The sometimes hyped Benefits of microdosing – regular use of small amounts of psychedelic drugs like lysergic acid diethylamide (LSD) – may be exaggerated, new research this week suggests. The study found that people on microdoses experienced psychological benefits, including a greater sense of well-being, but that these benefits were not materially different from how others felt when they took a placebo instead. The findings of the experimental study indicate that at least some of the positive aspects of microdosing can be attributed to the placebo effect, but the study has its own caveats.
Psychedelic drug treatment has emerged in recent years as a promising approach to improve people’s mental health. Some research has suggested that drugs such as LSD and psilocybin – the main ingredient in magic mushrooms – can help treat anxiety and depression, especially when combined with therapy. Other research has found proof of positive changes in animal or human brain cells upon exposure to psychedelics, further reinforcing the arguments for a true biological benefit. One method of using these drugs is microdosing, which means that people take much smaller doses than recreationally, on a regular schedule.
However, much of the evidence for the benefits of microdosing is based on real world observations or anecdotal experiences, which come with its limitations. For example, some people’s self-reported symptoms while on a drug will improve even if they don’t treated the underlying condition causing those symptoms. A clear way to overcome the limitations of anecdotal evidence is through a placebo-controlled study, but these studies are generally expensive and time-consuming and resource-intensive. This is especially true of microdosing studies, as these drugs are still illegal in many countries and scientists have to overcome hurdles to use them for research.
The authors behind this new study, published in eLife Tuesday, decided to take a unique approach when conducting their placebo-controlled study. They enlisted the help of people who already microdose regularly and then helped them run the experiment essentially themselves.
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These citizen scientists were instructed to make the experiment placebo-controlled, so they didn’t know whether they were taking a placebo or the real drug (usually LSD, but some were also taking psilocybin). This involved placing the drug, which was in powder form, in opaque gel capsules, and then placing these capsules and placebo capsules into envelopes containing a week’s supply of four doses. Some envelopes contain only placebo, others contain a mix of both placebo and the drug.
A QR code was added to all envelopes that allowed the researchers to know the contents of each envelope and the specific order of the pills taken that week, but not the volunteers. Some of the study subjects were randomly assigned two weeks of microdosing and the other two weeks were given a placebo, and some were given the placebo all the time. During the study, all volunteers completed regular surveys about their ongoing psychological state.
A total of 191 people completed the experiment, making it the largest placebo-controlled study of its kind, according to the authors. Microdosing volunteers reported psychological improvements from their baseline, including reduced anxiety and greater sense of well-being, but so did people taking placebo, and overall there were no significant differences between all three groups.
“The findings suggest that anecdotal benefits of microdosing may be explained by the placebo effect,” the authors wrote.
There are some important caveats to these findings. First, the study found a small but statistically significant difference in certain outcomes when comparing the placebo group to the microdose group; these include improvements in mood, energy and creativity. But the researchers claim there is also an everyday explanation for this. About 72% of the time, better than chance, the volunteers were able to accurately guess whether they were taking a placebo or a drug. So it’s possible that their expectations of feeling better rose when they correctly suspected they had taken the drug instead of a placebo, meaning their blindness wasn’t entirely foolproof.
The study also failed to control variables such as the purity or actual dosing of the microdosing, as it depended on the typical medications the volunteers were already taking (users reported an average of 13 microgramsgrams of LSD per dose, but the authors were unable to test how much of the active ingredient people were taking). And while they tried to make sure that people followed instructions they were given, the nature of the research meant that they had less control over whether everything was followed correctly. As for the ethics of this study, the authors said they only contacted self-identified microdosers and did not collect any other identifiable personal information from them in addition to their email (the study was approved by an outside committee).
It’s also worth highlighting that psychedelic drugs are being studied and taken in different ways for mental health, and microdosing is just one approach. Some researchers have argued that it is the intensive experience of taking psychedelics (in relatively high microdoses or macro doses), along with guided therapy, for example, really brings the clearest benefits to humans. In 2019, the drug was ketamine adjusted to an FDA-approved treatment for depression. This is taken in smaller doses than when taken recreationally and under medical supervision, but it can also be a higher dose than what people would take alone during microdosing.
Importantly, the authors also note that the study volunteers were generally healthy, with only 7% having a current diagnosis of mental health. So they don’t rule out that microdosing may still be helpful for people who are experiencing it mental illness.
Of course, no study should be seen as the last word on any topic, especially if it relies on an experimental approach. Still, the authors hope that their unique study design can be used in the future for other tricky research areas where it is difficult to include a placebo control. An immediate benefit could be the cost, as this study requires only about 1% of the funding typically used to conduct a clinical trial. Other potential applications for this approach include studying CBD, nootropics and nutrition, they wrote.