The authors question the assumption that psychedelics are safe for adolescents, a premise advanced by Jeffrey et al. who argued that because psychedelics have a favorable safety profile in adults, teenagers with near-adult neurodevelopment could be safely treated. While agreeing that new psychopharmaceuticals for adolescents are urgently needed, the authors challenge this safety assumption, citing growing evidence of risks associated with psychedelics in adult trials.
Electroconvulsive therapy (ECT) requires intravenous (IV) access, which can be difficult for pediatric patients and those with neurodevelopmental disorders. This case series of five patients aged 14–27 describes five strategies that helped them tolerate IV placement: oral anxiolytic premedication, planned physical restraint, intramuscular ketamine induction, inhalational sevoflurane anesthesia, and placement of an implanted venous access device. Using these individualized approaches, all patients were able to receive ECT. Consistent treatment protocols, multidisciplinary planning, and engagement of outpatient teams supported success. The findings show that adaptive strategies can improve access to ECT for special needs populations.