Journal of Psychopharmacology最新文献

{"title":"Ketamine, an interoceptive associative agent? Evidence from ketamine-assisted Mindfulness-Oriented Recovery Enhancement for opioid use disorder.","authors":"Benjamin R Lewis, Eric L Garland","doi":"10.1177/02698811261495546","DOIUrl":"https://doi.org/10.1177/02698811261495546","url":null,"abstract":"<p><strong>Background: </strong>Relapse in opioid use disorder (OUD) remains common despite pharmacotherapy. Altered interoceptive processing may contribute to addiction, and ketamine-induced changes in salience and insula-related networks may facilitate mindfulness-based interoceptive learning.</p><p><strong>Aims: </strong>This secondary analysis examined whether ketamine-assisted psychotherapy (KAP) added to Mindfulness-Oriented Recovery Enhancement (MORE) improved interoceptive awareness and whether these changes mediated reductions in opioid craving.</p><p><strong>Methods: </strong>Sixty-eight adults with OUD receiving buprenorphine were randomized to 8 weeks of MORE with or without KAP. Assignment was unblinded, and outcomes were self-reported. Interoception was assessed using ecological momentary assessment (EMA) of body awareness and Multidimensional Assessment of Interoceptive Awareness (MAIA) subscales. Posttreatment EMA data were available for 18 MORE + KAP and 15 MORE participants. Mixed-effects models and path analysis were conducted.</p><p><strong>Results: </strong>Piecewise modeling showed a greater increase in EMA-assessed body awareness salience in MORE + KAP during days 1-35, spanning the pre-dosing and first-ketamine-dose period (<i>B</i> = 0.039, standard error (SE) = 0.005, <i>p</i> < 0.001). Slopes attenuated during days 36-90 (group × slope-change: <i>B</i> = -0.035, SE = 0.008, <i>p</i> < 0.001), although body awareness remained higher for MORE+KAP through follow-up. MORE + KAP increased MAIA Self-Regulation and Body Listening. A composite of these facets mediated reduced opioid craving at 3 months (indirect effect: <i>B</i> = -11.27, 95% bootstrap confidence interval (CI) [-25.50, -0.25], <i>p</i> = 0.044; κ² = 0.378).</p><p><strong>Conclusions: </strong>Adjunctive ketamine was associated with rapid, sustained increases in body awareness salience. Improvements in interoceptive regulatory capacity mediated reduced opioid craving, supporting interoception as a potential mechanism and treatment target in ketamine-augmented mindfulness interventions for OUD.</p><p><strong>Clinicaltrials: </strong>gov:NCT04892251.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261495546"},"PeriodicalIF":5.3,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149342605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential effects of psilocybin derivatives on fentanyl-induced conditioned place preference in male and female mice.","authors":"Tiffini N Lovell, Peter B James, Skylar L Hodgins, Samuel Johnson Noya, Patrick Arner, Ana-Clara Bobadilla","doi":"10.1177/02698811261478613","DOIUrl":"10.1177/02698811261478613","url":null,"abstract":"<p><strong>Background: </strong>Fentanyl is the leading cause of fatal overdoses worldwide, and repeated use may lead to substance use disorder (SUD). In SUD, drug-associated contexts can trigger reward-related behavior even in the absence of the drug. Psychedelic compounds may weaken context-drug associations, reducing reward-related behavior to fentanyl.</p><p><strong>Aims: </strong>We evaluated the effects of the psychedelic psilocin and its derivatives, 4-MeO-MiPT and 4-HO-MiPT, on fentanyl-induced conditioned place preference (CPP) in male and female C57BL/6J mice.</p><p><strong>Methods: </strong>Mice were conditioned to distinct fentanyl and saline control contexts, then assessed for fentanyl place preference before and after treatment with one of the test compounds. Anxiety-related side effects of each compound were evaluated using an elevated plus maze (EPM) model.</p><p><strong>Results: </strong>Psilocin reduced fentanyl CPP exclusively in females, 4-MeO-MiPT in both sexes, and 4-HO-MiPT had no effect. None of the compounds significantly altered anxiety-like behaviors in EPM.</p><p><strong>Conclusion: </strong>These findings support further preclinical investigations of the sex-dependent effects of psilocin and 4-MeO-MiPT on fentanyl reward behavior.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"1889-1902"},"PeriodicalIF":5.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of pharmacologic therapies for irritability in pediatric autism spectrum disorder: A systematic review and network meta-analysis of randomized controlled trials.","authors":"Zuojun Wang, Liwei Fang, Shunxin Wang, Jingyi Zhao, Qiannuo Zhang, Xinyu Zou, De Wu","doi":"10.1177/02698811261495555","DOIUrl":"https://doi.org/10.1177/02698811261495555","url":null,"abstract":"<p><strong>Introduction: </strong>Irritability is a common and clinically significant feature of pediatric autism spectrum disorder (ASD). We conducted a systematic review and network meta-analysis (NMA) to compare and rank pharmacological interventions for irritability in this population.</p><p><strong>Methods: </strong>Multiple databases were searched up to September 1, 2025, for randomized controlled trials enrolling pediatric ASD with significant irritability. Risk of bias was assessed using Cochrane RoB 2.0, and confidence in network estimates was evaluated with Confidence in Network Meta-Analysis. Pairwise meta-analyses, subgroup analyses, and frequentist NMA were performed for efficacy and safety outcomes.</p><p><strong>Results: </strong>Forty-three RCTs involving 2711 participants, evaluating 35 drugs across 41 regimens, were included. Traditional pairwise meta-analysis suggested that pharmacotherapy improved irritability more than placebo, with greater effects in younger children (<12 years) and shorter trials (⩽8 weeks). In the NMA, risperidone (Ris; MD = 8.81, 95% CI: 6.01-11.61) and aripiprazole (MD = 5.53, 95% CI: 2.61-8.45) led to larger reductions in ABC-I scores compared with placebo, showing the highest probability among monotherapies (surface under the cumulative ranking curve: 98% and 85%). Among Ris combination regimens, the most favorable effect was observed for the addition of topiramate, with an MD of 7.55 (95% CI: 5.89-9.21) relative to Ris + placebo. In terms of safety, pharmacotherapy was associated with an absolute adverse events (AEs) risk increase of 0.08 versus placebo, with no severe events reported.</p><p><strong>Conclusion: </strong>Ris and aripiprazole had the highest ranking probabilities among monotherapies, and topiramate was the most promising Ris adjunct in the NMA. Pharmacotherapy carried a slightly elevated AE risk, with no severe events. However, rankings should be interpreted cautiously because most comparisons were indirect. Large high-quality head-to-head trials are needed to confirm comparative efficacy and long-term safety.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261495555"},"PeriodicalIF":5.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149322388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of psilocybin on sleep quality and brain microstructure in chronic cluster headache.","authors":"Kristoffer Brendstrup-Brix, Brice Ozenne, Patrick M Fisher, Dea S Stenbæk, Anja S Petersen, Sophia Armand, Drummond E-Wen McCulloch, Maja Rou Marstrand-Joergensen, Sara M Ulv Larsen, Annette Johansen, Rigmor H Jensen, Gitte M Knudsen, Martin K Madsen","doi":"10.1177/02698811261449380","DOIUrl":"10.1177/02698811261449380","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic cluster headache (CCH) suffer from poor sleep, which may impact their brain microstructure and parenchymal clearance of waste products. Psilocybin has shown promise for the treatment of CCH and has been linked to increased neuroplasticity with possible influences on brain microstructure.</p><p><strong>Aims: </strong>To investigate the effects of psilocybin on sleep, brain water diffusivity, and microstructure in CCH.</p><p><strong>Methods: </strong>Eleven CCH patients underwent diffusion-weighted MRI and subjective sleep quality assessment with the Pittsburgh Sleep Quality Index (PSQI) before and 1 week after three psilocybin administrations (0.14 mg/kg) spaced 1 week apart. Measures taken prior to intervention were also compared to 24 healthy controls, and subjective sleep quality was related to brain microstructure and diffusivity across groups.</p><p><strong>Results: </strong>We found that sleep was poor in CCH patients, but improved after psilocybin treatment (CCH mean PSQI change (SD) = -2.50 (2.1), <i>p</i>_FWER = 0.015). When analyzing brain microstructure and water diffusivity in conjunction, we found differences between CCH patients and controls, which were primarily driven by differences in grey matter. On average, psilocybin intervention in CCH patients was not associated with statistically significant changes in brain microstructure or water diffusivity. However, most patients exhibited lower white matter diffusivity and neurite volume after intervention. Subjective sleep quality showed borderline significant correlations of moderate effect size with brain microstructure and water diffusivity.</p><p><strong>Conclusion: </strong>Subjective sleep quality improved in CCH patients after psilocybin and showed some evidence of an association with measures of brain microstructure and water diffusivity.</p><p><strong>Clinicaltrials: </strong>gov identifiers:Prophylactic Effects of Psilocybin on Chronic Cluster Headache (EPOCH; NCT04280055) and The Neurobiological Effect of 5-HT2AR Modulation (NeuroPharm2; NCT03289949).</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"1784-1798"},"PeriodicalIF":5.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No evidence for deleterious effects of psilocybin and MDMA on working memory or related neurophysiological activity in a non-clinical population: An uncontrolled exploratory study.","authors":"Neil Wayne Bailey, Samantha Lee Webb, Bernadette Mary Fitzgibbon, Nigel Christopher Denning, Traill Dowie, Monica Margaret Schweickle, Anish Modak, Grace Chan, Jackie Knight, Molly Waldron, Kirsten Gainsford, Hannah Hawkes, Sonia Zammit, Novi Christina Sutanto, Kate Godfrey, Paul Bernard Fitzgerald","doi":"10.1177/02698811261464991","DOIUrl":"10.1177/02698811261464991","url":null,"abstract":"<p><strong>Background: </strong>Research indicates psychedelics hold therapeutic potential, but possible deleterious effects have been insufficiently examined. We explored working memory (WM) performance and WM-related neurophysiological activity before and after exposure to psilocybin or 3,4-methylenedioxymethamphetamine (MDMA) in an uncontrolled study.</p><p><strong>Methods: </strong>Healthy participants were exposed to a single dose of psilocybin or MDMA (data analysed from 29 participants for each drug, with 16 receiving both drugs after >3-month washout). One to 16 days before and 5-16 days after dosing, participants completed a 3back WM task and eyes-closed resting with electroencephalography (EEG), plus a 3back during a 3-month remote follow-up.</p><p><strong>Results: </strong>After dosing, both groups showed increased alpha to gamma WM-related oscillatory power (<i>p</i> < 0.001). After psilocybin, participants showed steeper WM-related aperiodic slopes (<i>p</i> = 0.018), an effect maximal in occipital electrodes (<i>p</i> < 0.001, Cohen's <i>d</i> = 0.802, BF₁₀ = 155.138), and significant in occipital electrodes during resting (<i>p</i> = 0.008). The MDMA group showed improved task accuracy in the post-dosing EEG session (<i>p</i> = 0.005, Cohen's <i>d</i> = 0.561, BF₁₀ = 7.809). Both groups showed improved accuracy at 3-months (<i>p</i>-holm < 0.001, Cohen's <i>d</i> = 0.678, BF₁₀ = 272.074).</p><p><strong>Conclusions: </strong>Our results are suggestive of enduring neurophysiological effects following a single dose of MDMA or psilocybin. Our results do not support concerns about cognitive impairments from single exposures to MDMA or psilocybin in controlled settings, suggesting clinical utility does not risk impairing WM. However, given the uncontrolled study design, future research is required to confirm our observations reflect drug-induced neurophysiological changes.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"1817-1838"},"PeriodicalIF":5.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychedelic therapy without durable effects: A review and re-evaluation of controlled studies between 1965 and 1977.","authors":"Torsten Passie, Michiel van Elk","doi":"10.1177/02698811261478606","DOIUrl":"10.1177/02698811261478606","url":null,"abstract":"<p><p>Common wisdom in the psychedelic literature suggests that early controlled trials of psychedelic therapy were methodologically flawed. In this review we challenge this view and discuss 11 controlled studies that were conducted in the United States and Canada between 1965 and 1977 to evaluate psychedelic (peak) therapy for individuals suffering from alcohol and opioid use disorder and psychoneuroses. We provide a narrative review of the designs, methods, settings, treatment issues and results and show that these studies already adhered quite well to the regulatory and evidentiary standards of their time. These early psychedelic trials tried to effectively address common methodological problems that still threaten the validity of contemporary psychedelic clinical trials (e.g., regarding blinding and active control conditions). Our review indicates that despite a significant heterogeneity in the methods and research designs, most early controlled studies converge on the same conclusion: there are no durable improvements in the condition of patients treated with psychedelic therapy beyond a few weeks. We discuss implications for contemporary psychedelic science in terms of (a) patient selection (i.e., better prospects for non-chronic conditions), (b) the problems with a single-sided focus on mystical experiences as the primary mechanism of action, (c) the positive afterglow as a therapeutic window of opportunity and (d) the need for a strong psychotherapeutic framework to induce sustained therapeutic effects.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"1711-1731"},"PeriodicalIF":5.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oregon's state-regulated psilocybin services: Early real-world safety signals.","authors":"Jason B Luoma, Christina Chwyl, Don Des Jarlais, Christopher S Stauffer, Ximena A Levander, Ryan R Cook, Adrianne R Wilson-Poe, Dennis McCarty, P Todd Korthuis","doi":"10.1177/02698811261481171","DOIUrl":"10.1177/02698811261481171","url":null,"abstract":"","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"1903-1905"},"PeriodicalIF":5.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating and creating a short-form of the persisting effects questionnaire: A measure of positive and negative outcomes from psychedelic experiences.","authors":"Rebecca Ehrenkranz, Nathan D Sepeda, Sean P Goldy, Brandon M Weiss, Praachi Tiwari, Arozo Azimi, David B Yaden","doi":"10.1177/02698811261473405","DOIUrl":"10.1177/02698811261473405","url":null,"abstract":"<p><strong>Background: </strong>The persisting effects questionnaire (PEQ) is a measure of self-reported positive and negative effects from psychedelic and other experiences. While this measure has been used in many studies on psychedelic substances, the scale has not been formally validated. The PEQ consists of over 140 items as well as several separate single items, causing high participant burden.</p><p><strong>Aims: </strong>Conduct statistical and qualitative validation procedures for the PEQ and generate a validated short form version (PEQ-SF).</p><p><strong>Methods: </strong>Validation procedures included (1) conducting exploratory factor analysis for dimensionality reduction, (2) correlations to establish convergent and divergent validity, (3) confirmatory factor analysis in a separate sample, (4) qualitative response process evaluation to ensure items are comprehensible, and (5) comparisons between the original PEQ and the short form in two psychedelic administration studies, one clinical, and one in healthy normals.</p><p><strong>Results: </strong>We found that the factor structure of the original PEQ was not quantitatively supported; factor analysis revealed a two-factor structure consisting of an overall positive and an overall negative factor. This two-factor structure was maintained in a short form version of the scale, consisting of 14 items with one positive valence and one negative valence factor and three single items from the original PEQ related to well-being and meaning.</p><p><strong>Conclusions: </strong>We found that the original PEQ did not have adequate validity and created a short form with strong psychometric properties that behaves similarly in drug administration studies.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"1862-1876"},"PeriodicalIF":5.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond head-twitch response: Acute psilocybin affects spontaneous behaviors in rats in a dose-dependent manner.","authors":"Praachi Tiwari, Bryan W Jenkins, Catherine F Moore, Hudson Zhou, Tylaah George, David B Yaden, Elise M Weerts","doi":"10.1177/02698811261478600","DOIUrl":"10.1177/02698811261478600","url":null,"abstract":"<p><strong>Background: </strong>Psychedelics have emerged as promising pharmacological agents for treating a range of neuropsychiatric disorders. While preclinical studies have provided valuable insight into the neural mechanisms underlying their effects, systematic characterization of psychedelic effects on inherent spontaneous behaviors in animal models remains limited.</p><p><strong>Methods: </strong>In the current study, male and female Sprague-Dawley rats were administered psilocybin (0.5, 1, 1.5 mg/kg, i.p.) or its vehicle (saline). Behaviors were video recorded for subsequent analysis. In addition to the widely studied head-twitch response and wet dog shakes (HTR/WDS), five additional spontaneous behaviors that were modulated by psilocybin (immobility, rearing, grooming, sniffing/digging, and circling) were assessed.</p><p><strong>Results: </strong>Assessed behaviors showed distinct dose-response profiles in both sexes. When compared to saline, psilocybin elicited HTR/WDS following a bell-shaped curve, while immobility increased linearly, with dose. Rearing and grooming decreased markedly even at low doses, sniffing/digging declined only at higher doses, and circling increased variably across doses for each sex. Furthermore, some behaviors were correlated in a dose-dependent manner.</p><p><strong>Conclusion: </strong>Together, our findings highlight a broader range of behaviors influenced by psilocybin beyond HTR and provide a framework for identifying its neurobehavioral effects in Sprague-Dawley rats within a widely used physiologically relevant dose range.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"1877-1888"},"PeriodicalIF":5.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychedelics and psychosis: A systematic review of recent-era studies (1984-2025).","authors":"José Augusto Silva Reis, Lara Zancaner Ueta, José Carlos Bouso, Jaime Eduardo Cecílio Hallak, Rafael Guimarães Dos Santos","doi":"10.1177/02698811261488575","DOIUrl":"10.1177/02698811261488575","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review evaluates the relationship between classical psychedelic drugs (D-Lysergic acid <i>N</i>,<i>N</i>-diethylamide, psilocybin, ayahuasca/<i>N</i>-<i>N</i>-dimethyl-tryptamine, and mescaline) and the emergence of psychotic symptoms, aiming to synthesize evidence from contemporary studies (1984-2025) regarding the risk factors, prevalence, and clinical characteristics of psychosis related to psychedelic use, to provide clinicians, therapists, and policymakers with a framework for identifying and mitigating risks related to these substances.</p><p><strong>Major findings: </strong>Fifty-two papers were included, comprising 1 larger-scale studies involving over 100,000 individuals and 34 case reports. Population-based data showed no consistent correlation between lifetime psychedelic use and psychosis. Controlled clinical settings showed minimal risk, with one documented case of transient delusions across all trials. Emergency and toxicological data reported higher rates of psychotic symptoms, likely reflecting the severity of cases prompting medical attention. Among case reports, 58% of individuals had a personal or family psychiatric history. First-episode psychosis, although rare, was documented in otherwise healthy individuals.</p><p><strong>Conclusions: </strong>The risk of prolonged psychosis remains remarkably low in controlled clinical settings where rigorous screening and supervision are employed. Personal/family history of psychosis and unsupervised, naturalistic use appear to be risk factors for psychosis. Although causality remains difficult to establish, these findings support the need for careful risk stratification, the adoption of clear diagnostic parameters, and trained clinical oversight as psychedelic-assisted therapies advance toward broader clinical populations.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"1732-1759"},"PeriodicalIF":5.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149269454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}