Broad-spectrum micronutrients (BSM) are shown to improve mental health in randomised controlled trials. Robust positive effects are reported for emotional regulation, irritability and aggression. The effect sizes are modest, but comparable to cognitive–behavioural therapy and antidepressants. It is time to consider BSM as an informed choice when treating psychological distress.

Psychostimulant prescribing for individuals with comorbid attention-deficit hyperactivity disorder and schizophrenia spectrum disorders appears increasingly common despite limited evidence to guide the practice. This commentary highlights diagnostic and treatment challenges, critiques the current evidence base and argues for cautious prescribing, greater attention to substance use and the development of pragmatic clinical guidance.

This article explores the development of ethological research on aggression in late socialist Czechoslovakia, focusing on the work of pharmacologist Miloslav Kršiak (1939–2016) at the Czechoslovak Academy of Sciences. Drawing on archival records, personal correspondence, and institutional sources, it examines Kršiak’s international networks and shows how he sustained collaborations with colleagues abroad, as well as the strategies he adopted to navigate the political setting of the Normalization period. The study also demonstrates how ethological approaches were adapted to meet state socialist research priorities, particularly in the study of addiction to over-the-counter analgesics. It suggests that, although pharmacological research on aggression drew on a shared transnational repertoire of methods, its development and uses were shaped by the political structures, institutional routines, and public health priorities of late state socialism. By tracing both transnational exchange and local adaptation, the article contributes to a more differentiated history of Cold War science and to a broader understanding of how biological approaches to aggressive behaviour took shape in different post-war settings.

This article examines the development of antipsychotic medications in the period following the discovery of chlorpromazine in the mid-1950s up to the early 21st century. This era is defined by the identification of dopamine modulation as the central mechanism for treating psychosis, and by the development of a diversity of treatments around this mechanism. This strategy yielded a broad range of effective treatments and transformed clinical care; however, with the notable exception of clozapine, it failed to produce substantial gains in overall efficacy. Newer agents primarily differed in tolerability rather than therapeutic impact. Partial dopamine agonists refined, rather than replaced, this approach. As a result, the dopaminergic era offers a cautionary lesson for psychiatric drug development and underscores the need to move beyond dopamine-based models per se.

The recent introduction of the first non-dopaminergic antipsychotic marks a pivotal moment in psychopharmacology. This article revisits the development of chlorpromazine, the world’s first licensed antipsychotic, and considers what its history reveals about innovation in psychiatric drug discovery. Chlorpromazine emerged in the early 1950s as a treatment for surgical shock. Its subsequent recognition as an antipsychotic transformed psychiatric care, ushering in the modern era of psychopharmacology. This article argues that chlorpromazine’s success was not serendipitous: it depended on specific enabling conditions, including rigorous behavioural neuroscience, astute clinical observation across disciplines, close collaboration between clinicians and industry, and relatively agile regulatory frameworks. Understanding these factors is essential as psychiatry enters a new phase of drug development for the treatment of psychosis.

After more than seven decades in which antipsychotic drug development has been dominated by dopaminergic mechanisms, the recent emergence of a muscarinic receptor-based treatment represents a conceptual shift in the pharmacotherapy of psychosis. This article reviews the history and development of the first clinically effective non-dopaminergic antipsychotic, tracing its origins to unexpected behavioural effects observed during trials of muscarinic agonists developed for Alzheimer’s disease. Early studies of the muscarinic agonist xanomeline demonstrated antipsychotic efficacy, but were limited by poor tolerability due to peripheral cholinergic adverse effects. Subsequent progress depended on the dissociation of central therapeutic effects from peripheral side-effects, through the combination of xanomeline with the peripherally restricted muscarinic antagonist trospium. The development of this treatment highlights several broader lessons for psychiatric drug discovery, including the value of revisiting previously abandoned compounds, the benefits of leveraging existing human safety data on the importance of early-phase translational research and the role of innovative companies.

There is an urgent need for more effective and better-tolerated treatments for mental illness. Achieving this requires responsible collaboration between academia, healthcare professionals, industry and people with lived experience. However, regulatory and compliance frameworks can make early-stage, non-promotional collaboration difficult, particularly when discussions are exploratory and multidisciplinary. Drawing on experience from the UK Research and Innovation Mental Health Platform’s attempted collaboration with an international pharmaceutical company, this article describes how engagement was delayed and constrained by uncertainty over regulatory interpretation, contractual requirements and differing compliance processes across jurisdictions. These barriers risk excluding people with lived experience, narrowing scientific dialogue and reducing opportunities to align innovation with patient priorities. Robust regulation remains essential to protect patients, maintain public trust and prevent inappropriate influence. However, frameworks should better distinguish promotional activity from transparent, pre-competitive scientific exchange enabling proportionate, inclusive and responsible early dialogue between academia, healthcare, industry and patient communities.

In response to the sustained decline in academic psychiatry posts and infrastructure across the UK, the Royal College of Psychiatrists’ Academic Strategy proposes seven strategic pillars to rebuild workforce capacity through collaboration and innovation, and argues for revitalising the discipline that is essential for scientific leadership, excellence and mental healthcare.

Psychedelics were used for centuries in healing and spiritual rituals, long before the mid-20th century when they became subjects of biomedical research. Although initial trials generated optimism, these were quickly overshadowed by sensationalist media coverage and political backlash. Following decades of inactivity, research on compounds including 3,4-methylenedioxymethamphetamine (MDMA) has resurged, along with the media attention. Investigating this growing interest, Bender et al employed a large-language model, validated against human raters, to analyse 25 years of media articles (2000–2025), quantifying trends in sentiment towards psychedelic therapies. Findings showed a dramatic increase in coverage, with positive sentiment peaking in 2020 followed by a significant decline from 2024, coinciding with the U.S. Food and Drug Administration’s decision not to approve MDMA-assisted therapy for post-traumatic stress disorder, and echoing the dynamics of the 1960s. The authors emphasise that sustained progress in the field will require reliance on scientific evidence to advance therapeutic applications.