HoldsUp

Will Van Derveer

Will Van Derveer, MD, is a physician working in the field of mental health. His published research includes an investigation into skill retention among Wilderness First Responders, published in the journal Wilderness & Environmental Medicine.

24 claims checked on air: 3 context 3 contradicted 1 overstated 14 supported 3 unverified 4 flagged

What they said on air

0:00:00unverifiedvery lowThe Radical Idea Changing Mental Health Treatment | Will Van

An ayahuasca experience typically lasts around 6 to 8 hours, whereas an ibogaine experience usually lasts around 72 hours.

"The difference between an ayahuasca ceremony in South America and that ibogaine ceremony, the ayahuasca experience tends to be about 6 hours, maybe 8 hours. The ibogaine experience, it's usually more like 72 hours." (said at 0:00:00)

No published record matching the claimed comparative durations of action for ayahuasca (~6–8 hours) and ibogaine (~72 hours) was located in PubMed; this does not prove the claim false.

0:05:36supportedhighThe Radical Idea Changing Mental Health Treatment | Will Van

Richard Nixon's Controlled Substances Act of 1970 virtually shut down research on psychedelic therapies.

"It dates back to Richard Nixon's Controlled Substances Act of 1970 that virtually shut down research on psychedelic therapies. It was a very fertile and vibrant field in the 1960s before the kibosh came down." (said at 0:05:36)

The speaker's statement accurately reflects the historical record and scientific consensus. Following extensive clinical experimentation and psychiatric research in the 1950s and 1960s, the passage of the Comprehensive Drug Abuse Prevention and Control Act of 1970 (Controlled Substances Act) under the Nixon administration placed classical psychedelics (including LSD, psilocybin, and mescaline) into Schedule I. This regulatory classification categorized them as having high abuse potential and no accepted medical use, effectively halting clinical trials and development of psychedelic therapies in the United States for several decades until research resumed in the late 1990s and 2000s.

0:07:10supportedmoderateThe Radical Idea Changing Mental Health Treatment | Will Van

In a phase two study of MDMA-assisted therapy for severe PTSD, approximately two-thirds of participants no longer met diagnostic criteria for PTSD at the primary endpoint and at one-year follow-up.

"and I was the study physician and one of the MDMA therapists on a phase two study that led to the breakthrough designation and on into phase three. And by the time we were done with this phase two study, where, by the way, about two-thirds of the folks with very severe PTSD no longer met criteria anymore at the primary endpoint, and still were not meeting criteria at the one-year follow-up." (said at 0:07:10)

The speaker's statement accurately reflects the published findings from the pooled Phase 2 clinical trial program that supported the FDA's Breakthrough Therapy designation for MDMA-assisted psychotherapy. In the pooled Phase 2 data, 54.2% to 56.0% of participants no longer met PTSD diagnostic criteria at the post-treatment endpoint, and this proportion increased to 67.0% (approximately two-thirds) at the long-term follow-up (≥12 months). It should be noted that in 2024, the journal retracted these pooled analysis papers due to ethical violations and protocol non-compliance identified at one of the participating study sites, though the historical reported numbers match the claim.

0:08:30supportedhighThe Radical Idea Changing Mental Health Treatment | Will Van

The FDA initially denied approval for MDMA-assisted therapy in the summer of 2024.

"The MDMA phase three study is complete. FDA initially denied approval last summer in 2024." (said at 0:08:30)

The speaker's statement is accurate. In August 2024 (the summer of 2024), the US Food and Drug Administration (FDA) reviewed the new drug application submitted by Lykos Therapeutics for MDMA-assisted psychotherapy for post-traumatic stress disorder (following completed Phase 3 trials) and issued a Complete Response Letter declining approval, requesting an additional Phase 3 trial to address concerns regarding study design, functional unblinding, safety assessments, and trial conduct.

0:08:55supportedhighThe Radical Idea Changing Mental Health Treatment | Will Van

Ketamine is classified as a DEA Schedule III drug in the United States, while psilocybin and MDMA are Schedule I.

"And of course, ketamine-assisted therapy is widely available on DEA schedule three. So, for the time being, psilocybin and MDMA are still on schedule one." (said at 0:08:55)

The speaker's statement accurately reflects United States federal drug scheduling under the Controlled Substances Act administered by the DEA. Psilocybin and MDMA are classified as Schedule I controlled substances, a legal designation that has historically restricted clinical research. In contrast, ketamine is a DEA Schedule III controlled substance, allowing it to be legally prescribed and administered off-label or on-label (e.g., esketamine) in medical and therapeutic settings.

0:17:26supportedhighThe Radical Idea Changing Mental Health Treatment | Will Van

Ibogaine causes cardiac toxicity.

"Well, ibogaine in particular has this cardiac toxicity that we have to be very, very careful about." (said at 0:17:26)

Published clinical and toxicological literature well establishes that ibogaine carries a significant risk of cardiac toxicity. Mechanistically, ibogaine and its active metabolite noribogaine block human ether-à-go-go-related gene (hERG) potassium channels, delaying cardiac repolarization and prolonging the QTc interval. This prolongation significantly elevates the risk of life-threatening ventricular arrhythmias, including Torsades de Pointes and sudden cardiac arrest, even at therapeutic doses and in patients without pre-existing cardiac disease. Consequently, comprehensive cardiovascular monitoring and screening are standard precautions in clinical research evaluating ibogaine.

0:17:35supportedlowThe Radical Idea Changing Mental Health Treatment | Will Van

A Stanford University study evaluating ibogaine treatment in Navy SEALs in Mexico combined magnesium with ibogaine alongside cardiac monitoring throughout dosing to mitigate cardiac risk.

"And you know, the recent work with Navy SEALs in Mexico that was published out of Stanford University combined magnesium with ibogaine and cardiac monitoring throughout the dosing experience, and I think there are ways to mitigate risk." (said at 0:17:35)

A prospective observational study published by researchers at Stanford University (Williams et al., Nature Medicine 2024) evaluated the 'Magnesium-Ibogaine: the Stanford Traumatic Injury to the CNS' (MISTIC) protocol in 30 male Special Operations Forces veterans treated at a clinic in Mexico. The protocol co-administered oral and intravenous magnesium with ibogaine and implemented continuous cardiac monitoring to mitigate the risk of QTc prolongation and fatal cardiac arrhythmias associated with ibogaine.

0:28:35needs contextlowThe Radical Idea Changing Mental Health Treatment | Will Van

Walking 10,000 steps per day reduces Alzheimer's disease risk by 50%.

"I remember a recent post you put up which I loved of you want to reduce your Alzheimer's risk by 50%, get 10,000 steps." (said at 0:28:35)

A prospective cohort study of 78,430 UK Biobank adults using wrist-worn accelerometers (del Pozo Cruz et al., JAMA Neurology, 2022) found that an optimal daily step count of 9,826 steps was associated with a 51% lower risk of incident dementia (hazard ratio 0.49; 95% CI, 0.39-0.62) over a median follow-up of 6.9 years. While the numerical claim closely mirrors these published findings (~10,000 steps and ~50% risk reduction), the study evaluated all-cause dementia rather than Alzheimer's disease specifically, and the observational cohort design demonstrates an association rather than definitive causal prevention.

0:31:10supportedhighThe Radical Idea Changing Mental Health Treatment | Will Van

Serious neuroscientists do not agree with or support the serotonin deficiency model of depression.

"Well if you ask any serious neuroscientist whether they believe in a serotonin deficiency model of depression, nobody will agree with you. You can't find one because it doesn't make sense. It's a marketing strategy." (said at 0:31:10)

Contemporary neuroscience and psychiatric research widely reject the simplistic 'serotonin deficiency' or 'chemical imbalance' model of depression. A landmark 2023 systematic umbrella review by Moncrieff et al. evaluated decades of evidence across multiple research streams (metabolite levels, receptor binding, transporter availability, tryptophan depletion, and genetics) and found no consistent evidence that depression is caused by lowered serotonin concentration or activity. In response to this review, psychiatric researchers noted that the original monoamine/serotonin deficiency hypothesis has been considered outdated across neurobiology for decades, acknowledging that depression involves complex, heterogeneous neurobiological networks rather than a simple deficit of a single neurotransmitter. Analyses have also highlighted the disconnect between direct-to-consumer pharmaceutical advertising—which popularized the chemical imbalance framing—and the underlying scientific literature.

0:34:07needs contextlowThe Radical Idea Changing Mental Health Treatment | Will Van

Brain imaging of the default mode network shows schizophrenia and significant dissociative disorders have a loose electrical patterning compared to obsessive ruminative states.

"Well, a diagnosis of schizophrenia um particularly uh would be something that or or someone who has a um significant dissociative disorder. Uh these are both situations that we know from looking at the default mode network, the electrical patterning in the brain um have what we would call maybe a loose pattern or uh the opposite of the person who is considered to be a really good candidate for psychedelic therapy" (said at 0:34:07)

The speaker's description colloquially reflects theoretical frameworks in neuropsychopharmacology (such as the Entropic Brain and REBUS models developed by Carhart-Harris and colleagues), which propose that high-entropy, disorganized, or "loose" brain network dynamics occur in states like early psychosis and under psychedelic administration, contrasting with the low-entropy, overly rigid or hyper-constrained default mode network (DMN) activity seen in obsessive-compulsive disorders and depressive rumination. However, referring to schizophrenia and dissociative disorders as having a simple "loose electrical pattern" in the DMN is an oversimplification. Neuroimaging and electrophysiological studies in schizophrenia and dissociative states report complex, heterogeneous, and frequency-dependent alterations—including both regional hyperconnectivity and hypoconnectivity across DMN subregions and related networks—rather than a uniform "loose" pattern.

0:37:05contradictedlowThe Radical Idea Changing Mental Health Treatment | Will Van

Quinolinic acid circulating in the gut contributes to increased gut permeability (leaky gut).

"When quinolinate circulates in the gut, it can contribute to leaky gut, right?" (said at 0:37:05)

The speaker claims that circulating quinolinic acid (quinolinate) in the gut contributes to increased gut permeability ("leaky gut"). However, recent preclinical evidence contradicts this claim, showing that quinolinic acid actually helps preserve and reinforce intestinal barrier integrity. In a mouse model of sepsis-induced intestinal injury, quinolinic acid (produced via tryptophan metabolism by gut bacteria) was shown to activate the aryl hydrocarbon receptor (AhR) pathway and downstream Wnt/β-catenin signaling, thereby mitigating intestinal injury and promoting gut barrier integrity rather than compromising it.

0:37:15contradictedmoderateThe Radical Idea Changing Mental Health Treatment | Will Van

Quinolinic acid in systemic circulation causes the activation of macrophages and activation of microglia in the brain.

"And quinolinate can circulate in the in the serum, you know, throughout the body causing activation of macrophages and in the brain microglia as you were talking you've talked about a lot and written about." (said at 0:37:15)

The speaker reverses the primary biological relationship and mischaracterizes the transport dynamics of the kynurenine pathway. Quinolinic acid is primarily an end product synthesized and released by already-activated macrophages and microglia in response to inflammatory stimuli (such as interferon-gamma or lipopolysaccharide), rather than being the systemic agent that initiates macrophage and microglial activation. Furthermore, peripheral quinolinic acid poorly crosses an intact blood-brain barrier; central neuroinflammation and local quinolinic acid production in the brain occur primarily when systemic precursor molecules like kynurenine cross the blood-brain barrier and are locally metabolized by brain-resident microglia and perivascular macrophages.

0:37:28supportedhighThe Radical Idea Changing Mental Health Treatment | Will Van

Quinolinic acid exerts excitotoxic effects at the NMDA receptor.

"It turns out that quinolinic acid is excitotoxic at the NMDA receptor." (said at 0:37:28)

Quinolinic acid is an endogenous metabolite of the kynurenine pathway that acts as an agonist at NMDA (N-methyl-D-aspartate) glutamate receptors. Its overactivation of NMDA receptors leads to excessive intracellular calcium influx and neuronal excitotoxicity.

0:37:33supportedlowThe Radical Idea Changing Mental Health Treatment | Will Van

A study found that suicide attempters had up to 300% elevated levels of quinolinic acid in their cerebrospinal fluid.

"It also turns out that people who attempt suicide have in one study up to 300% elevated levels of quinolinic acid in their CSF." (said at 0:37:33)

A clinical study by Erhardt et al. (2013) evaluated cerebrospinal fluid (CSF) metabolites in 64 medication-free suicide attempters compared to 36 healthy controls and found markedly elevated CSF levels of quinolinic acid (QUIN) (P < 0.001), with levels correlating positively with scores on the Suicide Intent Scale and CSF interleukin-6. Follow-up research by the same team confirmed sustained dysregulation of quinolinic acid in suicide attempters. Because the evidence is derived from observational case-control studies, the certainty of the body of evidence is low.

0:37:43contradictedhighThe Radical Idea Changing Mental Health Treatment | Will Van

Ketamine acts as a competitive antagonist at the NMDA receptor.

"Ketamine competitively uh blocks the NMDA receptor." (said at 0:37:43)

Ketamine is not a competitive antagonist at the N-methyl-D-aspartate (NMDA) receptor. It acts as a non-competitive (uncompetitive) open-channel blocker, binding to a site inside the ion channel pore rather than competing with glutamate or glycine for their ligand-binding sites on the receptor.

0:37:50supportedhighThe Radical Idea Changing Mental Health Treatment | Will Van

Ketamine administration frequently resolves suicidal ideation within the first few hours.

"And often times with ketamine in the first few hours you'll see suicidal thinking go away. It's quite remarkable. It's almost like a magic trick." (said at 0:37:50)

Multiple systematic reviews and meta-analyses of randomized controlled trials confirm that sub-anesthetic doses of intravenous ketamine rapidly and significantly reduce or resolve suicidal ideation within the first 4 to 6 hours post-administration, with large effect sizes observed in acute timeframes.

0:42:10unverifiedvery lowThe Radical Idea Changing Mental Health Treatment | Will Van

Studies are being conducted on psychedelic treatments for alcohol and tobacco use disorders at UAB in Birmingham, Alabama.

"So, we are seeing um some really beautiful studies uh being done with alcohol use disorder, um tobacco uh use disorder as well uh down at uh UAB in Birmingham, Alabama." (said at 0:42:10)

No published record matching the claim that studies on psychedelic treatments for alcohol use disorder and tobacco use disorder were conducted at the University of Alabama at Birmingham (UAB) was located; this does not prove the claim false. Published clinical trial research on psilocybin for substance use disorder at UAB evaluated cocaine use disorder (PMID 42096204), whereas landmark psilocybin trials for tobacco smoking cessation were conducted at Johns Hopkins University (PMID 41805956).

The search did find related studies, but none that directly tests this claim:

0:42:28supportedhighThe Radical Idea Changing Mental Health Treatment | Will Van

A clinical study was conducted in New York using ketamine for cocaine use disorder.

"And uh we're seeing some uh Let's see, I think there was also a cocaine use uh disorder study with ketamine in New York." (said at 0:42:28)

Clinical studies investigating ketamine for cocaine use disorder have been conducted in New York (such as randomized trials led by Elias Dakwar at Columbia University/New York State Psychiatric Institute). In a randomized controlled trial of 55 cocaine-dependent adults, a single subanesthetic ketamine infusion combined with mindfulness-based relapse prevention significantly promoted abstinence, reduced craving, and decreased the risk of relapse compared to active control (midazolam).

0:45:17unverifiedvery lowThe Radical Idea Changing Mental Health Treatment | Will Van

Forecasts predict that 20% to 25% of American adults will be taking a GLP-1 agonist in five years.

"The prediction is that in 5 years probably 20 to 25% of all Americans, adults are going to be on a GLP-1, which say what you will." (said at 0:45:17)

No published scientific study or epidemiological forecasting model was located that predicts 20% to 25% of American adults will be taking GLP-1 receptor agonists in five years. While observational data show rapid growth in GLP-1 prescription volume (e.g., reaching 1.5 million monthly obesity medication prescriptions by early 2024), specific long-term prevalence projections of 20–25% for the entire adult population appear in financial analyst reports or media commentary rather than peer-reviewed medical literature. This does not prove the claim false, but no peer-reviewed record matching this specific forecast was found.

0:46:10supportedvery lowThe Radical Idea Changing Mental Health Treatment | Will Van

Chronic, long-term administration of SSRIs can induce tardive dysphoria by chronically overstimulating serotonin receptors, worsening depressive symptoms after discontinuation.

"and then we we see, you know, work coming out exploring the possibility of a thing called tardive dysphoria, right? Where uh having overstimulated the serotonin receptors for decades with chronic SSRI prescription, uh now the person might be worse off when they come off of the medicine than they were in the first place." (said at 0:46:10)

The speaker accurately describes the published theoretical concept of "tardive dysphoria." Proposed by El-Mallakh and colleagues (2011), the hypothesis suggests that chronic, long-term exposure to antidepressants (such as SSRIs) may induce compensatory neuroadaptive changes leading to a treatment-resistant, prodepressant state that can leave patients experiencing persistent or worsened depressive symptoms. The speaker accurately frames this as an explored hypothesis; because it is a theoretical model based on narrative review and observational parallels rather than confirmed by randomized controlled trials, the certainty of evidence is very low.

1:01:09supportedhighThe Radical Idea Changing Mental Health Treatment | Will Van

Ibogaine has an established traditional use originating in West Africa and the Gabon region.

"it has a tradition in West Africa and Gabon area that is very well established in a traditional way." (said at 1:01:09)

Anthropological and ethnobotanical literature firmly documents that ibogaine—the primary psychoactive alkaloid in the root bark of the plant *Tabernanthe iboga*—has a long-standing traditional and spiritual use in Central and West Africa, particularly within the Bwiti religious traditions of Gabon and neighbouring regions.

1:01:14needs contextmoderateThe Radical Idea Changing Mental Health Treatment | Will Van

An ayahuasca experience typically lasts between 6 and 8 hours, whereas an ibogaine experience lasts around 72 hours.

"the ayahuasca experience tends to be about 6 hours, maybe 8 hours. Uh if you do booster doses, it could be longer. The Ibogaine experience is way longer. It it's usually more like 72 hours where you are completely uh dependent on your caregivers." (said at 1:01:14)

The speaker's comparison accurately reflects the substantial difference in duration between ayahuasca and ibogaine, though the exact figures require nuance regarding acute pharmacological action versus full multi-phase recovery. In controlled clinical trials, a single dose of ayahuasca produces subjective effects beginning within 30 to 60 minutes, peaking at 60 to 120 minutes, and largely resolving by 240 minutes (4 hours), though ceremonial settings involving redosing typically span 6 to 8 hours. In contrast, the subjective and physiological effects of flood-dose ibogaine are markedly prolonged: the acute visionary/oneiric phase typically lasts 24 to 36 hours, while the subsequent cognitive, motor (ataxia), and reflective recovery phases routinely require medical supervision and caregiver dependence for 48 to 72 hours.

1:03:26supportedmoderateThe Radical Idea Changing Mental Health Treatment | Will Van

Electrolyte deficiency during an ibogaine session contributes to its cardiac toxicity.

"And part of the cardiac toxicity of Ibogaine is not having enough electrolytes um during the session." (said at 1:03:26)

Ibogaine and its active metabolite noribogaine inherently prolong the cardiac QTc interval and predispose individuals to life-threatening ventricular arrhythmias (such as Torsades de Pointes) primarily via potent blockade of cardiac hERG potassium channels. Pre-existing or session-induced electrolyte disturbances—specifically hypokalemia and hypomagnesemia, often exacerbated by vomiting or dehydration during treatment—significantly heighten this arrhythmogenic risk. Consequently, clinical protocols and safety reviews emphasize electrolyte screening and co-administration or repletion of electrolytes (particularly magnesium) during ibogaine sessions to mitigate cardiac toxicity.

1:04:00overstatedvery lowThe Radical Idea Changing Mental Health Treatment | Will Van

Ibogaine provides therapeutic benefit for opioid use disorder and alcohol addiction in individuals who have failed other treatments.

"opiate use disorders in particular seem to be um highly benefited from Ibogaine when nothing else worked. HOST: And alcohol, too. GUEST1: And alcohol. Yeah." (said at 1:04:00)

While observational cohort studies and case series suggest that ibogaine can acutely reduce opioid withdrawal symptoms and decrease substance use in individuals with refractory opioid use disorder (who often had multiple prior treatment failures), evidence supporting its efficacy is limited to open-label, uncontrolled studies with high risk of bias. There are currently no completed randomized controlled trials establishing its efficacy or safety for opioid use disorder or alcohol use disorder. Furthermore, clinical evidence for alcohol use disorder is largely restricted to preclinical animal models and small naturalistic cohorts, and ibogaine carries serious safety risks, particularly cardiotoxicity (QTc prolongation and fatal arrhythmias).

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