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Research & Culture7 min readBy Shroomshack · Updated October 16, 2026

The Promising Psilocybin Trials

The Promising Psilocybin Trials

Search for psilocybin and depression and the pages that come back now include working clinics, not only early papers. In London, King's College London and the South London and Maudsley NHS Foundation Trust have spent years building a therapy model with COMPASS Pathways. In Australia, authorised psychiatrists have been able to prescribe psilocybin for treatment-resistant depression since 1 July 2023. This post is our reading of that public record, starting with the Maudsley Biomedical Research Centre's account of how the London work grew. For the study-by-study tour of the earlier landmarks, start with our clinical research guide.

The sessions in these programmes use a measured dose, a prepared room, trained people present, and follow-up afterwards. What follows is what those trials measured and what regulators have opened. It is not medical advice, and it is not a claim about any product on this site.

London built the clinic, then the European arm

The Maudsley account centres on James Rucker, a consultant psychiatrist at King's and at South London and Maudsley. An NIHR Clinician Scientist Fellowship let him build a small team, mentored by Allan Young, and launch the NIHR-funded PsiDeR trial in people with treatment-resistant depression. The study was built to look at safety and at whether symptoms moved, and to collect brain scans and blood measures at the same time.

That trial brought COMPASS Pathways in. With NIHR Maudsley support and COMPASS funding, Rucker led a phase 1 study of 89 healthy volunteers at the NIHR King's Clinical Research Facility, after the Home Office approved psilocybin for that research. The session model was worked out there: a trained therapist in a purpose-built room, with time afterwards to talk through the experience. Alongside the safety findings, the team showed that at least six people could be supported in one sitting.

King's then led the European arm of the COMPASS phase 2b trial in treatment-resistant depression. The Maudsley page says that London site recruited more people than any other centre, and that the trial finished in 2022 with results that drew wide coverage. In March 2023 COMPASS opened its phase 3 trial, and the King's team is leading the European arm of that one too. In November 2023 the three partners opened the Centre for Mental Health Research and Innovation, with six therapy rooms, four of them set up for dosing. The same group is also running a COMPASS psilocybin trial in post-traumatic stress, leading the European arm of an anorexia trial, and running a first study in autistic adults.

The page's 2026 update is the line that marks how far the NHS work has come. It says PsiDeR became the first publicly funded UK randomised controlled trial of psilocybin for treatment-resistant depression delivered in an NHS setting. A single dose, combined with psychological support, reduced depression symptoms compared with placebo, and that difference was still there at six weeks. The trial also found the sessions could be delivered safely in a community NHS setting.

Anya Borissova and James Rucker set the same pipeline out for UK psychiatrists in BJPsych Bulletin. They describe the therapy as three stages: preparation, a dosing day in a clinical room, and integration sessions after. It is not a capsule someone is sent home to take every morning. Their account of the 2022 international trial covers 233 adults with treatment-resistant depression, all of them with psychological support. At three weeks, 37 percent of the 25 mg group had responded, against 19 percent at 10 mg and 18 percent at 1 mg. Remission was 29 percent at 25 mg, 9 percent at 10 mg and 8 percent at 1 mg. At twelve weeks, 20 percent of the 25 mg group still met response, against 10 percent at 1 mg. They present those figures as the evidence the phase 3 trials were designed to test, which is the European work King's is now leading.

What ten people said it was like

A 2021 paper in the Electronic Journal of General Medicine took a different route. Redhwan Ahmed Al-Naggar, Hisham Alshaikhli and Gwen Erlam interviewed ten adults who were using psilocybin while dealing with depression or anxiety. They found people through social media and through groups already talking about that use, so these are conversations, not a controlled trial.

The themes were consistent enough to name. People described senses turning up, a feeling of being more connected, a steadier mood, more optimism, more say over their emotions, and an easier connection with other people. Several talked about comfort, peace and a calmer body, and about the sense that the experience had opened a new way of looking at things. The authors called that pattern promising even after a single dose, and said a health professional should be the one guiding the session.

What the scans and the reviews measured

The brain-scan paper is still the one hospitals quote. In April 2022, Richard Daws and colleagues at Imperial College London and UC San Francisco published scans from two depression trials in Nature Medicine. One was open-label, in treatment-resistant depression: 10 mg, then 25 mg a week later, with people knowing what they were receiving. The other compared psilocybin with escitalopram in major depression, double-blind, and both groups had psychological support.

Functional MRI, taken before and again after, showed the psilocybin sessions followed by a drop in how sealed-off the brain's usual networks were. Regions that mostly talk to themselves in depression, including networks tied to self-focused thought, became more connected with the rest of the brain. In the comparison trial that pattern lined up with how much depression scores moved, and it was still visible three weeks after the second dose. The escitalopram group did not show the same network change. The UCSF write-up is the plain-language version. The authors treat the scans as a clue to a mechanism, and they note that the duration of the change is still an open question.

Reviews stack the smaller trials. In 2023 Tessa Watford and Naqash Masood kept six studies and 319 adults in Clinical Psychopharmacology and Neuroscience. Half were randomised and half were open-label. Psychological support was part of every plan. On the measures those papers used, depression scores moved in favour of the psilocybin condition. The effects they spent the most time on during the session itself were anxiety, nausea and headache, and they describe those as mostly short-lived.

In 2024 Athina-Marina Metaxa and Mike Clarke pooled seven studies and 436 people for The BMJ and reported a moderate benefit on depression scores against placebo or a non-psychedelic drug, a standardised effect around 0.66. The journal later ran an expression of concern and, in 2025, a correction after data errors, including some results counted twice. The corrected paper still reports a benefit.

The US National Center for Complementary and Integrative Health, updated in May 2024, sets a 2023 analysis of five studies and 215 people beside those reviews: psilocybin plus psychological support, with symptoms lower for up to five weeks. The same page records the 2021 Imperial comparison, which did not separate from escitalopram on its main measure, and a 2023 trial of 104 people in JAMA: one 25 mg dose with support, symptoms lower within eight days, and a difference still there at six weeks.

Australia opened prescribing, and Europe is in the trials

On 3 February 2023 Australia's Therapeutic Goods Administration decided that from 1 July 2023, psilocybin could be prescribed for treatment-resistant depression, and MDMA for post-traumatic stress disorder. The prescriber has to be a psychiatrist with approval from a human research ethics committee, and then authorisation from the TGA under the Authorised Prescriber scheme. The TGA said these were the conditions with enough evidence of potential benefit in certain patients, and that use would be in a controlled medical setting. No psilocybin product has completed the TGA's full evaluation onto the Australian Register of Therapeutic Goods. The change is an access route for those psychiatrists, which is further than a trial listing and short of a branded medicine approval.

Nature reported the decision on 30 June 2023 as a world first: Australia allowing doctors to prescribe psilocybin and MDMA for those conditions. Live Science reported the same July start, with psilocybin for hard-to-treat depression and MDMA for post-traumatic stress, and quoted Michael Alpert describing Australia's model as one other countries would be watching.

Europe's public move so far is the trial network. The Maudsley partnership is the clearest example on the page: an NHS trust, a university and a company, a phase 3 programme with King's leading the European arm, and a London centre built for the sessions. Borissova and Rucker wrote their update for UK psychiatrists because that pipeline is already staffed and recruiting.

Canada's rules are a different page, covered in our Canada post. Medicines people are already taking are covered in the medications post. The safety guide is about mushroom experiences in general.

Sources

What the research says

Research on psilocybin is still young, and most trials give a measured dose with professional support. Results don't mean any product is safe or effective for you.

This guide is general information, not medical or legal advice. If you have health questions, talk to a health professional.