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Psilocybin for concussion: Monash opens a $1.5m MRFF trial

By Dr HB Lo, FACRRM 5 min read
Verdict Maybe — watch this

Monash University has opened enrolment for a $1.5m MRFF trial of psilocybin-assisted therapy for persistent post-concussion symptoms (PPCS) — the headache, brain fog, and mood disruption affecting up to half of concussion patients. No pharmacological treatment is currently approved.

The trial (60 participants, 25mg vs 4mg active placebo) tests whether psilocybin reduces neuroinflammation and supports neural recovery after brain injury. Results expected 2027–28.

This is early-stage research. Psilocybin in Australia requires an authorised psychiatrist — not accessible through general practice. If post-concussion symptoms persist, your GP is the right starting point for specialist referral.

What just happened

Monash University has opened enrolment for a $1.5 million trial investigating psilocybin-assisted therapy as a potential treatment for persistent post-concussion symptoms (PPCS). Funded by the Medical Research Future Fund over three years, the trial is the first in Australia specifically targeting the neurological and psychological sequelae of traumatic brain injury using a psychedelic compound.

The need is real. Concussions account for an estimated 56 million injuries worldwide annually — they are the most common form of traumatic brain injury. Up to 50% of people who sustain a concussion develop PPCS: the cluster of headache, brain fog, fatigue, cognitive slowing, sleep disruption, mood changes, and sensory sensitivity that persists beyond the expected recovery window of four to six weeks. In Australia, this translates to tens of thousands of people every year who are managing a condition for which no pharmacological treatment is currently approved.

Lead researcher Professor Terence O’Brien described the clinical gap plainly: “Given the lack of effective treatment options for persisting and debilitating concussion symptoms, we are excited to be studying a promising new approach.” The Monash Trauma Group is collaborating with the Clinical Psychedelic Lab at Monash to design the trial, which combines a therapeutic dose of psilocybin (25mg) with a structured preparation and integration psychotherapy programme. The control arm receives a 4mg active placebo dose designed to partially mimic the psychedelic experience without producing full therapeutic effects.

Enrolment opened in June 2026, with results expected by 2027–28.

The both-and

Why psilocybin might matter here

The proposed mechanism is the intersection of two things psilocybin does in the brain that are particularly relevant to post-injury neurology.

First, neuroinflammation. Traumatic brain injury triggers a sustained inflammatory response in brain tissue that, in a subset of patients, does not resolve with the primary injury. This neuroinflammation is believed to contribute to the perpetuation of PPCS, particularly the cognitive and mood symptoms. Preclinical research suggests psilocybin has anti-inflammatory properties in neural tissue, potentially through modulation of microglia — the brain’s resident immune cells. This is a plausible biological target; it is not yet established in human post-injury populations.

Second, neural plasticity. Psilocybin — through its primary action on serotonin 5-HT2A receptors — promotes dendritic growth and synaptogenesis (the formation of new neural connections). In healthy participants and in people with depression, this plasticity-enhancing effect appears to underlie some of the lasting psychological changes observed after psilocybin-assisted therapy. Whether the same mechanism is helpful in a brain recovering from injury is the question the Monash trial is designed to test.

Dr Paul Liknaitzky, who leads the Clinical Psychedelic Lab, framed the combined approach: “We’re testing a combined treatment approach that targets both the neurological and psychological drivers of patients’ symptoms.” The psychotherapy component — three preparation sessions and four integration sessions structured over six weeks, alongside a daily self-guided programme — is not incidental; psilocybin-assisted therapy in Australia is delivered as a psychotherapy-integrated protocol, not as a standalone pharmaceutical.

Where the evidence is and isn’t

It is worth being clear about the stage of the evidence. This is a Phase 2 trial in 60 participants. It has just opened for enrolment. There are no results. The proposed mechanisms are biologically plausible and grounded in related preclinical and human research in other conditions — but PPCS is a distinct clinical entity, and translating findings from depression or anxiety populations to a brain-injury population is not straightforward.

The TGA authorised the prescribing of psilocybin by specialist psychiatrists in February 2023, making Australia the first country to establish a regulated clinical pathway. That approval is for treatment-resistant depression, not for PPCS. The Monash trial is investigational research, not an approved treatment pathway. Enrolment in the trial and future clinical availability (if results are positive) are two different things, on different timelines.

There is also a practical constraint in the trial’s eligibility criteria: participants must discontinue antidepressants and psychiatric medications before enrolment. For many people managing mood symptoms post-concussion — who may be on antidepressants for exactly those symptoms — this is a significant requirement that adds complexity to participation decisions.

Why this matters for the 45-year-old woman in the room

PPCS disproportionately affects women. The literature on sex differences in concussion recovery is mixed, but consistent patterns suggest that women experience greater symptom severity and longer recovery trajectories after concussion than men with equivalent injury mechanisms. Sport, falls, and interpersonal violence — the three most common concussion mechanisms — affect women across the life course. The absence of an effective pharmacological treatment is not a minor inconvenience; for people in the years-long cohort of PPCS, it is a significant quality-of-life deficit.

The Monash trial is a credible institution asking a credible question with appropriate funding. That is a meaningful starting point. Whether psilocybin becomes part of the treatment landscape for PPCS depends on what the data show — and those results are two or more years away.

2 cents

If you or someone you know has been managing persistent symptoms after a concussion for six months or longer and conventional management has not fully resolved them: this trial is worth discussing with your GP. The eligibility requirements are specific — including the medication discontinuation requirement — and a GP familiar with your history can help work out whether enrolment is appropriate or whether other specialist input (neuropsychology, neurologist, physiotherapy-led concussion rehabilitation) should come first.

If you have been dismissed by the health system at some point in managing PPCS — told that concussion symptoms should have resolved, that there is nothing more to offer — this trial is a sign that the research community is taking the question seriously. That is not a treatment today. But it is a legitimate basis for sustained engagement with your own care.

The verdict is not yet in, and it won’t be for a couple of years. Watch this space.

Verdict: maybe — watch this.

Sources cited

  1. Medical Republic — Can psilocybin treat persistent concussion symptoms? 25 June 2026. https://www.medicalrepublic.com.au/can-psilocybin-treat-persistent-concussion-symptoms/126635
  2. Monash Trauma Group — psilocybin-assisted therapy research. https://www.monash.edu/medicine/translational/neuroscience/research/monash-trauma-group
  3. TGA — Change of classification of psilocybin and MDMA to enable prescribing by authorised psychiatrists (February 2023). https://www.tga.gov.au/news/news/change-classification-psilocybin-and-mdma-enable-prescribing-authorised-psychiatrists

Frequently asked questions

  • Can a GP refer me to the Monash psilocybin concussion trial?

    The Monash trial opened for enrolment in June 2026 and is accepting participants who have had persistent post-concussion symptoms (PPCS) for at least six months. The trial is based at Monash University in Melbourne. A GP can support a referral, but participants need to meet eligibility criteria including discontinuing antidepressants and psychiatric medications before participation — which is a significant requirement for people already on treatment for concussion-related mood symptoms. The pre-screening survey is available through the Monash Clinical Psychedelic Lab. A GP referral is a reasonable starting point to discuss whether the trial is appropriate for your situation.

  • What are persistent post-concussion symptoms and how are they currently managed?

    Persistent post-concussion symptoms (PPCS) refers to a cluster of symptoms — headache, fatigue, brain fog, difficulty concentrating, sleep disruption, mood changes, light and noise sensitivity — that continue beyond the expected recovery period (typically four to six weeks) after a concussion. PPCS occurs in up to 50% of concussion cases. There is currently no approved pharmacological treatment. Management is symptom-based: graduated physical and cognitive rest, sleep hygiene, physiotherapy for cervicogenic headache components, and psychological support for mood symptoms including cognitive behavioural therapy. Neuropsychology input is sometimes warranted for cognitive symptoms affecting work or study. The lack of disease-modifying treatment is a genuine gap that the Monash trial is attempting to address.