Blinding Fails in Psychedelic Trials

Psychedelic drugs produce such obvious acute effects that randomized trials are routinely unblinded: 90–95% of participants can tell whether they received the active drug, which undermines the double‑blind standard. A JAMA Psychiatry review comparing 24 studies found psychedelics no more effective than open‑label antidepressant treatment, suggesting effect estimates may be driven by expectation and trial procedure rather than drug efficacy alone. — This challenges the evidence base used for fast‑tracking approvals and public enthusiasm for psychedelics, with implications for regulators, veterans' care, and how we design clinical trials for subjective, perceptual drugs.