Psychiatry research
February 1, 2025
Damian Swieczkowski, Aleksander Kwaśny, Michal Pruc et al.
17 citations
In patients with Major Depressive Disorder, psilocybin reduces depression symptoms more than placebo by Day 8 and Day 15 after treatment, but not by Day 2. A 25 mg dose is the most effective among those tested (0.215 mg/kg, 10 mg, and 25 mg). Psilocybin carries a higher risk of adverse events, especially nausea. These findings come from a meta-analysis of three randomized placebo-controlled trials involving 389 adults.
Journal of Psychopharmacology
July 11, 2025
Aleksander Kwaśny, Patrycja Ciurkowska, Wiesław Jerzy Cubała et al.
6 citations
In interventional clinical trials of psilocybin and LSD, participants are overwhelmingly White, raising concerns about whether these therapies are safe and effective for diverse populations. A cross-sectional analysis of nine eligible trials (eight psilocybin, one LSD) registered on ClinicalTrials.gov through January 2025 found that among 501 psilocybin participants, 87.2% were White, 3.0% Black, and 5.0% Asian; ethnicity was reported in only four trials, with 13.4% identifying as Hispanic or Latino. The single LSD trial of 11 older adults reported no race or origin data. Participation-to-population ratios for U.S.-only trials confirmed underrepresentation of Black and Asian individuals. The authors conclude that broader recruitment and standardized reporting are essential to ensure equity and establish safety and efficacy across groups.
Psychiatry research
August 1, 2025
Damian Swieczkowski, Aleksander Kwaśny, Krzysztof Sadko et al.
5 citations
A cross-sectional evaluation of 40 clinical trials on ketamine and its enantiomers, esketamine and arketamine, for treatment-resistant depression reveals significant methodological inconsistencies. Key issues include inadequate blinding due to ketamine's dissociative effects, poor management of expectancy bias, and insufficient safety monitoring. Placebo response, accounting for a large portion of treatment effects, was inconsistently handled, and long-term follow-up was lacking in most trials, limiting understanding of extended safety. The findings call for harmonized, rigorous frameworks to improve regulatory approval and therapeutic success, with lessons applicable to other psychedelics under investigation for mental health disorders.
Progress in neuro-psychopharmacology & biological psychiatry
June 7, 2025
Damian Swieczkowski, Aleksander Kwaśny, Wiesław Jerzy Cubała
5 citations
Treatment-resistant depression (TRD) is difficult to treat because many patients do not respond to standard antidepressants. NN-dimethyltryptamine (DMT), a fast-acting psychedelic, may offer benefits due to its rapid onset and short duration. This systematic review of five clinical trials found that DMT was generally well-tolerated, with no serious adverse events. Intravenous DMT caused temporary increases in systolic blood pressure (up to 25.7%) and heart rate at higher doses. Inhalation led to mild throat discomfort, and oral or intranasal use caused mild nausea and dizziness, all short-lived. Psychotomimetic effects like ego dissolution were dose-dependent but manageable. Larger, well-controlled studies are needed to confirm safety and efficacy in TRD patients.
The International Journal of Psychiatry in Medicine
April 25, 2025
Damian Swieczkowski, Aleksander Kwaśny, Michal Pruc et al.
4 citations
Psilocybin rapidly reduced depressive and anxiety symptoms in cancer patients, though the effect on depression was not sustained at two weeks. Based on two randomized controlled trials, a network meta-analysis found that Beck Depression Inventory scores improved one day after administration but not at follow-up. State anxiety scores showed substantial reductions both at one day and two weeks; trait anxiety scores also improved at both time points. The highest dose tested (0.3 mg/kg) was the most effective. The small number of trials limits confidence in the findings, and larger, high-quality studies are needed.
Pharmacopsychiatry
April 17, 2025
Aleksander Kwaśny, Zuzanna Gaca, Damian Swieczkowski et al.
2 citations
Regulatory compliance in clinical trials of psilocybin for major depressive disorder and treatment-resistant depression shows gaps. A review of four trial protocols from ClinicalTrials.gov found that while they superficially met regulatory requirements, they inadequately addressed drug interactions, concurrent antidepressant use, and prohibited medications. Functional unblinding and expectancy bias were not fully accounted for. Risk mitigation relied on external criteria. Patients with bipolar or schizoaffective disorders were excluded. The most common psilocybin dose studied was 25 mg. Two trials were double-blind. The findings underscore the need for stricter adherence to regulatory standards in psychedelic clinical research and for exploring efficacy in broader populations.
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
January 16, 2026
Damian Swieczkowski, Aleksander Kwaśny, Krzysztof Sadko et al.
1 citation
Psilocybin-assisted therapies are being tested for major depressive disorder and treatment-resistant depression, but rigorous research requires not only measuring the drug's effects but also consistently reporting non-pharmacological factors—such as the physical and social environment (set and setting)—that can influence outcomes. To address this, the ReSPCT guidelines were developed as a 30-item framework for standardized reporting. This review evaluated 13 clinical trial protocols (11 Phase II and 2 Phase III) from ClinicalTrials.gov and the EU Clinical Trials Information System. Using the ReSPCT checklist, only 15.6% of 390 item-level assessments showed full compliance; 64.6% had partial compliance, and 19.
Journal of psychoactive drugs
April 18, 2025
Damian Swieczkowski, Aleksander Kwaśny, Krzysztof Sadko et al.
1 citation
Ibogaine, a non-classical psychedelic, is being studied as a potential treatment for substance use disorders, but safety concerns and lack of commercial interest hinder its development. A cross-sectional analysis of nine clinical trials from major registries found wide variability in trial designs, including dosing regimens and outcome measures. Most trials are early-phase, focusing on pharmacokinetics, withdrawal symptoms, and safety, with particular attention to cardiovascular risks. Preliminary evidence suggests possible therapeutic benefits, but the absence of large, late-phase trials prevents firm conclusions. Standardized clinical frameworks and lessons from research on classical psychedelics and MDMA could improve trial design and address issues like blinding and expectancy bias.
Ther Adv Psychopharmacol
June 29, 2026
Damian Swieczkowski, Aleksander Kwaśny, Wiesław Jerzy Cubała
Informed consent forms for ketamine clinical trials listed on ClinicalTrials.gov are often written at a reading level that exceeds the average adult's ability, potentially limiting participants' understanding of risks and benefits. The analysis found that most forms required a college-level reading proficiency, which is higher than recommended for patient materials. This gap in readability may compromise informed consent in mental health research.
International journal of psychiatry in clinical practice
June 1, 2026
Damian Swieczkowski, Aleksander Kwaśny, Michal Pruc et al.
Women made up 62.9% of participants across 13 esketamine clinical trials for mental health disorders, while men comprised 37.1%. The racial distribution showed White participants at 69.08%, Asian at 13.31%, Black or African American at 3.60%, American Indian or Alaska Native at 0.08%, and Native Hawaiian or Other Pacific Islander at 0.04%. Hispanic or Latino representation ranged from 10.57% to 11.02% due to reporting discrepancies in one trial. These trials demonstrate significant racial and ethnic disparities, with underrepresentation of minority groups, highlighting the need for regulatory efforts to improve diversity and fair representation in future research.