Psychedelics, Ketamine, and Next-Gen Approaches to Depression and PTSD

Psychedelics, ketamine, and innovative clinical tools are transforming the treatment landscape for depression and PTSD. Alan Ogden explores these next-generation therapies with Dr. Talia Cohen-Salal, CEO of NeuroCare, highlighting how advances in matching patients to the right treatments could upend conventional approaches and offer hope to those for whom standard protocols have fallen short.

Psychedelics and Novel Treatments: An Evolving Frontier

The mental health field is buzzing with excitement (and, frankly, a healthy dose of skepticism) about the impact of novel compounds. In the podcast, Dr. Cohen-Salal shared how NeuroCare is turning traditional protocols for depression and PTSD on their heads—not just tweaking what’s already out there, but re-thinking how we match people to treatments.

The premise, as Dr. Cohen-Salal explained, is “matching the right drug to the right patient instead of a patient trying to get better at the drug that isn’t suited to their biology.”

Here’s what NeuroCare is doing differently: For each patient, they take a simple blood draw, convert those blood cells into stem cells, and then into neurons. This creates a “model of the brain of that individual patient.” Instead of subjecting a person to months (or years) of trial and error with different antidepressants, researchers can test those medications directly on the patient’s neurons in a dish. The aim, as Dr. Cohen-Salal put it, is to “take that period of trial and error out of the patient and into the lab where it belongs.”

I, Alan, find this step nothing short of revolutionary for mental health. As I shared in the episode, during my pharmacy years I’d see patients returning with half-full bottles, frustrated with ineffective or intolerable antidepressants. Taking the guesswork out of the equation has obvious appeal, especially for stubborn depression and complex PTSD cases.

Precision, Pharmacogenomics, and the Patient Experience

It doesn’t stop with brain models. NeuroCare couples the neuronal readout with pharmacogenomics: “We also give that report together with the neuronal readout, which allows you to combine not just which drug is best, but also help understand how your lipid metabolism enzymes are going to process those drugs as well,” Dr. Cohen-Salal shared. In real terms, this means the report predicts drug effectiveness and helps flag potential side effects or problems with drug metabolism—core issues in psychiatric care.

Ketamines, Psychedelics, and the Next Wave of Clinical Trials

If you’ve read the headlines, you know the world’s watching ketamine and psychedelics for their rapid-acting effects on depression—sometimes where conventional treatments have failed. According to Dr. Cohen-Salal, their platform has welcomed these new compounds:

“Through PharmaCare, we’ve partnered with different companies working in the psychedelics base, working with ketamine and some of those new new new compounds that are coming onto the market and already launched on the market with Spravato.”

Spravato, just to clarify, is a nasal spray form of esketamine—a close cousin to classic ketamine—already FDA approved for certain depression cases. What excites me is that the NeuroCare platform can test such agents directly on patient-derived neurons. As Dr. Cohen-Salal explained, this means those struggling with treatment-resistant depression or PTSD may soon have more personal, scientifically grounded options based on how their unique brain actually responds to these next-gen drugs.

Psychedelic Research in Practice

Our discussion covered the evolving regulatory climate, too. As I noted, in Canada there’s been a surge of research—especially with psilocybin—and the regulatory landscape around cannabinoids has loosened significantly (though it’s since been re-tightened to curb misuse). Dr. Cohen-Salal pointed out that NeuroCare is ready to bring in new compounds to their test platform as soon as they earn a regulatory green light. So, psychedelics for depression and PTSD aren’t just abstract future hopes; they’re part of pragmatic, near-term research pipelines right now.

Comorbid Conditions: Complexity Is the Norm, Not the Exception

Depression rarely travels alone. In North America, the need for effective treatments is enormous. I shared in the episode, “I read this … that close to 60 percent of females in America, that includes Canada, the United States, had been on some sort of either anti-anxiety medication or something for depression, but some something to do with the challenge in their cognitive abilities.” While Dr. Cohen-Salal clarified that her experience aligns more with around 25 percent of the population having a depressive episode at some point, it’s clear these conditions are deeply prevalent. She highlighted: “It’s twice as prevalent in women as it is in men … in men, it’s actually more likely to cause suicide.”

Depression, PTSD, and Overlapping Treatments

Dr. Cohen-Salal made clear that depression and PTSD can’t be viewed in isolation, especially as there’s therapeutic crossover. Many antidepressants serve double duty, prescribed both for traditional depressive symptoms and for PTSD-related distress. NeuroCare’s clinical trials, while initially validated for depression, are now reaching into PTSD as well. “We have collaborations here starting … to do clinical trials in PTSD. And some physicians are choosing to use this off label,” she noted. For patients, this means hope that emerging treatments, especially those grounded in patient-specific biology, may soon extend to trauma-related disorders.

Brain Models: Accounting for Glial, Neuronal, and Immune Factors

One question I (Alan) raised was about brain cell types. Having personally been focused on optimizing brain detoxification after an injury—including working to boost glutathione in glial cells—I was reassured to hear that NeuroCare’s models incorporate a diversity of cell types. As Dr. Cohen-Salal answered, “We do have both the glial cells, the immune kind of response that might be happening locally, as well as the normal neuronal populations, both positive inhibitory and excitatory neurons.” This means the impact of novel drugs on all major brain cell subtypes (not just neurons) is being registered.

Mental Health, Genetics, and the Importance of Individual Biology

My own functional genetics approach aligns with the deep individualization that’s becoming possible. For example, I’m always looking at APOE variations—especially APOE4 and its relationship to cognitive function—and how diet and lifestyle can be fine-tuned. As I explained in the episode, we’ll soon be adding pharmacogenetics to our own LiveYourDNA protocols, though, as I say, “certainly not to the extent of the protocol that you’re doing,” speaking to NeuroCare’s advanced approach.

Beyond Medication: Metabolism, Hormones, and Broader Health Patterns

Dr. Cohen-Salal emphasized that the test includes not just the “most commonly prescribed FDA approved drugs for depression and indication,” but also considers the patient’s metabolic processing. This means factors like lipid metabolism can be identified as potential pitfalls. As I asked in the chat, there are broader physiological trends—like the “reduction quite a bit earlier in testosterone levels in young men” and “disruptions in women’s hormone panels at an earlier age than before”—which can influence mental health as much as, if not more than, the choice of medication. While NeuroCare’s main protocol doesn’t currently focus on hormones, both Dr. Cohen-Salal and I agreed that sleep, stress, and other lifestyle factors are critical.

Regulation, Accessibility, and the Path Forward

The logistics of accessing cutting-edge mental health diagnostics and care is another hurdle. I asked if Canadians could participate, for example, and Dr. Cohen-Salal clarified: “We are regulatory approved in the United States. So, yeah, you would have to come to the United States to do that, to do the test for now.” Sending blood samples across borders isn’t straightforward—and approval in the country where the blood is drawn remains essential for now.

But with ongoing regulatory changes and growing international research in psychedelics and related compounds for depression and PTSD, that may change in the not-too-distant future.

Conclusion: Personalized Care on the Horizon

In summary, the future of depression and PTSD care is looking radically more personal. As I discussed with Dr. Cohen-Salal, the ability to test traditional antidepressants, novel drugs like Spravato, and even psychedelic compounds directly on a patient’s own lab-grown neurons stands to transform treatment from guesswork to precision. At the same time, genetics, hormone trends, and the interplay of brain cell types inform a new depth of understanding.

Stay tuned—as these breakthroughs move from clinical trials to actual patient care, your questions and lived experiences are more important than ever. Curious how your own genetics fit into this rapidly changing scene? Explore our resources on functional genetics and personalized mental health, and don’t hesitate to reach out for more information.

Until next time, keep looking out for yourself and your loved ones—and remember, individualized mental health care isn’t science fiction anymore; it’s happening now.