Fasedienol nasal spray

At a glance

Compared with other treatments

Against a dummy spray (placebo), during a public speaking test: 1 of 4 large trials found less distress, 3 did not.

What it takes

Not available. It is only given inside clinical trials.

What it is

Fasedienol (also called PH94B) is a nasal spray made by the US company Vistagen. It is a new kind of drug, sprayed into the nose. The idea is to use it a few minutes before a feared moment, such as a talk or a meeting.

It is not approved as a medicine in any country we know of. You cannot get it from a doctor or a pharmacy. It is only given to people taking part in trials.

Why people are interested

Many people with social anxiety want something fast, just for the moment. Today the options are propranolol, which calms shaking but has little trial evidence for social anxiety, and benzodiazepines, which carry a risk of dependence. A spray that works in minutes and does not cause sleepiness would fill a gap. That is why news about it spreads fast.

What the trials found

All the large trials used the same test. People with social anxiety used the spray or a dummy spray (a placebo), then gave a short speech. They rated their distress during the speech.

• PALISADE-1: did not work. The spray did not reduce distress more than placebo, as reported in 2023.
• PALISADE-2: worked. In 141 people, distress fell more with the spray than with placebo. This is the result most news stories quote.
• PALISADE-3: did not work. In late 2025, the difference between spray and placebo was very small and not clear. Other measures showed no difference either.
• PALISADE-4: did not work. In 238 people, the spray did not beat placebo on the main or the other measures. The company pointed to a smaller group with very severe social anxiety, picked out after the results were in. Findings from groups chosen afterwards are often due to chance.

So 1 of 4 large trials was positive. All the results so far come from the company’s announcements and news reports. None of the large trials has a full paper in a journal, and ClinicalTrials.gov had no posted results for PALISADE-3 or PALISADE-4 when we checked on 9 November 2026.

Why a speech test can mislead

Every one of these trials measured one moment: a speech in a lab. Placebo sprays also reduced distress a lot in these tests. When people improve a lot on placebo, a drug has to do very well to stand out. A speech test also says little about whether you would feel better at work, at parties or on the phone over months.

What happens next

The company has said it plans to talk with the US Food and Drug Administration about another trial. The new trial would give repeated doses and measure social anxiety over time, not just during one speech. A smaller trial of repeat doses finished in August 2026. Its results were not posted when we checked. See trials waiting for results.

What it would take to change the rating

A clear benefit in a new large trial would change the picture, especially one that measured social anxiety over weeks rather than distress during one speech. Full publication of all four large trials, including the ones that failed, would help everyone judge it fairly.

What you can do now

• If you want something for one-off events, talk to your doctor about the options, including their limits. Talking to your doctor can help you prepare.
• For lasting change, cognitive therapy for social anxiety and SSRIs have far more evidence.
• Be wary of anything sold online as “fasedienol” or “PH94B”. It is not legally on sale.

Side effects

The company has reported the spray as well tolerated in its trials. The trials also had longer open-label parts, where everyone got the spray. Those results have not been published in a journal.