Ethical concerns and lack of data leave adolescent psychedelic therapy largely unexplored

There is a growing interest within the medical community in the use of psychedelic therapies to treat conditions ranging from depression and PTSD to anxiety and eating disorders. New research led by McGill University and published in The Lancet Child & Adolescent Health has found that while adolescents under 18 might also benefit from these types of treatments, they have been excluded from current clinical research in the field due to ethical, legal and regulatory concerns.

The lack of clinical evidence makes it difficult for clinicians and adolescent patients to make informed decisions with respect to the use of such therapies for this age group.

The researchers found that of the 1,600 psychedelics studies registered or published between January 2000 and April 2025, only four had proposed including participants under 18. None of these studies have been completed or published.

Current medical treatments for mental illness not always effective

The researchers point out that many young people with mental illness don’t respond to standard treatments, and some will face lifelong impairment, or worse. A 2020 review in the Journal of Child Psychology & Psychiatry found that approximately one in three adolescents with major depressive disorder will not improve with standard care involving antidepressant medication and psychotherapy.

They also warn that many clinicians already prescribe psychiatric drugs to adolescents without age-specific evidence from clinical trials. The use of MDMA- and psilocybin-assisted therapies may follow the same path unless research is completed before they are made clinically available, they argue.

“As professionals in the fields of psychedelic therapy and adolescent mental health, we face an ethical imperative not to ignore adolescents, but instead to anticipate risks, test safeguards, and develop clinical knowledge in the field,” said lead author Khaleel Rajwani, a Ph.D. candidate at the McGill University Department of Philosophy who studies ethical issues in psychiatry and mental health.

The authors note that psychedelic therapy at earlier ages may carry heightened risks, including impacts on cognitive and social development and potentially higher rates of adverse experiences compared to adults. However, they emphasize that these risks, which can vary with age and context, must be weighed against the serious consequences of untreated or treatment-resistant mental illness.

The importance of proceeding with caution

The team calls for initial research in the field to proceed with great caution, in populations with the greatest foreseeable risk-benefit ratio, with robust consent processes in place.

“We currently have essentially no clinical evidence about how psychedelic therapies might affect adolescents,” said senior author Brian Earp, an Associate Professor at the Center for Biomedical Ethics at the National University of Singapore. “Cautious and ethically responsible research can help us move beyond speculation and begin to assess whether emerging psychedelic therapies can benefit adolescents with unmet needs.”