Original Research J Clin Psychiatry September 2026

An Open-Label, Dose-Escalation Trial of Psilocybin-Assisted Therapy for Bipolar II Depression

JCP 2026;87(4):10.4088/JCP.25m16227

Full Article Read the complete peer-reviewed article in J Clin Psychiatry. Clinical Summary Patients with bipolar II depression have few effective options, and they have largely been excluded from psilocybin trials because of concern about mania risk. This study addresses the practical question clinicians face: whether psilocybin-assisted therapy can improve bipolar II depression without unacceptable psychiatric destabilization when used with structured psychotherapy and longitudinal monitoring. FAQ What did this trial find about psilocybin-assisted therapy for bipolar II depression?

Key Takeaways The dose-escalation design limited higher-dose exposure: 4 participants (28.5%) met remission criteria (MADRS ≤6) after the initial 10 mg session and did not proceed to 25 mg, suggesting some patients with bipolar II depression may improve before standard-dose administration is necessary. Clinical Guide How should clinicians structure a cautious psilocybin dose-escalation pathway for adults with bipolar II depression? Clinical Guide How should clinicians monitor for delayed suicidality, hypomania, and other psychiatric adverse effects after psilocybin-assisted therapy in bipolar II depression?