Psychedelic-assisted therapy

Figures checked September 2026

Psychedelic-assisted therapy is a treatment overseen by approved Psychiatrist A medical doctor who has specialised in mental health. Psychiatrists can diagnose, prescribe and do therapy, though many spend most of their time on medication and diagnosis rather than weekly sessions. More in the jargon decoder . A measured dose of a psychedelic drug is given to support psychological treatment (Royal Australian and New Zealand College of Psychiatrists, fact sheet). Only pharmaceutical-grade products are used. Since July 2023, authorised psychiatrists in Australia can prescribe MDMA for post-traumatic stress disorder (PTSD) and psilocybin for treatment-resistant depression (Therapeutic Goods Administration). This kind of treatment is rare and expensive, and it isn’t a first treatment for either condition.

What’s allowed in Australia

Only psychiatrists can prescribe MDMA or psilocybin for treatment. Before they can, Australia’s medication regulator, the Therapeutic Goods Administration, has to make them an authorised prescriber, and an ethics committee has to approve how they’ll run the treatment (Therapeutic Goods Administration). MDMA can be prescribed only for PTSD. Psilocybin can be prescribed only for treatment-resistant depression. Neither MDMA nor psilocybin is an approved medication in Australia. The regulator hasn’t assessed either one for quality, safety or how well it works.

Treatment-resistant depression means depression that hasn’t improved after two or more antidepressants, each taken at a proper dose for long enough. That’s the definition used by the Royal Australian and New Zealand College of Psychiatrists (Royal Australian and New Zealand College of Psychiatrists, guidance for psychiatrists). The psychiatrists’ college recommends psychedelic-assisted therapy only after established treatments have been tried without lasting improvement.

What treatment involves

Treatment has three parts (Royal Australian and New Zealand College of Psychiatrists, FAQs):

Preparation: sessions with your treatment team before any session with the drug.
Sessions with the drug: one to three over a few weeks, each lasting around six to eight hours (Royal Australian and New Zealand College of Psychiatrists, fact sheet). You take the drug only in a clinic, under supervision.
Integration: sessions afterwards where you and your treatment team work through what came up.

The talk therapy is just as important as the drug. The therapy is delivered by two health professionals working together, one of them a medical practitioner (Royal Australian and New Zealand College of Psychiatrists, guidance for psychiatrists). Before any session with the drug, the team should talk with you about whether and how they might touch you, for example by holding your hand. They’re also required to keep professional boundaries. It’s reasonable to ask how the team handles physical contact and boundaries, and to say what you’re comfortable with, before you start.

Psychedelic drugs can interact badly with medications used for mental health conditions. Some people need to come off those medications gradually, under medical supervision, before starting, and for some people that isn’t possible without becoming very unwell again. If you’re thinking about stopping a medication, speak to whoever prescribes it before you change anything.

What the research says

MDMA. Together, the two main trials included nearly 200 adults with PTSD (Mitchell and colleagues, 2021; Mitchell and colleagues, 2023). Everyone had the same therapy, including preparation and integration sessions, and half had MDMA while the others had a dummy pill. Both groups improved. The groups who had MDMA improved more.

An Australian review looked at 14 earlier reviews of MDMA-assisted therapy for PTSD, which covered 20 studies (Yong and colleagues, 2025). The reviews found MDMA-assisted therapy improved PTSD more than the same therapy without MDMA. Where reviewers rated how confident anyone could be in that finding, they rated it low or very low, mainly because of weaknesses in how the studies were run. Short-lived side effects were more common with MDMA. Side effects often weren’t recorded systematically, some didn’t match between the published papers and the trial registers, and there’s no information yet on long-term safety.

In 2024, the United States medication regulator decided the evidence wasn’t enough to approve MDMA-assisted therapy for PTSD, and asked for another large trial (Lykos Therapeutics, 2024). The same year, a journal withdrew three earlier papers from the MDMA research (Psychopharmacology, 2024). It had learned of serious ethics breaches at one trial site, which the authors had known about and not disclosed.

Psilocybin. The largest published trial included 233 adults with depression that hadn’t improved with other treatment (Goodwin and colleagues, 2022). Each had a single session with psilocybin, at one of three doses, along with psychological support. The lowest dose was so small it served as the comparison. After three weeks, people on the highest dose had improved more than people on the smallest. Whether that improvement lasted to 12 weeks was less clear. Most people had side effects, including headache, nausea and dizziness. Some people in every group had thoughts of suicide, suicidal behaviour or self-harm. The researchers said larger and longer trials, including comparisons with existing treatments, are needed.

A review combined seven psilocybin trials, which together included 436 people with depression (Metaxa and Clarke, 2024). Psilocybin helped more than the comparison treatment, and the reviewers rated their confidence in that as moderate. The benefit looked bigger in people who had used psychedelics before. People in these trials can often tell whether they were given psilocybin or the comparison treatment. That makes it harder to know how much of the benefit comes from the drug itself and how much from expecting it to help.

The psychiatrists’ college describes the evidence as promising but limited, and supports a cautious Approach (modality) The kind of therapy someone uses, such as CBT or psychodynamic therapy. You'll also see it called a modality. More in the jargon decoder led by the evidence as it grows (Royal Australian and New Zealand College of Psychiatrists, FAQs).

Risks, and who it may not suit

The biggest risk is that the drugs can make you more sensitive to emotions (Royal Australian and New Zealand College of Psychiatrists, fact sheet). That can bring frightening experiences, including fear, panic or reliving trauma, and it can cause harm, including making things worse or raising the risk of suicide. Feeling stressed when the experience isn’t what you expected is also possible. Physical side effects are generally minor: anxiety, restlessness, tiredness, jaw clenching, headache and a temporary rise in blood pressure.

The psychiatrists’ college says the treatment may not suit you if you or a close family member has had psychosis, or if you’ve had mania. The same goes if you have a history of repeated violence towards others, or if you’ve recently made a suicide attempt that needed hospital care. Some health conditions, such as some liver conditions, can also make the treatment unsuitable. A psychiatrist works this out with you in a careful assessment. The treatment won’t be suitable for everyone who meets the rules for it, and it starts with Informed consent Agreeing to treatment once you understand what it involves, including what it costs and what stays private. You can ask questions before you agree. More in the jargon decoder : making sure you understand what’s involved, including the risks, before you agree to treatment (Royal Australian and New Zealand College of Psychiatrists, FAQs).

If you’re under 18, this treatment isn’t something you can get, and the research it’s based on was all on adults.

What it costs, and how people get it

Because the medications aren’t approved, they can’t be listed on the Pharmaceutical Benefits Scheme (Royal Australian and New Zealand College of Psychiatrists, FAQs). Appointments with the psychiatrist may attract a Medicare Australia's public health insurance scheme. For mental health, it gives rebates on sessions with psychologists and some other professionals, usually through a Mental Health Treatment Plan. More in the jargon decoder Rebate The amount Medicare pays back towards a session. It comes back to you after you've paid, so what you pay yourself is the fee minus the rebate. More in the jargon decoder , but that’s a very small part of the total (Royal Australian and New Zealand College of Psychiatrists, fact sheet).

In May 2026, the regulator said about 40 psychiatrists held approval to prescribe both medications, and that about 164 people had had MDMA-assisted therapy and 74 had had psilocybin therapy outside research trials (ABC News, 2026). At one clinic, a course of MDMA-assisted therapy cost about $30,000, and psilocybin therapy about $20,000.

The Department of Veterans’ Affairs can fund psychedelic-assisted therapy for some eligible veterans who have tried several standard treatments without success and who meet strict clinical requirements (Department of Veterans’ Affairs). Only the authorised psychiatrist can apply for the funding, and treatment you’ve already paid for yourself can’t be refunded. The department describes psychedelic-assisted therapy as an emerging treatment that may have risks not yet known, and says it isn’t a first treatment for either condition. At least one private health insurer has funded it for some members, so it’s worth asking your insurer. Some people take part in research trials in Australia instead.

If you want to ask about psychedelic-assisted therapy, start with your GP (general practitioner) For most people, where getting help starts. A GP can write a Mental Health Treatment Plan, prescribe medication and refer you on, and some are trained to deliver a small number of structured therapy sessions themselves. More in the jargon decoder or a psychiatrist you already see. You need a GP Referral A letter from a GP, psychiatrist or paediatrician that you need for the Medicare rebate. You can see a psychologist without one if you pay the full fee. More in the jargon decoder to see a psychiatrist with a Medicare rebate. Who does what explains what a psychiatrist is trained to do.

Outside the medical system

Using psychedelics outside this pathway, even to treat yourself, is illegal in Australia (Royal Australian and New Zealand College of Psychiatrists, FAQs). Taking them yourself, or going to an underground retreat, is also very risky (Royal Australian and New Zealand College of Psychiatrists, fact sheet). There are very few safeguards and there may be no follow-up care. Many settings have nobody with medical skills to handle an emergency and are a long way from emergency services. Illegal drugs aren’t tested the way medications are, and can contain other substances or much more of the active drug than expected.

If other treatments haven’t helped

This isn’t a first treatment, and the treatments with the strongest evidence come first. What helps with PTSD covers those therapies for PTSD, and what helps with depression sets out the main treatments for depression. How therapy and medication work together covers what the research says about having both.

If therapy hasn’t helped yet, why therapy sometimes stops helping, and what each reason points to goes through the common reasons. If several treatments haven’t helped, a psychiatrist can go through all your options with you, including ones this page doesn’t cover.

With any treatment, how well you and your therapist work together matters a great deal. Why who you see matters more than what they do explains why.

If things are difficult right now, Lifeline is on 13 11 14, the Suicide Call Back Service is on 1300 659 467, and Kids Helpline is on 1800 55 1800 for anyone aged 5 to 25. In an emergency, call 000. Crisis and emergency support has the full list.

Where next

If you’re still working out whether you want therapy at all, what therapy actually is covers the basics. Would I benefit from therapy? starts from what you’d want to be different, rather than from whether things are bad enough.