Dispelling Myths About Psychedelics: In Conversation With Guy Goodwin, MD

CLINICAL CONVERSATIONS

In the ongoing phase 3 COMP006 trial, treatment with the psychedelic COMP360—a synthetic, proprietary formulation of psilocybin for managing treatment-resistant depression—led to a highly statistically significant reduction in symptom severity (P<0.001) and a clinically meaningful difference of -3.8 points in change on the Montgomery-Åsberg Depression Rating Scale (MADRS) score, successfully achieving the study’s primary endpoint.¹ Following this positive news, Psychiatric Times sat down for a conversation with Guy Goodwin, MD, the chief medical officer at Compass Pathways.² Goodwin provided insights not only into this trial, but how psychedelics are transforming the face of psychiatry as we know it.

Psychiatric Times: Could you talk to us about the success of COMP360 in phase 3 trials? Why this is such a huge achievement?

Guy Goodwin, MD: Yes, we announced that the second of our major phase 3 trials achieved a statistically significant effect at the primary endpoint. This is the third time that we have been able to demonstrate a clinically and statistically significant effect of COMP360 psilocybin in treatment-resistant depression. Essentially, that means we are in a position to get ready to submit an application to the FDA, and therefore, we hope we are on the way to some kind of approval later in the year.

PT: Can you talk about what differentiates COMP360 from other psychedelics?

Goodwin: Its properties are probably quite well known. It produces a strong, intense psychedelic experience that lasts for 3 to 4 hours and then wanes over a longer period, up to about 6 to 8 hours. The effects are difficult to sometimes describe, but they are often likened to being a sort of waking dream. Unlike an actual dream, where the detail can be a little imprecise, the detail may be super clear and the feelings may be extremely intense. Sometimes people describe this as having a sort of mystical quality. It is a very different sort of experience from talking to a therapist as an inwardly directed experience. It is something that the patients afterwards report having often been quite meaningful in itself, but also associated with a change in mood that may may be separate from the cognitive aspects of the experience—it is complicated.

It is also an immediate effect. Benefit is experienced so quickly, and we have now demonstrated that it is also a durable effect, which, of course, is perhaps almost the most important of the results that we announced the other week.

PT: Do you believe those effects are perhaps why it is uniquely posed to help patients with treatment-resistant depression?

Goodwin: We think so, because patients themselves certainly contrast the experience of taking psilocybin with the experience of taking conventional treatments and indeed, with the experience of conventional psychotherapy. We have done some in depth interviewing, particularly following our small study in posttraumatic stress disorder, where we dug in depth into what the patient experience was like and what their take-home messages were. It was very striking the way they described the effect, and very pleasing in that sense. We think that that uniqueness of the psychedelic experience is what drives the effect. But of course, we are not entirely sure how much it is the mental content, the understanding, and how much it is the effect on the brain that we know is also happening. I think it is fair to say, at the moment, we do not quite know where to place the emphasis, so we are very excited by the fact that we got the potential for 2 kinds of effect, and that seems to be the basis for the benefits we see in patients.

PT: Was there anything coming out of these phase 3 trials that surprised you?

Goodwin: First, the consistency of effect of the first administration surprised me. The trials are designed in a slightly different way. In the first study, we compared a single administration of 25 mg of psilocybin with inert placebo. The second trial, there are 2 administrations which are spaced at 3 weeks, comparing 25, 10, or 1 mg. What was very striking was the consistency of the effect of the first treatment between the 2 trials. That is quite unusual in psychiatry, and it argues for the quality of the studies. So that was, if not a surprise, a very pleasant finding.

Second is the durability. No one had studied, under double blind conditions, any antidepressant up to 26 weeks. We did that in the first of the studies that we have completed. That finding, maybe in hindsight, isn’t surprising, but I think we were surprised at how distinct the effect was and how validating it was, both of the design and also the treatment effect. It was persisting for so long after 26 weeks, and in addition, the placebo group were not showing responses, so they were clearly highly resistant to treatment. Again, that speaks to the authenticity of the actual study conduct.

PT: Is there anything specific you would like psychiatrists and mental health clinicians to know about COMP360 or perhaps psychedelics in general? Are there any myths you would like to dispel?

Goodwin: The most important message we want to get through is that this is a very acceptable treatment. There is a stigma attached to use of these drugs; there is a sense that decent, upstanding individuals should not want to engage with them. We find, in fact, that these drugs are very acceptable. Approximately 95% of the patients we are treating are naive to these drugs. They have not taken them before, so they're having them for the first time. And we're able to demonstrate, first of all, their efficacy, which is super, very important, but secondly also their tolerability, the fact that the side effects are very rapidly over within the vast majority, within 24 hours, and that for most people, it's a relatively comfortable experience. It's challenging in parts, but by and large, it's acceptable. And for example, in our trial, where there were two administrations of drug, very the majority of the patients, 90% of the patients, came back for the second treatment. That tells us that this is an acceptable treatment in the conditions that we provide, and those include careful preparation, a compliment on the day, so someone supports the patient on the day, and also a follow up appointments that take into account how the patient has experienced the day of a drug administration, and really takes account of any concerns that they may have at that point. And we think those that kind of support is also important to the safety of the experience, broadly speaking, going forward,

PT: In our February 2026 Special Report, which you chaired, you said that psychedelic drugs are poised to integrate into mainstream psychiatry. Do you believe that time is now?

Goodwin: We think the time is soon, though we cannot say now. It will be when the drugs are approved, and that is not in our hands. The question is, are we at the point in time where we will see an integration of the psychedelic experience into mainstream psychiatry? Yes—when these drugs are approved and when we are able to get them to the sites where these patients can be treated.

We are very encouraged by the rapid growth in the provision of interventional psychiatry sites. There is a sense of real excitement; there is going to be quite a major change in the way we think about treatments. These drugs really are different from what we currently have, and they are going to make a difference for a number of people. How we develop services and provide this treatment safely to patients, is, of course, going to be the big challenge that we look forward to helping the clinical services to solve.

PT: Anything else you would like to share?

Goodwin: We have tried to conduct all our studies to the highest possible standards and we are not looking for any kind of favors in terms of approval for these drugs. We want them to pass the highest possible tests that the FDA has devised for us, and we want to see them taken into practice carefully, thoughtfully, and used in a way that is of benefit to patients.

PT: Thank you!

Dr Goodwin is the chief medical officer at Compass Pathways, as well as an emeritus professor of psychiatry and a National Institute for Health Research emeritus senior investigator at the University of Oxford, UK.

References

1. Kuntz L. COMP360 psilocybin for treatment-resistant depression achieves primary endpoint in phase 3 trial. Psychiatric Times. February 17, 2026. https://www.psychiatrictimes.com/view/comp360-psilocybin-for-treatment-resistant-depression-achieves-primary-endpoint-in-phase-3-trial

2. Goodwin G. COMP360 for treatment-resistant depression: insights on new phase 3 trials from Guy Goodwin, MD. Psychiatric Times. March 12, 2026. https://www.psychiatrictimes.com/view/comp360-for-treatment-resistant-depression-insights-on-new-phase-3-trials-from-guy-goodwin-md