Biased Signaling in Psychedelic Action. Annu Rev Pharmacol Toxicol 2026 Jan;66(1):241-260
Date
08/13/2025Pubmed ID
40796124Pubmed Central ID
PMC12928165DOI
10.1146/annurev-pharmtox-062124-012545Scopus ID
2-s2.0-105028659029 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
Psychedelics show tremendous promise for treating psychiatric disorders and other illnesses, including pain and migraine. Despite decades of research, there is uncertainty which signaling mechanisms are necessary for rapid-acting and durable therapeutic effects of psychedelics. Although activation of the serotonin 5-HT2A receptor is critical for their psychopharmacological effects, the precise signaling pathways and receptor conformations responsible are still under investigation. This review summarizes progress in studying 5-HT2A signaling mechanisms and recent developments in the discovery of biased agonist tool compounds to disentangle therapeutic from adverse effects. Moreover, we review insights from structural studies regarding the design of psychedelic-derived compounds with tailored pharmacology and briefly discuss other 5-HT receptors that may be important for shaping therapeutic effects. Finally, by drawing parallels between 5-HT2A biased signaling and the opioid field, we conclude with lessons learned and discuss the need for more rigor and reproducibility to facilitate the development of novel psychedelic-based pharmacotherapies.
Author List
Wacker D, McCorvy JDAuthor
John McCorvy PhD Associate Professor in the Cell Biology Neurobiology and Anatomy department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AnimalsHallucinogens
Humans
Receptor, Serotonin, 5-HT2A
Serotonin 5-HT2 Receptor Agonists
Signal Transduction
