Psychedelic therapies show promise for adult mental health conditions, and there is growing interest in testing them in adolescents, who often experience these disorders earlier in life. Regulatory agencies are expected to require trials in younger populations after adult approvals. This paper outlines key considerations for designing and conducting such trials, including safeguards and best practices tailored to adolescents. It builds on adult trial methods and emphasizes increased psychological support and rigorous oversight. The goal is to ensure future adolescent trials are safe, ethical, and meet high scientific and regulatory standards, fostering patient-focused dialogue.
The recent approval of esketamine for adults has renewed interest in psychedelic compounds for psychiatric use, but their relevance for children and adolescents is unclear. This review examines the rationale for investigating classic serotonergic psychedelics (e.g., psilocybin, LSD), the entactogen MDMA, and dissociative compounds like ketamine and esketamine in young populations. Ongoing and planned trials primarily involve adolescents aged 16 years and older, driven by unmet needs in child and adolescent psychiatry, where few medications are approved and therapeutic response is often unsatisfactory. Potential targets include anorexia nervosa, autism spectrum disorder symptoms, obsessive-compulsive disorder, resistant depression, and severe PTSD. Translation to pediatric populations requires caution due to developmental vulnerabilities and limited long-term safety data.