How ibogaine could treat depression and anxiety - Nolan Williams

You're listening to ted talks daily where we bring you new ideas to spark your curiosity every day. I'm your host elise Hugh nolan Williams, who passed in October of this year, was an interventional neuropsychiatrist and the director of the Stanford brain stimulation lab. His groundbreaking research ranged from rapid acting plant based medicines to medical devices that can retrain misfiring brain circuits. He gave a talk at ted two twenty five in april about his latest research, the potential of a plant derived psychoactive compound called iogain to treat traumatic brain injury and PTSD. We're sharing his talk today in memory of nolan and to honor the legacy of his work, it's coming up.

您正在收听TED每日演讲，我们每天为您带来激发好奇心的新想法。我是主持人埃莉斯·休。诺兰·威廉姆斯于今年十月去世，他是一位介入性神经精神病学家，也是斯坦福脑刺激实验室主任。他的开创性研究涵盖了从速效植物药物到可以重新训练脑回路异常的医疗设备。今年四月，他在TED2025大会上发表了演讲，介绍了他的最新研究——一种名为伊波加因（ibogaine）的植物源性精神活性化合物治疗创伤性脑损伤和创伤后应激障碍的潜力。我们今天分享他的演讲，以纪念诺兰，并致敬他留下的工作遗产。演讲即将开始。

All right. At1756 you're all aboard a British naval vessel headed to the new world. You're down below deck with your fellow sailors and you're all sick. Your legs are swollen, your gums are bleeding, you just lost a tooth. You go to the ship's doctor and he tells you this is due to internal decay and laziness.

好吧。1756年，你们都在一艘驶往新世界的英国海军舰艇上。你们和同伴水手们在甲板下，你们都病了。你们的腿肿了，牙龈在流血，还刚刚掉了一颗牙。你们去找船医，他告诉你们这是由于内部腐烂和懒惰。

You ask about this foreign fruit medicine, this citrus medicine that you could take, and he tells you that this is not a treatment for what you have. It's too simple. It's a plant medicine, and he's an antiruiter. And instead, he prescribes you arsenic tonics. True story. And you get worse. And when you get to the new world. Half of your shipmates are deceased.

你们询问那种外国水果药，那种可以服用的柑橘类药物，他告诉你们这治不了你们的病。这太简单了。这是一种植物药，而他是一个“抗果派”。相反，他给你们开了含砷的补剂。这是个真实的故事。你们病情加重。当你们到达新世界时，你们一半的船员已经去世。

My name is nolan Williams and I'm here to talk to you about anti fruiters people who weaponize scientific skepticism to thwart new treatments from getting out to the world.

我叫诺兰·威廉姆斯，我今天在这里想和大家谈谈“抗果派”——那些将科学怀疑论武器化，以阻挠新疗法走向世界的人。

And so. Scurvy is an illness that killed2 million people from the time of columbus all the way through to the, eh, the time of widespread citrus adoption and scurvy is the result of a lack of vitamin c in the diet. And the reason why these sailors had a lack of vitamin c is because it was a long sea voyage. So you need to eat dried meats and that sort of thing. And so we, we observed early on in the fifteen hundreds this association between eating citrus fruit and the prevention or the treatment of scurvy. And so, eh, it was written early on that this was a precious medicine. Something could be used for this problem so much so that it actually birthed the world's first clinical trial. So the clinical trial is a scientific tool is the result of trying to find. Solution for scurvy. And so they gave all these man made treatments and then they gave citrus. And I don't have to tell you what. The answer to this scientific question was the people that got the citrus fruit were helping everybody else at the end of the experiment.

那么。坏血病是一种疾病，从哥伦布时代一直到柑橘被广泛采用的时期，它导致了200万人死亡，坏血病是饮食中缺乏维生素C的结果。这些水手缺乏维生素C是因为漫长的海上航行。因此需要吃干肉之类的东西。我们在16世纪早期就观察到了食用柑橘类水果与预防或治疗坏血病之间的关联。所以，嗯，很早就有记载说这是一种珍贵的药物。某种东西可以如此有效地解决这个问题，以至于它实际上催生了世界上第一个临床试验。临床试验作为一种科学工具，是人们试图寻找治疗坏血病方案的结果。于是，他们给了所有人造疗法，然后给了柑橘。我不必告诉你们这个科学问题的答案是什么。答案就是，在实验结束时，获得柑橘的人正在帮助所有其他人。

But there was a reaction. The royal societies did not like this idea. There was backlash, and many thought this was too simple to be a solution for such a problem, that a plant could not solve such a complex problem, and instead they prescribed. Arsenic. Mercury man made chemicals. Now, science eventually prevailed. You know that we were able to see that this was actually helpful. But the problem was that. From the time of James L S study. To the time of widespread implementation was more than a hundred years. A million people died, but this was a war waged against progress by these anti fruers. And it was another hundred years before we even knew what was in the citrus fruit that was improving scurvy, right? We rid the world of scurvy at that point.

但是遭到了反对。皇家学会不喜欢这个想法。出现了强烈抵制，许多人认为这太简单了，不可能是这样一个问题的解决方案，认为植物不可能解决如此复杂的问题，于是他们转而开具砒霜、汞等人造化学品。最终，科学占了上风。你们知道我们得以认识到这确实有效。但问题是，从詹姆斯·林德的研究开始，到被广泛采用，花了一百多年的时间。有一百万人因此死亡，而这是一场由这些“抗果派”发起的反对进步的战争。又过了一百年，我们才知道柑橘中改善坏血病的成分是什么，对吧？那时我们才从世界上消除了坏血病。

And so I'm going to switch to a new plant, medicine. Psychedelics, psychedelics have been used for thousands of years by indigenous populations. The tabernath, ioga root bark of central west Africa was used by the boiti for psychos spiritual purposes for centuries. And they knew that this was a powerful compound. It needed to be done in certain, you know, kind of medical like or medical settings in, in modern medicine. And we need to be able to monitor people because it does have risks, like a rare cardiac arrhythmia and death. And so the modern scourge of sailors navy seals isn't scurvy, it's traumatic brain injury and post traumatic stress disorder.

那么，我现在要转向一种新的植物药物：迷幻药。迷幻药已被土著居民使用了数千年。中西非的塔班那斯（Tabernanthe iboga）根皮几个世纪以来被布威提（Bwiti）教派用于精神和灵性目的。他们知道这是一种强效的化合物。它需要在某种，你们知道的，类似于医疗或现代医学的医疗环境下进行。我们需要能够监测人们，因为它确实存在风险，比如罕见的心律失常和死亡。所以，现代水兵和海豹突击队员的祸害不是坏血病，而是创伤性脑损伤和创伤后应激障碍。

And the treatments that are out there, oral antidepressants and talk therapy do help some people, but they're limited. And so these veterans have decided when they don't get, you know, improvement from the standard treatments, that some of them have gone out to take psychedelic medicines.

现有的治疗方法，如口服抗抑郁药和谈话疗法，确实对一些人有所帮助，但它们是有限的。因此，当这些退伍军人从标准治疗中没有得到改善时，他们中的一些人决定去服用迷幻药物。

And I was approached by one such veteran, eh, Marcus capone, him and his wife amber. Eh? Marcus had been a navy seal for thirteen years and suffered many traumatic brain injuries, had PTSD once he got out and he went down to Mexico. Outside of the US as a US soldier outside of the US down to a foreign country to receive a compound that is illegal in the USA compound that he believed saved his life. And when I met these folks I I heard the story. At first I was a little bit skeptical but then once I heard Marcus's story and other stories I became convinced that this was something worth studying.

一位这样的退伍军人找到了我，嗯，马库斯·卡彭，他和他的妻子安布尔。嗯？马库斯曾是一名海豹突击队员，服役十三年，遭受了多次创伤性脑损伤，退伍后患上了创伤后应激障碍，他去了墨西哥。作为一名美国士兵，他离开美国，前往外国接受一种在美国非法的化合物，他相信这种化合物救了他的命。当我遇到这些人，听说了这个故事。起初我有些怀疑，但当我听了马库斯和其他人的故事后，我确信这值得研究。

So now I'm going to let you listen to Eric's story and you tell me what you think I don't. Know exactly all the reasons why I'm not whole. I know a lot of the symptoms, like being a basically barely functioning alcoholic my entire life, to the point of neglecting myself, neglecting my kids. It's so bad that I have, like, zero control over it. I haven't gone a day without drinking in probably ten years. This is my last chance. I want to be able to heal myself. So that I can be whole. For my family.

现在，我来让你们听听埃里克的故事，然后你们告诉我你们怎么想。我并不完全清楚自己为何不完整。我知道很多症状，比如我这一辈子基本上就是个勉强能工作的酒鬼，严重到忽视自己，忽视我的孩子。情况糟透了，我似乎完全无法控制。我大概有十年没有一天不喝酒。这是我最后的机会。我想要能够治愈自己。这样我才能完整。为了我的家人。

So this is the study that we conducted at Stanford, just like Eric, most of these folks had PTSD in addition to traumatic brain injury beforehand. But after. They had a significant reduction. And cross the line to no longer meet PTSD diagnosis after they received iain. Significant reductions in anxiety, eighty plus percent, significant reductions in depression and remarkably. Resolution of disability from traumatic brain injury. Something that we haven't seen before. And so now I'm gonna let Eric tell you about that. It's. Been about seven months and pretty much everything is different.

这就是我们在斯坦福大学进行的研究。像埃里克一样，这些人在此之前除了创伤性脑损伤外，大多还患有创伤后应激障碍。但在之后，他们有了显著的改善。在接受伊波加因治疗后，他们跨过了界限，不再符合创伤后应激障碍的诊断标准。焦虑显著减少了80%以上，抑郁也显著减少，并且值得注意的是，创伤性脑损伤导致的残疾也得到了解决。这是我们以前从未见过的。现在，我让埃里克来告诉你们。已经大约七个月了，几乎一切都不同了。

A buddy of mine came by the house the other day. He had a drink with him. He drove there. Hey, you want to drink? No man, I'm good. I don't drink anymore, he's like. I'll get you a drink. I'm like, no, I really don't drink anymore. He's like, yeah, yeah, whatever. I'll go get you a drink. No, he didn't believe me. I mean, we're standing there talking for probably thirty minutes in that time before I would have smoked five cigarettes, you know, and he was like. Wait a minute. Did you quit smoking too? I was like, yeah. What? Everything has changed. It's hard to tell somebody like one weekend and everything's different, like some kind of magic pill or something, which it's not. I mean the, the real work started after the experience, but the experience gave me the tools to be able to do the work in the first place. There are so many people that could heal from this. There's, there are so many people that would still be here. I have friends that would still be here. I have family that would still be here.

前几天一个朋友来我家。他自己带了杯酒。他开车来的。“嘿，你想喝点吗？”“不用了，哥们，我很好。我不再喝酒了。”他说。“我给你拿杯喝的。”我说，“不，我真的不再喝酒了。”他说，“行，行，随便。我去给你拿杯喝的。”不，他不相信我。我的意思是，我们就站在那里聊了大概三十分钟，在那段时间里，要是以前我早就抽了五支烟了，你知道吗，然后他说：“等等，你也戒烟了？”我说，“是的。”“什么？”一切都变了。很难告诉别人，好像一个周末过后一切就都不同了，像某种神奇药丸似的，其实不是。我是说，真正的工作是在那次体验之后开始的，但那次体验首先给了我能够去做这份工作的工具。有那么多人可以从中痊愈。有，有那么多人本应还在世。我有朋友本应还在世。我有家人本应还在世。

So now I'm going to let Eric describe the effect. What did he feel while he was under this compound? And what a lot of people will describe is that they go back and look through earlier life memories. They're able to see these memories from a detached third party perspective and look at them and see them and really re -assimilate them into meaning. The visuals that I remember the most were like going through like a photo album, but like a rollodex and like, you flip it as fast as you can. But, and everything goes by and it's a blur. It's like flips out of my life, like an outsider looking in. It allowed me to confront traumas that had much more of an impact on me than I realized. That was one of the biggest things I got from the weekend is just like. That I need to stop poisoning myself in every aspect possible.

现在，我来让埃里克描述一下效果。在药物的作用下，他感觉到了什么？很多人会描述说，他们回去回顾了早年生活的记忆。他们能够从一个超然的第三方视角来看待这些记忆，审视它们，观察它们，并真正地将它们重新吸收并赋予意义。我记得最清晰的画面就像翻看相册，但更像快速翻动旋转名片架。一切闪过，变得模糊。就像从我的生活中翻出来一样，像一个局外人向内看。它让我能够面对那些对我的影响远比我想象中要大的创伤。那是我从那个周末得到的最重要的收获之一：我需要停止在每一个可能的方面毒害自己。

So, just like citrus for scurvy, psychedelic plant medicines were initially seen as quite positive and even the national institute of mental health director in the Mid sixties thought that these were powerful, potentially powerful therapeutic tools and tools for understanding the brain behavior, relationships. But unlike citrus for scurvy, psychedelic plant medicines, these plant medicines were made illegal.

所以，就像柑橘之于坏血病，迷幻植物药物最初也被认为是相当积极的，甚至60年代中期美国国家心理健康研究所的所长也认为它们是强大的、潜力巨大的治疗工具，也是理解大脑行为关系的工具。但与治疗坏血病的柑橘不同，这些迷幻植物药物、这些植物药物被宣布为非法。

Can you imagine how much longer it would have taken for us to be able to get citrus out if we made the orange illegal and so? There's hope, a small group of scientists in the early two thousands, including some in the audience. Have been able to get these studies back up and running some of them all the way through to being evaluated or reevaluated by the FDA very soon. I began, we're trying to get an investigational new drug application through the FDA right now.

你们能想象，如果我们当初把橙子定为非法，我们要花多长得多的时间才能让柑橘疗法问世吗？然而有希望的是，21世纪初，一小群科学家，包括在座的一些人，已经能够让这些研究重新启动并运行，其中一些研究很快将接受或已经接受FDA的评估或再评估。我们正在努力，目前正试图通过FDA提交一份研究性新药申请。

Now, am I telling you to go and run out and go to Mexico and take psychedelics? No, you need to wait until everything's done until the trials are done, if they are. To show us that these are positive, however, what I am saying is that the data shouldn't be evaluated by antiruers, it shouldn't be evaluated by believers either. It should be evaluated by open minded people that are able to look at the data clear minded.

那么，我是在告诉你们赶紧跑去墨西哥服用迷幻药吗？不，你们需要等到所有步骤完成，等到试验结束，如果它们证明这些结果是积极的。然而，我要说的是，数据不应该由“抗果派”来评估，也不应该由信徒来评估。它应该由能够清晰、理性地看待数据的、思想开放的人来评估。

And what I'm also here to tell you is, is that these compounds sit on schedule one, and what that means is that they're on the same level of control as her*in. Right. It means that there's no medicinal use and they have a high abuse liability. And so you can all sit here and think in the seventeen fifties it would have been crazy to make the orange illegal. What will our grandchildren think about us?

我在这里还要告诉你们的是，这些化合物被列在管制药品目录表（Schedule I）中，这意味着它们与海*因处于相同的管制级别。没错。这意味着它们没有药用价值，且有很高的滥用风险。所以，你们可以坐在这里想，在18世纪50年代，把橙子定为非法会是多么疯狂。我们的孙辈会怎么看我们？

And so we're on this edge between institutional rejection and acceptance and the time. The clock is ticking. And I'm going to ask you, did we make the orange illegal? Only time will tell. Thank you.

因此，我们正处在机构拒绝与接受的边缘，而时间在流逝。时钟正在滴答作响。我要问你们，我们把橙子定为非法了吗？只有时间能告诉我们答案。谢谢。

Couple of couple of questions I think, for everyone clearly answered that question of whether Eric needed additional help with additional drugs, for example. Yeah, he was. He was off of everything, eh? You know, these folks end up needing psychotherapy beforehand and they need a lot of psychotherapy, you know, after. Ah, so that that is part of it, but in terms. Of the drug treatment. I began that. Was it that was it OK? Ah, one of the things that I learned, eh, from you and tell me if I got this right, is that the reason why addiction becomes so much of a problem in so many cases is that the more you take a substance it, it dials up in your brain the amount of dopamine that you, you need to feel okay. And, and one possible effect of I began is that it basically resets that relentless scale that is otherwise almost impossible to psychologically do that.

我想有几个问题要问。...（主持人提问）例如，埃里克是否需要额外的药物帮助，这个问题对每个人来说答案都很明确。是的，他确实需要过。但他后来停掉了所有东西，对吗？要知道，这些人最终需要在治疗前接受心理治疗，并且在治疗后也需要大量的心理治疗。啊，所以这是其中的一部分，但就药物治疗本身而言...（主持人提问）伊波加因治疗，是那样，它起作用了吗？...啊，我从你们那里学到的一件事，嗯，告诉我我理解得对不对，成瘾在这么多情况下成为一个大问题的原因是，你摄入某种物质越多，它就会在你大脑中“调高”你为了感觉良好所需的多巴胺量。而伊波加因的一个可能效果是，它基本上重置了那个不断升级的刻度，否则从心理上几乎不可能做到这一点。

Yeah, that, that's the view is that part of what is going on is that this actually promotes growth factors called glialri neurotrophic factor in the brain, which has a role in regulating dopamine neurons. And so the view is that this kind of resets those dopamine neurons to function pre addiction like. And it's also true, I think, that if you take iain unsupervised, you risk like heart attack. It's arrhythmia, so an abnormal heart rhythm. And that's why it's important to, to do this under supervision. We think prophylaxing with certain kind of very low risk. Cardiac arrhythmia medications like magnesium sulfate can actually reduce the risk quite a bit. But it is something that needs to, to be in medical supervision and in cardiac supervision, but.

是的，这是其中的一种观点，认为其作用机制部分在于它实际上促进了大脑中称为胶质细胞源性神经营养因子的生长因子，这种因子在调节多巴胺神经元方面发挥作用。因此观点是，这类物质让这些多巴胺神经元的功能恢复到成瘾前的状态。同时我也认为，如果你在无人监督的情况下服用伊波加因，你会有类似心脏病发作的风险。是心律失常，即心律异常。这就是为什么必须在监督下进行这一点很重要。我们认为使用某些风险非常低的心律失常药物（如硫酸镁）进行预防性用药，实际上可以大大降低风险。但这确实需要在医疗监督和心脏监护下进行，不过...

To be clear in, in your sort of study of different kinds of medical interventions. How dramatic is this? Yeah, I mean, we, eh, we've never seen such a kind of a broad acting, eh, cns compound before, right? I mean, in my view, it's one of the, the most amazing drugs on the planet because of this. And so, you know, it's like, ah, it's the equivalent of like a broad acting antibiotic that can treat all infections. It seems to be able to treat this kind of, you know, in its early days. So we still have to do a lot of work to prove this totally in iain. But, you know, tbi, PTSD, depression, that's a really broad effect.

在您对不同类型医疗干预的研究中，这一点需要明确。它的效果有多显著？是的，我是说，我们，呃，我们以前从未见过如此广谱的、呃，中枢神经系统化合物，对吧？在我看来，正因为如此，它是地球上最神奇的药物之一。所以，你知道，这就像，啊，就像是一种可以治疗所有感染的广谱抗生素。在早期研究中，它似乎能够治疗这类疾病。所以我们仍然需要做很多工作来在伊波加因上完全证明这一点。但是，你们知道，创伤性脑损伤、创伤后应激障碍、抑郁症，这是一个非常广泛的作用效果。

Thank you so much for bringing news to ted. Thank you. That was nolan Williams speaking at ted2025.

非常感谢您为TED带来这个新消息。谢谢。以上是诺兰·威廉姆斯在TED2025的演讲。