The Legal Perspective on Psilocybin for Medical Use in Czechia: A Key Milestone and the Case for Broader Consideration Beyond the Clinical Setting

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The author is to be commended for providing an extremely well-informed, authoritative and overall balanced perspective on the state of psychedelic regulation in Czechia that is highly timely given developments elsewhere in the world, and well directed toward the further revision of relevant law in that country. Building on the author's previous published work, the essay makes a significant contribution to the global discourse around psychedelic law reform and may be expected to provide a valuable foundation for further analysis and debate.

Author Response

I would like to thank you for taking the time to review my manuscript. Your positive evaluation serves as a meaningful encouragement and confirms that my work is progressing in the right direction within the academic discourse. I have made an effort to improve the text both in terms of content and in its stylistic and linguistic expression. Once again, I am truly grateful for your time and support.

Reviewer 2 Report

Comments and Suggestions for Authors

I read with interest the essay titled "Psilocybin for Medical Use in Czechia: A Legal Milestone and the Case for Broader Consideration Beyond the Clinical Setting".

This is an insightful and timely contribution to the evolving discourse on psychedelic regulation. I offer the following comments for consideration:

1.. Consider using clearer subheadings or a brief introductory outline to guide the reader through the core sections.

2. the "spreading toxicomania" offense could benefit from a comparative legal perspective to better inform an international audience unfamiliar with this concept.

3. The reference to “How to Regulate Psychedelics” document is valuable but could be condensed slightly. The four regulatory models are well explained but dominate the latter part of the essay—consider summarizing them more briefly to retain focus on the Czech context.

4. The inclusion of qualitative data from ketamine therapy participants might be better integrated analytically to highlight key themes, rather than presented as standalone quotes.

5. The conclusion would benefit from a brief, bullet-style summary of key recommendations for policymakers or future researchers.

Author Response

Response to Reviewer 2 Comments

First of all, I am grateful for the constructive feedback provided on the commentary. Below I address each comment in turn and outline the corresponding revisions made to the manuscript.

1. Subheadings and Structural Clarity

I have revised the manuscript to include clearer subheadings that reflect the structure and progression of the argument. Additionally, I have added a brief introduction to orient the reader to the four main sections of the essay.

2. Comparative Legal Perspective on “Spreading Toxicomania”

I acknowledge the importance of contextualizing this offense for a broader audience. Due to its specific nature, the international comparison results difficult. Therefore, I have defined and explained the legal provision in detail and have expanded the discussion to clarify its historical and political origins, as well as its controversial and its negative effect on harm reduction efforts.

3. Length and Focus of Regulatory Models Section

I have revised this section to more explicitly connect each regulatory model to the Czech legal and policy context, while maintaining the detailed exposition of the models, as I regard it as necessary for a comprehensive and informed analysis.

4. Integration of Qualitative Data

I have revised this section to synthesize key themes emerging from participant reflections, offering a structured summary of their perspectives on both clinical and non-clinical models of psychedelic use.

5. Conclusion and Policy Recommendations

I have revised the conclusion to include policy and research recommendations.

 

I thank the reviewer again for their valuable input, which has helped me strengthen the clarity, relevance, and impact of this expert commentary.

Reviewer 3 Report

Comments and Suggestions for Authors

1. the title suggests a broad discussion of psilocybin in Czechia, but the text is mainly legal commentary; either the title should be narrowed to reflect the legal focus, or the manuscript expanded with clinical and research information on psilocybin.
2. if the author wants to keep the title unchanged, then it should be considered that the paper does not include data on Czech clinical trials, therapeutic outcomes, or patient perspectives; In fact he analysis heavily relies on secondary documents (e.g., How to Regulate Psychedelics) instead of providing original data or case-specific evidence on psilocybin in Czechia. Adding such information would make the analysis more robust and match readers’ expectations.
3. the section on ketamine-assisted therapy distracts from the main subject; it should be reframed as a comparative case that informs the psilocybin debate or replaced with psilocybin-centered content.

Author Response

First of all, I would like to thank the reviewer for their careful reading of the manuscript and for providing constructive feedback. I address their comments as follows:

Comment 1: “The title suggests a broad discussion of psilocybin in Czechia, but the text is mainly legal commentary; either the title should be narrowed to reflect the legal focus, or the manuscript expanded with clinical and research information on psilocybin.”

The focus of this manuscript is intentionally on the legal and regulatory framework surrounding psilocybin in Czechia. The title has therefore been revised to more accurately reflect the legal orientation of the paper. The manuscript does not aim to provide a comprehensive review of clinical applications or research outcomes, but rather a detailed analysis of the legal and policy context in which psilocybin-related therapies are situated.

Comment 2: “If the author wants to keep the title unchanged, then it should be considered that the paper does not include data on Czech clinical trials, therapeutic outcomes, or patient perspectives; In fact, the analysis heavily relies on secondary documents (e.g., How to Regulate Psychedelics) instead of providing original data or case-specific evidence on psilocybin in Czechia. Adding such information would make the analysis more robust and match readers’ expectations.”

As stated above, the manuscript is centered on the legal framework and regulatory aspects of psilocybin rather than clinical efficacy or patient outcomes. While I acknowledge that original clinical data are not included, the cited (secondary) sources provide the necessary legal and policy context to support the analysis. The scope of the manuscript is therefore consistent with a legal and regulatory focus, rather than a clinical or therapeutic one, as it is not a research paper, but an expert commentary.

Comment 3: “The section on ketamine-assisted therapy distracts from the main subject; it should be reframed as a comparative case that informs the psilocybin debate or replaced with psilocybin-centered content.”

The inclusion of ketamine-assisted therapy serves as a comparative reference – as a source of opinions/data regarding potential legal frameworks for both medicinal and non-medicinal psychedelic use. While ketamine therapy is not a psilocybin intervention per se, its mention illustrates relevant legal and social considerations that inform the ongoing debate on psilocybin legalization. This section has been reframed to clarify that its purpose is to provide a contextual comparison, while the central focus remains the legal and regulatory aspects of psilocybin.

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

it has now been improved and thus, it is ready to be published