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Ketamine trial for resistant depression shows positive results

The study is the largest to date comparing generic ketamine with placebo in treating severe depression.

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Ketamine trial for resistant depression shows positive results

A low-cost version of ketamine has shown promising results in its treatment of resistant depression in a double-blind trial. 

Researchers at the University of New South Wales (UNSW) Sydney and the affiliated Black Dog Institute have found that more than one in five participants achieved total remission from their symptoms after a month of bi-weekly injections of generic ketamine.

One-third of the 179 participants had symptoms improve by at least 50%.

The study, published today in the British Journal of Psychiatry, was a collaboration between six academic clinical mood disorder units in Australia and one in New Zealand and was funded by the Australian National Health and Medical Research Council (NHMRC).

Lead researcher Professor Colleen Loo stated: “For people with treatment-resistant depression – so those who have not benefitted from different modes of talk therapy, commonly prescribed antidepressants, or electroconvulsive therapy – 20%remission is actually quite good.

“We found that in this trial, ketamine was clearly better than the placebo – with 20% reporting they no longer had clinical depression compared with only 2% in the placebo group. This is a huge and very obvious difference and brings definitive evidence to the field which only had past smaller trials that compared ketamine with placebo.”

How did the trial work?

For the trial, participants were given two injections a week of either a generic form of ketamine or a placebo and were monitored for around two hours while acute dissociative and sedative effects wore off. 

The treatment was given over a month period and participants were assessed at the end of the trial and a month following the completion of the trail.

See also  Improvements in mood and mental health after psilocybin microdosing

The trial used the placebo Midazolam which also causes sedation to improve treatment masking. Midazolam is a sedative normally administered before a general anaesthetic, while in many previous studies, the placebo was saline.

“Because there are no subjective effects from the saline, in previous studies it became obvious which people were receiving the ketamine and which people received placebo,” Professor Loo stated.

“In using midazolam – which is not a treatment for depression, but does make you feel a bit woozy and out of it – you have much less chance of knowing whether you have received ketamine, which has similar acute effects.”

Other features of the recent trial that set it apart from past studies included accepting people into the trial who had previously received electroconvulsive therapy (ECT).

“People are recommended ECT treatment for their depression when all other treatments have been ineffective,” Prof. Loo says.

“Most studies exclude people who have had ECT because it is very hard for a new treatment to work where ECT has not.”

Additionally, the drug was delivered subcutaneously rather than by drip, thus greatly reducing time and medical complexity.

Improving patient access

The researchers emphasise that one of the key benefits of using generic ketamine for treatment-resistant depression is that it is much more affordable than the patented S-ketamine nasal spray which costs around AUD$800 per dose. 

The generic ketamine can cost as little as $5, and, patients need to pay for the medical care they receive to ensure their experience is safe, which costs $350 per session at the Black Dog Institute.

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Professor Loo stated: “With the S-ketamine nasal spray, you are out of pocket by about $1200 for every treatment by the time you pay for the drug and the procedure, whereas for generic ketamine, you’re paying around $300-350 for the treatment including the drug cost.”

Loo also emphasised that for both S-ketamine and generic ketamine treatments, the positive effects often wear off after a few days to weeks, so ongoing treatment may be required, depending on someone’s clinical situation. However, the prohibitive costs of the drug and procedure make this an unsustainable proposition for most Australians.

“This is why we’re applying for a Medicare item number to fund this treatment now, because it’s such a powerful treatment,” Loo said.

“And if you consider that many of these people might spend many months in hospital, or be unable to work and are often quite suicidal, it’s quite cost-effective when you see how incredibly quickly and powerfully it works. We’ve seen people go back to work, or study, or leave hospital because of this treatment in a matter of weeks.”

The researchers will next be looking at larger trials of generic ketamine over longer periods, and refining the safety monitoring of treatment.

Evegreen

Can Ego Death Be Measured? New Study Finds Link in Brain Activity After One DMT Dose

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A new study in The Journal of Neuroscience has shed light on how the psychedelic N,N-Dimethyltryptamine, or DMT, changes brain activity during its most intense psychological effects.

The research focuses on a key experience reported by many users of the drug, the temporary disappearance of the sense of self, often called ego-dissolution.

DMT is known for producing rapid, vivid and immersive psychedelic states that unfold within minutes. The study, led by Mona Irrmischer and colleagues, set out to identify what happens in the brain during this altered state, and how those changes relate to subjective feelings of becoming “less of a person,” or losing individual identity.

Dr Christopher Timmermann, one of the study’s co-authors, will be a panelist at the upcoming PSYCH Symposium: London 2025, on December 4 at London’s Conway Hall, where key figures in the psychedelics space will meet to discuss the future of policy, research and patient roll out.

To investigate this, the researchers used electroencephalography, EEG, which records electrical activity from the scalp. Twenty-seven healthy volunteers took part in two separate clinical sessions. In one, they were injected with DMT. In the other, they received a placebo saline injection. Neither participants nor experimenters were told which session was which at the time. EEG was recorded before and after injection, and participants later rated their subjective experience, including whether they felt the boundaries of their self dissolve.

The team measured what they call “criticality,” a property of brain activity that reflects the balance between order and randomness. A near-critical brain is thought to be versatile, able to shift fluidly between different states. It maintains patterns across long periods of time, which helps organize thought, perception and the experience of continuous identity. When the brain moves away from this balance, signals may become either too rigid or too chaotic.

See also  Psychedelics supported mental health during COVID-19, suggests survey

To quantify this, the researchers used two tools. One, detrended fluctuation analysis, or DFA, measures how consistent brain rhythms remain over longer timescales. Higher values indicate more structured, temporally coherent activity. Lower values show more noise and unpredictability. The other measure, the functional excitatory-inhibitory ratio, distinguishes whether changes push the brain toward suppressed subcritical states or toward unstable supercritical activity.

Under DMT, DFA values dropped significantly across several frequency bands, especially alpha rhythms. This means brain signals became less temporally organized and more entropic. The effect was widespread, not limited to a small region, indicating a broad shift in how neural networks behave over time.

The excitatory-inhibitory analysis provided further clarity. Rather than showing runaway excitation, the changes suggested that DMT pushed brain dynamics toward subcritical states, especially in parietal and occipital regions. These parts of the brain help integrate sensory information and support internal models that anchor a person’s sense of being a continuous self. Under DMT, their activity became less structured and less stable.

Critically, these neural shifts were directly tied to how people felt. Participants who reported stronger ego-dissolution also showed the biggest reductions in criticality, particularly in theta and alpha bands. This correlation suggests that the breakdown of long-range, temporally organized brain activity is closely linked to the subjective loss of self.

The authors emphasize that these effects do not resemble unconsciousness. Instead, they reflect a brain that cannot maintain its usual long-term patterns of self-representation. Without the steady temporal scaffolding that normally supports identity, experience becomes immediate, immersive and unanchored.

See also  Study shows positive results for topical ketamine in reducing pain

The study challenges a simple picture of psychedelics as increasing brain flexibility by moving closer to a balanced critical state. Under DMT, entropy does increase, but the rhythms most involved in self-processing move away from balanced dynamics. The result is not random chaos but a specific weakening of the neural patterns that hold the self together.

By showing how a psychedelic alters the brain in real time, the research provides a clearer biological explanation for one of the most mysterious psychedelic effects. It points to ego-dissolution not as a vague spiritual idea, but as a measurable change in how the brain organizes its activity over time.

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Evegreen

Psilocybin Shows Promise in Treating Obsessive-Compulsive Disorders: Is the Industry Getting Involved?

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A newly published systematic review titled on psilocybin’s effects on obsessive‑compulsive behaviours provides an up-to-date synthesis of research into the compound’s potential for treating OCD and related disorders. 

The study integrates findings from both animal models and early human trials, drawing attention to a consistent signal: reductions in obsessive or compulsive behaviours following psilocybin administration.

The review shows that in preclinical models (for example mice with altered grooming behaviours) psilocybin (or its active metabolite) produced marked reductions in compulsive-like behaviours, sometimes lasting beyond the immediate administration period. 

Clinically, although data remain limited, participants in early trials or case reports experienced rapid reductions in symptom severity (for example within hours or days) after single doses. The authors emphasise that while the mood-disorder applications of psilocybin are more advanced, this compulsive-behaviour indication is an important frontier.

In humans, single doses of psilocybin led to rapid symptom reductions. For example, in an open‑label study of nine treatment‑resistant OCD patients, reductions of 23 % to 100 % on the Y‑BOCS scale were recorded between 4 and 24 hours after dosing. A pilot trial in body dysmorphic disorder (a related OCRD) using a 25 mg psilocybin dose reported sustained improvements over 12 weeks in 58.3 % of participants. 

Mechanistically, the review highlights that psilocybin’s effects on compulsivity may not map exactly onto its classic psychedelic mechanism (5-HT₂A receptor activation). Some animal data suggest alternate or additional pathways (for instance 5-HT₇ receptor involvement, synaptic protein modulation) may underpin the anti-compulsive outcomes. The authors call for more robust, placebo-controlled human trials, ideally with neuroimaging and circuit-level biomarkers, to validate these early signals and clarify therapeutic protocols. 

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The authors of the review emphasise that while the findings are promising, the evidence remains early stage. Key limitations include small clinical sample sizes, lack of placebo‑controls, short follow‑up intervals and heterogeneity in doses and models. They call for larger, double‑blind, placebo‑controlled trials incorporating neuroimaging of fronto‑striatal circuits, to more precisely map psilocybin’s effect in OCRDs. 

The authors propose that psilocybin may one day serve as a treatment for disorders characterised by repetitive, intrusive behaviours, not just mood disorders.

Are companies developing psilocybin-based treatments for OCD?

Several biotechnology companies are advancing psilocybin-based therapies for obsessive-compulsive disorder (OCD), signalling growing clinical interest in this area. 

Ceruvia Lifesciences has received U.S. FDA approval for an Investigational New Drug application to begin a Phase 2 trial using its synthetic psilocybin compound, SYNP-101, for OCD. The multicentre, randomised, double-blind, placebo-controlled study will administer a single oral dose and monitor participants for 12 weeks to assess symptom reduction, making it one of the most advanced OCD-focused psilocybin programmes.

Filament Health is developing PEX010, a botanical psilocybin drug exported to Israel for a trial investigating treatment-resistant OCD and PTSD.

MycoMedica Life Sciences lists OCD among its target indications, though its programmes remain early stage, while Compass Pathways is exploring broader psychiatric uses for COMP360, including potential applications in OCD.

Photo by Mélissa Jeanty on Unsplash.

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Markets & Industry

What Happens At A Legal Psychedelics Center? Psilocybin Clinic Publishes Real-World Data For The First Time

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For the first time, data from real-world application of psilocybin treatment under a regulated program was published by one of the Oregon clinics providing treatment.

In 2020, Oregon became the first U.S. state to legalize psilocybin for supervised therapeutic use when voters approved Measure 109. The law established a regulated framework for “psilocybin services” that include preparation, guided sessions, and integration support, administered at licensed service centers. The rollout has been gradual and cautious, given regulatory, safety, and infrastructure challenges. 

Until recently, much of what was known about psilocybin therapy outcomes came from controlled clinical trials; there was little insight into how the legal, real-world version would operate, who would access it, and whether the benefits observed in trials would translate to broader populations.

A fresh report by Osmind, one of the clinics providing the treatment, represent the first systematic look at real-world data emerging from Oregon’s legal psilocybin program under Measure 109, offering insights into demographics, motivations, safety, and self-reported mental health changes in participants.

Interested in learning more about psychedelic medicine? APPLY NOW to join PSYCH Symposium: London 2025, on December 4 at Conway Hall.

Who Is Accessing Psilocybin Services? 

From the “Real-World Evidence” report, data were gathered between March 2024 and April 2025 at a licensed service center in Central Oregon. Of 311 applicants, 88 individuals completed the baseline survey and became part of the analytic sample. 

Key demographic and background characteristics include:

  • Median age was 47 years; 62% female; 77% Caucasian; 63% holding a four-year college degree or more.
  • 16 % were veterans;  around 59% employed; 30% reported household income over $100K.
  • Prior experience: about 50% had used psychedelics before; about 50% were currently in counseling or therapy.
See also  Improvements in mood and mental health after psilocybin microdosing

In terms of mental health, 61% identified depression as a primary concern, followed by anxiety (42%) and acute stress (24%). 

Many had complex, treatment-resistant histories and turned to psilocybin services after exhausting conventional options. Open-ended responses showed motivations spanning healing trauma, grief processing, managing obsessive or self-critical thoughts, and general desire for psychological insight or transformation.

This profile suggests that early adopters of Oregon’s program tend to be relatively educated, somewhat advantaged socioeconomically, and motivated by persistent mental health difficulties, not casual or recreational users. It also underscores gaps in diversity and access that future iterations of the program may need to address.

Outcomes, Safety & Changes in Mental Health Measures

The “Real-World Outcomes” report analyzed metrics across depression, anxiety, and subjective well-being using standardized tests to measure previous conditions and psychological state after the treatment in at a licensed service center. 

The findings were:

  • Depression (using the PHQ-8 scale): Mean reduction of 4.6 points, corresponding to a shift from moderate to mild severity
  • Anxiety (using the GAD-7 scale): Mean reduction of 4.8 points — a change exceeding commonly used clinical significance thresholds
  • Well-being (using the WHO-5 scale): Increase of 10.7 points, which is consistent with clinically meaningful improvement in mood and quality of life.

In terms of safety, there were no reportable serious adverse events in the 30-day follow-up period. 

However, about 3% of participants reported lingering negative effects (e.g. transient anxiety, existential distress, difficulties with family dynamics) at day 30.

These results mirror the direction of clinical trial evidence: meaningful decreases in depression and anxiety, and gains in well-being, but now observed in a legally regulated, real-world setting.

See also  Psilocybin therapy trial for resistant depression given ethics approval

The Value of Real-World Evidence

These Osmind studies are groundbreaking because they offer the first empirical window into how a legalized psilocybin service model is functioning in practice. 

Clinical trials, while essential, often operate under narrow inclusion criteria, intensive controls, and short timeframes. They may not capture the full heterogeneity of “real-world” users, variations in implementation, or longer-term safety signals.

By contrast, these reports show how ordinary people (beyond trial populations) are using psilocybin services, what their motivations are, who they tend to be, and how their mental health measures shift in naturalistic settings. The absence of serious adverse events (in the short term) and the alignment of benefits with trial findings lend credibility to the possibility that psilocybin therapy could scale responsibly under regulation.

Furthermore, the data highlight access and equity issues (e.g. limited racial/ethnic diversity, relatively high socioeconomic status) that policymakers, providers, and regulators will need to contend with. As more jurisdictions consider legalizing or regulating psychedelics, having real-world evidence is critical for designing best practices, safety protocols, reimbursement models, and oversight. 

These early reports thus help close the gap between controlled trials and population-level rollout, and that alone makes them a major milestone in the evolving field of psychedelic medicine.

Picture by Photo by Timur Weber on Pexels.

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Psychedelic Health is a journalist-led news site. Any views expressed by interviewees or commentators do not reflect our own. We do not provide medical advice or promote the personal use of psychedelic compounds. Please seek professional medical advice if you are concerned about any of the issues raised.

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