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• A sweeping executive order aims to fast-track psychedelic therapies, putting drugs like ibogaine in the national spotlight.
• The policy expands research funding, accelerates FDA review pathways, and opens access routes for patients with serious mental illness.
• The executive order explicitly calls out ibogaine therapy, despite limited research and serious questions about its safety profile.
• The move coincides with Trump’s recent call to reclassify medical cannabis as a less dangerous drug, marking major shifts in national policy around controlled substances.

President Trump signed an executive order aimed at expanding research and improving access to psychedelic drug therapies.

The April 18 order also aims to streamline and expedite the Food and Drug Administration’s approval process for certain high-priority treatments.

The Trump administration has touted the executive order as an important step toward addressing the nation’s mental health crisis, especially among U.S. veterans, who bear an outsized share of that burden.

A diverse coalition, including psychedelic research organizations, medical professionals, veterans groups, and podcaster Joe Rogan, has publicly celebrated the decision.

The order also allocates $50 million to support state-level psychedelic research. The shift in policy coincides with Trump’s recent move to reclassify medical cannabis as a less dangerous drug.

Matthew Johnson, PhD, professor of psychiatry and behavioral sciences at Johns Hopkins University, called the decision “welcome news,” adding that it is “building upon decades of science.”

Psychedelics are a class of drugs that act on the body’s serotonin system. They can produce well-known effects, including changes to visual perception, hallucinations, an altered sense of self, and feelings of insight or connection. Primary examples of psychedelics include LSD, psilocybin (“magic mushrooms”), and DMT.

The President’s executive order is one of the boldest federal actions on psychedelic drugs to date.

However, it is also being met with caution by some experts who expressed concern that expedited FDA approval of experimental therapies could be harmful to patients.

“It’s important to explore the use of psychedelics to treat [hard-to-treat] disorders like PTSD, that’s completely reasonable,” said Richard Friedman, MD, psychiatrist and director of the Psychopharmacology Clinic at Weill Cornell Medicine.

“What we don’t want to do is speed up the testing and evaluation of drugs if it means that we’re giving short shrift to the rigorous analysis of safety,” Friedman told Healthline.

Trump’s executive order is intended to target “the burden of suicide and serious mental illness rates in Ameica” through a number of levers involving research, access, and FDA review.

Here are the main points:

Breakthrough Therapy is an expanded Fast Track designation intended to expedite the development of drugs that have shown early clinical evidence of substantial improvement over existing therapies.

The voucher program is designed to shorten the FDA’s review period for such drugs; a process that might typically take six months or more could be reduced to 1 or 2 months.

Taken together, these two programs could significantly accelerate the development and approval of high-priority psychedelic therapies with promising clinical data.

Next, the order seeks to expand psychedelic research by allocating $50 million through the Advanced Research Projects Agency for Health (ARPA-H) to match state investments in psychedelic research programs. It also requires collaboration among the FDA, the Department of Health and Human Services (HHS), the Department of Veterans Affairs, and the private sector to increase interest and participation in psychedelic research clinical trials.

For patients, the executive order emphasizes the use of the Right to Try Act. This federal law allows eligible patients with life-threatening conditions to access investigational drugs outside of clinical trials.

A White House fact sheet explicitly includes experimental psychedelic therapies within the scope of the Right to Try Act, so long as they “have met basic safety requirements.”

While psychedelic therapy drugs, including psilocybin, MDMA, and ibogaine, all remain illegal Schedule I drugs, the executive order preemptively addresses potential rescheduling and legality based on therapeutic potential.

According to the White House, the order will direct the Attorney General of the United States to prepare for the rescheduling of specific drugs “as soon as possible,” following the successful completion of Phase 3 clinical trials.

“In most places, psychedelic possession is still a felony. The drug war on psychedelics is not over,” Johnson said.

Then there’s the issue of one drug in particular, the only one specifically named in the executive order: ibogaine.

Ibogaine is a naturally occurring psychoactive compound derived from the roots of the Tabernanthe iboga, a shrub native to Central Africa.

Ibogaine has become a cause célèbre among veteran groups for its supposedly transformative effects on those who live with PTSD and substance use disorder.

“Many of these individuals have essentially made it their life’s mission to send their fellow vets down [to Mexico] to get access to ibogaine clinics and treatment, as well as sowing the seeds in the United States to kind of move things along so we can get that approved here,” Johnson said.

Prominent individuals, including former Texas Governor Rick Perry and Robert O’Neill, the former Navy SEAL who killed Osama Bin Laden, have become outspoken supporters of ibogaine therapy. Then there’s Joe Rogan, the most widely listened-to podcaster in the United States and a noted psychedelic advocate, who has expressed support for ibogaine therapy.

The field is also moving forward in other domains of mental health. In perhaps the most high-profile study on ibogaine to date, researchers at Stanford found that ibogaine therapy had profound effects on PTSD, depression, and anxiety symptoms in U.S. combat veterans with traumatic brain injury (TBI).

The treatment had an immediate impact on mood and function in several domains of mental health. The average disability rating of the veterans prior to treatment was more than 30, but one month after treatment, it had dropped to just 5.1, a score that no longer indicated disability.

Other areas improved too; veterans experienced noticeable improvements in depression (87% reduction), PTSD symptoms (88% reduction), and anxiety (81%) reduction.

However, the trial was small — just 30 participants. While there were no serious adverse effects in that trial, the safety profile of ibogaine is a serious red flag for some in the field.

The wrinkle, according to experts, is that despite full-throated support from many in Trump’s circle, research on the drug remains significantly more limited than on other psychedelic therapies. There are serious concerns about its safety profile as well.

“In this field, in terms of FDA-approved trials, there’s been far more work and more advanced-stage work with psilocybin. And you could say the same thing for MDMA. Ibogaine is at a very different stage, in part because it’s been a more difficult challenge to get funding for the research and to get approval because it does have some additional safety concerns,” Johnson said.

Ibogaine, which is not a classic psychedelic but rather an atypical one that acts on multiple systems in the body, including opioid receptors, has been dogged by safety concerns.

“It is probably the most dangerous of all psychedelic-like compounds,” Friedman said. “Ibogaine is well known to have cardiotoxicity, which is not part of the public conversation, and that worries me.”

He points out that while its safety profile has been well documented, its therapeutic value has not.

“It’s not clear that ibogaine has distinctly advantageous pharmacologic benefits that classic psychedelics that are safer have,” he said.

Johnson, on the other hand, is generally more supportive of continued research despite other psychedelics being further along in the approval pipeline.

“All of these substances have been understudied,” he said. “It’s still an open question whether there’s something really special about ibogaine, but I’m very open to it.”

Set against the backdrop of the U.S. mental health crisis — especially among veterans, who have significantly higher rates of suicide, substance use disorders, and other mental health conditions than civilian populations — the Trump administration’s support for ibogaine suggests a willingness to accept potential risks.

Others, however, say that the focus on ibogaine in particular is both simplistic and dangerous:

“[Veterans] need more than just a magic molecule. They need an entire package of psychiatric treatment that includes empirically tested psychotherapies,” Friedman said.

“Anyone who knows anything about ibogaine would say pushing it as the first treatment to study is worrisome,” he added.

• A recent study found that semaglutide medications, such as Ozempic, may better preserve lean body mass than tirzepatide medications, such as Mounjaro.
• This may be due in part to tirzepatide leading to more significant weight loss.
• The findings show that maintaining a strength-training routine may help reduce muscle loss when using GLP-1s.

GLP-1 drugs have exploded in popularity due to their ability to promote significant weight loss. This class of medications has helped transform the way healthcare professionals treat obesity.

Semaglutide medications, such as Ozempic or Wegovy, and tirzepatide medications, such as Mounjaro and Zepbound, are the most popular GLP-1 drugs for weight loss.

A study recently published in medRxiv has shown that while tirzepatide appears to lead to greater weight loss, there may be a trade-off of a higher loss of lean body mass than semaglutide.

Lean body mass includes muscle, connective tissue, and other essential components that support metabolism, strength, and overall physical function.

This study is a preprint and has not yet been peer-reviewed in a scientific journal, but here’s what the researchers found.

The researchers measured each participant’s lean body mass before and after beginning their first prescription of either semaglutide or tirzepatide. They found that those on tirzepatide consistently showed a greater loss of lean body mass.

People on tirzepatide lost about 1.1% more lean body mass than those using semaglutide in the first 3 months of using the medications. This increased to 2% more lean body mass loss by 12 months.

“This finding is not entirely surprising. Tirzepatide is generally more potent than semaglutide, and with greater overall weight loss, you often see a higher degree of lean mass loss as well,” said Jeffrey Lee, MD, double board certified plastic surgeon and founder of JL Plastic Surgery, who also prescribes GLP-1s. Lee was not involved in the study.

“In other words, the more aggressive the weight loss, the greater the likelihood that some of that loss includes muscle, not just fat,” Lee told Healthline.

The study emphasizes the importance of physical activity while taking GLP-1s.

Lee agreed. “Exercise (particularly strength training) plays a critical role in preserving lean muscle mass while on GLP-1 medications,” he said.

“I emphasize to my patients that both adequate protein intake and exercise are essential for preserving muscle. Both aerobic exercise and resistance training are highly beneficial,” added Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA. Ali wasn’t involved in the study.

Lee noted that resistance training signals the body to maintain muscle, even in a calorie deficit, and should be a core part of any weight loss plan using GLP-1 drugs.

Ali emphasized that adequate protein intake is also an important factor in supporting muscle preservation.

“Just as important is the pace of weight loss — slower, more gradual weight reduction tends to better preserve lean mass compared to rapid weight loss. This is why careful dose titration and ongoing monitoring are key when using GLP-1s,” Ali told Healthline.