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

This survey study (n=410) showed that those with mental & physical health problems self-rated the effectiveness of microdosing as higher than conventional treatments in regards to ADHD/ADD and anxiety. They rated it as less effective than a high dose of psychedelics.

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.“

Authors: Nadia R. P. W. Hutten, Natasha L. Mason, Patrick C. Dolder & Kim P. C. Kuypers

Summary

INTRODUCTION

As of the last few years, there has been an increasing interest in the use of low doses of psychedelics for beneficial health-related purposes. However, empirical evidence regarding the efficacy of microdosing is currently lacking.

Psychedelic substances have been shown to provide therapeutic relief for individuals suffering from post-traumatic stress disorder, anxiety, and depression, as well as physical symptom relief in patients with pathologic pain. However, a psychedelic experience can prove challenging and thus psychological support is encouraged during and after the experience.

Anecdotal reports and small clinical trials support the potential therapeutic utility of psychedelic substances in reducing symptomatology of mental and physiological disorders. However, it has yet to be shown whether repeated sub-perceptual doses have therapeutic potential as well.

Design

To obtain a rate of base rate of microdosing in the psychedelic user groups, an online questionnaire was advertised to psychedelic users on several psychedelic websites and fora between March and July 2018.

Demographic Information

Respondents were asked about their age, gender, continent of origin, daily occupation, and highest level of education.

Psychedelic Substance Use History

Respondents were asked whether they had experience with LSD, 1P-LSD, ALD-52/1A-LSD, psilocybin, ayahuasca, DMT, 5-MeO-DMT, Salvinorin A, Mescaline, MDMA/Ecstasy, NBOMe’s, 2C’s, or any other psychedelic drug.

Mental and Physiological Diagnoses

Respondents were asked if they had been diagnosed with a psychiatric, neurological, or physical disorder, and then were given the option to enter free text when the disorder was not listed.

The two leading diagnostic manuals were used to cluster disorders into main categories, with 14 sub-categories for mental disorders and 11 sub-categories for physiological disorders.

Effectiveness of Conventional Prescribed Treatment

When respondents indicated to have been diagnosed with a specific mental or physiological disorder, they were asked whether they felt the treatment worked and whether their quality of life improved.

Effectiveness of Psychedelic Self-Medication

Respondents were asked whether they have used a psychedelic substance to treat their diagnosed disorder, and whether they used a microdose, a regular dose, or both.

Statistical Analysis

Data from 5,271 respondents were entered into the statistical program SPSS (version 24.0). A binary logistic regression was conducted for the mental and physiological diagnoses for each of the three effectiveness questions, and separate binary logic regressions were conducted for each category within the mental or physiological diagnosed group.

In order to examine whether ADHD/ADD and autism/Asperger’s account for the results of neurodevelopmental disorders, ad hoc analyses were conducted. The results show that ADHD/ADD accounts for a smaller proportion of the results than autism/Asperger’s.

Demographic Information

A total of 3,590 out of 5,681 respondents consented, were 18 years or older, and completed the questionnaire. One third indicated to have microdosed with at least one psychedelic substance, and 36.7% indicated to have been diagnosed with a disorder.

The majority of respondents were males, aged 28.9 years on average, with tertiary education being the prevailing daily occupation. They were from North-America, Europe, Australia, Asia, South-America and Africa, and the prevailing daily occupation was learning/studying.

All microdosers reported having had experience with regular doses of psychedelics, and the most frequently reported psychedelics were psilocybin, LSD, and 1P-LSD.

Mental and Physiological Diagnoses

A total of 1,062 diagnoses were reported, including 901 mental diagnoses and 161 physiological diagnoses. The average number of diagnoses was 2.5.

The three most prevalent mental diagnosed disorders are depressive disorders, anxiety disorders, and ADHD/ADD. The three most prevalent physiological diagnosed disorders are migraines, chronic pain, and cluster headaches.

TREATMENT

The majority of mental diagnoses were treated with conventional (non)pharmacological treatments. Psychedelics were used to self-medicate in more than half of the mental diagnoses.

The majority of physiological disorders were treated with conventional therapy, but in one-third of cases psychedelics were used to self-medicate. The most reported psychedelics used to self-medicate for psychological disorders are psilocybin, LSD, and MDMA.

Effectiveness of Psychedelic Microdosing Compared to Conventional Treatment

Binary logistic regression analysis demonstrated that MDP was significantly more effective than conventional treatment in improving three questions: did it work, symptoms disappeared, and QOL improved.

Separate binary logistic regressions per mental sub-category showed that MDP was more effective than conventional therapy for neurodevelopmental and anxiety disorders, but not for autism/Asperger’s.

The statistically significant OR for the three questions “did it work?”, “symptoms disappeared?”, and “QOL improved” was significantly higher compared to conventional treatment.

MDP was more effective compared to conventional treatment for the nervous system disorders, with ORs of 6.78, symptoms disappearance, and QOL improved.

Effectiveness of Psychedelic Microdoses Compared to Regular Doses

MDP was rated as less beneficial than regular doses for mental disorders, but was statistically equally effective for trauma- and stressor-related disorders, feeding and eating disorders, sleep-wake disorders, sexual dysfunctions, gender dysphoria, and disruptive, impulse control and conduct disorders.

There was no difference in SRE when comparing microdoses and regular doses to treat physiological disorders, as indicated by statistically non-significant OR for the three questions.

DISCUSSION

The present study aimed to investigate the self-rated effectiveness of self-medication with psychedelic microdoses (MDP) for diagnosed mental and physiological disorders, compared to conventional treatments and regular doses of psychedelics. The results showed that MDP was more beneficial for neurodevelopmental and anxiety disorders.

The current survey demonstrates that self-medication with MDP is more effective than conventional treatment in case of anxiety, ADHD/ADD, and physiological disorders such as pain. This is probably due to the fact that MDP produces potentially less unwanted effects compared to conventional pharmacological treatments.

Although MDP was only statistically significant when used for anxiety, ADHD/ADD and physiological disorders, it was rated as effective for depressive, bipolar, substance-related and personality disorders. OCD was not rated as more effective on any of the questions.

When self-medicating for depression and anxiety, microdoses of MDP were rated as less effective than regular doses of psychedelics. No difference was found for neurodevelopmental disorders, OCD related or physiological disorders such as chronic pain, suggesting a different mode of therapeutic action.

This study is not without its limitations, but the rates of mental disorders were in line with the general population worldwide, and most participants were diagnosed with more than one disorder.

The effectiveness of different kind of psychedelics was not possible due to the small sample size, and the disorder history (duration and severity) was not assessed. Additionally, the duration of symptom alleviation was not asked, and the self-selected sample might have been biased towards the favorability of psychedelics over all kinds of treatments.

To conclude, this study demonstrates that SRE of MDP is higher compared to conventionally offered treatment options and lower than regular psychedelic doses.