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u/mveaonReddit16h ago
Trials of psychedelics for mental health may be invalid, because it's fairly obvious to patients whether they've been given a psychedelic or a placebo. Blinding failed more than 90% of the time in the studies of psilocybin, LSD and DMT, and 85% of the time in studies of MDMA.
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Analysis Summary
Psychedelic trials have severe blinding problems — blinding integrity has been found to be poor in psychedelic macrodose RCTs that measured it, with participants often correctly guessing treatment allocation at 90%-95% rates. This matters because study participants' expectations about efficacy can influence outcomes when the blind is broken. The post omits that practical measures like independent raters and active placebos can partially mitigate expectancy effects, and blinding problems don't automatically disqualify medications from licensing decisions.
Claims Analysis (3)
“Blinding failed more than 90% of the time in studies of psilocybin, LSD and DMT”
94% correct guess rate for psilocybin in Bogenschutz et al.; LSD showed 95% correct guess rate in Holze et al. representing near-total unblinding.
“Blinding failed 85% of the time in studies of MDMA”
MDMA studies showed 70.5% average correct guess rate for placebo participants and 86.2% for personnel, supporting ~85% failure threshold cited.
“Trials of psychedelics may be invalid because patients can tell if they've been given a psychedelic or placebo”
Weak blinding integrity in trials has limited capacity to definitively attribute therapeutic effects to the psychedelic, supporting validity concerns.
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