{ "updated": "2026-10-23", "old_source_cutoff": "2015-01-01", "rules": { "sources_allowed": [ "Peer-reviewed journal articles", "Official company press releases (trial status and topline results only)", "Regulators and government bodies (FDA, EMA, TGA, MHRA, Health Canada, national agencies)", "Trial registries (ClinicalTrials.gov, EU CTIS, ISRCTN, ANZCTR)" ], "sources_not_allowed": [ "News articles, including articles about press releases", "Blogs, trade press, preprints, aggregators" ], "no_source_no_fact": true, "old_flag": "Any fact citing a source dated before 2015-01-01 shows an 'older study' marker." }, "tiers": [ { "id": "approved", "label": "Approved therapy", "short": "Approved", "help": "A medicines regulator has approved it for this condition. It is a prescription medicine, given under set conditions." }, { "id": "offlabel", "label": "Used off-label", "short": "Off-label", "help": "Not approved for this use, but backed by many controlled trials, so doctors can prescribe it off-label in many countries." }, { "id": "p3pos", "label": "Late-stage trials · positive results", "short": "Late‑stage", "help": "Phase 3: at least one large, late-stage trial met its main goal. This is the last step before a company asks regulators for approval. Not approved yet." }, { "id": "p3run", "label": "Late-stage trials · in progress", "short": "Late‑stage", "help": "Phase 3: a large, late-stage trial is running, but there are no results yet. Earlier, smaller trials looked promising enough to get here." }, { "id": "p2", "label": "Early research", "short": "Early", "help": "Phase 2 trials, pilots and small studies. Interesting signals at best, nothing you can rely on yet. The card says how strong each study was." }, { "id": "early", "label": "Early research", "short": "Early", "help": "Phase 2 trials, pilots and small studies. Interesting signals at best, nothing you can rely on yet. The card says how strong each study was." }, { "id": "none", "label": "Little or no evidence", "short": "Little or no evidence", "help": "Tested and didn't beat placebo, or reviews find the evidence too weak to rely on." } ], "substances": [ { "id": "psilocybin", "name": "Psilocybin", "aka": [ "magic mushrooms", "shrooms", "COMP360", "psilocin", "mushrooms" ], "kind": "Classic psychedelic", "oneliner": "The psychedelic closest to approval for depression.", "intro": "Psilocybin is the active compound in “magic mushrooms”. Most trials give one or two supervised doses, with psychological support before and after.", "guide": "https://statesofmind.com/articles/psilocybin-guide/", "access": [ [ "PsyAccess: authorised psychedelic therapy programmes in Europe", "https://psyaccess.health/types/pat-program/" ], [ "PsyAccess: clinical trial sites in Europe", "https://psyaccess.health/types/clinical-trial/" ] ], "safety": [ { "t": "Trials screen people carefully: a personal or family history of psychosis or bipolar disorder usually rules you out.", "refs": [ "goodwin2022" ] }, { "t": "In the largest Phase 2b trial, suicidal thoughts and self-harm were reported in all dose groups, including the lowest — a reminder that people in these trials are very unwell and need close follow-up.", "refs": [ "goodwin2022" ] }, { "t": "Outside the clinic, difficulties can last: in a self-selected survey of 608 people, about a third of those who reported extended difficulties said they lasted over a year.", "refs": [ "evans2023" ] } ] }, { "id": "mdma", "name": "MDMA", "aka": [ "ecstasy", "molly", "midomafetamine", "MDMA-assisted therapy", "EMP-01", "R-MDMA" ], "kind": "Entactogen", "oneliner": "Two positive Phase 3 trials for PTSD — and a rejection the field is still working through.", "intro": "In trials, MDMA is never given on its own: every positive result comes from MDMA given within a full course of therapy.", "access": [ [ "PsyAccess: authorised psychedelic therapy programmes in Europe", "https://psyaccess.health/types/pat-program/" ] ], "safety": [ { "t": "The FDA's 2024 rejection letter found that side effects weren't reliably recorded in the trials, including effects people experienced as positive, so the safety picture is incomplete.", "refs": [ "fda_crl_mdma" ] }, { "t": "Phase 3 trials excluded people with significant heart disease, and every dose was given in a clinic with therapists present.", "refs": [ "mapp1", "mapp2" ] } ] }, { "id": "ketamine", "name": "Ketamine", "aka": [ "racemic ketamine", "special K", "ketamine infusion", "KAP", "ketamine-assisted psychotherapy" ], "kind": "Dissociative", "oneliner": "Available today through off-label prescribing. The effect is real; so is the relapse problem.", "intro": "Ketamine is an anaesthetic. For depression it is given at lower doses, usually as an infusion in a clinic. This page covers racemic ketamine; esketamine (Spravato) has its own page.", "guide": "https://statesofmind.com/articles/ketamine-guide/", "access": [ [ "PsyAccess: ketamine and KAP clinics in Europe", "https://psyaccess.health/types/ketamine-clinic/" ] ], "safety": [ { "t": "Bladder and urinary damage (ketamine uropathy) is a recognised risk, best documented in heavy non-medical use; repeated medical use should include urinary checks.", "refs": [ "baus2024" ] }, { "t": "Experts flag misuse liability with repeated dosing, and long-term safety data are thin.", "refs": [ "mcintyre2021" ] } ] }, { "id": "esketamine", "name": "Esketamine (Spravato)", "aka": [ "Spravato", "esketamine nasal spray", "S-ketamine" ], "kind": "Dissociative", "approved_text": "treatment-resistant depression (US, EU) and for depression with acute suicidal thoughts (US; short-term emergency use in the EU)", "oneliner": "The only approved medicine in this tracker.", "intro": "Esketamine is one half (the S-enantiomer) of ketamine, given as a nasal spray in certified clinics.", "access": [ [ "PsyAccess: licensed Spravato centres in Europe", "https://psyaccess.health/types/spravato-center/" ] ], "safety": [ { "t": "In the US it is only available through a restricted programme: you take it at a certified clinic, stay at least two hours for monitoring, and can't drive until the next day.", "refs": [ "jnj_mono2025" ] } ] }, { "id": "lsd", "name": "LSD", "aka": [ "acid", "lysergide", "MM120", "DT120", "Definium", "MindMed" ], "kind": "Classic psychedelic", "oneliner": "2026's surprise: three positive Phase 3 trials, in anxiety and depression.", "intro": "The late-stage programme uses a single supervised dose of an LSD tablet (DT120, formerly MM120). It is not microdosing.", "access": [ [ "PsyAccess: clinical trial sites in Europe", "https://psyaccess.health/types/clinical-trial/" ] ], "safety": [ { "t": "In the Panorama trial, side effects were common on dosing day — illusions (68%), nausea (37%) and headache (24%) — with no drug-related serious adverse events.", "refs": [ "panorama" ] } ] }, { "id": "dmt", "name": "DMT", "aka": [ "dimethyltryptamine", "N,N-DMT", "SPL026", "VLS-01", "Helus", "Cybin" ], "kind": "Short-acting psychedelic", "oneliner": "Short sessions, early but real signals in depression.", "intro": "DMT's effects last minutes rather than hours, which is why developers hope it could fit into a normal clinic visit.", "safety": [] }, { "id": "5-meo-dmt", "name": "5-MeO-DMT", "aka": [ "mebufotenin", "BPL-003", "GH001", "toad venom", "bufo" ], "kind": "Short-acting psychedelic", "oneliner": "Two positive Phase 2b trials in treatment-resistant depression; Phase 3 has begun.", "intro": "A very short-acting psychedelic, given as a nasal spray (BPL-003) or inhaled (GH001) in trials.", "safety": [] }, { "id": "ayahuasca", "name": "Ayahuasca", "aka": [ "DMT and harmala", "yage", "daime" ], "kind": "Plant brew (DMT + MAOI)", "oneliner": "One small trial, lots of retreat claims.", "intro": "A traditional Amazonian brew that combines DMT with plant compounds (MAO inhibitors) that make it orally active.", "safety": [] }, { "id": "ibogaine", "name": "Ibogaine", "aka": [ "iboga", "magnesium-ibogaine" ], "kind": "Atypical psychedelic", "oneliner": "Striking stories in opioid addiction, a real heart risk, no controlled trials yet.", "intro": "Ibogaine comes from the iboga shrub. It's used in clinics outside the US and EU, mostly for opioid withdrawal.", "safety": [ { "t": "Ibogaine can disrupt the heart's rhythm (QT prolongation and arrhythmias).", "refs": [ "koenig2015" ] }, { "t": "In a Dutch study of 14 people detoxing from opioids, half developed a dangerously long QTc interval (over 500 ms).", "refs": [ "knuijver2022" ] } ] }, { "id": "noribogaine", "name": "Noribogaine", "aka": [ "ibogaine metabolite", "DemeRx" ], "kind": "Ibogaine derivative", "oneliner": "Ibogaine's main metabolite, back in US trials for the first time.", "intro": "Your body turns ibogaine into noribogaine. Developers hope it keeps the benefits with fewer risks — that's still a hope, not a finding.", "safety": [ { "t": "In an early safety study in people on opioid substitution therapy, noribogaine prolonged the QT interval in a dose-dependent way.", "refs": [ "glue2016" ] } ] }, { "id": "mescaline", "name": "Mescaline", "aka": [ "peyote", "San Pedro", "huachuma" ], "kind": "Classic psychedelic", "oneliner": "Almost no clinical research. What exists is self-report.", "intro": "The psychedelic in peyote and San Pedro cacti. There are no published controlled trials for any mental-health condition.", "safety": [] }, { "id": "cannabis", "name": "Medical cannabis", "aka": [ "cannabis", "marijuana", "weed", "THC", "CBD", "cannabinoids", "Sativex", "nabiximols" ], "kind": "Cannabinoid", "oneliner": "Legal on prescription in many countries; weak evidence for most mental-health uses.", "intro": "Includes THC, CBD and combinations. Legal status and evidence are two separate questions — this page is about evidence.", "safety": [ { "t": "Daily use of high-potency cannabis is linked to higher rates of psychotic disorder across Europe.", "refs": [ "diforti2019" ] } ] } ], "conditions": [ { "id": "depression", "name": "Major depressive disorder (MDD)", "group": "Depression", "aka": [ "major depressive disorder", "MDD", "low mood", "depressed" ], "oneliner": "Major depressive disorder (MDD), where standard treatment hasn't necessarily failed yet.", "selfcheck": "https://statesofmind.com/toolkit/screening/" }, { "id": "trd", "name": "Treatment-resistant depression", "group": "Depression", "aka": [ "TRD", "antidepressants not working", "resistant depression" ], "oneliner": "Depression that hasn't lifted after at least two antidepressants.", "selfcheck": "https://statesofmind.com/toolkit/screening/", "psyaccess": "https://psyaccess.health/guides/depression-treatment-not-working/" }, { "id": "suicidal", "name": "Suicidal thoughts", "group": "Depression", "aka": [ "suicidal ideation", "suicidality", "crisis" ], "oneliner": "Fast-acting help in a crisis — alongside, not instead of, standard care.", "crisis": true }, { "id": "ptsd", "name": "PTSD", "group": "Trauma", "aka": [ "post-traumatic stress disorder", "trauma", "post traumatic" ], "oneliner": "Post-traumatic stress disorder.", "selfcheck": "https://statesofmind.com/toolkit/screening/", "psyaccess": "https://psyaccess.health/guides/ptsd-treatment-options/" }, { "id": "anxiety", "name": "Anxiety disorders", "group": "Anxiety", "aka": [ "generalised anxiety disorder", "generalized anxiety", "GAD", "social anxiety", "anxiety", "worry" ], "oneliner": "Generalised anxiety disorder (GAD) and social anxiety.", "selfcheck": "https://statesofmind.com/toolkit/screening/", "psyaccess": "https://psyaccess.health/guides/anxiety-treatment-options/" }, { "id": "illness", "name": "Distress in serious illness", "group": "Anxiety", "aka": [ "end of life", "cancer", "life-threatening illness", "existential distress", "palliative" ], "oneliner": "Anxiety and depression linked to cancer and other life-threatening illness." }, { "id": "ocd", "name": "OCD", "group": "Anxiety", "aka": [ "obsessive-compulsive disorder", "obsessive compulsive" ], "oneliner": "Obsessive-compulsive disorder.", "psyaccess": "https://psyaccess.health/guides/ocd-treatment-options/" }, { "id": "adhd", "name": "ADHD", "group": "Neurodevelopmental", "aka": [ "attention deficit", "ADD", "attention-deficit/hyperactivity disorder" ], "oneliner": "Attention-deficit/hyperactivity disorder in adults.", "selfcheck": "https://statesofmind.com/toolkit/screening/" }, { "id": "eating", "name": "Eating disorders", "group": "Eating", "aka": [ "anorexia", "anorexia nervosa", "binge eating", "bulimia", "ED" ], "oneliner": "Mainly anorexia nervosa — the only eating disorder with published psychedelic trials so far." }, { "id": "addiction", "name": "Addiction", "group": "Addiction", "aka": [ "substance use disorder", "dependence", "SUD" ], "oneliner": "Alcohol, opioids, nicotine and stimulants — each tracked separately.", "psyaccess": "https://psyaccess.health/guides/addiction-treatment-options/" }, { "id": "alcohol", "name": "Alcohol use disorder", "group": "Addiction", "parent": "addiction", "aka": [ "alcoholism", "alcohol dependence", "drinking", "AUD" ], "oneliner": "Alcohol use disorder." }, { "id": "opioids", "name": "Opioid use disorder", "group": "Addiction", "parent": "addiction", "aka": [ "opioid addiction", "heroin", "OUD", "opioid withdrawal", "fentanyl" ], "oneliner": "Opioid use disorder and withdrawal." }, { "id": "tobacco", "name": "Nicotine addiction (smoking)", "group": "Addiction", "parent": "addiction", "aka": [ "smoking cessation", "quit smoking", "tobacco", "nicotine", "cigarettes" ], "oneliner": "Quitting smoking." }, { "id": "stimulants", "name": "Cocaine & stimulant addiction", "group": "Addiction", "parent": "addiction", "aka": [ "cocaine", "methamphetamine", "stimulant use disorder", "crack" ], "oneliner": "Cocaine and other stimulant use disorders." }, { "id": "pain", "name": "Chronic pain", "group": "Pain & sleep", "aka": [ "pain", "neuropathic pain", "fibromyalgia" ], "oneliner": "Long-term pain, including neuropathic pain." }, { "id": "headache", "name": "Migraine & cluster headache", "group": "Pain & sleep", "aka": [ "migraine", "cluster headache", "headaches" ], "oneliner": "Migraine and cluster headache." }, { "id": "insomnia", "name": "Insomnia & sleep", "group": "Pain & sleep", "aka": [ "sleep", "poor sleep", "can't sleep", "sleep problems" ], "oneliner": "Trouble falling or staying asleep." } ], "sources": { "comp005": { "id": "comp005", "label": "Compass: first Phase 3 (COMP005) topline", "url": "https://ir.compasspathways.com/News--Events-/news/news-details/2025/Compass-Pathways-Successfully-Achieves-Primary-Endpoint-in-First-Phase-3-Trial-Evaluating-COMP360-Psilocybin-for-Treatment-Resistant-Depression/default.aspx", "type": "company", "date": "2025-06-23", "cite": "Compass Pathways press release, 23 June 2025" }, "comp006": { "id": "comp006", "label": "Compass: second Phase 3 (COMP006) topline", "url": "https://ir.compasspathways.com/News--Events-/news/news-details/2026/Compass-Pathways-Successfully-Achieves-Primary-Endpoint-in-Second-Phase-3-Trial-Evaluating-COMP360-Psilocybin-for-Treatment-Resistant-Depression/default.aspx", "type": "company", "date": "2026-02-17", "cite": "Compass Pathways press release, 17 February 2026" }, "comp006_26w": { "id": "comp006_26w", "label": "Compass: COMP006 six-month data", "url": "https://ir.compasspathways.com/News--Events-/news/news-details/2026/Compass-Pathways-Announces-Six-Month-Data-from-Second-Phase-3-Trial-Confirming-Rapid-and-Durable-Profile/default.aspx", "type": "company", "date": "2026-07-07", "cite": "Compass Pathways press release, 7 July 2026" }, "comp005_52w": { "id": "comp005_52w", "label": "Compass: COMP005 52-week data", "url": "https://s204.q4cdn.com/927483861/files/doc_news/2026/PRESS-RELEASE_005-52wk-Data-vF2.pdf", "type": "company", "date": "2026-09-09", "cite": "Compass Pathways press release, 9 September 2026" }, "comp_cnpv": { "id": "comp_cnpv", "label": "Compass: rolling NDA review and priority voucher", "url": "https://ir.compasspathways.com/News--Events-/news/news-details/2026/Compass-Pathways-Announces-FDA-Granted-NDA-Rolling-Review-Request-and-Awarded-Commissioners-National-Priority-Voucher/default.aspx", "type": "company", "date": "2026-04-24", "cite": "Compass Pathways press release, 24 April 2026" }, "fda_cnpv": { "id": "fda_cnpv", "label": "FDA: priority vouchers for psychedelic treatments", "url": "https://www.fda.gov/news-events/press-announcements/fda-accelerates-action-treatments-serious-mental-illness-following-executive-order", "type": "regulator", "date": "2026-04-24", "cite": "US FDA press announcement, 24 April 2026" }, "goodwin2022": { "id": "goodwin2022", "label": "Goodwin et al., NEJM 2022", "url": "https://doi.org/10.1056/NEJMoa2206443", "type": "journal", "date": "2022", "cite": "Goodwin GM et al. Single-dose psilocybin for a treatment-resistant episode of major depression. N Engl J Med. 2022" }, "tga2023": { "id": "tga2023", "label": "TGA: authorised psychiatrists may prescribe", "url": "https://www.tga.gov.au/news/media-releases/change-classification-psilocybin-and-mdma-enable-prescribing-authorised-psychiatrists", "type": "regulator", "date": "2023", "cite": "Therapeutic Goods Administration (Australia), 2023" }, "raison2023": { "id": "raison2023", "label": "Raison et al., JAMA 2023", "url": "https://doi.org/10.1001/jama.2023.14530", "type": "journal", "date": "2023", "cite": "Raison CL et al. Single-dose psilocybin treatment for major depressive disorder: a randomized clinical trial. JAMA. 2023" }, "carhart2021": { "id": "carhart2021", "label": "Carhart-Harris et al., NEJM 2021", "url": "https://doi.org/10.1056/NEJMoa2032994", "type": "journal", "date": "2021", "cite": "Carhart-Harris R et al. Trial of psilocybin versus escitalopram for depression. N Engl J Med. 2021" }, "usona_reg": { "id": "usona_reg", "label": "uAspire Phase 3 (NCT06308653)", "url": "https://clinicaltrials.gov/study/NCT06308653", "type": "registry", "date": "2024", "cite": "ClinicalTrials.gov NCT06308653, Usona Institute" }, "helus_oct26": { "id": "helus_oct26", "label": "Helus Pharma: HLP003 programme update", "url": "https://www.sec.gov/Archives/edgar/data/0001833141/000106299326005468/exhibit99-1.htm", "type": "company", "date": "2026-10-21", "cite": "Helus Pharma press release (SEC filing, Ex. 99.1), 21 October 2026" }, "compass_ptsd": { "id": "compass_ptsd", "label": "Compass PTSD Phase 2, J Psychopharmacol 2025", "url": "https://doi.org/10.1177/02698811251362390", "type": "journal", "date": "2025", "cite": "Compass Pathways open-label Phase 2 of COMP360 in PTSD. J Psychopharmacol. 2025" }, "incannex2025": { "id": "incannex2025", "label": "Incannex: Phase 2 PSX-001 in GAD", "url": "https://ir.incannex.com/news-releases/news-release-details/incannex-reports-positive-results-phase-2-clinical-trial-psx-001", "type": "company", "date": "2025-08-26", "cite": "Incannex Healthcare press release, 26 August 2025" }, "griffiths2016": { "id": "griffiths2016", "label": "Griffiths et al., J Psychopharmacol 2016", "url": "https://doi.org/10.1177/0269881116675513", "type": "journal", "date": "2016", "cite": "Griffiths RR et al. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer. J Psychopharmacol. 2016" }, "ross2016": { "id": "ross2016", "label": "Ross et al., J Psychopharmacol 2016", "url": "https://doi.org/10.1177/0269881116675512", "type": "journal", "date": "2016", "cite": "Ross S et al. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer. J Psychopharmacol. 2016" }, "agrawal2024": { "id": "agrawal2024", "label": "Agrawal et al., Cancer 2024", "url": "https://doi.org/10.1002/cncr.35010", "type": "journal", "date": "2024", "cite": "Agrawal M et al. Psilocybin-assisted group therapy in patients with cancer diagnosed with a major depressive disorder. Cancer. 2024" }, "bogenschutz2022": { "id": "bogenschutz2022", "label": "Bogenschutz et al., JAMA Psychiatry 2022", "url": "https://pubmed.ncbi.nlm.nih.gov/36001306/", "type": "journal", "date": "2022", "cite": "Bogenschutz MP et al. Percentage of heavy drinking days following psilocybin-assisted psychotherapy vs placebo in the treatment of adult patients with alcohol use disorder. JAMA Psychiatry. 2022" }, "johnson2026": { "id": "johnson2026", "label": "Johnson et al., JAMA Netw Open 2026", "url": "https://doi.org/10.1001/jamanetworkopen.2026.0972", "type": "journal", "date": "2026", "cite": "Johnson MW, Naudé GP, Hendricks PS, Garcia-Romeu A. Psilocybin vs nicotine patch for smoking cessation: pilot randomized trial. JAMA Netw Open. 2026" }, "johnson2014": { "id": "johnson2014", "label": "Johnson et al., J Psychopharmacol 2014", "url": "https://doi.org/10.1177/0269881114548296", "type": "journal", "date": "2014", "cite": "Johnson MW et al. Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. J Psychopharmacol. 2014" }, "moreno2026": { "id": "moreno2026", "label": "Moreno et al., J Psychopharmacol 2026", "url": "https://doi.org/10.1177/02698811261424214", "type": "journal", "date": "2026", "cite": "Moreno FA et al. A randomized clinical trial of repeated doses of psilocybin for the treatment of obsessive-compulsive disorder. J Psychopharmacol. 2026" }, "davis2021": { "id": "davis2021", "label": "Davis et al., JAMA Psychiatry 2021", "url": "https://doi.org/10.1001/jamapsychiatry.2020.3285", "type": "journal", "date": "2021", "cite": "Davis AK et al. Effects of psilocybin-assisted therapy on major depressive disorder: a randomized clinical trial. JAMA Psychiatry. 2021" }, "mertens2026": { "id": "mertens2026", "label": "Mertens et al., JAMA Psychiatry 2026 (EPISODE)", "url": "https://doi.org/10.1001/jamapsychiatry.2026.0132", "type": "journal", "date": "2026", "cite": "Mertens LJ et al. Efficacy and safety of psilocybin in treatment-resistant major depression: the EPISODE randomized clinical trial. JAMA Psychiatry. 2026" }, "pellegrini2025": { "id": "pellegrini2025", "label": "Pellegrini et al., Compr Psychiatry 2025", "url": "https://doi.org/10.1016/j.comppsych.2025.152619", "type": "journal", "date": "2025", "cite": "Pellegrini L et al. Single-dose (10 mg) psilocybin reduces symptoms in adults with obsessive-compulsive disorder: a pharmacological challenge study. Compr Psychiatry. 2025" }, "aday2025": { "id": "aday2025", "label": "Aday et al., Front Pain Res 2025", "url": "https://doi.org/10.3389/fpain.2025.1527783", "type": "journal", "date": "2025", "cite": "Aday JS et al. Preliminary safety and effectiveness of psilocybin-assisted therapy in adults with fibromyalgia: an open-label pilot clinical trial. Front Pain Res. 2025" }, "moreno2006": { "id": "moreno2006", "label": "Moreno et al., J Clin Psychiatry 2006", "url": "https://doi.org/10.4088/JCP.v67n1110", "type": "journal", "date": "2006", "cite": "Moreno FA et al. Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. J Clin Psychiatry. 2006" }, "peck2023": { "id": "peck2023", "label": "Peck et al., Nature Medicine 2023", "url": "https://doi.org/10.1038/s41591-023-02455-9", "type": "journal", "date": "2023", "cite": "Peck SK et al. Psilocybin therapy for females with anorexia nervosa: a phase 1, open-label feasibility study. Nat Med. 2023" }, "douglass2026": { "id": "douglass2026", "label": "Douglass, Spriggs et al., BJPsych 2026", "url": "https://doi.org/10.1192/bjp.2026.10687", "type": "journal", "date": "2026", "cite": "Douglass H, Spriggs M et al. Psilocybin-therapy for adult females with anorexia nervosa: a pilot study. Br J Psychiatry. 2026" }, "schindler2021": { "id": "schindler2021", "label": "Schindler et al., Neurotherapeutics 2021", "url": "https://doi.org/10.1007/s13311-020-00962-y", "type": "journal", "date": "2021", "cite": "Schindler EAD et al. Exploratory controlled study of the migraine-suppressing effects of psilocybin. Neurotherapeutics. 2021" }, "schindler2022": { "id": "schindler2022", "label": "Schindler et al., Headache 2022", "url": "https://doi.org/10.1111/head.14420", "type": "journal", "date": "2022", "cite": "Schindler EAD et al. Exploratory investigation of a patient-informed low-dose psilocybin pulse regimen in the suppression of cluster headache: a randomized, double-blind, placebo-controlled trial. Headache. 2022" }, "schindler2024": { "id": "schindler2024", "label": "Schindler et al., J Neurol Sci 2024", "url": "https://doi.org/10.1016/j.jns.2024.122993", "type": "journal", "date": "2024", "cite": "Schindler EAD et al. Psilocybin pulse regimen reduces cluster headache attack frequency in the blinded extension phase of a randomized controlled trial. J Neurol Sci. 2024" }, "evans2023": { "id": "evans2023", "label": "Evans et al., PLOS ONE 2023", "url": "https://doi.org/10.1371/journal.pone.0293349", "type": "journal", "date": "2023", "cite": "Evans J et al. Extended difficulties following the use of psychedelic drugs: a mixed methods study. PLOS ONE. 2023" }, "mapp1": { "id": "mapp1", "label": "Mitchell et al., Nature Medicine 2021 (MAPP1)", "url": "https://doi.org/10.1038/s41591-021-01336-3", "type": "journal", "date": "2021", "cite": "Mitchell JM et al. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nat Med. 2021" }, "mapp2": { "id": "mapp2", "label": "Mitchell et al., Nature Medicine 2023 (MAPP2)", "url": "https://doi.org/10.1038/s41591-023-02565-4", "type": "journal", "date": "2023", "cite": "Mitchell JM et al. MDMA-assisted therapy for moderate to severe PTSD: a randomized, placebo-controlled phase 3 trial. Nat Med. 2023" }, "fda_crl_mdma": { "id": "fda_crl_mdma", "label": "FDA Complete Response Letter, MDMA (Aug 2024)", "url": "https://download.open.fda.gov/crl/CRL_NDA215455_20240808.pdf", "type": "regulator", "date": "2024-08-08", "cite": "US FDA Complete Response Letter, NDA 215455 (midomafetamine), 8 August 2024" }, "maps_aug26": { "id": "maps_aug26", "label": "MAPS statement on the resubmission", "url": "https://maps.org/2026/08/10/maps-responds-to-report-of-progress-for-mdma-assisted-therapy-for-ptsd-with-fda/", "type": "company", "date": "2026-08-10", "cite": "Multidisciplinary Association for Psychedelic Studies (MAPS), statement, 10 August 2026" }, "bag_ch": { "id": "bag_ch", "label": "Swiss FOPH: exceptional licences", "url": "https://www.bag.admin.ch/en/exceptional-licences-for-banned-narcotics", "type": "regulator", "date": "2026", "cite": "Swiss Federal Office of Public Health (FOPH/BAG)" }, "sessa2021": { "id": "sessa2021", "label": "Sessa et al., J Psychopharmacol 2021", "url": "https://doi.org/10.1177/0269881121991792", "type": "journal", "date": "2021", "cite": "Sessa B et al. First study of safety and tolerability of MDMA-assisted psychotherapy in patients with alcohol use disorder. J Psychopharmacol. 2021" }, "danforth2018": { "id": "danforth2018", "label": "Danforth et al., Psychopharmacology 2018", "url": "https://doi.org/10.1007/s00213-018-5010-9", "type": "journal", "date": "2018", "cite": "Danforth AL et al. Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study. Psychopharmacology. 2018" }, "emp01": { "id": "emp01", "label": "AtaiBeckley: EMP-01 Phase 2a topline", "url": "https://ir.ataibeckley.com/news-releases/news-release-details/ataibeckley-announces-positive-topline-results-exploratory-phase", "type": "company", "date": "2026-02-26", "cite": "AtaiBeckley press release, 26 February 2026" }, "wolfson2020": { "id": "wolfson2020", "label": "Wolfson et al., Scientific Reports 2020", "url": "https://doi.org/10.1038/s41598-020-75706-1", "type": "journal", "date": "2020", "cite": "Wolfson PE et al. MDMA-assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study. Sci Rep. 2020" }, "kvam2025": { "id": "kvam2025", "label": "Kvam et al., BJPsych 2025", "url": "https://doi.org/10.1192/bjp.2025.10320", "type": "journal", "date": "2025", "cite": "Kvam TM et al. MDMA-assisted therapy as a treatment for major depressive disorder: proof of principle study. Br J Psychiatry. 2025" }, "anand2023": { "id": "anand2023", "label": "Anand et al., NEJM 2023 (ELEKT-D)", "url": "https://doi.org/10.1056/NEJMoa2302399", "type": "journal", "date": "2023", "cite": "Anand A et al. Ketamine versus ECT for nonpsychotic treatment-resistant major depression. N Engl J Med. 2023" }, "mcintyre2021": { "id": "mcintyre2021", "label": "McIntyre et al., Am J Psychiatry 2021", "url": "https://pubmed.ncbi.nlm.nih.gov/33726522/", "type": "journal", "date": "2021", "cite": "McIntyre RS et al. Synthesizing the evidence for ketamine and esketamine in treatment-resistant depression: an international expert opinion. Am J Psychiatry. 2021" }, "marcantoni2020": { "id": "marcantoni2020", "label": "Marcantoni et al., J Affect Disord 2020", "url": "https://pubmed.ncbi.nlm.nih.gov/33065824/", "type": "journal", "date": "2020", "cite": "Marcantoni WS et al. A systematic review and meta-analysis of the efficacy of intravenous ketamine infusion for treatment resistant depression. J Affect Disord. 2020" }, "zarate2006": { "id": "zarate2006", "label": "Zarate et al., Arch Gen Psychiatry 2006", "url": "https://pubmed.ncbi.nlm.nih.gov/16894061/", "type": "journal", "date": "2006", "cite": "Zarate CA et al. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry. 2006" }, "nyemetoder2025": { "id": "nyemetoder2025", "label": "Nye metoder (Norway): ketamine decision", "url": "https://www.nyemetoder.no/aktuelt/kan-ta-i-bruk-ketamin-som-behandlingsmetode-ved-behandlingsresistent-depresjon/", "type": "regulator", "date": "2025", "cite": "Nye metoder / Beslutningsforum for nye metoder, Norway, 2025" }, "baus2024": { "id": "baus2024", "label": "BAUS consensus on ketamine uropathy, BJU Int 2024", "url": "https://pubmed.ncbi.nlm.nih.gov/38778743/", "type": "journal", "date": "2024", "cite": "British Association of Urological Surgeons consensus statement on ketamine uropathy. BJU Int. 2024" }, "wilkinson2018": { "id": "wilkinson2018", "label": "Wilkinson et al., Am J Psychiatry 2018", "url": "https://doi.org/10.1176/appi.ajp.2017.17040472", "type": "journal", "date": "2018", "cite": "Wilkinson ST et al. The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis. Am J Psychiatry. 2018" }, "abbar2022": { "id": "abbar2022", "label": "Abbar et al., BMJ 2022", "url": "https://doi.org/10.1136/bmj-2021-067194", "type": "journal", "date": "2022", "cite": "Abbar M et al. Ketamine for the acute treatment of severe suicidal ideation: double blind, randomised placebo controlled trial. BMJ. 2022" }, "feder2021": { "id": "feder2021", "label": "Feder et al., Am J Psychiatry 2021", "url": "https://pubmed.ncbi.nlm.nih.gov/33397139/", "type": "journal", "date": "2021", "cite": "Feder A et al. A randomized controlled trial of repeated ketamine administration for chronic PTSD. Am J Psychiatry. 2021" }, "macconnel2025": { "id": "macconnel2025", "label": "MacConnel et al., J Psychopharmacol 2025", "url": "https://pubmed.ncbi.nlm.nih.gov/39400075/", "type": "journal", "date": "2025", "cite": "MacConnel HA et al. Rapid and sustained reduction of treatment-resistant PTSD symptoms after intravenous ketamine in a real-world, psychedelic paradigm. J Psychopharmacol. 2025" }, "abdallah2022": { "id": "abdallah2022", "label": "Abdallah et al., Neuropsychopharmacology 2022", "url": "https://pubmed.ncbi.nlm.nih.gov/35301425/", "type": "journal", "date": "2022", "cite": "Abdallah CG et al. Ketamine treatment for PTSD in military personnel and veterans: a randomized clinical trial. Neuropsychopharmacology. 2022" }, "grabski2022": { "id": "grabski2022", "label": "Grabski et al., Am J Psychiatry 2022 (KARE)", "url": "https://pubmed.ncbi.nlm.nih.gov/35012326/", "type": "journal", "date": "2022", "cite": "Grabski M et al. Adjunctive ketamine with relapse prevention-based psychological therapy in the treatment of alcohol use disorder. Am J Psychiatry. 2022" }, "morekare": { "id": "morekare", "label": "MORE-KARE Phase 3 (ISRCTN85955128)", "url": "https://www.isrctn.com/ISRCTN85955128", "type": "registry", "date": "2024", "cite": "ISRCTN85955128, MORE-KARE, University of Exeter / NIHR" }, "dakwar2019": { "id": "dakwar2019", "label": "Dakwar et al., Am J Psychiatry 2019", "url": "https://pubmed.ncbi.nlm.nih.gov/31230464/", "type": "journal", "date": "2019", "cite": "Dakwar E et al. A single ketamine infusion combined with mindfulness-based behavioral modification to treat cocaine dependence: a randomized clinical trial. Am J Psychiatry. 2019" }, "glue2017": { "id": "glue2017", "label": "Glue et al., J Psychopharmacol 2017", "url": "https://pubmed.ncbi.nlm.nih.gov/28441873/", "type": "journal", "date": "2017", "cite": "Glue P et al. Ketamine's dose-related effects on anxiety symptoms in patients with treatment refractory anxiety disorders. J Psychopharmacol. 2017" }, "taylor2018": { "id": "taylor2018", "label": "Taylor et al., Neuropsychopharmacology 2018", "url": "https://pubmed.ncbi.nlm.nih.gov/29191177/", "type": "journal", "date": "2018", "cite": "Taylor JH et al. Ketamine for social anxiety disorder: a randomized, placebo-controlled crossover trial. Neuropsychopharmacology. 2018" }, "whittaker2021": { "id": "whittaker2021", "label": "Whittaker et al., systematic review 2021", "url": "https://pubmed.ncbi.nlm.nih.gov/34466687/", "type": "journal", "date": "2021", "cite": "Whittaker E et al. Systematic review of ketamine in anxiety disorders. 2021" }, "rodriguez2013": { "id": "rodriguez2013", "label": "Rodriguez et al., Neuropsychopharmacology 2013", "url": "https://pubmed.ncbi.nlm.nih.gov/23783065/", "type": "journal", "date": "2013", "cite": "Rodriguez CI et al. Randomized controlled crossover trial of ketamine in obsessive-compulsive disorder. Neuropsychopharmacology. 2013" }, "beaglehole2025": { "id": "beaglehole2025", "label": "Beaglehole et al., 2025", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11760645/", "type": "journal", "date": "2025", "cite": "Beaglehole B et al. Ketamine versus active control in treatment-resistant OCD: randomised pilot trial. 2025" }, "heroiu2026": { "id": "heroiu2026", "label": "Heroiu et al., systematic review 2026", "url": "https://pubmed.ncbi.nlm.nih.gov/42311186/", "type": "journal", "date": "2026", "cite": "Heroiu et al. Ketamine in obsessive-compulsive disorder: a systematic review. 2026" }, "fda_spravato2019": { "id": "fda_spravato2019", "label": "FDA approval of Spravato (2019)", "url": "https://www.fda.gov/news-events/press-announcements/fda-approves-new-nasal-spray-medication-treatment-resistant-depression-available-only-certified", "type": "regulator", "date": "2019-03-05", "cite": "US FDA press announcement, 5 March 2019" }, "ema_spravato": { "id": "ema_spravato", "label": "EMA: Spravato EPAR", "url": "https://www.ema.europa.eu/en/medicines/human/EPAR/spravato", "type": "regulator", "date": "2019", "cite": "European Medicines Agency, Spravato European public assessment report" }, "jnj_mono2025": { "id": "jnj_mono2025", "label": "J&J: Spravato approved as monotherapy (2025)", "url": "https://www.jnj.com/media-center/press-releases/spravato-esketamine-approved-in-the-u-s-as-the-first-and-only-monotherapy-for-adults-with-treatment-resistant-depression", "type": "company", "date": "2025-01-21", "cite": "Johnson & Johnson press release, 21 January 2025" }, "jnj_mdsi2020": { "id": "jnj_mdsi2020", "label": "Janssen: US approval for acute suicidal ideation (2020)", "url": "https://www.jnj.com/media-center/press-releases/janssen-announces-u-s-fda-approval-of-spravato-esketamine-ciii-nasal-spray-to-treat-depressive-symptoms-in-adults-with-major-depressive-disorder-with-acute-suicidal-ideation-or-behavior", "type": "company", "date": "2020-08-03", "cite": "Janssen press release, 3 August 2020" }, "popova2019": { "id": "popova2019", "label": "Popova et al., Am J Psychiatry 2019 (TRANSFORM-2)", "url": "https://pubmed.ncbi.nlm.nih.gov/31109201/", "type": "journal", "date": "2019", "cite": "Popova V et al. Efficacy and safety of flexibly dosed esketamine nasal spray combined with a newly initiated oral antidepressant in treatment-resistant depression. Am J Psychiatry. 2019" }, "daly2019": { "id": "daly2019", "label": "Daly et al., JAMA Psychiatry 2019 (SUSTAIN-1)", "url": "https://pubmed.ncbi.nlm.nih.gov/31166571/", "type": "journal", "date": "2019", "cite": "Daly EJ et al. Efficacy of esketamine nasal spray plus oral antidepressant treatment for relapse prevention in patients with treatment-resistant depression. JAMA Psychiatry. 2019" }, "reif2023": { "id": "reif2023", "label": "Reif et al., NEJM 2023 (ESCAPE-TRD)", "url": "https://pubmed.ncbi.nlm.nih.gov/37792613/", "type": "journal", "date": "2023", "cite": "Reif A et al. Esketamine nasal spray versus quetiapine for treatment-resistant depression. N Engl J Med. 2023" }, "fu2020": { "id": "fu2020", "label": "Fu et al., J Clin Psychiatry 2020 (ASPIRE I)", "url": "https://pubmed.ncbi.nlm.nih.gov/32412700/", "type": "journal", "date": "2020", "cite": "Fu DJ et al. Esketamine nasal spray for rapid reduction of major depressive disorder symptoms in patients who have active suicidal ideation with intent (ASPIRE I). J Clin Psychiatry. 2020" }, "ionescu2021": { "id": "ionescu2021", "label": "Ionescu et al., Int J Neuropsychopharmacol 2021 (ASPIRE II)", "url": "https://pubmed.ncbi.nlm.nih.gov/32861217/", "type": "journal", "date": "2021", "cite": "Ionescu DF et al. Esketamine nasal spray for rapid reduction of depressive symptoms in patients with MDD who have active suicide ideation with intent (ASPIRE II). Int J Neuropsychopharmacol. 2021" }, "voyage": { "id": "voyage", "label": "Definium: Phase 3 Voyage topline (GAD)", "url": "https://www.businesswire.com/news/home/20260812579720/en/Definium-Therapeutics-Announces-Positive-Topline-Results-from-Phase-3-Voyage-Study-of-DT120-ODT-in-Generalized-Anxiety-Disorder", "type": "company", "date": "2026-08-12", "cite": "Definium Therapeutics press release, 12 August 2026" }, "panorama": { "id": "panorama", "label": "Definium: Phase 3 Panorama topline (GAD)", "url": "https://www.sec.gov/Archives/edgar/data/1813814/000110465926107275/tm2625365d1_ex99-1.htm", "type": "company", "date": "2026-09-14", "cite": "Definium Therapeutics press release (SEC filing, Ex. 99.1), 14 September 2026" }, "emerge": { "id": "emerge", "label": "Definium: Phase 3 Emerge topline (MDD)", "url": "https://ir.definiumtx.com/news-events/press-releases/detail/232", "type": "company", "date": "2026-06-22", "cite": "Definium Therapeutics press release, 22 June 2026" }, "robison2025": { "id": "robison2025", "label": "Robison et al., JAMA 2025", "url": "https://doi.org/10.1001/jama.2025.13481", "type": "journal", "date": "2025", "cite": "Robison R et al. Single treatment with MM120 (lysergide) in generalized anxiety disorder: a randomized clinical trial. JAMA. 2025" }, "holze2023": { "id": "holze2023", "label": "Holze et al., Biological Psychiatry 2023", "url": "https://doi.org/10.1016/j.biopsych.2022.08.025", "type": "journal", "date": "2023", "cite": "Holze F et al. Lysergic acid diethylamide-assisted therapy in patients with anxiety with and without a life-threatening illness: a randomized, double-blind, placebo-controlled phase II study. Biol Psychiatry. 2023" }, "gasser2014": { "id": "gasser2014", "label": "Gasser et al., J Nerv Ment Dis 2014", "url": "https://doi.org/10.1097/NMD.0000000000000113", "type": "journal", "date": "2014", "cite": "Gasser P et al. Safety and efficacy of LSD-assisted psychotherapy for anxiety associated with life-threatening diseases. J Nerv Ment Dis. 2014" }, "mueller2025": { "id": "mueller2025", "label": "Mueller et al., JAMA Psychiatry 2025", "url": "https://doi.org/10.1001/jamapsychiatry.2025.0044", "type": "journal", "date": "2025", "cite": "Mueller L et al. Safety and efficacy of repeated low-dose LSD for ADHD treatment in adults: a randomized clinical trial. JAMA Psychiatry. 2025" }, "krebs2012": { "id": "krebs2012", "label": "Krebs & Johansen, J Psychopharmacol 2012", "url": "https://pubmed.ncbi.nlm.nih.gov/22406913/", "type": "journal", "date": "2012", "cite": "Krebs TS, Johansen PØ. Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials. J Psychopharmacol. 2012" }, "bern_lsd_aud": { "id": "bern_lsd_aud", "label": "LSD for alcohol use disorder, Bern (NCT05474989)", "url": "https://clinicaltrials.gov/study/NCT05474989", "type": "registry", "date": "2022", "cite": "ClinicalTrials.gov NCT05474989, University of Bern" }, "erritzoe2026": { "id": "erritzoe2026", "label": "Erritzoe et al., Nature Medicine 2026", "url": "https://doi.org/10.1038/s41591-025-04154-z", "type": "journal", "date": "2026", "cite": "Erritzoe D et al. A short-acting psychedelic intervention for major depressive disorder: a phase IIa randomized placebo-controlled trial. Nat Med. 2026" }, "muller2025": { "id": "muller2025", "label": "Müller et al., Med 2025", "url": "https://doi.org/10.1016/j.medj.2025.100725", "type": "journal", "date": "2025", "cite": "Müller F et al. Efficacy and safety of low- versus high-dose-LSD-assisted therapy in patients with major depression: a randomized trial. Med. 2025" }, "falchi2025": { "id": "falchi2025", "label": "Falchi-Carvalho et al., Neuropsychopharmacology 2025", "url": "https://doi.org/10.1038/s41386-025-02091-6", "type": "journal", "date": "2025", "cite": "Falchi-Carvalho M, Palhano-Fontes F et al. Rapid and sustained antidepressant effects of vaporized N,N-dimethyltryptamine: a phase 2a clinical trial in treatment-resistant depression. Neuropsychopharmacology. 2025" }, "vls01_jul26": { "id": "vls01_jul26", "label": "AtaiBeckley: VLS-01 Phase 2b fully dosed", "url": "https://www.globenewswire.com/news-release/2026/07/06/3322260/0/en/ataibeckley-doses-last-patient-in-vls-01-phase-2b-trd-study-plans-phase-3-in-major-depressive-disorder.html", "type": "company", "date": "2026-07-06", "cite": "AtaiBeckley press release, 6 July 2026" }, "lilly_atai": { "id": "lilly_atai", "label": "Lilly to acquire AtaiBeckley", "url": "https://www.prnewswire.com/news-releases/lilly-to-acquire-ataibeckley-to-advance-therapies-for-treatment-resistant-depression-and-other-mental-health-conditions-302827468.html", "type": "company", "date": "2026-07-16", "cite": "Eli Lilly and Company press release, 16 July 2026" }, "bpl003_2b": { "id": "bpl003_2b", "label": "atai & Beckley Psytech: BPL-003 Phase 2b topline", "url": "https://ir.atai.com/news-releases/news-release-details/atai-life-sciences-and-beckley-psytech-announce-positive-topline/", "type": "company", "date": "2025", "cite": "atai Life Sciences and Beckley Psytech press release, 2025" }, "atai_q1_26": { "id": "atai_q1_26", "label": "AtaiBeckley: Q1 2026 programme update", "url": "https://ir.atai.com/news-releases/news-release-details/ataibeckley-reports-first-quarter-2026-financial-results-and", "type": "company", "date": "2026-05-12", "cite": "AtaiBeckley press release, 12 May 2026" }, "cubala2026": { "id": "cubala2026", "label": "Cubała et al., JAMA Psychiatry 2026", "url": "https://doi.org/10.1001/jamapsychiatry.2026.0096", "type": "journal", "date": "2026", "cite": "Cubała WJ et al. GH001 vs placebo in patients with treatment-resistant depression: a randomized clinical trial. JAMA Psychiatry. 2026" }, "roberts2026": { "id": "roberts2026", "label": "Roberts et al., J Psychopharmacol 2026", "url": "https://doi.org/10.1177/02698811261420087", "type": "journal", "date": "2026", "cite": "Roberts C et al. A phase 2 uncontrolled, open-label study of intranasal BPL-003 (5-methoxy-N,N-dimethyltryptamine) in patients with treatment-resistant depression. J Psychopharmacol. 2026" }, "gh_hold": { "id": "gh_hold", "label": "GH Research: FDA lifts clinical hold on GH001", "url": "https://ghres.gcs-web.com/news-releases/news-release-details/gh-research-announces-fda-lifts-clinical-hold-gh001-clearing/", "type": "company", "date": "2026-01-05", "cite": "GH Research press release, 5 January 2026" }, "gh_q2_26": { "id": "gh_q2_26", "label": "GH Research: Q2 2026 update", "url": "https://ghres.gcs-web.com/news-releases/news-release-details/gh-research-reports-second-quarter-2026-financial-results-and", "type": "company", "date": "2026-08-06", "cite": "GH Research press release, 6 August 2026" }, "palhano2019": { "id": "palhano2019", "label": "Palhano-Fontes et al., Psychol Med 2019", "url": "https://doi.org/10.1017/S0033291718001356", "type": "journal", "date": "2019", "cite": "Palhano-Fontes F et al. Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial. Psychol Med. 2019" }, "noller2018": { "id": "noller2018", "label": "Noller et al., Am J Drug Alcohol Abuse 2018", "url": "https://doi.org/10.1080/00952990.2017.1310218", "type": "journal", "date": "2018", "cite": "Noller GE et al. Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study. Am J Drug Alcohol Abuse. 2018" }, "brown2018": { "id": "brown2018", "label": "Brown & Alper, Am J Drug Alcohol Abuse 2018", "url": "https://doi.org/10.1080/00952990.2017.1320802", "type": "journal", "date": "2018", "cite": "Brown TK, Alper K. Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes. Am J Drug Alcohol Abuse. 2018" }, "knuijver2022": { "id": "knuijver2022", "label": "Knuijver et al., Addiction 2022", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9292417/", "type": "journal", "date": "2022", "cite": "Knuijver T et al. Safety of ibogaine administration in detoxification of opioid-dependent individuals: a descriptive open-label observational study. Addiction. 2022" }, "koenig2015": { "id": "koenig2015", "label": "Koenig & Hilber, Molecules 2015", "url": "https://pubmed.ncbi.nlm.nih.gov/25642835/", "type": "journal", "date": "2015", "cite": "Koenig X, Hilber K. The anti-addiction drug ibogaine and the heart: a delicate relation. Molecules. 2015" }, "cherian2024": { "id": "cherian2024", "label": "Cherian et al., Nature Medicine 2024", "url": "https://doi.org/10.1038/s41591-023-02705-w", "type": "journal", "date": "2024", "cite": "Cherian KN et al. Magnesium-ibogaine therapy in veterans with traumatic brain injuries. Nat Med. 2024" }, "texas_sb2308": { "id": "texas_sb2308", "label": "Texas Governor: ibogaine research law (SB 2308)", "url": "https://gov.texas.gov/news/post/governor-abbott-signs-ibogaine-treatment-research-law-at-texas-capitol", "type": "regulator", "date": "2025-06-11", "cite": "Office of the Texas Governor, Senate Bill 2308 signed, 11 June 2025" }, "glue2016": { "id": "glue2016", "label": "Glue et al., Clin Pharmacol Drug Dev 2016", "url": "https://doi.org/10.1002/cpdd.254", "type": "journal", "date": "2016", "cite": "Glue P, Cape G, Tunnicliff D et al. Ascending single-dose, double-blind, placebo-controlled safety study of noribogaine in opioid-dependent patients. Clin Pharmacol Drug Dev. 2016" }, "aginliebes2021": { "id": "aginliebes2021", "label": "Agin-Liebes et al., ACS Pharmacol Transl Sci 2021", "url": "https://doi.org/10.1021/acsptsci.1c00018", "type": "journal", "date": "2021", "cite": "Agin-Liebes G et al. Naturalistic use of mescaline is associated with self-reported psychiatric improvements and enduring positive life changes. ACS Pharmacol Transl Sci. 2021" }, "black2019": { "id": "black2019", "label": "Black et al., Lancet Psychiatry 2019", "url": "https://doi.org/10.1016/S2215-0366(19)30401-8", "type": "journal", "date": "2019", "cite": "Black N et al. Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis. Lancet Psychiatry. 2019" }, "bonnmiller2021": { "id": "bonnmiller2021", "label": "Bonn-Miller et al., PLOS ONE 2021", "url": "https://doi.org/10.1371/journal.pone.0246990", "type": "journal", "date": "2021", "cite": "Bonn-Miller MO et al. The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: a randomized cross-over clinical trial. PLOS ONE. 2021" }, "wang2021": { "id": "wang2021", "label": "Wang et al., BMJ 2021", "url": "https://pubmed.ncbi.nlm.nih.gov/34497047/", "type": "journal", "date": "2021", "cite": "Wang L et al. Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials. BMJ. 2021" }, "cooper2017": { "id": "cooper2017", "label": "Cooper et al., Eur Neuropsychopharmacol 2017", "url": "https://doi.org/10.1016/j.euroneuro.2017.05.005", "type": "journal", "date": "2017", "cite": "Cooper RE et al. Cannabinoids in attention-deficit/hyperactivity disorder: a randomised-controlled trial. Eur Neuropsychopharmacol. 2017" }, "diforti2019": { "id": "diforti2019", "label": "Di Forti et al., Lancet Psychiatry 2019", "url": "https://doi.org/10.1016/S2215-0366(19)30048-3", "type": "journal", "date": "2019", "cite": "Di Forti M et al. The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI). Lancet Psychiatry. 2019" } }, "cells": [ { "s": "psilocybin", "c": "trd", "tier": "p3pos", "headline": "Two positive Phase 3 trials; the FDA filing is under way. Not approved yet.", "facts": [ { "t": "Two Phase 3 trials of COMP360 psilocybin met their main goal. In the first (258 people), one 25 mg dose beat placebo by 3.6 points on the MADRS depression scale at week 6; in the second (581 people), 25 mg beat a 1 mg dose by 3.8 points.", "refs": [ "comp005", "comp006" ] }, { "t": "Those are modest average differences, and individual results vary a lot. In the second trial, 39% of people on 25 mg saw their symptoms drop by at least a quarter by week 6, and those responses held to at least six months.", "refs": [ "comp006_26w" ] }, { "t": "In the first trial's open-label extension, about 80% of the 25 mg group took another dose; at one year their depression scores averaged about 13 points below where they started.", "refs": [ "comp005_52w" ] }, { "t": "The FDA agreed to a rolling review and gave COMP360 a national priority voucher, which can shorten review to one or two months once the application is complete. Compass expects to finish filing in Q4 2026.", "refs": [ "comp_cnpv", "fda_cnpv", "comp006_26w" ] }, { "t": "This builds on a 233-person Phase 2b trial published in the New England Journal of Medicine.", "refs": [ "goodwin2022" ] }, { "t": "Not every trial has been positive. In EPISODE, an academic Phase 2b trial in Germany (144 people), 25 mg didn't significantly beat an active placebo on its main measure: 17% responded, versus 11%. Thoughts of suicide on dosing days were slightly more common with psilocybin.", "refs": [ "mertens2026" ] }, { "t": "In Australia, authorised psychiatrists have been allowed to prescribe psilocybin for treatment-resistant depression since 2023.", "refs": [ "tga2023" ] } ] }, { "s": "psilocybin", "c": "depression", "tier": "p3run", "headline": "Phase 3 under way (Usona); solid Phase 2 data, no Phase 3 results yet.", "facts": [ { "t": "In a Phase 2 trial of 104 adults with major depression, one dose of psilocybin cut depression scores by about 12 points more than an active placebo at six weeks.", "refs": [ "raison2023" ] }, { "t": "An earlier Johns Hopkins trial (27 people) compared two psilocybin sessions with a waiting list: 71% responded at four weeks. A waiting list isn't a placebo, so this overstates the drug's own effect.", "refs": [ "davis2021" ] }, { "t": "Head-to-head against the antidepressant escitalopram, psilocybin was not significantly better on the main measure, though some secondary results favoured it.", "refs": [ "carhart2021" ] }, { "t": "Usona Institute is running a Phase 3 trial (uAspire). The FDA gave this programme a national priority voucher in April 2026. No Phase 3 results have been published.", "refs": [ "usona_reg", "fda_cnpv" ] }, { "t": "A related molecule, HLP003 (Helus Pharma), finished enrolling its first Phase 3 trial in 2026, with results expected in Q4 2026. It isn't psilocybin itself.", "refs": [ "helus_oct26" ] } ] }, { "s": "psilocybin", "c": "ptsd", "tier": "early", "headline": "One small open-label study. Everyone knew they got psilocybin.", "facts": [ { "t": "In an open-label Phase 2 study of 22 people with PTSD, one 25 mg dose was followed by large symptom drops at 12 weeks, with no serious side effects. Without a placebo group, this can't tell us how much was the drug.", "refs": [ "compass_ptsd" ] } ] }, { "s": "psilocybin", "c": "anxiety", "tier": "p2", "headline": "One positive Phase 2 trial in generalised anxiety, so far only as a company announcement.", "facts": [ { "t": "In a randomised, placebo-controlled Phase 2 trial of 73 adults with GAD, two psilocybin sessions cut anxiety scores by 12.8 points versus 3.6 with placebo. These are company-reported results; the full paper isn't out yet.", "refs": [ "incannex2025" ] } ] }, { "s": "psilocybin", "c": "illness", "tier": "p2", "headline": "Among the most replicated findings in the field, but still small trials.", "facts": [ { "t": "Two randomised trials in people with life-threatening cancer found large, lasting drops in depression and anxiety after one supported session.", "refs": [ "griffiths2016", "ross2016" ] }, { "t": "A newer open-label study of 30 people with cancer and depression tested psilocybin in a group format and also saw sizeable improvements.", "refs": [ "agrawal2024" ] } ] }, { "s": "psilocybin", "c": "alcohol", "tier": "p2", "headline": "One good randomised trial; confirmation still needed.", "facts": [ { "t": "In a double-blind trial of 93 adults with alcohol dependence, psilocybin plus therapy roughly halved the share of heavy-drinking days compared with an active placebo over 32 weeks.", "refs": [ "bogenschutz2022" ] } ] }, { "s": "psilocybin", "c": "tobacco", "tier": "p2", "headline": "Beat nicotine patches in a small unblinded trial.", "facts": [ { "t": "In a randomised pilot of 82 daily smokers, about 40% of the psilocybin group had stayed off cigarettes at six months, versus about 10% on nicotine patches. Everyone knew which treatment they got.", "refs": [ "johnson2026" ] }, { "t": "This follows an earlier 15-person open-label pilot that reported high quit rates.", "refs": [ "johnson2014" ] } ] }, { "s": "psilocybin", "c": "ocd", "tier": "early", "headline": "First small placebo-controlled trial is encouraging. Very early days.", "facts": [ { "t": "In a randomised trial of 15 adults, weekly high doses of psilocybin reduced OCD symptoms more than an active placebo over four weeks.", "refs": [ "moreno2026" ] }, { "t": "In a UK study of 19 adults, a 10 mg dose eased compulsions more than a 1 mg dose for about a week. Doses were given in a fixed order rather than at random, and the effect faded within a month.", "refs": [ "pellegrini2025" ] }, { "t": "That team's first study, with 9 patients, dates back to 2006.", "refs": [ "moreno2006" ] } ] }, { "s": "psilocybin", "c": "eating", "tier": "early", "headline": "Two small uncontrolled studies in anorexia. Safety signals only.", "facts": [ { "t": "In an open-label study of 10 women with anorexia, psilocybin was safe and tolerable; four had meaningful drops in eating-disorder symptoms at three months.", "refs": [ "peck2023" ] }, { "t": "A 2026 pilot with 21 women saw eating-disorder scores fall at every follow-up, but body weight didn't change meaningfully, and there was no comparison group.", "refs": [ "douglass2026" ] } ] }, { "s": "psilocybin", "c": "headache", "tier": "early", "headline": "Tiny controlled studies with mixed results.", "facts": [ { "t": "In a 10-person placebo-controlled study, one dose reduced migraine days over the following two weeks.", "refs": [ "schindler2021" ] }, { "t": "In cluster headache, a small trial didn't show a clear drop in attack frequency, though a later blinded extension phase did.", "refs": [ "schindler2022", "schindler2024" ] } ] }, { "s": "psilocybin", "c": "pain", "tier": "early", "headline": "A five-person pilot in fibromyalgia. Far too early to say.", "facts": [ { "t": "In an open-label pilot of 5 adults with fibromyalgia, two psilocybin sessions with therapy were followed by less pain and better sleep a month later, with no serious side effects. Recruitment stopped early, and there was no comparison group.", "refs": [ "aday2025" ] } ] }, { "s": "mdma", "c": "ptsd", "tier": "p3pos", "headline": "Two positive Phase 3 trials. Rejected by the FDA in 2024; resubmitted in 2026.", "facts": [ { "t": "MDMA-assisted therapy met its main goal in two Phase 3 trials, in severe PTSD (90 people) and in moderate-to-severe PTSD (104 people). The comparison group got the same therapy with a placebo.", "refs": [ "mapp1", "mapp2" ] }, { "t": "In August 2024 the FDA declined to approve it. Its letter cites unreliable recording of side effects, no proof the benefit lasts beyond 18 weeks and possible selection bias (many participants had used MDMA before), and asks for a new trial.", "refs": [ "fda_crl_mdma" ] }, { "t": "In August 2026, MAPS — the non-profit behind the original trials — said the sponsor, Resilient Pharmaceuticals, is resubmitting without a new Phase 3 trial. Resilient itself has not announced it.", "refs": [ "maps_aug26" ] }, { "t": "Australia allows authorised psychiatrists to prescribe MDMA for PTSD, and Switzerland grants patient-by-patient exceptional licences.", "refs": [ "tga2023", "bag_ch" ] } ] }, { "s": "mdma", "c": "anxiety", "tier": "p2", "headline": "Small trials in social anxiety, including a version of MDMA without the therapy.", "facts": [ { "t": "In a 12-person randomised pilot, MDMA-assisted therapy reduced social anxiety in autistic adults more than placebo.", "refs": [ "danforth2018" ] }, { "t": "In a 71-person Phase 2a trial, two doses of R-MDMA (EMP-01) without psychotherapy improved social anxiety scores by about 12 points more than placebo. The trial wasn't powered for significance. Eli Lilly agreed to buy the developer in July 2026.", "refs": [ "emp01", "lilly_atai" ] } ] }, { "s": "mdma", "c": "illness", "tier": "early", "headline": "One small pilot.", "facts": [ { "t": "In an 18-person randomised pilot in people with life-threatening illness, MDMA-assisted therapy showed a trend towards lower anxiety. Too small to draw conclusions.", "refs": [ "wolfson2020" ] } ] }, { "s": "mdma", "c": "alcohol", "tier": "early", "headline": "Open-label safety study only.", "facts": [ { "t": "A UK open-label study of 14 people after alcohol detox (BIMA) found MDMA-assisted therapy safe and well tolerated. There was no control group.", "refs": [ "sessa2021" ] } ] }, { "s": "mdma", "c": "depression", "tier": "early", "headline": "One 12-person proof-of-principle study.", "facts": [ { "t": "In an open-label study of 12 adults with major depression, 9 responded after two MDMA sessions with therapy. The authors themselves say this can't establish efficacy.", "refs": [ "kvam2025" ] } ] }, { "s": "ketamine", "c": "trd", "tier": "offlabel", "headline": "Strong evidence for fast relief; keeping it going is the hard part.", "facts": [ { "t": "The rapid antidepressant effect of a single low-dose infusion was first shown in a small placebo-controlled trial in 2006 and has been replicated many times since.", "refs": [ "zarate2006", "marcantoni2020" ] }, { "t": "In a 403-person trial, ketamine was at least as effective as electroconvulsive therapy (ECT) for treatment-resistant depression: 55% responded versus 41% with ECT.", "refs": [ "anand2023" ] }, { "t": "Relief often fades within days to weeks once infusions stop, and nobody has settled the best maintenance schedule yet.", "refs": [ "marcantoni2020", "mcintyre2021" ] }, { "t": "Racemic ketamine isn't licensed as an antidepressant, but it can be prescribed off-label; Norway, for example, now funds it in specialist care for treatment-resistant depression under set conditions.", "refs": [ "nyemetoder2025" ] } ] }, { "s": "ketamine", "c": "suicidal", "tier": "p2", "headline": "Fast, short-lived relief from suicidal thoughts. A bridge, not a cure.", "facts": [ { "t": "Pooling individual data from 167 patients, one infusion reduced suicidal thoughts within a day, with effects lasting up to a week.", "refs": [ "wilkinson2018" ] }, { "t": "In a 156-person randomised trial, 63% of inpatients on ketamine were free of suicidal thoughts on day 3, versus 32% on placebo. By six weeks the groups no longer differed.", "refs": [ "abbar2022" ] } ] }, { "s": "ketamine", "c": "ptsd", "tier": "p2", "headline": "One positive trial, one larger null result.", "facts": [ { "t": "In a 30-person randomised trial, six infusions over two weeks reduced chronic PTSD symptoms more than an active placebo.", "refs": [ "feder2021" ] }, { "t": "A larger trial in 158 military personnel and veterans found no significant PTSD benefit over placebo.", "refs": [ "abdallah2022" ] }, { "t": "In a US clinic, 117 patients who got at least six infusions with preparation and integration sessions saw their PTSD scores drop by almost half. It's a look back at clinic records with no comparison group.", "refs": [ "macconnel2025" ] } ] }, { "s": "ketamine", "c": "alcohol", "tier": "p3run", "headline": "Positive Phase 2; a Phase 3 trial is recruiting in the UK.", "facts": [ { "t": "In the UK KARE trial (96 people), ketamine infusions plus relapse-prevention therapy led to more days without alcohol over six months than placebo.", "refs": [ "grabski2022" ] }, { "t": "MORE-KARE, a Phase 3 trial across NHS sites, is now testing this at scale. No results yet.", "refs": [ "morekare" ] } ] }, { "s": "ketamine", "c": "stimulants", "tier": "p2", "headline": "One encouraging randomised trial in cocaine use.", "facts": [ { "t": "In a 55-person randomised trial, a single ketamine infusion plus mindfulness-based therapy kept 48% of people off cocaine in the final two weeks, versus 11% with an active placebo.", "refs": [ "dakwar2019" ] } ] }, { "s": "ketamine", "c": "anxiety", "tier": "early", "headline": "Short-lived effects in small studies.", "facts": [ { "t": "Small studies in treatment-resistant generalised and social anxiety show quick relief that fades within days to a couple of weeks.", "refs": [ "glue2017", "taylor2018" ] }, { "t": "A systematic review found signals worth researching, but nothing near guideline-level evidence.", "refs": [ "whittaker2021" ] } ] }, { "s": "ketamine", "c": "ocd", "tier": "early", "headline": "Three small randomised trials, short-term effects.", "facts": [ { "t": "A 2026 systematic review counted three small randomised trials: rapid anti-obsessional effects, but too little to judge lasting benefit, dosing or safety.", "refs": [ "heroiu2026" ] }, { "t": "The first crossover trial (15 adults) dates from 2013.", "refs": [ "rodriguez2013" ] }, { "t": "A 2025 pilot in 12 people with treatment-resistant OCD found greater short-term improvement than an active control.", "refs": [ "beaglehole2025" ] } ] }, { "s": "esketamine", "c": "trd", "tier": "approved", "headline": "Approved in the US and EU since 2019; a standalone treatment in the US since 2025.", "facts": [ { "t": "The FDA approved esketamine nasal spray for treatment-resistant depression in March 2019, and the EU followed in December 2019 — in both cases alongside an oral antidepressant.", "refs": [ "fda_spravato2019", "ema_spravato" ] }, { "t": "In January 2025 the FDA also approved it as a monotherapy, without a daily antidepressant.", "refs": [ "jnj_mono2025" ] }, { "t": "The benefit is real but moderate: about 4 points more improvement on the MADRS than placebo at four weeks.", "refs": [ "popova2019" ] }, { "t": "Staying on it helps: people who continued were much less likely to relapse (26.7% versus 45.3%).", "refs": [ "daly2019" ] }, { "t": "Head-to-head against quetiapine, more people reached remission with esketamine at week 8 (27.1% versus 17.6%).", "refs": [ "reif2023" ] } ] }, { "s": "esketamine", "c": "suicidal", "tier": "approved", "headline": "Approved for depression with acute suicidal thoughts. It eases depression faster; it didn't beat placebo on suicidality itself.", "facts": [ { "t": "Since 2020, the US label covers depressive symptoms in adults with major depression who have acute suicidal ideation or behaviour, alongside an oral antidepressant. The EU authorises a short-term use in psychiatric emergencies.", "refs": [ "jnj_mdsi2020", "ema_spravato" ] }, { "t": "In the two trials behind this approval, depression improved faster than with placebo within 24 hours, but the drug didn't separate from placebo on the suicidality measure.", "refs": [ "fu2020", "ionescu2021" ] } ] }, { "s": "lsd", "c": "anxiety", "tier": "p3pos", "headline": "Two positive Phase 3 trials in generalised anxiety. Filing planned for 2027.", "facts": [ { "t": "One supervised 100 µg dose of DT120 beat placebo in the Phase 3 Voyage trial (214 people): anxiety scores fell 5.4 points more at week 12.", "refs": [ "voyage" ] }, { "t": "The second Phase 3, Panorama, also met its goal: a 5.1-point advantage at week 12, with effects seen from day 2.", "refs": [ "panorama" ] }, { "t": "This followed a 198-person Phase 2b trial in JAMA, where the effect was still there at week 12.", "refs": [ "robison2025" ] }, { "t": "Definium plans to meet the FDA before the end of 2026 and file in the first half of 2027.", "refs": [ "panorama" ] }, { "t": "Earlier, an academic Phase 2 trial in Switzerland (42 people) also found LSD-assisted therapy reduced anxiety.", "refs": [ "holze2023" ] } ] }, { "s": "lsd", "c": "depression", "tier": "p3pos", "headline": "One positive Phase 3 trial so far; the second pivotal trial hasn't reported.", "facts": [ { "t": "In the Phase 3 Emerge trial (149 adults), one 100 µg dose cut depression scores by 8.1 points more than placebo at week 6. 24% reached remission, versus 3% on placebo.", "refs": [ "emerge" ] }, { "t": "A second pivotal trial, Ascend, is part of the programme; its results aren't out yet.", "refs": [ "emerge" ] }, { "t": "An academic Swiss trial (61 people) compared high and low doses of LSD with therapy. The high dose did better on the clinician-rated scale, but the self-rated measure just missed significance, and neither result held after adjusting for how depressed people were at the start.", "refs": [ "muller2025" ] } ] }, { "s": "lsd", "c": "illness", "tier": "p2", "headline": "Small controlled trials, an old idea revisited.", "facts": [ { "t": "A 12-person pilot found LSD-assisted therapy reduced anxiety linked to life-threatening disease.", "refs": [ "gasser2014" ] }, { "t": "A larger Phase 2 trial (42 people with anxiety, with or without serious illness) confirmed lasting reductions in anxiety.", "refs": [ "holze2023" ] } ] }, { "s": "lsd", "c": "adhd", "tier": "none", "headline": "Properly tested — and microdosing didn't work.", "facts": [ { "t": "In a placebo-controlled trial of 53 adults, LSD microdoses twice a week for six weeks did no better than placebo. Both groups improved, and those who believed they got LSD improved more.", "refs": [ "mueller2025" ] } ] }, { "s": "lsd", "c": "alcohol", "tier": "early", "headline": "A historical signal, modern trials only starting.", "facts": [ { "t": "A meta-analysis of six trials from the 1960s and 70s (536 people) found a single LSD dose reduced alcohol misuse.", "refs": [ "krebs2012" ] }, { "t": "A modern trial is recruiting in Switzerland.", "refs": [ "bern_lsd_aud" ] } ] }, { "s": "dmt", "c": "depression", "tier": "p2", "headline": "One small, positive placebo-controlled trial.", "facts": [ { "t": "In a 34-person Phase 2a trial, one intravenous DMT session (about 10 minutes) with therapy cut depression scores by 7.4 points more than placebo at two weeks.", "refs": [ "erritzoe2026" ] } ] }, { "s": "dmt", "c": "trd", "tier": "p2", "headline": "Phase 2b fully dosed; results due by the end of 2026.", "facts": [ { "t": "VLS-01, a buccal DMT film, is in a 156-person placebo-controlled Phase 2b trial in treatment-resistant depression. Dosing finished in July 2026; results are expected in Q4 2026.", "refs": [ "vls01_jul26" ] }, { "t": "In a Brazilian open-label trial of 14 people, inhaled DMT cut depression scores by about 21 points within a week, and 8 of the 14 were in remission. Everyone knew they got DMT, and there was no placebo group.", "refs": [ "falchi2025" ] } ] }, { "s": "5-meo-dmt", "c": "trd", "tier": "p3run", "headline": "Two positive Phase 2b trials; Phase 3 started in 2026.", "facts": [ { "t": "In a placebo-controlled Phase 2b trial of 81 people, published in JAMA Psychiatry, inhaled GH001 cut depression scores by 15.5 points more than placebo after 8 days; 58% were in remission, versus none on placebo.", "refs": [ "cubala2026" ] }, { "t": "The FDA lifted its US clinical hold on GH001 in January 2026.", "refs": [ "gh_hold" ] }, { "t": "Intranasal BPL-003 met its main goal in a 193-person Phase 2b trial. An earlier open-label study in 12 people found most were ready to go home about 1.5 hours after the dose.", "refs": [ "bpl003_2b", "roberts2026" ] }, { "t": "BPL-003's Phase 3 programme (ReConnection-1 and -2) was initiated in mid-2026, with results expected in early 2029. Eli Lilly agreed to buy the developer in July 2026.", "refs": [ "atai_q1_26", "vls01_jul26", "lilly_atai" ] }, { "t": "GH Research still plans to start its own Phase 3 in 2026.", "refs": [ "gh_q2_26" ] } ] }, { "s": "ayahuasca", "c": "trd", "tier": "early", "headline": "One small randomised trial. Nothing larger since.", "facts": [ { "t": "In a 29-person placebo-controlled trial in Brazil, one ayahuasca session reduced depression scores within a week more than placebo.", "refs": [ "palhano2019" ] } ] }, { "s": "ibogaine", "c": "opioids", "tier": "early", "headline": "Observational studies only. Promising stories, serious heart risk.", "facts": [ { "t": "Observational studies from New Zealand (14 people) and Mexico (30 people) reported less withdrawal and reduced opioid use after treatment. There were no control groups.", "refs": [ "noller2018", "brown2018" ] }, { "t": "In a Dutch study of 14 people, half developed dangerous QTc prolongation — a heart-rhythm warning sign.", "refs": [ "knuijver2022" ] }, { "t": "In 2025 Texas passed a law letting the state co-fund an FDA trial of ibogaine for opioid use disorder, depression and PTSD.", "refs": [ "texas_sb2308" ] } ] }, { "s": "ibogaine", "c": "ptsd", "tier": "early", "headline": "One uncontrolled study in veterans.", "facts": [ { "t": "In 30 US special-operations veterans with traumatic brain injury, magnesium-ibogaine was followed by large drops in PTSD, depression and anxiety a month later. Without a control group, that's a signal, not proof.", "refs": [ "cherian2024" ] } ] }, { "s": "noribogaine", "c": "opioids", "tier": "early", "headline": "Didn't ease withdrawal in its only trial so far.", "facts": [ { "t": "In a placebo-controlled safety study in opioid-dependent people, single doses of noribogaine showed only a non-significant trend towards less withdrawal (27 people).", "refs": [ "glue2016" ] } ] }, { "s": "noribogaine", "c": "alcohol", "tier": "early", "headline": "First US trial just cleared. No results.", "facts": [ { "t": "In April 2026 the FDA allowed a Phase 1 study of noribogaine for alcohol use disorder — the first US study of any ibogaine derivative. That's permission to test, not evidence it works.", "refs": [ "fda_cnpv" ] } ] }, { "s": "mescaline", "c": "depression", "tier": "early", "headline": "Self-report survey only.", "facts": [ { "t": "In an online survey of 452 people who had used mescaline, most of those with a past depression diagnosis said it improved afterwards. Surveys like this can't show cause and effect.", "refs": [ "aginliebes2021" ] } ] }, { "s": "mescaline", "c": "alcohol", "tier": "early", "headline": "Self-report survey only.", "facts": [ { "t": "In the same survey, 76% of respondents with past alcohol problems reported improvement. Self-selected and retrospective.", "refs": [ "aginliebes2021" ] } ] }, { "s": "cannabis", "c": "depression", "tier": "none", "headline": "Reviews find no good evidence.", "facts": [ { "t": "A Lancet Psychiatry review of 83 studies found very little, very low-quality evidence that cannabinoids improve depression.", "refs": [ "black2019" ] } ] }, { "s": "cannabis", "c": "anxiety", "tier": "none", "headline": "Weak evidence at best.", "facts": [ { "t": "The same review found very low-quality evidence for anxiety disorders; the only signal was low-quality evidence of small improvements in anxiety in people with other medical conditions.", "refs": [ "black2019" ] } ] }, { "s": "cannabis", "c": "ptsd", "tier": "none", "headline": "Tested in a controlled trial — no better than placebo.", "facts": [ { "t": "In a randomised crossover trial in 80 veterans, three types of smoked cannabis did no better than placebo on PTSD symptoms.", "refs": [ "bonnmiller2021" ] }, { "t": "Reviews rate the wider PTSD evidence as very low quality.", "refs": [ "black2019" ] } ] }, { "s": "cannabis", "c": "adhd", "tier": "early", "headline": "One small trial missed its main goal.", "facts": [ { "t": "In a 30-person randomised trial, a THC/CBD spray (Sativex) didn't significantly improve the main measure of attention and activity.", "refs": [ "cooper2017" ] } ] }, { "s": "cannabis", "c": "pain", "tier": "p2", "headline": "Many trials, small benefits.", "facts": [ { "t": "Pooling randomised trials of chronic pain, medical cannabis gave small improvements in pain, physical function and sleep — real, but modest.", "refs": [ "wang2021" ] } ] }, { "s": "cannabis", "c": "insomnia", "tier": "p2", "headline": "Small sleep benefits, mostly in people with chronic pain.", "facts": [ { "t": "In trials of people with chronic pain, medical cannabis brought a small improvement in sleep quality.", "refs": [ "wang2021" ] } ] } ], "summaries": { "psilocybin": { "proven": [ { "t": "Reduces treatment-resistant depression more than placebo or a 1 mg dose, in two Phase 3 trials.", "refs": [ "comp005", "comp006" ] }, { "t": "In people who respond, the effect of one or two doses can last at least six months.", "refs": [ "comp006_26w" ] } ], "not": [ { "t": "Not an approved medicine anywhere yet. Australia allows authorised psychiatrists to prescribe it.", "refs": [ "tga2023" ] }, { "t": "Whether it beats a standard antidepressant: a head-to-head trial found no significant difference.", "refs": [ "carhart2021" ] }, { "t": "PTSD, OCD and anorexia: only small or uncontrolled studies so far.", "refs": [ "compass_ptsd", "moreno2026", "peck2023" ] } ] }, "mdma": { "proven": [ { "t": "MDMA with therapy reduced PTSD symptoms more than the same therapy with placebo, in two Phase 3 trials.", "refs": [ "mapp1", "mapp2" ] } ], "not": [ { "t": "That the benefit lasts beyond 18 weeks, and that side effects were fully recorded. The FDA said neither was shown.", "refs": [ "fda_crl_mdma" ] }, { "t": "Depression, alcohol use and social anxiety: small pilots only.", "refs": [ "kvam2025", "sessa2021", "danforth2018" ] } ] }, "ketamine": { "proven": [ { "t": "Rapid relief in treatment-resistant depression, often within hours to days.", "refs": [ "zarate2006", "marcantoni2020" ] }, { "t": "As effective as electroconvulsive therapy (ECT) in a 403-person trial.", "refs": [ "anand2023" ] }, { "t": "A short-term drop in suicidal thoughts after a single infusion.", "refs": [ "wilkinson2018", "abbar2022" ] } ], "not": [ { "t": "How to keep the effect: relief often fades within days to weeks once infusions stop.", "refs": [ "marcantoni2020", "mcintyre2021" ] }, { "t": "PTSD: one positive trial, one larger null result.", "refs": [ "feder2021", "abdallah2022" ] }, { "t": "Anxiety and OCD: short-lived effects in small studies.", "refs": [ "whittaker2021", "heroiu2026" ] } ] }, "esketamine": { "proven": [ { "t": "Approved for treatment-resistant depression in the US and EU since 2019.", "refs": [ "fda_spravato2019", "ema_spravato" ] }, { "t": "Staying on it roughly halves the risk of relapse compared with stopping.", "refs": [ "daly2019" ] }, { "t": "More people reached remission than with quetiapine, a standard add-on.", "refs": [ "reif2023" ] } ], "not": [ { "t": "That it reduces suicidality itself: trials showed faster relief from depression, not fewer suicidal thoughts than placebo.", "refs": [ "fu2020", "ionescu2021" ] }, { "t": "Any use outside depression: it isn't licensed for anything else.", "refs": [ "ema_spravato" ] } ] }, "lsd": { "proven": [ { "t": "One supervised dose reduced generalised anxiety more than placebo, in two Phase 3 trials.", "refs": [ "voyage", "panorama" ] }, { "t": "One supervised dose reduced major depression more than placebo, in one Phase 3 trial.", "refs": [ "emerge" ] } ], "not": [ { "t": "Not approved anywhere yet. The developer plans to file with the FDA in the first half of 2027.", "refs": [ "panorama" ] }, { "t": "Microdosing: it did no better than placebo for adult ADHD.", "refs": [ "mueller2025" ] }, { "t": "Alcohol use: the evidence comes from 1960s and 70s trials.", "refs": [ "krebs2012" ] } ] }, "dmt": { "proven": [], "not": [ { "t": "Promising, not proven: one 34-person trial showed a short-term drop in depression after a single session.", "refs": [ "erritzoe2026" ] }, { "t": "Treatment-resistant depression: larger Phase 2b results are due by the end of 2026.", "refs": [ "vls01_jul26" ] } ] }, "5-meo-dmt": { "proven": [], "not": [ { "t": "Promising, not proven: two positive Phase 2b trials in treatment-resistant depression.", "refs": [ "gh_hold", "bpl003_2b" ] }, { "t": "Phase 3 started in 2026; results aren't expected until 2029.", "refs": [ "atai_q1_26" ] } ] }, "ayahuasca": { "proven": [], "not": [ { "t": "Depression: one 29-person placebo-controlled trial, nothing larger since.", "refs": [ "palhano2019" ] } ] }, "ibogaine": { "proven": [ { "t": "It can disrupt the heart's rhythm: half the people in one detox study developed dangerous QTc prolongation.", "refs": [ "koenig2015", "knuijver2022" ] } ], "not": [ { "t": "Opioid addiction: observational studies only, with no control groups.", "refs": [ "noller2018", "brown2018" ] }, { "t": "PTSD and depression: one uncontrolled study in veterans.", "refs": [ "cherian2024" ] } ] }, "noribogaine": { "proven": [ { "t": "It prolongs the QT interval, more so at higher doses.", "refs": [ "glue2016" ] } ], "not": [ { "t": "Opioid withdrawal: only a non-significant trend in its one trial.", "refs": [ "glue2016" ] }, { "t": "Alcohol use: the first US trial was cleared in 2026, with no results yet.", "refs": [ "fda_cnpv" ] } ] }, "mescaline": { "proven": [], "not": [ { "t": "Any clinical benefit: the only evidence is a self-report survey of past users.", "refs": [ "aginliebes2021" ] } ] }, "cannabis": { "proven": [ { "t": "Small improvements in chronic pain and sleep quality.", "refs": [ "wang2021" ] }, { "t": "Daily use of high-potency cannabis is linked to higher rates of psychosis.", "refs": [ "diforti2019" ] } ], "not": [ { "t": "Depression, anxiety and PTSD: reviews and a controlled trial find no good evidence.", "refs": [ "black2019", "bonnmiller2021" ] }, { "t": "ADHD: one small trial missed its main goal.", "refs": [ "cooper2017" ] } ] } }, "condition_descriptions": { "depression": "Major depressive disorder (MDD): persistent low mood and loss of interest lasting at least two weeks and getting in the way of daily life. Trials here enrolled people with MDD whose depression was not classed as treatment-resistant.", "trd": "Depression that hasn't eased after at least two antidepressants, taken at a proper dose for long enough.", "suicidal": "Thoughts of ending your life, often during a severe depressive episode. Treatments here are given in hospitals and clinics, alongside crisis care.", "ptsd": "Flashbacks, nightmares, avoidance and feeling constantly on guard after a traumatic event.", "anxiety": "Generalised anxiety disorder (constant, hard-to-control worry) and social anxiety disorder.", "illness": "Anxiety, depression and existential distress that come with cancer or another life-threatening illness.", "ocd": "Unwanted, intrusive thoughts (obsessions) and repeated actions or rituals (compulsions) that are hard to resist.", "adhd": "Long-standing problems with attention, restlessness and impulsivity, here in adults.", "eating": "Includes anorexia nervosa, bulimia and binge-eating disorder. Published psychedelic research so far is almost all in anorexia.", "addiction": "Includes alcohol, opioid, nicotine and stimulant (cocaine, methamphetamine) use disorders, tracked separately.", "pain": "Pain that lasts longer than three months, including neuropathic pain and fibromyalgia.", "headache": "Migraine (recurring, often one-sided headaches with nausea or sensitivity to light) and cluster headache (short, extremely painful attacks around one eye that come in bouts). These are the only headache types with published psychedelic trials so far.", "insomnia": "Trouble falling or staying asleep, or sleep that doesn't feel restful." }, "disclaimer": [ "Everything here comes from clinical trials: carefully screened participants, trained people in the room, medical support on hand. None of that comes with taking a substance on your own. Most of these substances are controlled in most countries, and most are not approved treatments for any mental health condition.", "The risks are real: a raised heart rate and blood pressure, intense distress during a session, serious interactions with psychiatric medication, and a greater risk of harm for anyone with psychosis or bipolar disorder in their own or their family's history. Never stop or change prescribed medication on your own to try something else. If you're considering this route, do it with a doctor who knows you, somewhere it's legal and available." ], "page_disclaimer": "This page summarises clinical research. It isn't medical advice. Trial results come from screened participants with professional support on hand, and they don't transfer to taking a substance on your own. Most of these substances are controlled, and several interact dangerously with psychiatric medication. Never stop or change prescribed medication on your own; talk it through with a doctor who knows you.", "faq": [ { "q": "What is psychedelic-assisted therapy?", "a": [ { "t": "A psychedelic is given in a supervised session, with preparation sessions before and talking therapy afterwards to make sense of the experience, as in the [psilocybin](goodwin2022) and [MDMA](mapp1) trials.", "refs": [ "goodwin2022", "mapp1" ] }, { "t": "In trials, the drug is never handed over to take at home: every dose is given [in a clinic](mapp1), with trained staff present.", "refs": [ "mapp1" ] } ] }, { "q": "Does psilocybin therapy work for depression?", "a": [ { "t": "For treatment-resistant depression, [two](comp005) [Phase 3 trials](comp006) found one or two doses of psilocybin worked better than placebo or a very low dose.", "refs": [ "comp005", "comp006" ] }, { "t": "The average effect is modest, and not everyone responds, but for people who do, it can last [six months](comp006_26w) or more.", "refs": [ "comp006_26w" ] }, { "t": "Against a standard antidepressant, psilocybin [hasn't been shown](carhart2021) to be better yet.", "refs": [ "carhart2021" ] } ] }, { "q": "Is psilocybin therapy legal?", "a": [ { "t": "Psilocybin isn't an approved medicine anywhere yet. Australia lets [authorised psychiatrists](tga2023) prescribe it for treatment-resistant depression, and in the US, Compass expects to complete its [FDA application](comp006_26w) by the end of 2026.", "refs": [ "tga2023", "comp006_26w" ] } ], "more": [ "Laws differ a lot by country. Check where you live on our ", "Psychedelic Therapy Legality Map", "https://statesofmind.com/psychedelics-legality-map/" ] }, { "q": "Is MDMA therapy approved for PTSD?", "a": [ { "t": "Not yet. It worked better than placebo in [two](mapp1) [Phase 3 trials](mapp2), but the FDA [turned it down](fda_crl_mdma) in 2024, citing gaps in safety reporting and durability.", "refs": [ "mapp1", "mapp2", "fda_crl_mdma" ] }, { "t": "In 2026 the application went back to the FDA without a new trial, [according to MAPS](maps_aug26).", "refs": [ "maps_aug26" ] }, { "t": "Australia allows [authorised psychiatrists](tga2023) to prescribe it for PTSD.", "refs": [ "tga2023" ] } ] }, { "q": "How long does ketamine work for depression?", "a": [ { "t": "Ketamine can lift depression [within hours](zarate2006) to [a day](wilkinson2018).", "refs": [ "zarate2006", "wilkinson2018" ] }, { "t": "Without further infusions, the effect [often fades](marcantoni2020) within days to weeks, which is why clinics usually give a [course of treatments](mcintyre2021).", "refs": [ "marcantoni2020", "mcintyre2021" ] } ] }, { "q": "What's the difference between ketamine and Spravato?", "a": [ { "t": "Spravato is esketamine, one half of the ketamine molecule, given as a nasal spray. It's an approved medicine for treatment-resistant depression [in the US](fda_spravato2019) and [the EU](ema_spravato).", "refs": [ "fda_spravato2019", "ema_spravato" ] }, { "t": "Ketamine infusions are [prescribed off-label](mcintyre2021), which is legal but means the drug isn't licensed for depression.", "refs": [ "mcintyre2021" ] }, { "t": "In the US, Spravato is only given in [certified clinics](jnj_mono2025), with at least two hours of monitoring afterwards.", "refs": [ "jnj_mono2025" ] } ] }, { "q": "Can LSD treat anxiety?", "a": [ { "t": "A single supervised dose of an LSD tablet (DT120) reduced generalised anxiety more than placebo in [two](voyage) [Phase 3 trials](panorama) in 2026.", "refs": [ "voyage", "panorama" ] }, { "t": "It isn't approved yet. The developer plans to apply to [the FDA](panorama) in the first half of 2027.", "refs": [ "panorama" ] } ] }, { "q": "Does microdosing work?", "a": [ { "t": "The best test so far says no, at least for ADHD. In [a placebo-controlled trial](mueller2025), LSD microdoses did no better than placebo, and people who believed they were on LSD improved more.", "refs": [ "mueller2025" ] } ] }, { "q": "Can psychedelics help with addiction?", "a": [ { "t": "Early trials are encouraging: psilocybin with therapy [roughly halved](bogenschutz2022) heavy-drinking days, and ketamine with therapy increased [alcohol-free days](grabski2022).", "refs": [ "bogenschutz2022", "grabski2022" ] }, { "t": "Psilocybin also [beat nicotine patches](johnson2026) in a small unblinded smoking trial.", "refs": [ "johnson2026" ] }, { "t": "Ibogaine for opioid addiction has [only observational evidence](noller2018), and a documented [heart risk](knuijver2022).", "refs": [ "noller2018", "knuijver2022" ] } ] }, { "q": "What are the risks of psychedelic therapy?", "a": [ { "t": "Even in carefully run trials, people can have very difficult sessions, and [suicidal thoughts](goodwin2022) were reported in all dose groups of a large psilocybin trial.", "refs": [ "goodwin2022" ] }, { "t": "Outside trials, some people report difficulties that [last for months](evans2023).", "refs": [ "evans2023" ] }, { "t": "Specific substances carry specific risks: [heart-rhythm problems](knuijver2022) with ibogaine, and [bladder damage](baus2024) with frequent ketamine use.", "refs": [ "knuijver2022", "baus2024" ] } ] } ] }