Psilocybin-assisted therapy

What it is

Psilocybin with preparation, supervised dosing, and integration. Stronger published signal for depression than for PTSD so far.

Evidence

Depression evidence is stronger than PTSD evidence. Early veteran open-label pilots exist. No finished large PTSD RCT. VA PIVOT (announced August 2026) is a multi-site trial of psilocybin for treatment-resistant depression in veterans (~240 target, several VA sites). PTSD comorbidity may be allowed — it is still a depression trial, not a PTSD approval study.

Access for veterans

Trials; a few state-regulated programs; uneven retreats. Not a standard VA clinic offering.

Cautions

State psilocybin rules are not a PTSD product and do not cover MDMA, ibogaine, or 5-MeO-DMT.

Sources

• VA PIVOT announcement, August 2026 (TRD in veterans; sites reported include Birmingham, Tuscaloosa, Portland).
• VA National Center for PTSD — PAT professional page.

Evidence reviewed September 2026.

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