The branches · Mood and drive · could move a stage within 1 to 5 years
A psychedelic therapy is approved for prescription
Psilocybin, the active part of certain mushrooms, and MDMA, given a few times under supervision with talking therapy, have in trials lifted depression and post-traumatic stress that nothing else had shifted. On 1 July 2023 Australia became the first country to let specially approved psychiatrists prescribe them, outside any trial. Other regulators have so far declined. It is on this branch because the change it makes is to how a person feels, on purpose and at their request.
What would count
A regulator somewhere allows a doctor to prescribe a classic psychedelic (psilocybin, LSD, DMT, mescaline) or MDMA as a treatment for a named condition outside a trial, in the regulator's own published notice.
Who settles it: The regulator's own notice (Australia's Therapeutic Goods Administration, the United States Food and Drug Administration, the European Medicines Agency or an equivalent)
Where it stands
In clinical use. Reached on 1 July 2023, on the record of tga.gov.au. Could move a stage within 1 to 5 years.
The last reading
Once a week every upgrade is read against the news, against what would count above. Open a line to see what that week held. Every reading of this upgrade is on this week's reading.
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16 October 2026 No change
Nothing in the window moves the stage. In the United States, Compass Pathways' psilocybin (COMP360) is on an expedited review path (a priority voucher granted 2026-04-24, the application's last parts expected in the last quarter of 2026) with a decision expected late 2026 or early 2027, which would be a second regulator on the rung this entry already holds, not a new rung. On the claim still to check: the Australian regulator's page, which would not load on 2026-10-16 when the record was written, loaded tonight in a browser. It is titled 'Change to classification of psilocybin and MDMA to enable prescribing by authorised psychiatrists', published 3 February 2023, and says that from 1 July 2023 authorised psychiatrists may prescribe MDMA for post-traumatic stress disorder and psilocybin for treatment-resistant depression, under the Authorised Prescriber Scheme, with no approved product evaluated by the regulator. That is the wording the entry describes.
Notes
The record is the Therapeutic Goods Administration's decision of February 2023, in force from 1 July 2023, allowing authorised psychiatrists to prescribe psilocybin for treatment-resistant depression and MDMA for post-traumatic stress disorder. It is a change of drug schedule plus a permission scheme for named psychiatrists, not the approval of a registered medicine, which is enough for the ladder's rung (a doctor can give it outside a trial) and is said plainly here. New Zealand allowed one named psychiatrist to prescribe psilocybin in June 2025; the United States regulator declined an MDMA application in 2024. Esketamine, a nasal spray approved in the United States in 2019, is a dissociative anaesthetic rather than a classic psychedelic and is left out of the test. The rung in wide use needs a counted population, and prescriptions under the Australian scheme are in the low hundreds.