The sometimes exaggerated the benefits of microdose, which are regularly used in small amounts of psychedelic drugs, such as lysergic acid diethylamide (LSD), could be overstated, new research suggests this week. The study found that people who microdossed experienced psychological benefits, including a greater sense of well-being, but that these benefits were not substantially different from how others felt when they took a placebo. The results of the experimental study indicate that at least some of the positive aspects of the microdose can be attributed to the placebo effect, but the study has its own warnings.
Psychedelic drug treatment has emerged as a promising approach to improving people’s mental health in recent years. Some studies have suggested that medications such as LSD and psilocybin, the main ingredient in magic mushrooms, may help treat anxiety and depression, especially when combined with therapy. Other investigations have found tests of positive changes in the brain cells of animals or people when exposed to psychedelics, further reinforcing the case for real biological benefit. One method of using these drugs is microdose, which is when people take much smaller doses than those used recreationally, on a regular schedule.
However, much of the evidence for the benefits of microdose is based on real-world observations or anecdotal experiences, which includes its limitations. Some symptoms that some people self-report while taking a medication will improve, for example, even if they have not. treated the underlying condition that caused these symptoms. One clear way to overcome the limitations of anecdotal evidence is through a placebo-controlled study, but these studies are generally expensive and require a lot of time and resources. This is especially true for microdose studies, as these drugs are still illegal in many countries and scientists have to jump over obstacles to use them for research.
The authors of this new study, published on Tuesday at eLife, they decided to take a unique approach to conducting their placebo-controlled study. They asked for help from people who were already microdosing regularly, and then essentially helped them carry out the experiment on their own.
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These citizen-scientists were instructed on how to make the experiment controlled with placebo, so that they did not know if they were taking a placebo or the actual drug (mostly LSD, but some were also taking psilocybin). This included placing the medicine, which was in powder form, inside opaque ice capsules, and then placing these capsules and placebo capsules inside envelopes containing a weekly four-dose supply. Some envelopes contained nothing but placebo, others contained a mixture of placebo and the drug.
All envelopes had an attached QR code that would allow researchers to know the contents of each envelope and the specific order of the pills taken that week, but not the volunteers. Some of the study subjects were randomly assigned to microdose two of the four weeks and received placebo for the other two weeks, and some received placebo all the time. During the study, all volunteers periodically completed surveys about their ongoing psychological state.
A total of 191 people completed the experiment, making it the largest placebo-controlled study of its kind, according to the authors. Microse volunteers reported psychological improvements from baseline, including reduced anxiety and a greater sense of well-being, but so did people taking placebo, and there were generally no significant differences between three groups.
“The results suggest that the anecdotal benefits of microdose may be explained by the placebo effect,” the authors wrote.
There are some important warnings in these findings. On the one hand, the study found a small but statistically significant difference in certain results when comparing the placebo group with the microdose group; they include improvements in mood, energy, and creativity. But researchers argue that there is also a mundane explanation. Approximately 72% of the time, better than chance, volunteers were able to guess exactly whether they were taking a placebo or a drug. Therefore, it is possible that their expectations of feeling better increased when they correctly suspected that they had taken the drug instead of placebo, which means that their blinding was not entirely infallible.
The study also failed to control for variables such as purity or actual dose of microdose, as it was based on typical medications that volunteers already used (on average, users reported taking 13 microdoses).grams of LSD per dose, but the authors were unable to test the amount of the active ingredient people were taking). And while they tried to make sure people adhered to the instructions they were given, the very nature of the study meant they had less control over whether everything was followed correctly. Regarding the ethics of this research, the authors said that they only reached self-identified microdosers and did not collect any other personally identifiable information other than their email (the study was authorized by an external committee ).
It is also worth noting that psychedelic drugs are being studied and taken for mental health in different ways, and that microdose is just one approach. Some researchers have argued that it is the intense experience of taking psychedelics (either in microdose or relatively high macrodoses), along with guided therapy, that really provides the clearest benefits to people, for example. In 2019, the drug was ketamine adapted in an FDA-approved treatment for depression. It is taken in smaller doses than when taken recreationally and under medical supervision, but it can also be a higher dose than people would take on their own while microdosing.
Importantly, the authors also note that the study volunteers were generally healthy, with only 7% having a current mental health diagnosis. Therefore, they do not rule out the possibility that microdosification is still useful for experimenting people mental illness.
Of course, no study should be seen as the final word on any topic, especially when it is based on an experimental approach. However, the authors hope that their unique study design can be used in the future for other complicated research areas where it is difficult to include a placebo control. An immediate benefit could be the cost, as this study only required about 1% of the funding normally used to conduct a clinical trial. Other possible applications for this approach include studying CBD, nootropics, and nutrition, they wrote.