The Promise of Psychedelic Science

Berton and colleagues frame the paper by observing that most psychiatric medications were developed decades ago, during a period of limited understanding of neuropsychiatric pathophysiology. As a consequence, existing treatments often provide partial or transient relief, creating a need for fundamentally new therapeutic approaches. Psychedelics are presented as a particularly promising avenue because they can produce rapid and sustained effects across several disorders, including depression, post-traumatic stress disorder (PTSD), and substance use disorder (SUD). The authors argue that fully understanding how these compounds work will require multidisciplinary efforts spanning chemistry, molecular biology, neuroscience, psychology, and clinical research. This article serves as an overview of a Special Issue of ACS Pharmacology & Translational Science that highlights research on how psychedelics impact brain function across molecular, cellular, and organismal scales. Berton summarises contributions ranging from structure–activity relationship (SAR) studies of small molecules to investigations of psychoplastogenic and anti-inflammatory effects, biomarker development, clinical findings on suicidality and addiction, and ethical issues. The editorial sets out to map the breadth of ongoing investigations and to emphasise the translational challenge of turning psychedelic science into safe, effective clinical tools.

Rather than reporting original experimental methods or aggregated meta-analytic data, the paper summarises findings from multiple studies included in the Special Issue. Several SAR investigations are highlighted: Gatch and colleagues used rat discrimination tasks to show that various tryptamine analogues produce DOM-like effects, while Halberstadt and colleagues observed abuse-related activity with automated head-twitch assays. A notable chemical observation was that O-acetylation of 4-hydroxy-N,N-dialkyltryptamines markedly reduced potency in vitro but not in vivo, consistent with a prodrug mechanism. Stove and colleagues studied a series of NBOMe positional isomers in G protein and β-arrestin activation assays, finding variable stimulation of 5-HT2A receptors; modelling work based on an active-state cryo-EM structure of 5-HT2A helped to explain isomer-specific differences. Work on psychoplastogenic and anti-inflammatory properties is also summarised. Nichols and co-workers contributed SAR work aimed at the psychoplastogenic pharmacophore and used a rodent allergic asthma model to probe anti-inflammatory effects; they reported little correlation between anti-inflammatory and hallucinogenic effects, suggesting the possibility of developing non-hallucinogenic anti-inflammatory leads. Berton’s group reports that brief stimulation of cortical neurons by ketamine and LSD is sufficient to produce sustained neuronal growth in rodents, a mechanism that might underlie long-lasting behavioural effects after a single dose. In humans, Kuypers and colleagues found that low doses of LSD (<20 μg) increased plasma brain-derived neurotrophic factor (BDNF), supporting the idea that even subperceptual doses can engage plasticity-related biology. The issue also notes the recent report of a non-hallucinogenic psychedelic analogue with sustained therapeutic properties. Efforts to identify biomarkers and mechanistic signatures are represented by Carrera, Torterolo, and colleagues, who used EEG to show that ibogaine induces gamma oscillatory patterns resembling REM sleep—consistent with its dream-like subjective effects. Other translational chemistry work showed ibogaine binds monoamine transporters and can act as a pharmacochaperone; Frissmuth and Newman engineered ibogaine analogues aimed at correcting monoamine transporter folding defects. Regarding suicidality, Weissman and colleagues reviewed the nascent literature and concluded psychedelic therapy might reduce suicidal ideation, while Ross and colleagues reported that psilocybin-assisted psychotherapy reduced suicidal ideation in people with cancer. Clinical optimisation and predictors of response are examined across several contributions. Johnson and colleagues experimentally compared music genres and found that overtone-based music occasioned more mystical-type experiences and increased smoking abstinence compared with Western classical music. In a study of male AIDS survivors, Stauffer and colleagues reported that baseline attachment anxiety correlated with mystical-type experiences and baseline attachment avoidance correlated with challenging experiences. Aday and colleagues’ systematic review identified psychological predictors: preoccupation, apprehension, and confusion were linked to adverse effects, while openness, absorption, acceptance, and surrender were associated with mystical-type experiences; biological measures such as 5-HT2A receptor binding potential and rostral anterior cingulate cortex (rACC) volume were also noted as important predictors, whereas participant sex did not predict response. Liknaitzky and colleagues discuss combining psychedelics with mindfulness meditation as a way to initiate and sustain adaptive behavioural change. The issue also addresses ethical and cultural concerns. Johnson warns about the risk of clinicians imposing religious or spiritual beliefs on patients and stresses safeguards such as involving multiple healthcare workers to reduce abuse risk. Schenberg and colleagues raise concerns about cultural appropriation of psilocybin-related traditional medicines. Berton closes by emphasising the need to avoid hype and to pursue psychedelic research with rigorous scientific standards.

Berton interprets the collected contributions as evidence that psychedelic science is advancing on multiple fronts—chemistry, molecular mechanisms, animal models, human biomarkers, and clinical investigation—but that substantial uncertainties remain. The editorial highlights two recurring themes: first, that psychedelics can engage rapid and sustained biological changes (for example, psychoplastogenic effects and BDNF increases) which may underpin therapeutic benefits; second, that therapeutic mechanisms may be dissociable from hallucinogenic subjective effects, opening a path toward non-hallucinogenic therapeutics. The authors note, however, that the question of whether subjective experiences are necessary for clinical benefit remains contested within the field. Limitations and uncertainties acknowledged in the overview include the nascent state of research on suicidality, the unresolved debate about the role of subjective effects, and the early stage of biomarker development. The editorial also flags ethical and implementation risks: potential clinician misconduct, cultural appropriation, and insufficient attention to set and setting. Practical implications discussed by the contributors include the importance of developing robust biomarkers to evaluate efficacy and mechanisms, the potential to exploit SAR findings to produce safer or non-hallucinogenic compounds, and the need to study factors that influence therapeutic response systematically (for example, music, attachment style, and biological markers). Finally, the authors caution against premature clinical enthusiasm and call for careful, rigorous, multidisciplinary research to translate psychedelic science into safe, evidence-based therapies.