#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

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. 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. * This episode is brought to you by Nordic Naturals, the #1-selling fish-oil brand in the US! More than 80% of Americans don’t get enough omega-3 fats from their diet. That is a problem because the body can’t produce omega-3s, an important nutrient for cell structure and function. Nordic Naturals solves that problem with their doctor-recommended Ultimate Omega fish-oil formula for heart health, brain function, immune support, and more. Ultimate Omega is made exclusively from 100% wild-caught sardines and anchovies. It’s incredibly pure and fresh with no fishy aftertaste. All Nordic Naturals’ fish-oil products are offered in the triglyceride molecular form—the form naturally found in fish, and the form your body most easily absorbs. Go to Nordic.com and discover why Nordic Naturals is the #1-selling omega-3 brand in the U.S. Use promo code TIM for 20% off your order of Ultimate Omega. * This episode is also brought to you by Eight Sleep! Eight Sleep’s Pod Cover is the easiest and fastest way to sleep at the perfect temperature. It pairs dynamic cooling and heating with biometric tracking to offer the most advanced (and user-friendly) solution on the market. Simply add the Pod Cover to your current mattress and start sleeping as cool as 55°F or as hot as 110°F. It also splits your bed in half, so your partner can choose a totally different temperature. Conquer this winter season with the best in sleep tech and sleep at your perfect temperature. Many of my listeners in colder areas enjoy warming up their bed after a freezing day. Go to eightsleep.com/Tim and save $250 on the Pod Cover by Eight Sleep this winter. Eight Sleep currently ships within the USA, Canada, the UK, select countries in the EU, and Australia.  * This episode is also brought to you by AG1! I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. I do my best with nutrient-dense meals, of course, but AG1 further covers my bases with vitamins, minerals, and whole-food-sourced micronutrients that support gut health and the immune system.  Right now, you’ll get a 1-year supply of Vitamin D free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit DrinkAG1.com/Tim to claim this special offer today and receive your 1-year supply of Vitamin D (and 5 free AG1 travel packs) with your first subscription purchase! That’s up to a one-year supply of Vitamin D as added value when you try their delicious and comprehensive daily, foundational nutrition supplement that supports whole-body health. * [00:00] Start [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. * For show notes and past guests on The Tim Ferriss Show, please visit tim.blog/podcast. For deals from sponsors of The Tim Ferriss Show, please visit tim.blog/podcast-sponsors Sign up for Tim’s email newsletter (5-Bullet Friday) at tim.blog/friday. 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