Australia reclassified psilocybin as a Schedule 8 substance for treatment-resistant depression, a major policy shift. Implementation faces challenges: limited prescriber access, no Australian Register of Therapeutic Goods-listed products, lack of standardized training, and high costs. Ethical issues include informed consent, cultural safety, and therapeutic fidelity in trauma-informed care. Recommendations include national training accreditation, fidelity monitoring, and research into neurobiologically informed stratification models for treatment. These steps aim to ensure safe, equitable, and evidence-based integration of psilocybin-assisted therapy into Australia's mental health system.
People with post-traumatic stress disorder who had a sustained clinical response to oral ketamine showed distinct baseline differences in DNA methylation and gene expression across 112 genes compared with non-responders. Key biomarkers included DENND5B, ZFY, PDGFRA, CPT1A, AHRR, and others involved in metabolism, cell signaling, neuronal development, immune response, and synaptic plasticity. Non-responders had persistent dysregulation in these pathways, suggesting biological barriers to treatment. Clinically, sustained responders had more severe PTSD at baseline and responded at lower ketamine doses. The findings point toward molecular profiling that could help personalize ketamine therapy for PTSD.