Read the full review published in the Schizophrenia Bulletin academic.oup.com/schizophreni...

10/ Led by former @hopkinsmedicine.bsky.social Megan Hosein and Zach Cordner, cochairs @fredbarrettphd.bsky.social and Trisha Suppes, CPCR’s Dr. Matthew Reid, @existwell.bsky.social, and Sarah Walser, Stu Charney, UT Austin’s D. Greg Fonzo, and Utah’s Dr. Ben Lewis

9/ The bottom line: Psilocybin could transform psychiatry. But for now, it should be seen as a second- or third-line option and used with great care until evidence catches up.

Optimism is warranted—but caution is essential.

8/ So what’s the way forward?

The Task Group calls for:

• Big, multi-site research collaborations
• More diverse study populations
• Public funding (not just philanthropy or venture capital)
• Standard training + monitoring systems
• Early engagement with regulators & insurers

7/ Ethics can’t be ignored either. Patients are deeply vulnerable under psilocybin. Boundaries have been crossed in clinical trials. Risks of exploitation—sexual, ideological, or cultural—are real.

And the field must grapple with equity and respect for Indigenous traditions.

6/ Then there’s training. Right now, no national standards exist. Many “training programs” are unregulated, retreat-style, and data-free.

The consensus calls for rigorous curricula, certification, and oversight—like any other medical specialty.

5/ Even if safe, scaling is another challenge. Current therapy models are long, expensive (~$6.6k per course), and hard to imagine in routine practice without major redesign.

Insurance and reimbursement questions loom large.

4/ Safety signals are real:

• Suicidal thoughts/self-harm events have occurred in trials
• Risks for mania in bipolar disorder remain unknown
• Drug interactions (e.g., SSRIs, lithium) could blunt or even worsen effects
• Long-term cardiac and perceptual risks aren’t well studied

3/ But the hype, media buzz, and commercial momentum are outpacing the science.

We don’t yet have clear answers on optimal (minimal necessary) dose, safety in the long run, or how it works across diverse communities.

2/ Psilocybin has shown striking results in early trials for depression, addiction, and more. Some patients go into remission after only a few sessions.

Phase III trials are underway, and many are imagining a future where psilocybin is part of everyday psychiatry.