It was truly a pleasure to join with Disabled American Veterans for a dynamic interview exploring the current research on psychedelic treatments for Veteran mental health conditions like PTSD. In the interview, I share the state of research on the safety and efficacy of psychedelic treatments and the clinical trials that our talented team is conducting. Thank you sincerely to Matthew Saintsing, Barry Jesinoski, Rob Lewis, and Cody VanBoxel for the opportunity to share our work at Johns Hopkins with the Veteran community. It means a lot. youtube.com/watch?v=iKlLOn6X… For Veterans interested in the currently active PAMVET trial, please do feel welcome to visit hopkinspsychedelic.org/pamve… for more information.

Williams and colleagues (2026) recently published a great meta-analysis showing that psilocybin interventions (PAT) are no more effective in treating depression than traditional antidepressants (TAD). jamanetwork.com/journals/jam… This stands in contrast to many bold claims about psilocybin's superiority relative to standard of care antidepressant pharmacotherapy. However, one of the main learnings I've made over the last few years is how much people differ in their therapeutic response to psilocybin, which is obscured when looking at the PAT group's average change. Of course, this variability characterizes both PAT and TAD, but I would hypothesize more to PAT. Time will tell, but the point I want to make is that the rate of nonresponse represents an opportunity for precision medicine to test modifications to the therapy that may produce better results for nonresponders, e.g., having to do with more appropriate dosing based on PK/PD, optional additional sessions, step-up dosing schedules that start lower and elevate dose depending on acute response, psychotherapeutic pairings, more psychosocial support before dosing. Critics might say this moves the goal posts, but those who have seen how helpful PAT can be for responders may be motivated to try enhancing the overall response rate - which would in turn impact the group average efficacy that people heavily focused on. In addition, I wanted to share the item level analysis Robin Carhart-Harris, David Erritzoe, David Nutt, Bruna Giribaldi and I did on the classic Psilodep2 trial (the only trial to directly compare PAT to TAD). journals.sagepub.com/doi/10.… A reminder that participants in this trial responded comparably to PAT and TAD on the primary outcome measure, the QIDS-SR-16. What you can see here are the particular symptoms that responded better to PAT than TAD. We see evidence of this even on the QIDS measure. Decending red bars indicate a difference between PAT and TAD on each symptom favoring PAT. Note the stark differences on symptoms like Libido, underlining the sexual side effects of TAD, as well as Energy/Motivation, and Guilt. A takeaway is that these treatments may very well affect individuals and depression differently. The paper also emphasizes that not all depressive symptoms are equally impairing or the most relevant to the needs of individual patients. i encourage scientists and clinicians to be nuanced in their examination of the relative clinical utility of PAT and TAD rather than simply looking at group averages. Much is missed about the value of new treatment mechanisms for impacting people who have not been served by conventional treatments. Much is missed about variability in acute and durable response that precision medicine approaches may help with. Much is missed in the potential value of different therapies in impacting different symptoms. Time and data will tell. #antidepressants #psychedelics #psychedelic-assisted therapy