LSD microdosing in major depressive disorder: results from an open-label trial

This open-label Phase IIa trial (n=19, 15 male) found that an 8-week regimen of microdosed LSD (8μg initially, then 6-20μg twice weekly) for major depressive disorder was well-tolerated with no serious adverse events or cardiac valvulopathy, achieved 59.5% reduction in MADRS scores sustained for six months, and had only one withdrawal due to anxiety.

Abstract of LSD microdosing in major depressive disorder

Major depressive disorder (MDD) affects approximately 5% of the global population. Classic psychedelics have shown promise in treating various mental health disorders. This study evaluated the feasibility and tolerability of an 8-week regimen of microdosed lysergic acid diethylamide (LSD) as a treatment for major depressive disorder in an open-label phase 2A trial (LSDDEP1). Nineteen participants (15 male), most of whom were taking an antidepressant medication (n = 15), took 16 doses of LSD (8 μg initially, then 6–20 μg twice weekly at home), with the first dose administered in the clinic. We assessed tolerability through withdrawal rates due to adverse events and feasibility by clinic visit attendance. Safety measures included adverse events, blood laboratory tests, electrocardiography (ECG), and echocardiography. Depression was measured using the Montgomery-Åsberg Depression Rating Scale (MADRS). No serious or severe adverse events and clinical alterations in safety measures were observed, being this the first study to evaluate valvulopathy after repeated psychedelic administration in humans. One participant withdrew due to experiencing anxiety when dosing; all scheduled clinic visits were attended. MADRS scores were reduced by 59.5% at the end of the intervention and were sustained for up to six months. Improvements were also noted in anxiety, rumination, stress, and quality of life. While limited by an open-label design and small sample size, this study provides preliminary evidence supporting the safety and feasibility of treating moderate depression with microdosed LSD and underscores a need for further randomised controlled trials.

Authors: Dimitri Daldegan-Bueno, Carina Joy Donegan, Rachael Sumner, Anna Forsyth, William Evans, Malak Alshakhouri, Lisa Reynolds, Rhys Ponton, Todd Smith, Partha Roop, Nicholas Hoeh, Nathan Allen, Frederick Sundram, David Menkes & Suresh Muthukumaraswamy

Summary of LSD microdosing in major depressive disorder

Note: The subsequent Phase IIb trial didn’t find a significant effect over placebo. “89 people (mean age 38.3 +- 10.3 years; 53 [60%] females) were randomised to placebo (n = 45) or LSD (n = 44). The placebo group had a MADRS score of 23.0 (SD = 6.4) at Baseline and 14.6 (SD = 8.6) at eight weeks, presenting a 36.4% reduction. The LSD group had a MADRS score of 23.6 (SD = 6.5) at baseline and 16.6 (SD = 8.1) at eight weeks, presenting a 29.89% reduction. There was no effect of drug allocation on depression severity (MADRS) score at the eight-week time-point (p = 0.5469).”

Daldegan-Bueno and colleagues begin by situating major depressive disorder (MDD) as one of the most significant contributors to global health burden, affecting around 280 million adults worldwide. Traditional antidepressant medications, while commonly prescribed, are limited by delayed onset, inconsistent effectiveness, and adverse side effects. Consequently, there is a growing need for innovative treatments that act more rapidly and are better tolerated. In recent years, classic psychedelics such as LSD, DMT, psilocybin, and mescaline have gained scientific attention for their potential in treating mental health conditions, particularly depression.

The authors explain that microdosing—taking sub-perceptual amounts of psychedelics—has become increasingly popular as a self-managed approach to improving mood, cognition, and creativity. Microdoses typically range from 5 to 20 micrograms for LSD, doses far below those that cause hallucinations or significant perceptual changes. Observational studies suggest that people microdose to self-treat mood disorders, but rigorous clinical evidence remains sparse. Previous controlled studies have indicated that single microdoses can influence brain connectivity, mood, and cognition in healthy participants. Repeated microdosing has been linked to increases in energy and creativity on dosing days, prompting speculation that such effects might alleviate depressive symptoms.

A key concern addressed by the authors involves the safety of repeated LSD exposure. LSD activates serotonin receptors (specifically 5-HT2B receptors) that have been associated with valvulopathy, a type of heart valve disease. This receptor interaction led the United States Food and Drug Administration (FDA) to recommend monitoring heart valve function in studies involving repeated psychedelic dosing. No previous research had yet assessed repeated LSD microdosing in people with MDD, nor examined cardiac safety outcomes such as valvulopathy. On this basis, Daldegan-Bueno and colleagues designed an open-label Phase IIa clinical trial to assess the tolerability, safety, and feasibility of an eight-week regimen of LSD microdosing in adults with MDD.

Materials and Methods

Study Design and Ethical Approval

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Find this paper

LSD microdosing in major depressive disorder: results from an open-label trial

https://doi.org/10.1016/j.neuropharm.2025.110762

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Cite this paper (APA)

Daldegan-Bueno, D., Donegan, C. J., Sumner, R., Forsyth, A., Evans, W., Alshakhouri, M., Reynolds, L., Ponton, R., Smith, T., Roop, P., Hoeh, N., Allen, N., Sundram, F., Menkes, D., & Muthukumaraswamy, S. (2025). LSD microdosing in major depressive disorder: Results from an open-label trial. Neuropharmacology. Advance online publication. https://doi.org/10.1016/j.neuropharm.2025.110762

Study details

Compounds studied
LSD

Topics studied
Depression Microdosing

Study characteristics
Open-Label

Participants
19 Humans

Compound Details

The psychedelics given at which dose and how many times

LSD 6 - 20
μg | 16x

Linked Clinical Trial

Assessing the effects of Lysergic acid diethylamide (LSD) microdosing in people experiencing depression (LSDDEP1)
This open-label pilot trial (n=20) aims to evaluate the tolerability and feasibility of LSD microdosing in patients with major depressive disorder (MDD).

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