The Viability of Microdosing Psychedelics as a Strategy to Enhance Cognition and Well-being – An Early Review

This 2019 review examines the viability of microdosing psychedelics as a method to improve cognition and well-being. Available evidence indicates a variety of benefits including improvements in mood, focus, and creativity, with some people experiencing no discernible effects or expressing concerns about selective negative consequences like increased anxiety, however, most insights stem from observational studies using convenience samples that are biased or unrepresentative of the general population.

Abstract

“Review: Psychedelic substances are currently experiencing a renaissance in interest for both therapeutic as well as recreational applications. It has been proposed that microdosing, i.e., ingesting sub-perceptual doses of a psychedelic, could confer some of the benefits of these substances to users while minimizing the risks associated with full-dose use. This review aimed to summarize and examine the extant literature on psychedelic microdosing. Exploratory evidence published to date indicates a variety of benefits reported by microdosers including improvements in mood, focus, and creativity, with some null reports, and a minority of people reporting selective negative consequences such as increased anxiety and physiological discomfort. Methodological limitations of current evidence, however, make definitive conclusions hard to draw. Recommendations for future research are given.”

Authors: Joel Bornemann

Summary

Psychedelic substances are experiencing a renaissance in interest for both therapeutic as well as recreational applications. Microdosing may confer some of the benefits of these substances to users while minimizing the risks associated with full-dose use.

Introduction

Despite their continued illegality in most parts of the world, psychedelic substances have been experiencing a resurgence of interest in both therapeutic and recreational applications. Psychedelics may be useful in the treatment of substance dependence, end-of-life anxiety and depression, treatment-resistant depression, and obsessive-compulsive disorder. However, full-dose psychedelic use can be immensely challenging and may result in psychological problems like panic attacks, flashbacks, and hallucinogen persisting perception disorder.

Researchers have proposed that microdosing psychedelics can be a viable strategy to improve cognitive functioning and well-being, while minimizing the risks associated with full-dose use.

Methods

To find relevant studies on microdosing psychedelics, I searched Scopus, Pub-med, ProQuest, Google Scholar, and sEURch. Eleven observational studies, one quasi-experimental study, and nine experimental studies were included in the final selection. Due to the paucity of research, much of the evidence remains qualitative. The subsections of this review are structured in order of increasing evidential strength.

General effects

Although information is scarce, a number of observational, qualitative studies have provided preliminary statistics on the distribution of general effect patterns in their respective populations. Most participants reported experiencing positive effects, with negative effects being more commonly experienced by one fifth of participants.

Johnstad (2018) interviewed 21 participants recruited through internet fora and reported mostly positive experiences, among some null reports. However, some participants experienced backfiring effects associated with more long-term use.

In a study of comorbid drug use in college students, 69% reported at least one negative consequence of microdosing. However, the most commonly cited negative consequence was the experience of hallucinations, which is most likely a result of a failure to dose correctly.

Microdosers report positive effects with some reporting no discernible effects and a number of reported challenges, including having to measure doses oneself and hiding the practice from others.

Creativity

Multiple studies attest to an improvement of creativity associated with microdosing. Qualitative and quantitative studies have found that microdosers report improved creativity, though it cannot be established that the effects observed are a result of a microdosing practice.

Prochazkova et al. (2018) assessed measures of general intelligence, divergent thinking, and convergent thinking in visitors to a psychedelic festival in the Netherlands. They found that psychedelic substances may help creativity by improving task transitioning processes in the brain.

In contrast to previous research, one observational study found no changes in creativity among microdosing participants, and a more objective creativity task showed no differences beyond a marginal increase in attempts for the highest dose.

Focus and productivity

Microdosing psychedelic substances appears to improve focus and productivity at work, and has been reported in several qualitative studies. However, negative accounts regarding focus were outweighed by positive accounts in an almost 2:1 ratio.

Polito and Stevenson (2019) found that participants had lower levels of distractibility and increased absorption at follow-up, compared with baseline, and that the experimental, placebo-controlled study by Bershad et al. (2019) found neither effects on working memory function nor on focus and productivity.

A study conducted on a subset of the Family et al. [2019] sample found that people under the influence of an LSD microdose tended to overestimate supra-second time intervals, but this finding was restricted to the 2000 – 4000 millisecond range.

Mood and general well-being

Qualitative studies have reported that microdosing can improve mood, energy, self-efficacy, openness toward friends and family, attitude toward life, and extroversion. Quantitative studies have reported that microdosing can decrease dysfunctional attitudes and negative emotionality, and increase wisdom and open-mindedness.

Two experimental studies that investigated higher-dose psychedelic effects but included low-dose conditions for comparison report mixed results, with some participants reporting positive behavior changes and positive mood changes, while others report no or only very few noteworthy alterations on mood and emotional processing.

General

Anderson et al. (2019a), Johnstad (2018), Hutten et al. (2019b) reported reduced use of substances such as caffeine, alcohol and tobacco, and Moreno et al. (2006) reported some improvements in OCD symptoms for microdoses of psilocybin, but no placebo condition was included.

Depression

Although generally dwarfed by the seemingly strong anti-depressive effects of full psychedelic doses, some studies have shown that psychedelic microdoses may also help with depression and depressive symptoms.

Anxiety

The evidence surrounding the effects of microdosing on anxiety is contested. Some studies have reported relief from anxiety, while others have reported increased anxiety.

As for quantitative evidence, Hutten et al. (2019b) found that microdosing was both more effective than traditional treatments and less effective than higher psychedelic doses for treatment of anxiety disorders, while Griffiths et al. (2016) found that 15% of patients experienced an episode of anxiety during the session.

Physiological effects

Research on the physiological effects of psychedelic microdosing remains almost exclusively qualitative. Some participants reported a significant buildup of tolerance, while others reported no tolerance.

As for acute physiological effects of microdosing, Johnstad (2018) reported reductions in migraines for some participants, and Hutten et al. (2019b) found that microdosing was a more effective treatment than conventional options for nervous system diseases like migraines and cluster headaches.

No research has examined the long-term effects of microdosing psychedelic substances, but 5-HT2B agonists have been implicated in valvular heart disease. Further research is needed to determine the long-term effects of microdosing.

Discussion

This study summarized the extant literature on the topic of psychedelic microdosing and found that most people experienced positive effects, with some experiencing no discernible effects or expressing concerns about selective negative consequences like increased anxiety.

Two arguments against a placebo-based explanation have been proposed: (1) the specific effects of microdosing may be too specific to be due to placebo or nocebo effects; (2) people’s expectations of microdosing effects may not be associated with actual experiences.

The phenomenon of microdosing may be heavily influenced by expectations and placebo, but individual genetic and epigenetic differences may also account for some of these data.

Researchers have found that analogies from full doses do not commonly hold for microdoses, and vice versa. Neuroimaging studies could help determine to what extent analogies between full doses and microdoses are appropriate, and whether microdoses could have similar anti-depressive properties.

There is no consensus on the precise definition of a microdose, but the experimental evidence reviewed here ranges from 12 g/kg body weight to 45 g/kg body weight. Standardized experimental procedures are needed to address confusion and confounds related to this issue.

Methodologically strong research on psychedelic substances continues to be difficult due to lack of official approval and the high cost of legally acquiring the substances.