Any near-term FDA psychedelic action will favor ketamine-class agents with established blinding over MDMA/psilocybin.

The FDA (the US drug regulator) is more likely to approve new ketamine-based medicines than MDMA or magic mushroom treatments in the near future. The problem with MDMA and psilocybin studies is that participants usually know whether they got the real drug or a placebo — which makes the results harder to trust. Ketamine studies don't have that problem as badly, so they're easier for regulators to evaluate.

Oral prolonged-release ketamine RCTs offer the methodological rigor I require; MDMA's unblinding remains unresolved. I protect patients, not narratives.