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

This paper (2020) reviews the available evidence on psychedelic microdosing. The author concludes that the current literature, although seemingly promising, is methodologically insufficient to allow strong conclusions.

Abstract

“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.”

Author: 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. Recently, research indicates that psychedelics may be useful in the treatment of substance dependence, end-of-life anxiety and depression, treatment-resistant depression, and obsessive-compulsive disorder. However, psychedelic use can also be associated with enduring 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

I searched Scopus, Pub-med, ProQuest, Google Scholar, and sEURch for studies on microdosing psychedelics and found 21 studies that met the inclusion criteria. These studies include 11 observational studies, 1 quasi-experimental study, and 9 experimental studies. Due to the paucity of research in this area, most evidence remains qualitative. The subsections of this review are structured in order of increasing evidential strength.

General effects

Although information is scarce, observational, qualitative studies have provided preliminary statistics on the distribution of general effect patterns in their respective populations. Most participants reported experiencing positive effects, and the most commonly reported reason for stopping a microdosing practice was the feeling that the practice was ineffectual.

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

A study by Fossos-Wong et al. (2018) found that 69% of people who reported microdosing in the past year also reported at least one negative consequence of the practice, but the most commonly cited negative consequence was the experience of hallucinations.

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 have found that microdosing is associated with an improvement of creativity. Though it cannot be established that the effects are a result of microdosing, it is possible that more creative people are more likely to seek out the microdosing experience.

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 participants showed significant improvements in both convergent and divergent thinking with no significant changes in fluid intelligence.

One observational study found no changes in creativity among microdosing participants, while another experiment administered four single doses of LSD to 20 volunteers found no differences in creativity beyond a marginal increase in attempts for the highest dose.

Focus and productivity

Several qualitative studies have reported that microdosing psychedelic substances can improve focus and productivity at work, including increased productivity and less procrastination. However, negative accounts regarding impaired focus were outweighed by positive accounts in an almost 2:1 ratio.

Polito and Stevenson (2019) found that participants with a daily LSD intake of 5 g/day experienced lower levels of distractibility and increased absorption at follow-up, compared to controls. However, the experimental, placebo-controlled study by Bershad et al. (2019) found no effects on working memory function or focus and productivity.

A study of human microdosing found that subjects under the influence of an LSD microdose tended to overestimate supra-second time intervals, but this finding is at odds with previous research showing that full doses of psilocybin and LSD tend to lead to underestimations of supra-second time intervals.

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 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 after psychedelic experiences, while others report no or only very few noteworthy alterations on mood and emotional processing.

General

Researchers have found that microdosing psilocybin is effective for treating conditions such as ADD/ ADHD and anxiety disorders, and have also reported improvements in conditions such as obsessive-compulsive disorder, post-traumatic stress disorder, and narcolepsy.

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.

Although two full-dose experimental studies that included microdosing control conditions obtained conflicting results, one study on cancer patients found a 24% clinical response rate on anxiety after the low-dose session, and the other study found slight increases in both state and trait anxiety for people in the low-dose condition.

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.

Microdosing psychedelics has been shown to reduce migraines in some participants, and to be as effective as conventional treatments for nervous system diseases like migraines and cluster headaches. However, there have also been reports of insomnia, increased heart rate, mild to severe headaches and nausea, and physiological discomfort.

No research has examined the long-term effects of microdosing, but 5-HT2B agonists have been suggested to be implicated in valvular heart disease. Future research should investigate the possible cardiovascular effects of a long-term microdosing practice.

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 effects; (2) people’s expectations of microdosing effects may not be associated with the actual experienced effects.

Anderson et al. (2019a) note that almost every effect that was mentioned as an advantage was also mentioned as a disadvantage, suggesting that the phenomenon of microdosing may be heavily influenced by expectations and placebo.

Researchers have found that analogies from full doses do not commonly hold for microdoses and vice versa, although many of the reported effects seem similar between doses at least in terms of direction. Neuroimaging studies could help determine to what extent analogies between full doses and microdoses are appropriate.

There is no consensus on the precise definition of a microdose, but studies using psilocybin at doses between 12 g/kg and 45 g/kg have reported perceptual distortions. 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.