Psychedelics like psilocybin are being explored as a new treatment for depression, but their use requires psychological support alongside the drug. There is debate about the exact role of this support and who should deliver it, which affects how these treatments could be implemented in public health services like the National Health Service. The authors outline a model for delivering psychological support in publicly funded settings and call for further research to identify the essential elements of support. They emphasize that implementation must be based on high-quality evidence and ensure equitable access for all patients, not just those who can pay.
A 4-week course of subcutaneous racemic ketamine produced short-term clinical benefit in a minority of people with treatment-resistant depression, with response rates declining substantially after treatment cessation. Among 130 participants, 30% responded at treatment end (Montgomery-Åsberg Depression Rating Scale reduction ≥50%), but only 17% remained responders 4 weeks later, and over 50% experienced less than a 25% reduction in depression scores. No difference in response was found between fixed and flexible dosing regimens. Prior ketamine treatment during an earlier randomized trial did not affect later outcomes. No suicides or suicidal behavior requiring admission occurred, and only expected side effects were observed.
Anxiety disorders are common and disabling. Current medications have limited effectiveness, notable side effects, and little innovation. This editorial reviews past, current, and emerging anxiolytic treatments, including psychedelic-assisted therapies, and highlights key themes. There remains a major need for improved medications to reduce disability and improve quality of life.