Psychedelic Treatments in Adolescent Psychopharmacology: Considering Safety,Ethics,and Scientific Rigor

Abstract

Interest in psychedelic therapies for adults is rapidly growing, with substances like 3,4-methylenedioxymethamphetamine for posttraumatic stress disorder, psilocybin for treatment-resistant depression, and lysergic acid diethylamide for generalized anxiety disorder showing promise. However, research on these therapies in children and adolescents is limited, with no recent trials. Despite this lack of scientific exploration, adolescents may still experiment with these substances for both recreational and therapeutic purposes as accessibility continues to increase. This raises significant concerns, as adolescents are a vulnerable population requiring heightened caution and safety measures. Therefore, we advocate for structured, safe, and well-controlled exploration of psychedelic therapies in adolescents.

Imminent Need for Novel Treatments in Adolescent Mental Health

The United States is in the midst of a youth mental health crisis, with psychiatric illnesses as the leading cause of death and disability in children and adolescents (AHRQ, 2022). In 2021, 3.7 million adolescents in the United States experienced at least one major depressive episode with severe impairment, 1.5% of adolescents experienced severe impairment due to posttraumatic stress disorder (PTSD), and 1.1% of adolescents had generalized anxiety disorder (GAD), with 32% of that subset suffering severe impairment (Kessler et al., 2012b, 2012a; NIMH, 2022). Approximately 40% of teens with major depressive disorder find their symptoms persist even after receiving first-line, evidence-based treatment (Dwyer et al., 2020). This underscores the need for not only increased access to care but also the exploration of more effective psychotherapeutic and pharmacologic treatments. One promising emerging treatment modality is psychedelic therapy, particularly the use of psilocybin for depression, lysergic acid diethylamide (LSD) for GAD, and 3,4-methylenedioxymethamphetamine (MDMA) for PTSD.

Efficacy of MDMA/Psilocybin/LSD Therapy in Adults

There has been a notable growth in recent studies exploring classical psychedelics (such as psilocybin, LSD, and ayahuasca) and empathogens/entactogens (such as MDMA) for the treatment of psychiatric disorders. A 2020 review in the American Journal of Psychiatry identified 14 “well-designed clinical trials” investigating LSD, MDMA, psilocybin, and ayahuasca (Reiff et al., 2020). Currently, the United States Food and Drug Administration (FDA) has granted “breakthrough therapy” designation for MDMA for PTSD, LSD for GAD, and psilocybin for treatment-resistant depression and major depressive disorder (Compass Pathways, 2018; MindMed, 2024; Reiff et al., 2020; Usona Institute, 2019). Given the advanced research status of these three compounds (Table 1), this discussion will focus on their current investigations and proposed prioritization for research in adolescents.

Table 1.

Summary of Existing Double-Blind Randomized Controlled Trials of Psychedelic Therapeutics

Compound	Study, year published	Design	Condition	Intervention	Control	Number of patients	Mean age patients	Primary outcome	Primary outcome result	Response rate (criteria)	Remission rate
Psilocybin	Carhart-Harris et al., 2021	Double-Blind, RCT	Moderate to severe MDD	2 doses (25 mg) psilocybin + daily placebo, psychological support	2 placebo-like (1 mg) doses psilocybin, daily escitalopram, psychological support	59	41.2	QIDS (change from baseline at 6 weeks)	Non-significant between group difference	Non-significant between group difference	57% psilocybin, 29% escitalopram
	Goodwin et al., 2022	Double-Blind, RCT	Treatment-resistant depression	Moderate (10 mg) or high (25 mg) dose psilocybin, psychological support	Placebo-like (1 mg) dose of psilocybin, psychological support	223	39.8	MADRS (change in baseline at 3 weeks)	−12 (25 mg), −7.9 (10 mg), −5.4 (1 mg)	37% (25 mg), 19% (10 mg), 18% (1 mg), (> 50% reduction from baseline)	29% (25 mg), 9% (10 mg), 8% (1 mg)
	von Rotz et al., 2023	Double-Blind, RCT	Major depressive disorder	Moderate dose (0.215 mg/kg) of psilocybin (e.g., 16 mg for 70 kg person), psychological support	Placebo, psychological support	52	36.8	MADRS (change in baseline at 2 weeks)	−13 in psilocybin, a significantly larger decrease than in placebo	58% in psilocybin, 15% in placebo. −13 on MADRS in psilocybin, (> 50% reduction from baseline)	54% psilocybin, 12% placebo
	Raison et al., 2023	Double-Blind, RCT	Major depressive disorder	High (25 mg) dose of psilocybin, psychological support	100 mg niacin, psychological support	104	41.1	Between-group difference on MADRS from baseline at 6 weeks	12.3 point greater decrease in MADRS scores in psilocybin than placebo	58% psilocybin vs. 20% niacin (> 50% reduction from baseline)	25% psilocybin, 9.1% placebo
MDMA	Mithoefer et al., 2011	Double-Blind, RCT	PTSD	125 mg MDMA, psychotherapy	Inactive placebo, psychotherapy	20	40.4	CAPS-IV (change from baseline at 4 days and 2 months following each experimental session)	−53.7 (125 mg MDMA), −20.5 (placebo)	83% (125 mg) vs. 25% (placebo). (> 30% reduction in baseline CAPS score)	83% (125 mg) vs. 25% (placebo)
	Oehen et al., 2013	Double-Blind, RCT	PTSD	125 mg MDMA, psychotherapy	25 mg MDMA (active placebo), psychotherapy	12	41.4	CAPS-IV (change from baseline to 3 weeks following the end of treatment/session 3)	−15.6 (125 mg MDMA), −3.2 (active control)	50% (125 mg) vs. 0% (active control) (> 15pt reduction in baseline CAPS score)	0% of either group in full remission at 3 week endpoint
	Ot’alora et al., 2018	Double-Blind, RCT	PTSD	75 mg, 125 mg MDMA, psychotherapy	40 mg MDMA (active placebo), psychotherapy	19	42	CAPS-IV (change from baseline to 1 month after 2nd experimental session)	−26.3 (125 mg MDMA), −24.4 (100 mg MDMA), −11.5 (active control)	50% (125 mg) vs. 55.6% (100 mg) vs. 16.7% (active control) (> 30% reduction in baseline CAPS score)	41.7% (125 mg) vs. 44.4% (100 mg) vs. 33.3% (active placebo)
	Mithoefer et al., 2018	Double-Blind, RCT	PTSD	75, and 125 mg MDMA, psychotherapy	30 mg MDMA (active control), psychotherapy	26	40	CAPS-IV (change from baseline to 1 month after 2nd experimental session)	−44.3 in 125 mg, −58.3 in 75 mg, −11.3 (active control)	100% (75 mg) vs. 67% (125 mg) vs. 29% (active control) (> 30% reduction in baseline CAPS score)	58% (125 mg) vs. 86% (75 mg) vs. 29% (30 mg)
	Mitchell et al., 2023	Double-Blind, RCT	PTSD	120 mg MDMA, psychotherapy	Inactive placebo, psychotherapy	91	41	CAPS-V (change from baseline to 18 weeks)	−23.7 (120 mg MDMA), 14.8 placebo	86.5% (120 mg) vs. 69% (placebo) (> 10 point reduction in CAPS-5 score)	71.2% (120 mg) vs. 47.6% (placebo)
LSD	MindMed, 2024	Double-Blind, RCT	GAD	200 ug LSD (MM120), 100, 50, and 25 ug	Inactive placebo	200		HAM-A (change from baseline to week 4)	−21.9 (100 ug MM120) vs. −14.2 (placebo)	65% (100 ug LSD)	48% (100 ug LSD)

RCT, randomized controlled trial; MDD, major depressive disorder; QIDS, quick inventory of depressive symptomatology; MADRS, montgomery-åsberg depression rating scale; MDMA, 3,4-methylenedioxymethamphetamine; PTSD, posttraumatic stress disorder; CAPS-IV, clinician-administered PTSD scale based on DSM-IV; CAPS-V, clinician-administered PTSD scale based on DSM-V; LSD, lysergic acid diethylamide; GAD, generalized anxiety disorder; HAM-A, hamilton anxiety rating scale.

Psilocybin, a “classical psychedelic” (5-HT_2A agonist), is currently being explored for indications ranging from alcohol use disorder to anorexia nervosa, obsessive-compulsive disorder (OCD), and major depressive disorder. The larger trials to date have focused on treatment-resistant depression and major depressive disorder. Clinical trials have demonstrated clinically significant and sustained reductions in depressive symptoms and functional disability without serious adverse events (Raison et al., 2023). Some studies have been critiqued with concerns focused on functional unblinding, inadequate assessment of adverse events, and short durations of follow-up (Aday et al., 2022; Breeksema et al., 2022). It is essential to address prior criticisms when designing future research in order to enhance its impact and validity (Raison et al., 2023). The largest Phase 2 trial to date included 104 participants randomized to receive either 25 mg psilocybin or 100 mg niacin (placebo), both with psychological support. This study found that psilocybin was associated with significantly decreased Montgomery–Asberg Depression Rating Scale (MADRS) scores compared with niacin (mean difference −12.3, p < 0.001) without serious treatment-emergent adverse events (Raison et al., 2023). Notably, the antidepressant effects have been shown to persist at least 12 months following treatment in most individuals, with 75% of patients in one study still exhibiting a treatment response at the 12-month mark (Gukasyan et al., 2022). Phase 3 trials are now underway to investigate psilocybin for major depressive disorder, with plans to follow participants for one year posttreatment to address concerns about the durability of response (NCT06308653).

Although MDMA is often grouped with other classical psychedelics such as psilocybin, it has characteristics of both a psychedelic and stimulant, and is often referred to as an “empathogen” or “entactogen.” MDMA has been studied most extensively for the treatment of severe PTSD, in conjunction with psychotherapy. A randomized, placebo-controlled Phase 3 clinical trial demonstrated that MDMA significantly reduced PTSD symptoms, even in individuals with severe forms of the disorder (Mitchell et al., 2023). In this trial, symptoms decreased by a mean of 23.7 points on the Clinician-Administered PTSD Scale for DSM-5 (CAPS-V) in 53 patients receiving MDMA, compared to a 14.8-point decrease in patients receiving inactive placebo with therapy. At the study endpoint, 71% of participants in the MDMA arm no longer met diagnostic criteria for PTSD, compared to 47.6% in the control group (Mitchell et al., 2023). Although this specific Phase 3 trial only extended to two months following therapy, a pooled analysis of long-term follow-ups from MDMA-assisted psychotherapy indicated that symptom improvement persisted for at least 12 months posttreatment (Jerome et al., 2020). Despite these promising results, the FDA recently rejected the new drug application for midomafetamine (MDMA capsule formulation), citing insufficient data on safety and efficacy. The primary concerns pertained to the durability of treatment effects, potential expectancy bias, and the role of psychotherapy [Psychopharmacologic Drugs Advisory Committee Meeting (PDAC), 2024]. Due to these concerns, the FDA has requested an additional Phase 3 trial to further evaluate the safety and efficacy of MDMA.

LSD, another classical psychedelic, has been proposed for the treatment of multiple psychiatric disorders (such as psychosomatic diseases, alcohol use disorder, and depression), however breakthrough status has been specifically granted for the treatment of GAD (Fuentes et al., 2019; MindMed, 2024). A Phase 2B clinical trial was completed at the end of 2023, investigating four different doses of LSD d-tartrate in 198 participants (NCT05407064). Although the full data from this study has not yet been published, the trial sponsors released information indicating that it met its primary and key secondary endpoints. The optimal dose in the trial (100 ug) resulted in a 7.7-point improvement on the Hamilton Anxiety rating scale (HAM-A) at week 12, with a 48% clinical remission rate at that time (MindMed, 2024). According to MindMed’s press release following the End-of-Phase 2 meeting with the FDA, initiation of the Phase 3 trials is scheduled for the second half of 2024 (MindMed, 2024).

Paucity of Existing Psychedelics Research in Adolescents

Despite major advances in psychedelic and empathogen research in adults, no therapeutic studies have been conducted in adolescents since the 1960s. To the best of our knowledge, there are no completed adolescent clinical trials, with only one registered on Clinicaltrials.gov, set to begin in July 2025, examining treatment-resistant PTSD (Jeffrey, 2024).

Following the synthesis of LSD in 1938, psychedelics were viewed by some scientists and physicians as a potential breakthrough. LSD was marketed as “Delysid” and psilocybin as “Indocybin,” and throughout the 1950s and 1960s, hundreds of papers were published, exploring the effects of psychedelics on various mental health conditions, including schizophrenia, autism, alcohol use disorder, OCD, and depression (Rucker et al., 2018). Some studies included children, though these often lacked controlled designs or statistical analyses. Much of this research focused on children diagnosed with what was then termed “autistic schizophrenia” (Rhead, 1977). Many of the studies were small case studies, lacked control groups, and primarily used LSD. While some findings suggested potential benefits, such as “augmentation of language, disinhibition of play, greater affective contact, disappearance of self-destructive behaviors,” other results were inconclusive (Rhead, 1977). Yet even within the context of poorly controlled and ethically ambiguous research, there were indications of “relative safety and therapeutic promise” with minimal adverse effects, and “the worst outcome being that the children did not improve” (Rhead, 1977). However, no systematic research has yet identified the neurobiological risks for adolescents undergoing psychedelic treatment. Cautious and rigorous study in a medical environment is critical to address unanswered questions.

By the late 1960s, societal and political pressures led to the classification of psychedelics as Schedule I drugs at the 1967 UN Convention on Drugs (Rucker et al., 2018). Since then, there have been no studies on psychedelics as therapeutics in adolescents. However, psychedelics have been explored outside of therapeutic contexts, most notably in a retrospective analysis of 16,255 individuals from the Swedish Twin Registry. This study suggested that psychedelic use may be linked to lower rates of psychotic symptoms but also found an increased risk of manic symptoms in individuals genetically predisposed to schizophrenia or bipolar I disorder (Simonsson et al., 2024).

Need for Structured, Safe, and Ethical Research

Clinical research on psychedelics was effectively halted in the late 1960s due to governmental regulations, which were influenced by biased media coverage, political factors, and ethical concerns. This occurred amid utopian thinking and unregulated clinical approaches. Well-designed and systematic research can mitigate the risk of this occurring again and can allow us to continue to make advances in this field (Yaden et al., 2021).

One of the chief reasons for the necessity of rigorous and systematic research is necessary for psychedelic therapeutics in any population is the strong influence of expectations and context (“set and setting”) on the psychedelic experience (Yaden et al., 2021). A well-controlled environment can enhance potential benefits, while an unsafe or uncontrolled environment could lead to significant harm (Yaden et al., 2021). Scientific open-label and clinical trial research is essential to establish safe and effective psychotherapeutic paradigms, ensuring that interventions are evidence-based and optimized for patient benefit.

Finally, there are lessons to learn from the increased availability of cannabis and ketamine as treatments for mental health disorders. Medical cannabis programs have expanded the range of treatable conditions to include tic disorders, PTSD, OCD, autism spectrum disorder, and Tourette syndrome in several states. A study analyzing popular ketamine treatment websites found that ketamine was being promoted not only for depression, but also for PTSD, chronic pain, Lyme disease, alcohol use disorder, and opioid withdrawal (Crane et al., 2023). In addition, 7/17 of the websites did not disclose any potential adverse effects in their advertisements, and 10 sites did not disclose that their services were for off-label uses of ketamine (Crane et al., 2023). The unregulated use and misinformation surrounding cannabis and ketamine highlight the need for scientific scrutiny in the investigation of psychedelic therapeutics to ensure safety and prevent adverse events secondary to unregulated use.

The official position of the American Psychiatric Association reflects the need for scientific scrutiny, stating there is currently insufficient evidence for the use of psychedelics for mental health treatment outside of research studies. The association endorses further research conducted “with the same scientific integrity and regulatory standards applied to other promising therapies in medicine,” emphasizing that treatments should be determined by “evidence in accordance with applicable regulatory standards and not by ballot initiatives or popular opinion” (Alpert et al., 2022).

Considerations for Psychedelic Research in Adolescents

Adolescence marks a significant neuroplastic period of brain maturation, often referred to as a “critical period,” where teens undergo significant development of higher-order cognitive abilities through structural and functional changes that facilitate the transition to a mature brain (Bara et al., 2021; Larsen and Luna, 2018). During this time, developments in higher-order cognitive processes such as impulse control, planning, and internally guided behavior become evident from both behavioral and neurobiological perspectives. Studies changes in gray matter distribution, white matter pathway integrity, and synapse proliferation, all pointing to significant functional and structural plasticity that extends through adolescence (Larsen and Luna, 2018; Selemon, 2013).

Due to this critical period in development, it is prudent to fully consider the potential impact of any substance (therapeutic or nontherapeutic) on the development of the mature brain. Emerging research on the impacts of cannabis on the developing brain has raised concerns regarding potential disruptions in synaptic plasticity, functional connectivity, and structural morphology (Bara et al., 2021, Blest-Hopley et al., 2020). A literature review published in the Journal of the American Academy of Child and Adolescent Psychiatry examined the impacts of cannabis exposure in adolescents, and concluded that there was a strong association between heavy use in early adolescence and poor cognitive and psychiatric outcomes in adulthood, though it was acknowledged that further research must be done before a causal effect can be drawn between cannabis exposure alone and negative impacts on the adolescent brain (Levine et al., 2017).

Contrary to the maladaptive changes to plasticity observed with cannabis exposure (Bara et al., 2021), psychedelics have been shown to induce rapid and sustaining plasticity in the brain (Vollenweider and Preller, 2020). Studies have suggested this could be the mechanism by which they produce a positive therapeutic effect (Vollenweider and Preller, 2020). The exact mechanisms by which these compounds act to promote plasticity both on the molecular and cortical network levels remain an active area of debate.

Though it is critical to be cautious about studying drugs that affect neural plasticity in adolescents, already characterized by high neuroplasticity, it is equally important to consider that maladaptive and inflexible changes in brain circuitry (which can be induced by adverse childhood experiences) are strongly associated with a heightened risk of depression and other mental disorders (Ho and King, 2021). In addition, early brain maturation and cognitive inflexibility have been documented in children with PTSD (Ho and King, 2021). These reductions in plasticity and cognitive flexibility may respond to treatments that enhance neural plasticity. Thus, psychedelic therapeutic agents may hold promise in restoring adolescent brains to a developmentally beneficial level of plasticity.

Development of studies in adolescents

There is significant concern that psychedelic therapeutics may have variable tolerability and safety profiles in adolescents. Previous experience shows that the tolerability of SSRIs differs across age groups, with children, adolescents, and adults experiencing varying side effect profiles and dose-responses. For example, side effects of “activation” (symptoms such as hyperactivity, insomnia, restlessness, and irritability) have been shown to be more common in children than adolescents, and more common in both children and adolescents than in adults (Reinblatt et al., 2019; Strawn et al., 2023). This suggests differences in susceptibility to various adverse events as one age, potentially due to metabolic differences (Reinblatt et al., 2019; Strawn et al., 2023).

Similarly, ketamine dosing requires age-specific adjustments, for both antidepressant and dissociative effects. An open-label trial of intravenous (IV) ketamine for adolescent treatment-resistant depression initially dosed participants based on ideal body weight, which has been suggested to be sufficient for adults, and found a response (defined by a 50% decrease in the Children’s Depression Rating Scale Revised [CDRS-R]) in only 5/13 participants. However, when dosing was modified to dosing based on actual body weight, 5/8 of those dosed with this regimen were responders (Cullen et al., 2018). Though this was a small study, differences in dose-response are well-documented in emergency medicine literature and guidelines for emergency department ketamine sedation, which suggest that pediatric patients require higher doses (1.5–2.0 mg/kg for pediatric patients compared to 1 mg/kg for adults), with no significant difference in dosing requirements between adolescents and children (Green et al., 2011, Kannikeswaran et al., 2016).

Like ketamine and SSRIs, psychedelics may exhibit differences in tolerability in adolescents, necessitating tailored dosing strategies and monitoring protocols. This may call for a return to Phase 2 open-label trials specifically exploring dose-response and side effects prior to advancement towards the size and scale of adult trials.

Future studies in adolescents must also consider genetic susceptibility to various conditions due to the risks posed to certain cohorts. This is demonstrated well in the cross-sectional adolescent twin study discussed above (Simonsson et al., 2024), which found that psychedelic use was associated with increased manic symptoms in individuals with genetic susceptibility to schizophrenia or bipolar I disorder. This finding underscores the importance of considering genetic factors and susceptibility when designing clinical trials. A detailed and careful family history is a critical component of screening adolescents for enrollment in psychedelic trials.

Overall, we suggest that studies in adolescents should first be limited to compounds most studied and understood in adults (MDMA, LSD, and psilocybin), focusing on patients suffering significant impairment despite conventional treatment with psychotherapy and pharmacology. Studies should determine the optimal doses for adolescents and monitor adverse events that may be more prevalent in this population. These points, as well as further considerations for study design and protocols in adolescent populations, are outlined in Table 2.

Table 2.

Essential Considerations for Designing Psychedelic Therapeutic Trials in Adolescents

Consideration	Key suggestions
Pediatric Pharmacokinetics/ Pharmacodynamics	Prioritize compounds with established safety profiles and efficacy from adult studies (psilocybin, MDMA, LSD). Consider developmental differences in pharmacokinetics and pharmacodynamics for dosing and protocol development for adolescent patients. Conduct Phase 2 trials with varying doses adjusted for weight and age to determine optimal dosing regimens, and perform dose-response studies to identify variations in tolerability and clinical effects.
Developmentally informed adjunctive psychotherapy or psychological support	Design treatment settings that prioritize safety and comfort for adolescent patients to increase the likelihood of a positive experience. Train facilitators and/ortherapists on how to create a supportive atmosphere that prioritizes physical and psychological comfort for adolescent patients. Perform ongoing quality assurance processes to assess and improve all aspects of the patient experience.
Informed assent and consent	Ensure patients have a comprehensive understanding of the compounds, research protocols, the potential benefits, risks, and unpredictable aspects of the experience. Tailor the explanations to the individual based on psychosocial and neurocognitive development. Facilitate separate discussions with adolescents and parents to ensure assent is given independently of parents’ perspectives, prior to a joint discussion. Maintain continuous communication throughout the trial period to ensure adolescents consistently provide informed assent, especially in long-term or multi-dosing studies.
Patient selection, family screening	Conduct a comprehensive family history assessment during enrollment to identify potential genetic predispositions to adverse effects. Consider genetic screening and our counseling for individuals with potential genetic susceptibility to schizophrenia or bipolar I disorder, as these individuals could be at higher risk of adverse events, such as increased manic symptoms (Simonsson et al., 2024).
Developmentally informed clinical targets	Select adolescents with treatment-resistant conditions according to a defined criterion for treatment resistance and conduct a comprehensive assessment of all prior treatment attempts. Consider the unpredictable nature of neuroplasticity during adolescence.
Adverse event monitoring	Implement a standardized reporting system for adverse events, with precise definitions of adverse events and clearly defined monitoring timelines. Utilize both subjective self-reporting and objective measures (such as clinical evaluations and vital signs) to monitor adverse effects. Conduct continuous safety monitoring to track adverse events associated with unregulated use.

MDMA, 3,4-methylenedioxymethamphetamine; LSD, lysergic acid diethylamide.

Conclusion

Despite promising results for psilocybin, LSD, and MDMA-based treatments in adults, research on psychedelics in adolescents remains scarce. Existing studies are limited to case reports from the mid-20th century. As psychedelics gain popularity in science and media, and with decriminalization efforts, adolescents are likely to encounter increased availability of MDMA and psilocybin. This underscores the need for safe, ethical, and rigorous research to establish clear guidelines on the safe and beneficial use of psychedelics in adolescents. Given the critical neuroplastic period of adolescence, it is essential to consider the impact of psychedelics on the developing brain. Research suggests psychedelics may induce beneficial plasticity, unlike the maladaptive effects of other substances such as cannabis; however, their use in adolescents requires careful consideration. Studies should prioritize compounds with established safety profiles in adults (MDMA, LSD, and psilocybin) and focus on determining appropriate dosing and monitoring adverse effects for adolescents.

Footnotes

Authors’ Contributions

All authors contributed to the preparation of the manuscript. The paper was conceptualized by Dr. Paul Croarkin, Isabella Sutherland, and Dr. Ming-Fen Ho. The first draft of this manuscript was written by Isabella Sutherland, and all authors contributed edits and commented on previous versions of the manuscript. All authors participated in revisions and read, edited, and approved the final manuscript.

Disclosure Statement

Dr. Croarkin has received research support from the National Institutes of Health (NIH), National Science Foundation (NSF), Brain and Behavior Research Foundation and the Mayo Clinic Foundation. Dr. Croarkin has received research support from Pfizer, Inc. He has received grant-in-kind equipment support from Neuronetics, Inc., and MagVenture, Inc. for investigator-initiated studies. He received grant-in-kind supplies and genotyping from Assurex Health, Inc. for an investigator-initiated study. He served as the principal investigator for a multicenter study funded by Neuronetics, Inc. and a site principal investigator for a study funded by NeoSync, Inc. Dr. Croarkin serves a site principal investigator for a study funded by Innosphere. Dr. Croarkin served as a paid consultant for Engrail Therapeutics, Meta Platforms, MindMed, Myriad Neuroscience, Sunovion, and Procter & Gamble Company. Dr. Croarkin is employed by Mayo Clinic. He receives compensation as the Editor-in-Chief for the Journal of Child and Adolescent Psychopharmacology. The other authors have no disclosures or conflicts of interest.

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