Summary
Psychedelics hold promise for psychiatry, yet clinical translation remains premature. Addressing the challenges of psychedelics in psychiatry requires advances in mechanistic study, clinical implementation, regulatory governance and public discourse in parallel.
Information
Psychedelics are playing an increasingly important role in psychiatric research, offering new hope for the treatment of psychiatric disorders. Esketamine, the enantiomer of ketamine, has been approved as a therapy for treatment-resistant depression (TRD) in multiple jurisdictions. 1 In Australia, psilocybin for TRD and 3,4-methylenedioxymethamphetamine (MDMA) for post-traumatic stress disorder can be prescribed by authorised psychiatrists under strict regulatory controls. 2 These approvals have reinforced their clinical optimism, but current evidence remains constrained by small samples, functional unblinding, expectancy effects, heterogeneous psychological support and limited long-term follow-up on safety and efficacy. Reference Yao, Guo, Lu, Liu, Huang and Diao3 Unlike conventional pharmaceuticals, psychedelics exert effects through a complex interplay of pharmacology, psychotherapy and context. Therefore, whether the current evidence is sufficiently mature to warrant widespread clinical adoption must be critically assessed. Reference Nutt, Crome and Young4 Addressing these challenges will require parallel progress in mechanistic study, clinical implementation, regulatory governance and public discourse (Fig. 1).
Read full paper
