First-of-its-kind trial finds psychedelic microdosing is equal to placebo
A first of its kind "self-blinded" trial testing the effect of psychedelic microdosing has found the anecdotally popular practice may be an example of a strong placebo effect. The research, led by Imperial College London, suggests there is little difference in reported benefits between a microdose and a placebo.
Psychedelic microdosing in not a new phenomenon, but it has grown in mainstream popularity over the past decade. American researcher James Fadiman famously popularized the idea with his book The Psychedelic Explorer's Guide in 2011.
The key to microdosing is the belief that frequent low doses of psychedelics such as LSD can generate enhancements to productivity, creativity, mental well-being and energy. But most importantly, a microdose must be so small the user does not experience any perceptual or hallucinogenic effects.
Microdosing has managed to flourish in popularity despite very little empirical evidence showing it works. A small, but growing, body of science is only now subjecting the practice to the rigors of clinical research, but taboo and prohibition have stifled the ability to run a rigorous controlled trial actually testing whether it works.
“Restrictive drug policies make placebo-controlled studies on psychedelics difficult and expensive, in particular for microdosing, which involves taking psychedelics over a longer time period,” the researchers note in the introduction to their newly published study.
So the team from Imperial College London developed a unique self-blinding protocol to solve the problem. Volunteers, who self-report personal microdosing practice, were directed to create their own collection of microdoses and placebos.
The gel-caps were then placed into envelopes marked with QR codes. The envelopes are shuffled and the volunteers are subsequently blinded from what they are taking. Only the researchers, via the QR codes, can track the placebos from the active doses.
The study recruited 191 subjects for a four-week protocol. The cohort was broken up into three groups: placebo, microdosers and a half-half group taking microdoses for two weeks and placebo for two weeks.
Across the study period the cohort completed a number of cognitive and psychological tests. Balázs Szigeti, lead author on the new study, says the results showed those subjects taking a placebo reported the same benefits as those taking microdoses.
“Our findings confirmed some of the beneficial psychological effects of microdosing from anecdotal reports and observational studies, such as improved sense of wellbeing and life satisfaction,” says Szigeti. "But we see the same improvements among participants taking placebos. This suggests that the improvements may not be due to the pharmacological action of the drug but can instead be explained by the placebo effect.”
The researchers are clear in noting the limitations of their study. Obviously, as volunteers were using their own psychedelic substances in the trial, it is impossible to verify purity and dosage. But this factor is suggested as giving the research “greater ecological validity” than a rigorously controlled clinical trial.
The results are presented not as “clinical evidence” but rather more representative of “real life microdosing.” All the volunteers were self-admitted regular microdosers and many in the placebo group were ultimately surprised to find they were not taking active microdoses during the trial period.
"I have just checked the remaining envelopes and it appears that I was indeed taking placebos throughout the trial,” one participant is reported as saying. “I’m quite astonished […] It seems I was able to generate a powerful 'altered consciousness' experience based only the expectation around the possibility of a microdose.”
Another limitation recognized by the researchers is the fact the study comprised participants with an active history of microdosing. Some advocates of the practice suggest it can take weeks, or months, for microdosing to generate quantifiable beneficial effects.
So not only is the study not designed to detect any cumulative long-term effects from microdosing, but the reported benefits seen in the placebo group could be lingering effects from prior microdosing behaviors.
“We cannot rule out the possibility that a study in a clinical population would yield more promising results. In the present healthy sample, where well-being scores are high at baseline, there is less scope for potential improvements, which could have prevented the observation of placebo-microdose differences,” the researchers write.
Ultimately this research is by no means the end of the microdosing debate. More controlled clinical trials are certainly necessary to better understand the phenomenon but perhaps one of the strongest outcomes presented here is a demonstration of a new kind of citizen-science methodology.
Sitting in between an observational study and a controlled clinical trial, this kind of self-blinded naturalistic methodology offers novel, cost-effective insights into real-world uses of drugs. David Erritzoe, senior author on the study, hopes to see more research utilize this unique methodology.
“Accounting for the placebo effect is important when assessing trends such as the use of cannabidiol oils, fad diets or supplements where social pressure or users’ expectations can lead to a strong placebo response,” says Erritzoe. “Self-blinding citizen science initiatives could be used as an inexpensive, initial screening tool before launching expensive clinical studies.”
The new study was published in the journal eLife.
Source: Imperial College London