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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  Developing non-hallucinogenic antidepressant compounds

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.

See also  Taking the trip out of psychedelics

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.

Markets & Industry

FDA Grants Breakthrough Therapy Designation to The Psychedelic Luvesilocin for Postpartum Depression

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The U.S. Food and Drug Administration (FDA) has granted breakthrough therapy designation to psychedelic drug luvesilocin, from biopharmaceutical developer Reunion Neuroscience, for the treatment of postpartum depression. 

Luvesilocin is a recently-discovered proprietary psychedelic that can produce an acute subjective experience of around 3 to 4 hours shorter than that reported for some classic psychedelics such as LSD. 

It is the ninth psychedelic to receive breakthrough therapy designation by the agency, a qualification meant to to expedite the development and review of drugs that are intended to treat a serious or life-threatening condition, when preliminary clinical evidence shows that the drug could demonstrate a substantial improvement over available therapy. 

The Trial

Postpartum depression affects a substantial portion of people who have recently given birth. Globally, the condition is estimated to occur in roughly 10 % to 20 % of postpartum women.

According to the announcement from last week, Reunion’s clinical trial achieved its primary endpoint, showing a statistically significant reduction in depression seven days after administration.¡

Participants receiving a 30mg dose showed reductions in depressive symptoms as early as Day 1 that were maintained through Day 28 of follow-up, with 70 % of those patients in remission at both Day 7 and Day 28. 

With BTD status, luvesilocin is eligible for benefits associated with the FDA’s Fast Track program and will receive enhanced guidance and engagement with senior FDA leadership.

Reunion Neuroscience has said it plans to initiate a pivotal Phase 3 trial of luvesilocin in postpartum depression in 2026. The company is also enrolling patients in a Phase 2 trial for adjustment disorder related to cancer and other medical conditions, and anticipates beginning a Phase 2 trial in generalized anxiety disorder in early 2026.

See also  Drug Science and UCL to tackle FDA concerns on therapy component of MDMA treatment

What Luvesilocin Is and How It Works

Luvesilocin belongs to a class of molecules known as substituted tryptamines. 

Tryptamines are a family of compounds derived from the amino acid tryptophan, which includes endogenous neurotransmitters like serotonin, as well as classical psychedelic agents such as psilocin and DMT. Many structurally related molecules share the same backbone and interact with serotonin receptors, producing altered perceptions and changes in mood and cognition.

Chemically, luvesilocin is a prodrug of 4-HO-DiPT, meaning the compound is metabolised in the body to release the active serotonin receptor agonist, in a similar way to how psilocybin is metabolized into psilocin, which is the active ingredient producing a psychedelic effect in humans.

The active moiety of luvesilocin, 4-HO-DiPT, itself is part of this broader class and was described in the scientific literature as early as the late 1970s. It differs slightly in structure from psilocin (the active form of psilocybin), which may influence its receptor interactions and subjective effects. 

Unlike many classic psychedelics taken orally, luvesilocin is administered via subcutaneous injection, which contributes to its more predictable and shorter duration.

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Psychedelics Clinical Trial Update: Positive Results from Psilocybin and DMT on the Road for FDA Approval

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Clinical updates from Compass Pathways and Helus Pharma from last week marked a significant step forward in the psychedelics development landscape, with new data emerging from late stage and mid stage programs targeting depressive disorders.

Compass reported positive results from its second Phase 3 trial of COMP360, a synthetic psilocybin therapy for treatment resistant depression, meeting the study’s primary endpoint at Week 6. The company said the 25 mg dose produced a statistically significant reduction in depressive symptoms versus a control group, with rapid onset and a safety profile consistent with earlier studies, supporting planned regulatory discussions.

Helus Pharma (formerly Cybin) reported positive results from a mid stage clinical trial of its DMT based therapy, SPL026, in people with moderate to severe depression. Participants who received the treatment showed significantly greater improvements in their symptoms than those given placebo, with effects emerging within a week and lasting for several weeks. No treatment related serious safety issues were reported.

Compass Pathways Posts Second Positive Phase 3 Result in Treatment Resistant Depression

Compass Pathways reported results from its second Phase 3 trial evaluating COMP360, a proprietary synthetic psilocybin formulation, in patients with treatment resistant depression. The study forms part of the company’s pivotal development program and follows earlier positive findings.

The company has advanced COMP360 through a development that now includes two positive Phase 3 trials in treatment resistant depression. The therapy previously received Breakthrough Therapy designation from the U.S. Food and Drug Administration and a comparable innovation pathway designation in the UK. Last month, Compass also announced an acceptance by the FDA of COMP360 for the indication of PTSD.

See also  First patient dosed in Phase 1 DMT trial

Recently, CEO Kabir Nath told Psychedelic Health that based on the latest stream of positive clinical results, COMP360 “could potentially be looking at a launch in early 2027,” though the psychedelics spae is still recovering from the rejection of Lykos’ MDMA application in 2024.

According to Compass, the latest trial met its primary endpoint, demonstrating a statistically significant reduction in depressive symptoms compared with control at week 6, as measured by the Montgomery Asberg Depression Rating Scale, or MADRS. Patients receiving a 25 mg dose showed a mean reduction that translated into a 3.8 point difference versus the 1 mg control group at the primary timepoint.

The antidepressant effect was observed rapidly, with separation from control evident as early as the day after administration. Treatment effects were sustained through at least six weeks. In a related Phase 3 study within the same program, a subgroup of participants maintained clinically meaningful reductions in MADRS scores through 26 weeks following one or two dosing sessions. Retreatment in eligible patients appeared to yield consistent response patterns, and no unexpected safety findings were reported across the studies.

Treatment resistant depression remains a major unmet need, defined generally as inadequate response to at least two prior antidepressant therapies. Compass has indicated that it intends to engage with the FDA to discuss next steps, including a potential rolling submission of a New Drug Application. The company has previously guided toward a possible submission timeline in late 2026, contingent on regulatory feedback and completion of required analyses.

Helus Pharma Reports Mid Stage Data Showing Rapid Symptom Improvement in Depression

In parallel, Helus Pharma, formerly known as Cybin, released detailed results from a Phase 2a randomized, placebo controlled study of SPL026, an intravenous formulation of N,N dimethyltryptamine, or DMT, in adults with moderate to severe major depressive disorder. The findings were published in the journal Nature Medicine and reflect one of the more advanced controlled studies of DMT in this indication.

See also  Cybin aims to quantify brain activity during the psychedelic experience 

The SPL026 program was previously led by the company Small Pharma, which was acquired by Cybin in 2023. Earlier this year, Cybin announced it would change its name to Helus Pharma, following a recent trend of companies in the psychedelics space rebranding to reflect a more mature subsector within biotech.

By the second week of the study, people who received SPL026 showed significantly greater improvements in their depression symptoms than those who received a placebo. On average, the difference between the two groups was clear and clinically meaningful, with an even larger gap already visible after just one week.

At Week 2, about 35 percent of participants given SPL026 experienced a marked improvement in symptoms, compared with 12 percent of those on placebo. Nearly 29 percent of treated participants saw their symptoms ease to the point of remission, versus 12 percent in the placebo group. In a follow up phase where all participants could receive the treatment, many maintained their improvements for up to three months.

The safety profile was described as manageable, with no treatment related serious adverse events reported in the study population. Acute psychedelic effects were consistent with the pharmacology of DMT and were administered in a controlled clinical setting with psychological support.

Despite the positive data, Helus has indicated that it does not plan to advance SPL026 in its current intravenous format. Instead, the company intends to use the findings to inform development of next generation short acting serotonergic agonists within its broader pipeline. Topline data from a separate Phase 2 program targeting generalized anxiety disorder are anticipated in 2026.

See also  The role of belief in ketamine as a treatment for depression

Together, the updates from Compass and Helus reflect continued maturation of the psychedelics field, with one company reporting confirmatory Phase 3 outcomes in treatment resistant depression and another publishing controlled mid stage data in major depressive disorder. Regulatory engagement and strategic portfolio decisions will shape the next phase of development as sponsors seek to translate controlled trial results into potential approvals and commercial pathways.

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Evegreen

Can A Psychedelic Experience Reshape Your Worldview? New Study Says Yes, It Can

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A new study investigates how so-called “self-transcendent” psychedelic states can trigger enduring changes in meaning-making, values, and perceptions of reality.

A new study published in Nature explores how psychedelic experiences can lead to lasting changes in how people understand themselves, others, and the world. Rather than focusing on symptom reduction or clinical outcomes, this new research examines something more foundational: how psychedelics may shift a person’s underlying worldview.

The research team used a mixed-methods design combining quantitative scales with qualitative analysis. Ninety participants who reported having undergone a transformative psychedelic experience completed questionnaires measuring awe and perceived connectedness, alongside open-ended questions about how their perspectives had changed. Around three-quarters of participants were based in the UK, with the remainder from other English-speaking countries and Europe.

 Breaking Mental Frameworks Through Awe

Researchers have previously argued for incorporating metaphysical philosophy into psychedelic therapy to help improve therapeutic outcomes.

At the core of the new study is the concept of awe. Awe is described as an “epistemic emotion”, one that arises when existing mental frameworks are insufficient to explain an experience. Psychedelic states often evoke this response through feelings of vastness, boundlessness, and deep interconnectedness. According to the authors, such experiences can force a re-evaluation of previously held assumptions about the self and the world.

Quantitative analysis showed that two aspects of awe recalled from the psychedelic experience, perceived vastness and connectedness, were significantly associated with greater perceived overlap between the self and others long after the experience had ended. In other words, participants who recalled more intense feelings of vastness and connection during their psychedelic experience were more likely to later report feeling less psychologically separate from other people, non-human life, and the world as a whole.

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The qualitative findings add further depth. Through thematic network analysis, the researchers identified three clusters of epistemic shifts commonly reported by participants. Previously, researchers have determined that a mystical and insightful psychedelic drug experience may be linked to long-term reductions in anxiety and depression symptoms.

The first involved an expanded awareness and greater openness to complexity. Many participants described becoming more comfortable with uncertainty and ambiguity, and less reliant on rigid or reductionist explanations of reality.

The second cluster related to the dissolution of boundaries, both social and natural. Participants reported weakened distinctions between self and other, human and non-human, and mind and environment. This often translated into a more holistic or systems-based way of thinking.

The third cluster centred on increased prosociality. Participants frequently described greater compassion, acceptance of difference, and concern for others and the wider ecological system. These changes were not framed as abstract beliefs, but as practical shifts in how people related to others and made everyday decisions.

The authors situate these findings within broader theories of psychedelic action, including predictive coding models, which suggest that psychedelics relax rigid top-down beliefs and allow new interpretations to emerge. From this perspective, psychedelic-induced awe may act as a catalyst for reorganising how meaning is constructed.

Importantly, the paper emphasises that such worldview shifts require integration. Without appropriate cultural, social, and psychological support, the authors note that profound experiences of “boundlessness” may be destabilising rather than beneficial.

As psychedelic research increasingly moves beyond symptom-focused outcomes, this study highlights the importance of understanding how these substances can reshape fundamental ways of knowing, with implications for mental health, social connection, and ecological awareness.

See also  Transform Drugs releases groundbreaking book: How to regulate psychedelics

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