Comment on: History repeating: guidelines to address common problems in psychedelic science

Psychedelic research rigor debates, especially around double-blind placebo-controlled trials, are met with a critique focused on how blinding failures and placebo assumptions are interpreted. The comment argues that claims about “serious doubts” in the last decade must be weighed against the scale of the broader psychedelic clinical trial literature. It also challenges how conflicts of interest are assessed and questions whether declaring RCTs as a universal “gold standard” is epistemically justified. A central issue is unblinding: the author argues that psychiatric and psychopharmacology contexts make blinding difficult, and that double-blinding can introduce additional biases while also reducing external validity. For psychedelic-assisted therapy, the drugs are said to affect self-awareness and agency, making blinding not just technically imperfect but conceptually misaligned with the intervention being studied. The comment proposes reframing factors often labeled “placebo effect” (expectancy, therapeutic alliance, self-narratives, interpersonal behavior, beliefs) as treatment-relevant signals that should be measured and reported rather than dismissed as noise, and calls for broader methodological approaches alongside RCTs, including real-world evidence.