Microdosing For Mental Health? A Psychiatrist Weighs In

Psychedelic drugs have been used in spiritual retreats and ceremonies, psychiatric research studies, and recreationally. They have the potential to rewire the circuits of the brain and bring about lasting changes in the way people see themselves and the world they live in. To put it more informally, they can blow your mind.

Classic psychedelics include psilocybin (from hallucinogenic mushrooms), LSD, mescaline (from the peyote cactus) and DMT (one of the components of ayahuasca). 

These drugs can cause major physiological disturbances, including changes in thought, mood, and perception. They can elicit feelings of universal connectedness and peace, but their use can also lead to “bad trips,” characterized by frightening hallucinations and delusions, negative thought spirals, extreme paranoia and emotional distress. 

With the two most common psychedelics, psilocybin and LSD, the experience can last 6-12 hours. It can be quite an ordeal. People are willing to undergo this ordeal because of the remarkable benefits that have been reported. 

Clinical research has found that psychedelics are effective for depression, anxiety and addictions when other treatments have failed. Some people also report enhanced creativity, more meaning in their lives, and an underlying sense of well-being.

That raises the question of whether the mind-blowing trip is necessary in order to achieve the benefits of the drug. Does the transcendent experience of tripping lead to psychological benefits, or is it something more subtle that occurs when the drug interacts with the brain? 

This uncertainty has led some to experiment with microdosing—taking a dose of the drug too small to elicit the experience of a trip, but perhaps enough to provide psychological benefits.

A microdose is typically 1/5 to 1/20 of a usual dose. Microdosers might go to work and interact socially in their usual way. The problem is that since psychedelics are purchased on the black market, the potency of the product may vary quite a bit.

This problem is magnified with mushrooms, because the concentration of the active psychedelic ingredient varies from plant to plant. As a result, people may take more than they intended.

A patient of mine who experimented with microdosing experienced this problem. He took what he thought was his usual microdose before heading off to work, and found himself tripping by the time he got there. He almost lost his job as a result of his bizarre behavior. Other negative side effects of microdosing include anxiety and other unpleasant effects.

At the same time, microdosing appears to have significant benefits. Users have reported improved mood and anxiety, enhanced connection to others and cognitive enhancement. 

One study followed 953 microdosers and 180 non-microdosing comparators for 30 days to see if they could find differences between them. They were able to identify small- to medium-sized improvements in mood and mental health among the microdosers. It looked like the effects were real.

From a scientific perspective, studying both microdosers and non-microdosers is better than just interviewing microdosers by themselves because it provides a comparison. It makes sure there’s really a difference, rather than the microdosers simply having a good day or a good week.

But it doesn’t account for the possibility of a placebo effect, the possibility that microdosers felt better because they expected to feel better. Ruling out a placebo effect would require a “blind” trial in which neither group knew whether they were getting a microdose or an inert substance with no hallucinogenic properties. 

A study led by a researcher at the University of Buenos Aires aimed to do just this: compare a microdose of psychedelic mushrooms with a placebo—an identical capsule containing edible mushrooms.

The research volunteers didn’t know which one they were getting. At the end of the study, the researchers found positive effects on creativity and cognitive function, but there was no difference between the two groups. In this study, the benefits were apparently a placebo effect.

It’s still too early to say for sure whether or not microdosing has intrinsic benefits or is simply a placebo. More studies will be needed before we can decide with any confidence. 

In the meantime, those looking for relief from anxiety or depression would be better off talking to a healthcare professional about antidepressants, psychotherapy and other treatments that have been extensively tested for safety and efficacy. 

Those looking for a boost in creativity, greater connections with others and a sense of inner peace might consider things like spending time in nature, doing volunteer work or practicing meditation. These things may require more effort than microdosing, and they may not be as exciting, but fashionable shortcuts to a better self often turn out to be a dead end.