How does psychedelic microdosing differ from other treatments for anxiety?

Doctor's Answer

People who use psychedelics such as:

  • LSD or
  • psilocybin (magic mushrooms).

This improves their mental health and boost their overall well-being tend to do so with a technique called microdosing. Taking microdoses of a psychedelic drug means taking only a fraction of a dose that is required to have a full-blown psychedelic experience, or "trip." Over recent years, quite a number of interesting papers on microdosing of psychedelic drug has been published.

  • Psilocybin

Two studies showed that psilocybin, the active psychedelic compound in magic mushrooms, alleviated symptoms of treatment-resistant depression. Psilocybin has been subsequently pinpointed as the psychoactive substance in "magic mushrooms".

Another related paper published in the journal Frontiers in Pharmacology examined if the quality of the psychedelic experience was linked with the success of the treatment. The researchers gave questionnaires to a group of 20 volunteers who underwent two treatment sessions with psilocybin. The researchers looked at the so-called feeling of oceanic boundlessness, which is a "mystical-type experience" involving feelings of unity and a lack of boundaries between the self and the universe.

The study revealed that the more strongly the participants felt this experience, the better was their mental health in the long-term. Depressive symptoms subsided, and the mental benefits lasted for weeks after the treatment in participants who reported a strong mystical experience.

  • Ayahuasca

An area of development looked at the potential of the Amazonian plant mixture Ayahuasca to treat depression and alcohol use disorder. The researchers opine that Ayahuasca "may be a safe and promising treatment" for these mental health problems.

  • N-Dimethyltryptamine (DMT)

The fourth area of research investigates the effects of the hallucinogen N, N-Dimethyltryptamine (DMT) on male and female rodents in an attempt to discover its effects on mental and physical health. The researchers chose DMT because the compound can be found in Ayahuasca, and its molecular structure is analogous to that of other microdosing drugs, such as LSD and psilocybin.

Olson and colleagues gave the rats 1 milligram/kilogram of body weight, which is a tenth of the dose that would be necessary to induce a hallucinogenic experience in the rodents. The rats took this dose once every 3 days for a period of 2 months. In the 2 days between the doses, the researchers tested the rats' mood and cognitive function. The scientists found that DMT helped the rodents overcome their fears in a test used to model anxiety and post-traumatic stress disorder.

Quite a number of reservations have been expressed regarding the studies on psychedelic drugs. First, most of the studies were done on animals. So far there are very few studies done on humans. It is hard to generalise results from animals to humans.

Second, the few studies done on humans are not well controlled. Typically, they will need to be compared with a standard form of treatment that is already well recognised. Chief among the issues raised is the lack of controlled scientific studies, the standard measure in medical science -- where the effect of a treatment is measured in those taking it against a control or placebo group (who do not take the compound).

Third, the authors also cite a lack of certainty around the doses used in previous trials, as well as where the substances came from, and their potency.

Fourth, the adverse effects of the psychedelics (for example, on the heart functions) are not adequately emphasised by some papers.

Furthermore, the researchers often lament that one of the limitations of antidepressants is that they may cause ‘emotional blunting’ or apathy. This is indeed found to be a side effect of antidepressants but the newer ones like agomelatine are less likely to be associated with such a problem. Psychedelic substances are classified as illicit substances in many countries.

If one gets arrested by the police for possessing them, that will surely make the pre-existing anxiety or depression worse. The drugs in the field -- chiefly psilocybin, LSD and DMT -- remain Schedule 1 Drugs under the UN Convention and Class A under the Misuse of Drugs Act in the UK. In the UK, this currently means only researchers with a licence from the Home Office are able to obtain and test substances, and anyone obtaining substances for microdosing without a licence could face prosecution.

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