Welcome to the November/December 2022 issue of the Journal of Clinical Psychopharmacology. There are many interesting, stimulating, and thought-provoking articles in this issue. I would like to highlight a few of them. On pages 581-588 Dr. Nicole Ledwos and colleagues offer a critical appraisal of current evidence for the antidepressant effects of classic psychedelics from contemporary clinical trials and highlight the pitfalls that should be addressed before clinical translation in a paper entitled “A Critical Appraisal of Evidence on the Efficacy and Safety of Serotonergic Psychedelic Drugs as Emerging Antidepressants: Mind the Evidence Gap". There is an accompanying Editorial by Associate Editor, Dr. Richard Balon, on pages 515-516 entitled, “Are Magic Mushrooms Really Magic? Psilocybin in the Treatment of Depression". The Senior Author of the paper, Dr. Ishrat Husain, joins Dr. Balon and Digital Editor, Dr. Julia Koretski, in an interesting podcast which can be found here.
In recent years, most of the large pharmaceutical companies have lost interest in the development of new medications to treat psychiatric illness. Although several smaller companies have filled the void, it is important to step back and analyze the models of how psychiatric medications have been developed in the past and whether new paradigms are warranted. The current issue contains 2 commentaries that propose different models for psychiatric medication development. On pages 518 to 522, Dr Nassir Ghaemi argues that structural changes are needed and that an alternative nonprofit drug discovery paradigm should be created. On pages 523 to 525, Dr William Potter presents a different point of view, arguing that better approaches to decreasing the risks involved with psychiatric drug development are needed, not new funding mechanisms. We would welcome your views on this subject. Please join the conversation at: https://www.linkedin.com/company/jcpjournal/
Finally, on pages 565-580, Leung and colleagues in a paper entitled, “The Modernization of Clozapine: A Recapitulation of the Past in the United States and the View Forward" discuss the history of how clozapine became FDA approved and how the frequency of safety warnings added to the FDA prescribing information may have contributed to fears about clozapine, as evidenced by numerous published survey studies. The authors discuss how the clozapine Risk Evaluation and Mitigation Strategy (REMS) program has been modified several times in the last decade, causing access and safety issues for patients. They also discuss that evidence suggests that the FDA REMS requirements for hematologic monitoring are too cumbersome, and that it may be possible to safely loosen requirements. The paper has an accompanying podcast which can found here. And as you will see, there are many other interesting Original Contributions and Letters to the Editor in the November/December, 2022 issue!
Anthony J. Rothschild, MD