorders—so, treatment-resistant depression, disorders that are notoriously difficult to address, such as OCD, and many others.

Nolan’s work resulted in an FDA clearance for the world’s first noninvasive, rapid-acting neuromodulation approach for treatment-resistant depression. And I’ve tested this myself, and we get into this in the conversation. He has published papers in Brain, American Journal of Psychiatry, and Proceedings of the National Academy of Sciences. Results from his studies have gained attention in Science and NEJM Journal Watch. He has received two NARSAD Young Investigator Awards, the Gerald L. Klerman Award, and the National Institute of Mental Health Biobehavioral Research Award for Innovative New Scientists.

We also discuss things like ibogaine that are seemingly unrelated to neuromodulation, as Nolan is very well-versed in multiple disciplines and in multiple toolkits, both pharmacological and non-invasive neuromodulatory. It’s this combination, actually, this rare Venn diagram, that makes him incredibly interesting to me.

I really enjoyed this conversation. I think it is very important, highly tactical, and I hope you enjoy it as much as I did.

P.S. “Magnesium–Ibogaine Therapy in Veterans with Traumatic Brain Injuries” is now live in Nature Medicine.

Listen to the episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, Google Podcasts, Amazon Music, or on your favorite podcast platform. Watch the interview on YouTube here.

Brought to you by Nordic Naturals Ultimate Omega fish oil, Eight Sleep’s Pod Cover sleeping solution for dynamic cooling and heating, and AG1 all-in-one nutritional supplement.

The transcript of this episode can be found here. Transcripts of all episodes can be found here.

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#714: A Glimpse of the Future: Electroceuticals for 70%–90% Remission of Depression, Brain Stimulation for Sports Performance, and De-risking Ibogaine for TBI/PTSD

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Want to hear another episode that explores the frontier of ibogaine therapy? Listen to my conversation with Hamilton Morris in which we discussed Alexander Shulgin’s psychedelic research at the height of the War on Drugs, concerns about psychedelic research in the for-profit sector, how ibogaine’s usefulness for treating opioid addiction was discovered, sustainable alternatives to popularly used compounds, required reading, and much more.

#511: Hamilton Morris on Iboga, 5-MeO-DMT, the Power of Ritual, New Frontiers in Psychedelics, Excellent Problems to Solve, and More

What was your favorite quote or lesson from this episode? Please let me know in the comments.

SCROLL BELOW FOR LINKS AND SHOW NOTES…

SELECTED LINKS FROM THE EPISODE

Connect with Dr. Nolan Williams:

Brain Stimulation Lab | Twitter

SHOW NOTES

[07:49] How SAINT helped Deirdre Lehman.
[13:59] Typical vs. atypical sequences of activation.
[21:00] Psychiatry 1.0, 2.0, 3.0.
[26:41] How SAINT (Stanford Accelerated Intelligent Neuromodulation Therapy) came to be.
[34:00] TMS vs. ECT.
[35:26] Rewards and risks of shortening treatment timeframe.
[43:43] Numbers treated and common side-effects.
[46:32] Patient demographics.
[49:51] Where to find current open trials.
[51:01] Observed benefits of SAINT over more conventional treatments.
[52:45] Adapting treatment when symptoms prove misleading.
[58:03] SAINT remission numbers versus those of alternative therapies.
[1:02:50] Delayed remission speculation.
[1:07:06] How Nolan became The Ibogaine Bachelorette.
[1:11:37] The origin of Nolan’s interest in ibogaine.
[1:12:40] Amazing results of the quickest-recruiting study Nolan has ever run.
[1:15:19] Dealing with alexithymia and self-reporting inaccuracies in research.
[1:19:41] Ibogaine research gets federal funding (approved since this conversation took place)!
[1:21:09] Isolating the ibogaine effect.
[1:21:49] The value of life review on ibogaine.
[1:25:56] How ibogaine differs from other psychedelic treatments.
[1:30:05] The challenge behind synthesizing naturally occurring compounds.
[1:31:54] Coping with ibogaine’s cardiac risks.
[1:39:37] Understanding habitual action through ibogaine, Ozempic, caffeine, and alcohol.
[1:45:43] Ibogaine for TBI.
[1:50:08] Ibogaine for alleviating opioid withdrawal symptoms.
[1:51:34] Ibogaine in Kentucky.
[2:00:59] Weighing ethics with potential outcomes in research.
[2:04:31] Can ibogaine be sourced (or synthesized) sustainably?
[2:08:24] Does 5-MeO-DMT complement ibogaine enough to justify its collection?
[2:16:48] What might Psychiatry 4.0 look like?
[2:25:12] Could we develop therapies to change hand dominance?
[2:28:08] Boosting performance.
[2:34:01] Parting thoughts.

UPDATE FROM BRYAN HUBBARD:

Since Dr. Williams’ interview, a new Attorney General has assumed office in Kentucky. In a letter dated December 26th, 2023, Bryan Hubbard resigned from the Kentucky Opioid Abatement Advisory Commission due to the new Attorney General’s opposition to the use of its funds for ibogaine research.

MORE DR. NOLAN WILLIAMS QUOTES FROM THE INTERVIEW

“You’re actually sending a memory signal into the brain. The stimulation pattern you’re sending into the brain, this kind of Morse code, is really a ‘Turn on, stay on, remember to stay on’ memory signal that’s going into the brain. You’re just basically taking the hippocampus, the part of the brain that’s involved in memory and that signaling that comes out of there, and you’re playing that back through the prefrontal cortex in a way to try to tell the prefrontal cortex to ‘Turn on, stay on, and remember to stay on.’”
— Dr. Nolan Williams

“I’m a pragmatist … for me, the patient’s the most important thing. I have this view of psychiatry that it’s going to look like in-patient cardiology in 20 years where we’re going to use drugs, we’re going to use devices, we’re going to be able to figure out what the best thing is for that patient.”
— Dr. Nolan Williams

“If we gave one of the big pharma companies a hundred billion dollars and said, “Don’t just re-synthesize ibogaine, but make a drug that works like ibogaine,” … I think they’d have a hard time doing it because we don’t have the neuroscience to understand what’s going on there.”
— Dr. Nolan Williams

“What’s so hard about this scientifically, and to get the scientific community fully on board with these ideas, is that we’re likely going to figure out this works before we have any idea on how it works.”
— Dr. Nolan Williams

“If people think it’s really weird, it’s a positive signal that I need to do it.”
— Dr. Nolan Williams

PEOPLE MENTIONED

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William Meller

2 years ago

Nice way he delves into brain signals and the future of psychiatry. How might these insights influence the development of AI-driven mental health solutions?

Christopher W Strehlo

2 years ago

Tim, this may already be appearing in your stats, but your Jan. 5, 2024 Bulletin got me to click on more links than ever before– all of them, I think. This info might be too nebulous to help, but I hope it does, in some way.

Christopher W Strehlo

2 years ago

“…giving us more…It doesn’t care about our weaknesses, our insecurities, our blindspots, our biases…”

Which is why I want an AI that will focus on making me better, and will remind me to do so using the voice of Patrick Stewart, or Neil Gaiman. Come on, technology!

frank

1 year ago

Dr. Nolan Williams explores mental health’s future, hinting at breakthroughs before understanding. Just like mastering a car parking game—winning before mastering the mechanics. How does unpredictability spice up your virtual parking adventures?

Grace June

1 year ago

Hey Tim, I have been following you for maybe a decade and finally started doing my own writing. I shared a podcast episode on Substack where I shared about my mental health story with psychedelics- a cautionary tale. I appreciate all the new cool things that help people recover yet for myself having tried so many things to largely ill effect, I’ve discovered that the most basic things are what allow me to thrive and I wish more people knew about how powerful the simplest things can be, like water intake, being outside, and having healthy friendships. I’ve tried so many things including a Stellate block and learned that ultimately most of the answers are (at least for now!!) more simple than the complex uphill struggle I was making it. Thanks for always being clutch with amazing guests and helpful info.

Mike Boyle

1 year ago

One of the most important podcast I have ever heard. It corresponds with accelerated TMS therapy I received in Austin from my Functional medicine team after caring for my business partner for eight months while he was dying of cancer.

After 30 sessions in 5 days combined with Ketamine therapy I went from being profoundly depressed to being on top of the world.

This is real stuff, thanks again Tim for doing this. So important. I feel like therapy like this could have saved my mother who was bipolar and schizophrenic and killed herself when I was 11.

Brook

1 year ago

I suffered a head injury in 2021 that caused a concussion and I never recovered from it. After 2 years of neurologists getting me minimal improvement, I had to step up and do it for myself. Microdosing psilocybin for about 3 months did more to bring my brain back than two years of being treated by neurologists.