Takeaways From APA 2026: Transforming Psychiatric Treatment

Embracing a New Type of Treatment Target

Throughout the presentations, one previously common topic of conversation was mostly absent: classical neurotransmitters. While the traditional "big names"—dopamine, serotonin, glutamate, etc—were mentioned, they appear to no longer be the stars of the show.

This follows a slow but steady shift in psychiatric treatment away from directly targeting neurotransmitters, toward the indirect, tailored approach of neuromodulation. For example, various sessions focused on glucagon-like peptide-1 (GLP-1) and its hypothesized role as a neuromodulator of various brain circuits—where emerging evidence suggests it may impact such crucial functions as appetite, reward, and mood. Potential effects on classical neurotransmitters (here, glutamate, GABA, dopamine, and serotonin) were described as a downstream effect of a promising treatment target, rather than the centerpiece of it.

Other presentations omitted discussion of receptors altogether, instead embracing a concept relatively new to psychiatry: functional connectivity. In various conditions, mounting evidence suggests that illness does not result from a handful of regions malfunctioning independently, but rather dysfunction across networks and impaired intercommunication. Treatments are following suit: deep brain stimulation (DBS) is thought to impact functional connectivity, as are psychedelics, one of the hottest topics of the conference.

Increased Understanding of Treatment Resistance

Some conversations at APA 2026 scrutinized "treatment resistance" and the potential overuse of the term—which may be conflated with "nonadherence" or "partial response"—and the harm the diagnostic category and even the term itself may cause with respect to patient and provider outlook. It appears that, as we wait for the approval of advanced therapeutic options, the field is trying to impact treatment-resistance-related apathy and negative outcomes by reconsidering clinical perspectives and the language used with patients.

Using Big Data to Advance Diagnosis

As technology continues to evolve, psychiatrists are asking, "What place does it have in my field, and in my practice?" Diagnosing psychiatric illness early in a disease course is a challenge in part because certain psychopathological features are shared among many conditions. Several sessions explored how technological tools may help address this issue—specifically, how intricate data collected from the population (eg, language mapping, facial expressions) may help predict future psychiatric illness. Such tools may also be able to distinguish between disparate presentations of the same illness, potentially enabling more tailored treatment. While these efforts are far from validation and use, they offer hope to psychiatrists struggling to identify highly heterogeneous and interlinked disorders.

A Growing Interest in GLP-1 Receptor Agonists

GLP-1 receptor agonists (RAs) continue to advance into psychiatry, with mentions at APA 2026 appearing to spike higher than in years past. One discussion focused on weight loss. Certain antipsychotics and antidepressants are known to be associated with significant weight gain, and there appeared to be a renewed interest this year in using GLP-1RAs to help mitigate the potential impact.

Another potential use discussed at APA 2026 was for substance use disorder (SUD). The thought is that, given the impact of GLP-1RAs on food cravings and "food noise," perhaps the same impact can be had on cravings and "noise" related to addictive substances. Preliminary studies largely support this hypothesis, and trials led by pharma and the National Institutes of Health are underway to test GLP-1RA effectiveness more broadly and rigorously. They are also being considered for a variety of other uses, such as the treatment of eating disorders, psychotic disorders, and mood disorders.

The Buzz Around Psychedelics—the Next Big Breakthrough?

Compared with GLP-1RAs, psychedelics appear much closer to being introduced into psychiatry practice, as reflected at APA 2026. From clinical trial data reviewed on the main stage to a presentation by the director of the National Institute on Drug Abuse, sessions indicated that psychiatry is embracing the radical shift—and potential opportunity—that approval of psychedelics in psychiatry would represent. These agents represent a fundamentally different mechanism of action, as just 1 or 2 administrations are thought to reorganize brain networks. Talks and featured booths emphasized the broad utility that psychedelics may have across disorders, including those where patients have historically not experienced symptom relief; among the disorders mentioned were treatment-resistant depression, major depressive disorder, generalized anxiety disorder, and SUD.

Other discussions focused on the practical shifts that psychedelic approval and use would necessitate. Psychedelics could represent a "one-shot," intensive treatment experience, as opposed to the semi-frequent treatment cadence that psychiatrists are more used to. This would require a shift in practice structure as well as specialized personnel. Also, certain psychedelic agents will cause patients to "trip," as it is unclear how important this experience is to the therapeutic effect. While these types of psychedelics may have few "traditional" psychiatric side effects, they would introduce new, though transient, side effects associated with the psychedelic experience. Only time will tell how the field will adapt to these new considerations.

Bringing it All Together

APA 2026 underscored how psychiatry is expanding into new territory, in terms of how we view psychiatric dysfunction, treatments, and diagnostic tools. While many of the developments represent work in progress, the meeting made clear that the field is entering a new era marked by greater complexity, greater ambition, and, potentially, more individualized care.

The HWP Group eagerly anticipates the next wave of advancements and is well positioned to help clients navigate psychiatry's changing landscape—from strategy development, to content creation, to program execution.

Reported by The HWP Group's Norah Koblesky