Psychedelics & Neurostimulation for Brain Rewiring | Dr. Nolan Williams

Psychedelics & Neurostimulation for Brain Rewiring | Dr. Nolan Williams

Huberman LabOct 10, 20222h 48m

Andrew Huberman (host), Nolan Williams (guest), Narrator, Narrator

Neural circuitry of depression and brain–heart interactionsTranscranial magnetic stimulation (TMS) and the SAINT/SNT protocolPsychedelic‑assisted therapies: ketamine, psilocybin, MDMA, ibogaine, ayahuascaSSRIs, serotonin hypotheses, and the shift to circuit‑based psychiatryTrauma, PTSD, moral injury, and treatment in special operations veteransSleep, circadian rhythm interventions, and mood regulationCannabis, alcohol, and comparative drug risks for mental health

In this episode of Huberman Lab, featuring Andrew Huberman and Nolan Williams, Psychedelics & Neurostimulation for Brain Rewiring | Dr. Nolan Williams explores rewiring Depression: Psychedelics, TMS, and Brain‑Heart Circuit Breakthroughs Andrew Huberman interviews psychiatrist and neurostimulation expert Dr. Nolan Williams about cutting‑edge treatments for depression and trauma, focusing on transcranial magnetic stimulation (TMS) and psychedelic‑assisted therapies. Williams explains how specific prefrontal and cingulate circuits govern mood, heart rate, and our sense of control over internal states, and how targeted stimulation can rapidly reverse severe, even suicidal, depression. They review emerging evidence for ketamine, psilocybin, MDMA, ibogaine, ayahuasca, and cannabis, including mechanisms, safety, and how these compare to traditional SSRIs and psychotherapy. The conversation also covers sleep, circadian tools, and Williams’ SAINT/SNT protocol, a high‑dose, accelerated TMS regimen now in clinical trials that can remit treatment‑resistant depression in days.

Rewiring Depression: Psychedelics, TMS, and Brain‑Heart Circuit Breakthroughs

Andrew Huberman interviews psychiatrist and neurostimulation expert Dr. Nolan Williams about cutting‑edge treatments for depression and trauma, focusing on transcranial magnetic stimulation (TMS) and psychedelic‑assisted therapies. Williams explains how specific prefrontal and cingulate circuits govern mood, heart rate, and our sense of control over internal states, and how targeted stimulation can rapidly reverse severe, even suicidal, depression. They review emerging evidence for ketamine, psilocybin, MDMA, ibogaine, ayahuasca, and cannabis, including mechanisms, safety, and how these compare to traditional SSRIs and psychotherapy. The conversation also covers sleep, circadian tools, and Williams’ SAINT/SNT protocol, a high‑dose, accelerated TMS regimen now in clinical trials that can remit treatment‑resistant depression in days.

Key Takeaways

Depression is a circuit disorder linking mood, cognition, and the heart, not just a “chemical imbalance.”

Williams describes depression as the most disabling condition worldwide and a major risk factor for medical disease, now recognized by the American Heart Association as a coronary artery disease risk factor. ...

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Left and right prefrontal circuits act as mood “balances,” and timing between DLPFC and cingulate predicts recovery.

Lesion and TMS data show that circuits functionally connected to left DLPFC are antidepressant when excited, while right DLPFC circuits are associated with mania when overactive. ...

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Accelerated, individualized TMS (SAINT/SNT) can remit severe, treatment‑resistant depression in 1–5 days.

Standard FDA‑cleared TMS delivers modest stimulation once daily for six weeks with partial response rates. ...

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Psychedelics may work by reopening plasticity to rewrite entrenched emotional “rules,” but drug state and biology both matter.

Ketamine, psilocybin, MDMA, ibogaine, and ayahuasca each induce highly plastic states in which traumatic or depressive memories can be re‑experienced and reconsolidated in new ways—akin to an extreme form of exposure and response prevention or cognitive restructuring. ...

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Different psychedelics have distinct use‑cases, mechanisms, and safety profiles—and should remain medical, not recreational, tools.

MDMA shows strong, durable effects for PTSD (about two‑thirds achieve clinically significant relief after 1–3 sessions) without evidence of long‑term cognitive harm in controlled or “pure use” cohorts, contradicting earlier flawed neurotoxicity claims. ...

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Psychiatry is moving from “chemical imbalance” (2.0) to “circuit‑based” (3.0) models, which are more hopeful and actionable.

SSRIs clearly help many with depression, anxiety, and OCD, but their delayed onset and broad systemic actions suggest they work via downstream plasticity and circuit changes rather than fixing a simple serotonin deficit. ...

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Sleep, circadian alignment, and substance choices strongly modulate mood circuits—and can be leveraged or misused.

A “triple therapy” combining one night of sleep deprivation, carefully timed circadian phase shift, and bright light exposure can rapidly improve depression, likely by resetting circadian–mood coupling, but must be medically supervised because sleep loss is pro‑anxiety. ...

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Notable Quotes

Depression is the most disabling condition worldwide, and yet as acuity increases, our psychiatric treatments actually decrease.

Dr. Nolan Williams

The heart very consistently seems to be the end organ of the dorsolateral prefrontal cortex.

Dr. Nolan Williams

In people that are normal, healthy controls, the dorsolateral prefrontal cortex is temporally in front of the anterior cingulate. In depression, it flips—and with effective treatment, we can flip it back.

Dr. Nolan Williams

Psychiatry 3.0 is about circuits. It says your brain networks are dysregulated, but they’re correctable. You are not permanently broken.

Dr. Nolan Williams

If we discovered these psychedelic substances today, we’d probably call them a major breakthrough in psychiatry—because they let us do things with plasticity we just haven’t been able to do before.

Dr. Nolan Williams

Questions Answered in This Episode

In your SAINT/SNT patients who relapse after an initial remission, what patterns do you see in their brain connectivity or life circumstances that might help predict who will need maintenance stimulation versus one‑time treatment?

Andrew Huberman interviews psychiatrist and neurostimulation expert Dr. ...

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Given your ketamine+naltrexone findings, how would you design a definitive human study to test whether non‑hallucinogenic psychedelic analogues (like modified LSD or psilocybin) can match the antidepressant effect of classic psychedelics without the trip?

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For special operations veterans treated with ibogaine and later 5‑MeO‑DMT, how do the qualitative psychological changes (e.g., moral injury repair, self‑forgiveness) compare to what you see in MDMA‑assisted psychotherapy for PTSD?

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How would you triage a severely depressed, suicidal patient today among SSRIs, intensive psychotherapy, ketamine, SAINT/SNT, and psilocybin or MDMA trials—what clinical or neuroimaging markers would most strongly push you toward one modality over another?

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You noted that alcohol is likely to be re‑evaluated much like smoking; what specific policy or clinical practice changes do you think academic medical centers should make in the next decade to better align with the comparative drug‑harm data?

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Transcript Preview

Andrew Huberman

(Upbeat music) Welcome to the Huberman Lab Podcast, where we discuss science and science-based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today, my guest is Dr. Nolan Williams. Dr. Williams is a medical doctor and professor of psychiatry and behavioral sciences at Stanford University School of Medicine. His laboratory and clinic focus on depression and other mood disorders. They focus specifically on the use of transcranial magnetic stimulation, which is a brain stimulation technique that can either activate or quiet specific brain circuits, as well as circuits within the body, in order to treat depression and other mood disorders. Other laboratories and clinics use TMS. What sets apart the work of Nolan Williams and colleagues is that they combine TMS with other treatments, and some of those treatments are among the more cutting edge that you've probably heard about these days, including ibogaine, psilocybin, MDMA, cannabis, DMT, and other drugs that, at this point in time, are experimental in terms of clinical trials, but that at least the preliminary data show hold great promise for the treatment of depression and other mood disorders. In the course of my discussion with Dr. Williams, we covered things such as the history of each of these drugs, how they came to be, and their current status in terms of their clinical use and legality. We also talk about their safety profiles, both in children and in adults, and we talk about what the future of psychedelic research and clinical use really looks like. For instance, we discuss how a number of laboratories and clinics are modifying psychedelics to remove some of their hallucinogenic properties while maintaining some of their antidepressant or anti-trauma properties. You'll also learn about some fascinating research in Dr. Williams' laboratory focus on ketamine, which is a drug that is increasingly being used to treat depression, and contrary to common belief, the effects of ketamine, in terms of relieving depression, may not actually arise from its dissociative effects. One thing that you'll find extraordinary about Dr. Williams is that not only does he have vast knowledge of the various treatments for depression, but that he and his laboratory are really combining these treatments in the most potent way, that is combining psychedelic treatments with brain-machine interface, or combining brain-machine interface with particular learning protocols, that is neuroplasticity protocols, which can directly change the brain in specific ways. So today, you're going to learn a tremendous amount about the neural circuitry underlying depression, as well as positive moods. You'll also learn about all the various drugs that I described, and you're really going to learn about the current status and future of the treatment of mood disorders. Today, you'll also learn about a number of ongoing studies in Dr. Williams' laboratory. I should mention that they are recruiting subjects for these studies. If you go to BSL, which stands for Brain Stimulation Laboratory, so that's bsl.stanford.edu, you have the opportunity to apply for one of these clinical trials for the treatment of depression and other mood disorders. I confess that the conversation with Dr. Williams was, for me, one of the more stimulating and informative conversations I've ever had about psychedelics, which is simply to say that his breadth and depth of knowledge on that topic is incredible, and his breadth and depth of knowledge in terms of the underlying brain science and how it can all be combined with clinical applications is also extraordinary. I'm sure that by the end of today's episode, you're going to come away with a tremendous amount of knowledge about the clinical and non-clinical uses of those substances, and you're going to understand a lot more about how the healthy and diseased brain work. I'm pleased to announce that the Huberman Lab Podcast has now launched a premium channel. I want to be very clear that the Huberman Lab Podcast will continue to be released every Monday at zero cost to consumer, and there will be no change in the format of these podcasts. The premium channel is a response to the many questions we get about specific topics, and it will allow me to really drill deep into specific answers related to those topics. So once a month, I'm going to host an Ask Me Anything, so-called AMA, where you can ask me anything about specific topics covered on the Huberman Lab Podcast, and I will answer those questions. Those, of course, will be recorded. There will also be other premium content available to premium subscribers, such as transcripts and short videos of new tools and unique tools for mental health, physical health, and performance. If you want to check out the premium channel, you can go to hubermanlab.com/premium. There is a $10 a month charge or $100 per year, and I should mention that a large portion of the proceeds from the Huberman Lab Premium Channel will go to support scientific research that develops the very sorts of tools that we talk about on the Huberman Lab Podcast. The rest of the support for the Huberman Lab Podcast Premium Channel will go to supporting the regular Huberman Lab Podcast. Again, that's hubermanlab.com/premium. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desire and effort to bring zero-cost-to-consumer information about science and science-related tools to the general public. In keeping with that theme, I'd like to thank the sponsors of today's podcast. Our first sponsor is InsideTracker. InsideTracker is a personalized nutrition platform that analyzes data from your blood and DNA to help you better understand your body and help you reach your health goals. I've long been a believer in getting regular blood work done, for the simple reason that many of the factors that impact your immediate and long-term health can only be analyzed with a quality blood test. One problem with a lot of DNA tests and blood tests, however, is you get data back about levels of metabolic factors, levels of hormones, et cetera, but you don't know what to do with that information. InsideTracker makes interpreting your data and knowing what to do about it exceedingly easy. They have a personalized platform where you can go and you can see those levels of hormones, metabolic factors, lipids, et cetera, and they point to specific nutritional tools, behavioral tools, supplement-based tools, et cetera, that can help you bring those numbers into the ranges that are optimal for you. If you'd like to try InsideTracker, you can go to insidetracker.com/huberman to get 20% off any of InsideTracker's plans. Again, that's insidetracker.com/huberman to get 20% off.Today's episode is also brought to us by Eight Sleep. Eight Sleep makes smart mattress covers with cooling, heating, and sleep tracking capacity. I started sleeping on an Eight Sleep mattress cover a few months ago, and it is simply incredible. In fact, I don't even like traveling anymore (laughs) because they don't have Eight Sleep mattress covers in hotels and Airbnbs. One of the reasons I love my Eight Sleep mattress cover so much is that, as you may have heard before on this podcast or elsewhere, in order to fall and stay deeply asleep, you need your body temperature to drop by about one to three degrees, and I tend to run warm at night, which makes it hard to sleep and sometimes wakes me up in the middle of the night. When you sleep on an Eight Sleep mattress cover, you can program the temperature of that mattress cover for specific times in the early, middle, and late part of your night so that the mattress stays cool, and as a consequence, you sleep very, very deeply. It also tracks your sleep, so it's paying attention to how many times you're moving, how deep your sleep is. It gives you a sleep score, all wonderful data to help you enhance your sleep. And of course, sleep is the foundation of mental health, physical health, and performance, which makes an Eight Sleep a terrific tool for enhancing not just your sleep, but all aspects of your life, really. If you're interested in trying an Eight Sleep mattress cover, you can go to EightSleep.com/huberman to check out the Pod 3 cover, and you can save $150 at checkout. Eight Sleep currently ships to the USA, to Canada, the UK, and select countries in the EU and Australia. Again, that's EightSleep.com/huberman to save $150 at checkout. Today's episode is also brought to us by ROKA. ROKA makes eyeglasses and sunglasses that are of the absolute highest quality. The company was founded by two All-American swimmers from Stanford, and everything about ROKA eyeglasses and sunglasses were designed with performance in mind. I've spent a lifetime working on the visual system, and I can tell you that your visual system has to contend with some pretty significant challenges in order to be able to see clearly as you move from one area to the next, for instance, when you go from a shady area to a bright area. ROKA understands this and have designed their sunglasses and eyeglasses accordingly so you always see with crystal clarity. In addition, because they were initially designed for performance, things like running and biking, they're extremely lightweight, but they have a terrific aesthetic. So unlike a lot of eyeglasses and sunglasses that were designed for sports and make you look like a cyborg, they have styles that make you look like a cyborg if you like those, but they also have styles that you'd be perfectly comfortable wearing to work or out to dinner, et cetera. They're really terrific glasses. I love mine because I can wear them anywhere, and I also use them when running and going out hiking, et cetera. If you'd like to try ROKA eyeglasses or sunglasses, you can go to ROKA, that's ROKA.com and enter the code Huberman to save 20% off your first order. Again, that's ROKA, ROKA.com and enter the code Huberman at checkout. On many episodes of the Huberman Lab Podcast, we talk about supplements. While supplements aren't necessary for everybody, many people derive tremendous benefit from them, things like enhancing sleep and the depth of sleep or for enhancing focus and cognitive ability or for enhancing e- energy or adjusting hormone levels to optimal range for you. The Huberman Lab Podcast is now partnered with Momentous Supplements. To find the supplements we discuss on the Huberman Lab Podcast, you can go to Live Momentous, spelled OUS, LiveMomentous.com/huberman. And I should just mention that the library of those supplements is constantly expanding. Again, that's LiveMomentous.com/huberman. And now for my discussion with Dr. Nolan Williams. Thanks for joining today. I'm really excited to have this conversation. It's been a long time coming, and I have a lot of questions about different compounds, psychedelics in particular.

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