"If you can’t see in a proper trial that it works for the symptoms, for things that people can actually detect and feel and experience in their lives, then it’s just not that interesting," says Dr. Michiel van Elk.
Multiple clinical studies have shown the potential mental health benefits of full-dose psychedelic use, but when it comes to microdosing, the science is far from settled.
In a recent New York Times article, health and science writer Dana Smith questioned the increasingly popular narrative that taking low, non-hallucinogenic doses of drugs like lysergic acid diethylamide (LSD) and psilocybin in regular intervals improved mood and cognitive function. Her report revealed that much of the research surrounding the positive effects of microdosing was incomplete, if not altogether flawed, and that most studies were undersized and failed to control for a placebo. Furthermore, most evidence suggesting microdosing lessened anxiety and alleviated depression was anecdotal at best.
“You probably only participate at this point in a trial in microdosing if you really have a strong belief that this might help you,” Dr. David Erritzoe, the clinical director of the Centre for Psychedelic Research at Imperial College London, told the Times.
People who expect to benefit from a drug often do, which is a reason most researchers opt for placebo-controlled studies when possible. Two notable microdosing trials from last year did control for a placebo, but in each case the participants reported improved moods and well-being regardless of whether they took the placebo or low doses of a psychedelic.
“I was initially surprised but also a bit disappointed by the results, because when we set up the study we were quite optimistic,” Leiden University assistant professor of cognitive psychology Michiel van Elk, who oversaw one of the studies, said.
In the third placebo-controlled study, published just last month, the results were equally underwhelming with researchers concluding that “repeated low doses of LSD are safe, but produce negligible changes in mood or cognition in healthy volunteers.”
Pointing to the fact that neuroimaging technology has definitively shown how microdoses of psilocybin and LSD can directly impact brain chemistry, some researchers still believe the benefits of low-dose psychedelics are more than just wishful thinking.
“I wouldn’t say it’s all placebo. Clearly, it’s an active drug,” Harriet de Wit, a researcher and professor of psychiatry and behavioral neuroscience at the University of Chicago, said. “We see brain changes that are a little bit like the high dose effect.”
Both Dr. de Wit and Dr. van Elk thought it was possible the microdosing studies themselves were flawed by everything from short run times and inadequate questionnaires to it being near impossible to control for a placebo with hallucinogens—after all, how can someone expecting a drug with psychoactive effects be fooled by a placebo?
While Dr. van Elk was optimistic microdosing could one day prove beneficial, he had decided to abandon his low-dose research because of its inherent difficulties. Dr. Erritzoe planned to do the same, telling the Times he would probably return to macrodosing studies after completing his next trial.
“If you can’t see in a proper trial that it works for the symptoms, for things that people can actually detect and feel and experience in their lives, then it’s just not that interesting,” he said, adding, “I’m not trying to shoot down microdosing. I’m just being cautious and saying at the moment, it does not look particularly optimistic.”