April 22, 2026

Top News
Trump's Psychedelic Order Accelerates Psilocybin Pathways While Xanomeline/Trospium Enters Schizophrenia Care
Drug Development

The investigational drug EMP-01 demonstrated meaningful clinical improvements in patients with social anxiety disorder in a Phase 2a trial.

Substance Use
First large‑scale survey estimates that 2.8% of US population used psilocybin in the past year

A new survey indicates 2.8% of US adults used psilocybin in the past year, driven by decriminalization efforts and growing interest in its potential antidepressant effects.

Drug Development
Incannex Highlights Psilocybin Anxiety Program Amid U.S. Policy Shift - TipRanks

Incannex advances its psilocybin program for anxiety treatment in the context of shifting U.S. regulatory policies, highlighting potential future therapeutic options for mood disorders.

Drug Development

This article provides a comparative analysis of side effect profiles and discontinuation rates for NMDA receptor antagonists, offering critical prescribing guidance for managing treatment-resistant depression.

Diagnosis & Treatment

The article addresses strategies for optimizing more efficacious treatments in patients with treatment-resistant depression, a critical area for psychiatric prescribing.

Clinical Pearls

Bite-sized clinical takeaways from today's literature (sources from Aug 29 – Apr 22)

  • The conclusion of the Clozapine REMS simplifies prescribing protocols but requires clinicians to maintain vigilance regarding agranulocytosis monitoring without formal registry barriers.
  • Prescribe xanomeline/trospium as a novel antipsychotic option for schizophrenia, noting its distinct muscarinic mechanism avoids traditional D2 receptor blockade side effects.
  • Consider pretreatment subcallosal cingulate functional connectivity patterns to predict response to brain stimulation therapies like rTMS or ECT in treatment-resistant depression.
  • Evaluate electrolyte status immediately in patients presenting with atypical movement disorders to rule out osmotic demyelination syndrome mimicking extrapyramidal symptoms.
  • Monitor for tinnitus in patients initiating SSRIs, as specific serotonin circuit activation may drive this adverse effect requiring potential medication adjustment.
  • Utilize GLP-1 agonists to potentially mitigate metabolic side effects of antipsychotics like clozapine while addressing psychiatric comorbidities.
  • Recognize that antidepressants effective for methamphetamine use disorder can serve as a viable pharmacological intervention in substance use treatment protocols.
  • Approach antipsychotic deprescribing in schizophrenia as a systemic care issue requiring structured support rather than attributing discontinuation solely to patient non-compliance.
  • Be aware that the amygdala kindling model remains the most reliable preclinical predictor for seizure medication success, unlike other rodent models which may fail to translate clinically.

Drug Development 2

Effective antidepressant medication reviews: Key points for practice and community pharmacists - thepharmacist.co.uk

This article outlines key clinical considerations for community pharmacists to optimize antidepressant medication reviews, directly supporting evidence-based prescribing and monitoring practices.

Amyloid‐related imaging abnormalities (ARIA) in anti‐amyloid therapies for Alzheimer's disease: An update from the Alzheimer's Association ARIA workgroup

The Alzheimer's Association provides updated guidelines for detecting, monitoring, and mitigating amyloid-related imaging abnormalities (ARIA) in patients receiving anti-amyloid immunotherapies for Alzheimer's disease.

Substance Use 3

Association between state‐level kratom regulations and poison center‐reported severe medical outcomes and healthcare use: A United States national analysis

This national analysis indicates that state-level kratom bans correlate with significantly lower rates of severe medical outcomes and healthcare utilization compared to unrestricted states, informing regulatory strategies for substance use disorders.

Editorial: Treatment and management of stimulant use disorder and co-occurring disorders

This editorial highlights the urgent need for integrated treatment frameworks addressing stimulant use disorder and co-occurring psychiatric conditions like ADHD, while noting emerging pharmacotherapies such as a cocaine vaccine and gaps in current evidence-based interventions.

This Common Antidepressant Can Help Cut Back Methamphetamine Use - ScienceAlert

A common antidepressant demonstrates efficacy in reducing methamphetamine use, offering a potential pharmacological treatment option for substance use disorder.

Diagnosis & Treatment 4

Psychometric properties of Lithuanian translation of the self-report version of the Liebowitz social anxiety scale in young adult sample

The Lithuanian translation of the Liebowitz Social Anxiety Scale Self-Report demonstrates excellent internal consistency, though high correlations between subscales suggest limited utility for differentiating specific anxiety domains in cross-sectional research.

Group CBT targeting hostile attribution bias in adolescents and young adults with ASD traits

A pilot study indicates that 8-session group CBT significantly reduces hostile attribution bias and improves social functioning and quality of life in adolescents with ASD traits, though QOL gains may not linearly correlate with bias reduction.

Effectiveness and mechanisms of Intensive Short-Term Dynamic Psychotherapy for treatment-resistant depression: a reanalysis of a randomized controlled trial

Intensive Short-Term Dynamic Psychotherapy demonstrates large, durable efficacy for treatment-resistant depression, though the hypothesized mechanism of action involving sequential reduction of emotional repression was not supported by reanalysis data.

Evidence in practice: implementing KAT in indigenous health services

A pilot program demonstrates that Ketamine-Assisted Therapy (KAT) is feasible and effective for depression, anxiety, and PTSD in an Indigenous context when delivered through a culturally responsive model.

Policy & Regulation 5

Executive order speeds up psychedelic research for severe mental health conditions - KGUN 9

An executive order is accelerating the pace of clinical research into psychedelics for treating severe mental health conditions, potentially expediting future FDA approvals and prescribing pathways.

Trump executive order lifts psychedelics biotechs

A Trump executive order aims to accelerate research and access to psychedelics for mental health conditions, potentially influencing the investment landscape for related biotechs.

US speeds research into mind-altering drugs — including mysterious ‘ibogaine’

A US executive order directs the FDA to accelerate review of psychedelic therapies including ibogaine for addiction, depression, and PTSD while mandating $50 million in federal funding to lower research barriers.

Trump signs order backing psychedelic research

President Trump signed an executive order to boost federal research into psychedelics like psilocybin, LSD, and MDMA for potential mental health treatments.

Virginia sets rules for potential psilocybin treatment - AOL.com

Virginia establishes regulatory frameworks for potential psilocybin-assisted therapy, signaling a shift in state-level policy regarding this emerging psychopharmacological treatment.

Neuroscience 3

From neuroinflammation to neural inference: computational psychiatry meets precision medicine

This review proposes a framework linking neuroinflammation and immune dysregulation to computational deficits in schizophrenia, advocating for multi-modal biomarkers to enable precision medicine rather than offering specific new drug prescribing guidance.

Subcallosal cingulate functional connectivity in depression: a systematic review of brain stimulation–induced changes and pretreatment connectivity predictors

This systematic review identifies pretreatment subcallosal cingulate functional connectivity patterns as potential biomarkers for predicting response to brain stimulation therapies (DBS, rTMS, ECT, TUS) in treatment-resistant depression.

Iron dyshomeostasis in neuropsychiatric disorders

This review details how cerebral iron dyshomeostasis contributes to the pathophysiology of neuropsychiatric disorders like depression, schizophrenia, and ADHD, identifying iron metabolism as a potential therapeutic target.

Clinical Pearl 3

Target engagement in a head-to-head clinical trial of dysphoric versus anxiosomatic transcranial magnetic stimulation targets

A head-to-head trial indicates that baseline connectivity to the TMS target site predicts anxiety improvement in depression patients, whereas induced connectivity changes did not predict outcomes, suggesting circuit architecture is a critical factor for targeting protocols.

Antidepressant Side Effects: How to Know if You Should Push Through or Switch - WebMD

This article provides clinical guidance on managing antidepressant side effects, helping prescribers decide when to continue therapy versus switching medications.

Clinical Pearls for Prescribing Xanomeline/Trospium in Schizophrenia - Psychiatry Advisor

This article provides clinical prescribing guidance for the novel muscarinic antagonist combination xanomeline/trospium, a new treatment option for schizophrenia.

Podcast Summary 1

The Emerging Role of GLP-1s in Psychiatry with Roger S. McIntyre, MD, FRCPC

This podcast discusses the emerging potential of GLP-1 agonists to treat psychiatric conditions and mitigate metabolic side effects of antipsychotics like clozapine, challenging traditional monoamine-based treatment paradigms.

Digital Health 1

Transcranial Photobiomodulation (tPBM) for Somatic Symptoms in Treatment-Resistant Depression

A clinical trial is recruiting to evaluate transcranial photobiomodulation as an intervention for somatic symptoms in treatment-resistant depression.

Mechanism of Action 4

Subanesthetic doses of ketamine to rats and monkeys rapidly increases radioligand binding in brain to phosphodiesterase-4, an indirect marker of cAMP

Preclinical PET imaging demonstrates that subanesthetic ketamine rapidly increases cAMP activity via PDE4 inhibition in rodents and non-human primates, providing mechanistic evidence for its rapid antidepressant effects.

SSRIs May Trigger Tinnitus

A study identifying a specific serotonin circuit linking SSRIs to tinnitus provides a mechanistic explanation for this adverse effect and suggests a potential therapeutic target.

Dopaminergic modulation of pancreatic beta-cell insulin secretion and implications for antipsychotic-induced glucose dysregulation: a systematic review and meta-analysis - Nature

This systematic review elucidates the mechanism by which dopaminergic modulation of pancreatic beta-cells contributes to antipsychotic-induced glucose dysregulation, offering critical mechanistic insight for managing metabolic side effects in patients treated with antipsychotics.

mTOR-driven autophagy–inflammation crosstalk underlies schizophrenia pathophysiology

This article identifies mTOR-driven autophagy-inflammation crosstalk as a core mechanism in schizophrenia pathophysiology, suggesting potential targets for future pharmacological intervention.