Nassir Ghaemi, MD, MPH, Shares What’s Not Exciting in Psychiatry—and What Would Be Exciting

CONFERENCE REPORTER

There are opportunities for improvement in psychiatry, according to Nassir Ghaemi, MD, MPH. Ghaemi, professor of psychiatry at Tufts University, shared his insights, disappointments, and hopes for the field in addition to advice for earlier career psychiatrists in an exclusive interview with Psychiatric Times at the 2025 American Psychiatric Association Annual Meeting in Los Angeles, California.

“I'm not excited about hallucinogens, so-called psychedelics¹ that everyone thinks are so great,” he told Psychiatric Times. “They're just more symptomatic drugs, may you give short-term benefits like aspirin for a fever or Tylenol for a headache. We already have 50 drugs like that, and even if they're a little better, it's just super Tylenol, super aspirin.”

Instead, Ghaemi would like to see interventions that better target the prevention of episodes and improve the course of illness, especially in mood disorders and schizophrenia, he said. “I think that's what we need,” he told Psychiatric Times. “That's what I would be excited about if people were to do that.”

Ghaemi explained there are “a few small companies looking at some things that way, but the majority of the work is not along those lines.”

The prospect of another version of the DSM² also does not excite Ghaemi. “I think the problem with DSM is that it may be reliable, meaning we can agree on terms, but it's not proven valid, which means it hasn't been proven that these terms are accurate in terms of reality,” he said.

“It's a problem, then, for rese arch when you use invalid concepts,” Ghaemi added. “You don't get positive studies and genetics or imaging or pharmacology… If you're using invalid diagnoses, then all these drug treatments that are symptomatic anyway don't work out as well.”

To early career clinicians, Ghaemi offered personal and professional advice. Key, he said, us not to undervalue yourself. “Early career psychiatrists tend to take jobs that are offered them a little too quickly, and they often can get either better positions or better offers. So I would say you should value how much you're worth after all this training and get a good job. And, if it's not good enough, get a different one,” Ghaemi told Psychiatric Times.

On an intellectual level, Ghaemi suggested early career clinicians should avoid believing everything they have been taught. “There's an old saying in medicine that half of what we know is true and half is false. We just don't know which half,” he said.

“And that's the course of a psychiatric education, Ghaemi added. “You get taught a lot, you graduate, you think you know a lot, but half of what you believe is false, you just don't know which half.”

“So don't believe everything that you think you know, and be prepared to learn more and to give up some of your cherished ideas if you can,” he said.

References

1.MacIntyre MR, Nair M, Bursztajn HJ. Ketamine and Psychedelics: The Journey From Magical Mystery to Informed Consent. Psychiatric Times. 2023;40(8):22-25.

2. Morehead D. The DSM: Diagnostic manual or diabolical manipulation? Psychiatric Times. March 21, 2022. Accessed May 20, 2025. https://www.psychiatrictimes.com/view/the-dsm-diagnostic-manual-or-diabolical-manipulation

3. Pies RW. Poor DSM-5—So misunderstood. Psychiatric Times. March 23, 2021. Accessed May 20, 2025. https://www.psychiatrictimes.com/view/poor-dsm5-so-misunderstood