Self-Rated Effectiveness of Microdosing With Psychedelics for Mental and Physical Health Problems Among Microdosers

Abstract

Background: There is a growing interest in the use of psychedelic substances for health related purposes, including symptom relief for disorders like anxiety, depression, and pain. Although the focus of recent clinical trials has been on high doses of these substances, anecdotal evidence suggests that low (micro) doses are also effective, and may be more suitable for certain conditions. Nonetheless, empirical evidence regarding the efficacy of microdosing with psychedelics for symptomatic relief is lacking. The present study aimed to investigate, by means of an online questionnaire, the self-rated effectiveness (SRE) of microdosing with psychedelics (MDP) for mental and physiological disorders compared to the conventional prescribed treatment and to regular doses of psychedelics. Methods: An online questionnaire was launched on several websites and fora between March and July 2018. Respondents who had consented, were 18 years of age or older, had experience with microdosing and were diagnosed with at least one mental or physiological disorder by a medical doctor or therapist (N = 410; 7.2%) were included in the analyses. Odds ratio were calculated to compare the SRE of MDP with conventional treatment, and regular psychedelic doses for mental and physiological diagnoses for each of the three effectiveness questions (“Did it work,” “Symptom disappear,” “Quality of life improved”). Results: Odds ratio showed that SRE of MDP was significantly higher compared to that of conventional treatments for both mental and physiological diagnoses; and that these effects were specific for ADHD/ADD and anxiety disorders. In contrast, SRE of MDP was lower compared to that of higher, regular psychedelic doses for mental disorders such as anxiety and depression, while for physiological disorders no difference was shown. Conclusion: This study demonstrates that SRE of MDP to alleviate symptoms of a range of mental or physiological diagnoses is higher compared to conventionally offered treatment options, and lower than regular (‘full’) psychedelic doses. Future RCTs in patient populations should objectively assess the effectivity claims of psychedelics, and whether these are dose related, disorder specific, and superior to conventional treatments.

The therapeutic potential of microdosing psychedelics in depression

“…20 In addition, people really expecting certain effects sometimes stop with microdosing because the practice was not deemed effective, or the effects did not meet their expectations. 14 With regard to placebo-controlled studies, the presence of a placebo can correct for this expectancy effect. However, a placebo effect might occur, as shown by Olson et al, which can make it harder to find subtle effects as these expectancy or 'placebo' effects might decrease the chance of demonstrating statistically significant differences between the active treatment and placebo.…”

“…[8][9][10][11] While the intensity or quality of the psychedelic experience seems to contribute to its therapeutic effect, 12 anecdotal evidence also suggests that repeated use of smaller doses without the psychedelic experience ('microdosing') is efficacious self-treatment for people suffering from affective disorders. 13,14 In general, a microdose is considered to be one tenth of a dose normally causing hallucinogenic effects. When taking the doses used in clinical research as a reference, 2,4 a microdose then would be 10-20 mcg of LSD and/or 0.3-0.5 g of psilocybin-containing mushrooms.…”

“…24,25 This seems to be confirmed in the reports of people self-treating with microdoses of psychedelics to combat symptoms of affective disorders such as depression and anxiety disorders. 14,26 Despite the positive claims of microdosers who self-treat their conditions, no clinical trial to date has focused on the question whether (repeated) administration of psychedelics in low doses can serve therapeutic potential in affective disorders. The aim of the present review was to investigate, based on findings from (controlled) experimental studies in healthy volunteers and patient samples, whether there is scientific evidence supporting potential efficacy and safety of low doses of psychedelics in the treatment of affective disorders.…”

“… 8 – 11 While the intensity or quality of the psychedelic experience seems to contribute to its therapeutic effect, 12 anecdotal evidence also suggests that repeated use of smaller doses without the psychedelic experience (‘microdosing’) is efficacious self-treatment for people suffering from affective disorders. 13 , 14 …”

“…24 , 25 This seems to be confirmed in the reports of people self-treating with microdoses of psychedelics to combat symptoms of affective disorders such as depression and anxiety disorders. 14 , 26 …”