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What to Know About 'Microdosing' Psychedelics

— Research is sparse and definitions aren't consistent, experts say

MedpageToday
A photo of a lab technician holding a small vial of psilocybin.

Taking small doses of psychedelics, referred to as "microdosing," has become increasingly popular, but little is known about the safety or efficacy of the trend.

Google searches related to microdosing psychedelics such as "magic mushrooms" and psilocybin -- the psychoactive substance in those mushrooms -- have been rising over the past 5 years, according to . There have been particular surges in Oregon and Colorado, the only two states where psilocybin is legal, though the substance is decriminalized in a handful of other states and cities. On Reddit, has more than a quarter million members with dozens of posts each day.

David Hellerstein, MD, of Columbia University in New York City, told 鶹ý that a therapeutic psychedelic dose of psilocybin is around 25 mg and could result in a "trip" with altered reality. But microdosing involves much less of the substance, generally about 1 to 3 mg, or about a tenth of a psychedelic dose, taken up to every few days. That's with psilocybin; it would be much harder to dose mushrooms themselves because they contain other compounds, he added.

Hellerstein said microdosing has been a word-of-mouth phenomenon for a long time, but social media presents new ways for proponents to tout the purported mental health and cognitive benefits.

Microdosing has particularly become popular among mothers, with Instagram accounts like racking up tens of thousands of followers to view educational and testimonial content. Some posts even claim that microdosing mushrooms can improve relationships and unlock better parenting.

Smita Das, MD, PhD, MPH, of Stanford University in California and immediate past chair of the Council on Addiction Psychiatry at the American Psychiatric Association, said that there's "insufficient research to comment on the safety and efficacy of microdosing," and that even less is known about microdosing psychedelics for mothers specifically.

"What many of these mothers are trying to accomplish with microdosing includes managing anxiety, stress, and emotional well-being. We have evidence-based ways of trying to help with those concerns, such as therapy, and for some who have more mild concerns, coaching," Das said, pointing out that parenting while using a hallucinogen "presents safety concerns."

There hasn't been much research on microdosing, with of ongoing or completed clinical trials assessing microdoses of psilocybin. A trial from Argentina found microdosing mushrooms may result in noticeable subjective effects and altered brain activity, but evidence of enhanced well-being, creativity, and cognitive function is lacking.

Other research has begun looking at potential risks of microdosing. A assessed the long-term cardiac health effects of microdosing psychedelics -- some of which "share structural similarities with medications which raise the risk of cardiac fibrosis and valvulopathy" -- and found that "chronic microdosing may carry a risk of fibrosis and [valvular heart disease]."

Das noted that much of the existing research is observational and has small sample sizes. In order to determine safety and efficacy of microdosing psychedelics, research must include "blinding, a defined population, a target health or behavior outcome, and validated measures of that outcome," she said.

Just defining "microdosing" is a challenge, experts said. Paul Hutson, PharmD, MS, director of the Transdisciplinary Center for Research in Psychoactive Substances at the University of Wisconsin in Madison, said there's still no consensus as to the definition of a "microdose."

For instance, Hutson said, would microdosing be considered "a sub-hallucinogenic dose, that when you close your eyes, you don't see any changes in vision or images? Or is it just kind of a little sparkle effect, a little bit of hallucinations, a little bit of euphoria, or changes in senses?"

Das agreed that the definitions around microdosing are unclear, as "the intention among users is to produce a benefit without causing issues with cognition or emotions."

She added that much of the reported benefits of microdosing come from anecdotes touted by individuals, but often it's not even clear if they are microdosing, "what that means, what outcome they are reporting, or what other variables may be influencing their reports."

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    Rachael Robertson is a writer on the 鶹ý enterprise and investigative team, also covering OB/GYN news. Her print, data, and audio stories have appeared in Everyday Health, Gizmodo, the Bronx Times, and multiple podcasts.