The VA has launched the PIVOT (Psilocybin Intervention for Veterans Overcoming Treatment-Resistant Depression) clinical trial to evaluate the safety and effectiveness of psilocybin for veterans with treatment-resistant major depression, including those with co-occurring PTSD. The randomized, controlled study will compare two psilocybin dosage levels and assess changes in depression severity, side effects, and patient-reported outcomes. Conducted at five VA sites across Alabama, Oregon, Pennsylvania, and Washington, the trial will use pharmaceutical-grade psilocybin in a closely monitored clinical setting with psychological support and rigorous safety protocols. VA officials say the study reflects a commitment to exploring innovative treatment options for veterans whose mental health conditions have not responded to existing therapies.