2025 continues to deliver progress, fueled by innovations in new mechanisms of action to improve neurotransmission, promote neuroplasticity, alleviate side effects, and more. However, as unmet needs rise and inherent challenges of heterogeneity, translatability, and placebo responses remain largely unresolved, the field is left to wonder: was Cobenfy just a ‘one-off’, or are we on the verge of a new wave of transformative approvals?