The Future of Mental Health Treatments Without the High
Researchers and clinicians have long been fascinated by the potential of psychedelic drugs like ketamine and psilocybin to treat conditions such as depression, PTSD, and anxiety. But one question keeps popping up: Is the psychedelic “trip” necessary for these drugs to work? Or can patients experience relief without ever realizing they took a mind-altering substance?
A groundbreaking study led by Stanford anesthesiologist and neuroscientist Dr. Boris Heifets is diving into this very question—and the results could shape the future of mental health treatments as we know it.
What Happens When You Take Ketamine While Asleep?
In a novel clinical trial, Dr. Heifets administered ketamine to patients who were under general anesthesia. The aim? To separate the drug’s biological effects on the brain from the hallucinogenic experience patients usually report.
This approach directly challenges the idea that the psychedelic trip is central to healing. If ketamine still works while the patient is unconscious, it suggests the therapeutic benefits may stem more from how the brain rewires itself chemically than from the subjective experience.
Why This Matters for the Future of Mental Health Treatments
For some patients, especially those with treatment-resistant depression, the idea of a mind-altering trip can be intimidating—or even counterproductive. The ability to harness the power of psychedelics without the hallucinations could widen access and reduce stigma around these therapies.
It also opens the door to more rigorous placebo-controlled studies. If participants don’t know whether they’ve received a psychedelic drug, researchers can better isolate its true effects. That’s been a major challenge in psychedelic research until now.
Rethinking Psychedelics in Interventional Psychiatry
A New Direction for Psychedelic-Assisted Therapy
This shift in approach signals an exciting evolution in the future of mental health treatments. It may be possible to develop next-generation psychedelic therapies that deliver benefits with fewer side effects, lower psychological risks, and more scalable clinical use. For example:
Ketamine Infusion Therapy and Spravato (Esketamine) are already FDA-approved for treatment-resistant depression.
Psilocybin Therapy and MDMA-Assisted Therapy are in late-stage trials.
By reducing the need for intensive therapeutic support during trips, clinics could treat more patients safely and efficiently.
If science confirms that the psychedelic experience isn't essential for recovery, the door opens to broader innovations, including non-psychedelic analogs and targeted brain stimulation techniques like neurofeedback and EEG-guided interventions.
What's Next?
The next phase in this research will likely involve exploring long-term outcomes—do patients who receive ketamine under anesthesia experience the same levels of sustained improvement as those who are awake? And if so, can this method be adapted to other psychedelic compounds?
As these questions are explored, one thing is clear: the future of mental health treatments is rapidly evolving, and interventional psychiatry is at the forefront.
References
Short Wave Podcast. (2025, April 8). Would ketamine treatment help if you didn’t know you got it? NPR. https://www.npr.org/2025/04/08/
Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., & Monnette, C. (2019). Ketamine Assisted Psychotherapy—A Systematic Narrative Review of the Literature. Frontiers in Psychology, 10, 2750. https://doi.org/10.3389/fpsyg.2019.02750
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