Morning Rounds: March 25-31

With the conclusion of the 2026 meeting of the American Society for Clinical Psychopharmacology, review some of the expert interviews and latest news from the conference.

The First Panel of Psychiatric Experts Weighs in on Deprescribing at ASCP 2026

Joseph F. Goldberg, MD, convened a panel of ASCP Deprescribing Task Force experts in a special installment of Brain Trust: Conversations in Psychopharmacology, within the broader national debate following the MAHA Institute summit on mental health and the Department of Health and Human Services' stated plans to curb "psychiatric overprescribing." The panel emphasized that deprescribing must reflect judicious, intentional, clinically indicated decision-making by trained clinicians—not ideologically driven medication reduction. David W. Goodman, MD, highlighted that inaccurate diagnoses and inappropriate prescribing stem partly from a broad range of prescribers with varying degrees of training and background, while Roger S. McIntyre, MD, FRCPC, noted an ongoing supply-and-demand mismatch in mental health services that exacerbates treatment complexity.

Phase 3 Program Investigating COMP360 Psilocybin for Treatment-Resistant Depression: Breaking Poster Data From the 2026 ASCP Annual Meeting

Compass Pathways presented late-breaking poster data on their phase 3 program investigating COMP360—a synthetic, proprietary psilocybin formulation—for treatment-resistant depression (TRD), reporting highly statistically significant and clinically meaningful improvements in Montgomery-Åsberg Depression Rating Scale (MADRS) scores across both the COMP005 and COMP006 trials. COMP360 is the first classic psychedelic to consistently achieve a highly statistically significant result and clinically meaningful effect, with a generally well-tolerated safety profile. Investigators noted that 2 treatment sessions generally produced superior outcomes compared to 1, though some patients experienced dramatic benefit from a single administration, and Compass Pathways has indicated plans to advance discussions with the FDA with the goal of submitting a new drug application.

ASCP 2026 Task Force Reaches International Consensus on Psychiatric Polypharmacy

A group of 60 international psychopharmacology experts—including clinical trialists, academic pharmacists, psychiatrists, and authors of prior practice guidelines—reached broad consensus on key principles of psychiatric polypharmacy via a Delphi process. A core finding was agreement that fewer medications are preferable when feasible, with the task force recommending that clinicians begin with monotherapy before considering combination strategies. This work represents one of the first organized international efforts to establish expert consensus standards around psychiatric polypharmacy, distinguishing clinically necessary multi-drug regimens from those that may be amenable to rationalization or reduction.

DT-120 for Generalized Anxiety: Addressing the Gap With Optimized LSD Pharmacotherapy

Definium Therapeutics presented detailed adverse event data from phase 1 and phase 2b studies of DT-120, a pharmaceutically optimized formulation of lysergic acid diethylamide (LSD), framing the presentation as an effort to provide clinicians and researchers a transparent, comprehensive account of the compound's safety profile. Phase 2b efficacy data showed that a single dose of DT-120 produced a 7.7-point separation from placebo on a generalized anxiety disorder (GAD) measure, with 48% of participants with moderate-to-severe GAD achieving full clinical remission at 12 weeks post-dose. Karlin situated the development program within a significant unmet clinical need, noting that no new pharmacologic agent has been approved for GAD in over 19 years and that the condition remains substantially underdiagnosed in clinical practice.

ASCP Consensus Recommendations Aim to Define When and How to Consider Deprescribing Stimulants in ADHD Care

The consensus statement identifies specific clinical scenarios in which deprescribing warrants consideration, organized into 3 categories: inadequate efficacy, associated harm, and misuse. David W. Goodman, MD, noted the availability of approved nonstimulant alternatives—including atomoxetine and viloxazine—and highlighted the anticipated arrival of additional nonstimulant options, underscoring the importance of individualized, evidence-based reassessment of stimulant continuation in adult ADHD care.