Expert Opinion on Pharmacotherapy
November 10, 2023
Michail Kalfas, Rosie H Taylor, Dimosthenis Tsapekos et al.
28 citations
Psychedelic therapy is transforming treatment for treatment-resistant depression (TRD) by increasing benefits and reducing risks. Psilocybin shows promise as a potential game-changer, with initial evidence indicating a rapid antidepressant effect that lasts at least three months for some responders. However, more rigorous, double-blind, comparator-controlled trials with adequate statistical power are needed to understand how psychedelics work and their long-term effects in TRD. Psychedelics may also benefit other psychiatric conditions like bipolar depression and post-traumatic stress disorder.
Expert Opinion on Pharmacotherapy
March 24, 2026
Donatella Marazziti, Matteo Gambini, Riccardo Gurrieri et al.
After decades of limited use, psychedelic compounds are reemerging as potential treatments for mental disorders that do not respond to existing therapies. This narrative review examines the current clinical and regulatory landscape of psychedelic-assisted therapies, covering ketamine, esketamine, MDMA, psilocybin, LSD, DMT, 5-MeO-DMT, and ibogaine for conditions like major depressive disorder, PTSD, and substance use disorders. The authors argue that these therapies will not follow standard prescription models but require specialist-delivered, psychotherapy-integrated care. Late-stage trials show promise for high-need populations, but unresolved challenges around long-term safety, scalability, workforce training, equity of access, and legal accountability remain.
Expert Opinion on Pharmacotherapy
January 22, 2026
Diana Orsini, Sara D Di Luch, Gabrielle F. M. Lovell et al.
A large body of evidence from clinical trials and real-world studies supports the antidepressant effects of intravenous ketamine and intranasal esketamine. Larger studies have provided reassuring safety data, including for long-term treatment. Alternative routes of administration show promise for scalability, but their efficacy relative to intravenous ketamine remains unclear. Preliminary data suggest ketamine may also be effective for bipolar disorders, personality disorders, posttraumatic stress, and obsessive-compulsive disorder. Further research is needed to optimize protocols, such as combining ketamine with other interventions. Challenges include functional unblinding, expectancy-related bias, and treatment costs.