Text: Arnaud demaison

LSD treatment, without addiction

Psychedelic microdosing can be used to treat depression, migraine or post-traumatic stress. Close-up of an increasingly popular phenomenon.

These laws aimed to ban recreational use, but they also discouraged research.

In the series Nine Perfect Strangers, Nicole Kidman runs a wellness centre where she slips low doses of LSD to her residents without their knowledge, to help them cope with their past traumas, meeting varying degrees of success. While this fiction departs from the medical and ethical considerations that usually accompany such treatment, it highlights an increasingly common practice: microdosing.

Many substances including LSD or psilocybin are circulating where people have the means to get them. A microdose is usually between 5% and 10% of the amount normally required to achieve a psychedelic effect. There are no hallucinations, the effects are subtle and allow people to function normally, as if taking a conventional drug. These positive results have made the phenomenon so popular that it has prompted research into it. But these drugs continue to struggle with an image problem.

War on drugs

The US government’s drug prohibition policy, launched in the 1970s under President Nixon, had repercussions around the world. A list of substances designated as drugs to be banned would be taken up as far as Europe, lumping together opiates, cannabis and psychedelics. These laws aimed to ban recreational use, but they also discouraged research. Debates on cannabis liberalisation are beginning to lift certain moral and political barriers.

Gabriel Thorens, a psychiatrist specialising in addiction medicine at the HUG, feels that psychedelics still suffer from a bad reputation in 2022. The expert says, “we know that we should now distinguish between the psychotropic effect, which affects our perception, and the addictive effect, which disturbs the reward system and causes dependency. For example, LSD is hallucinogenic but has little or no addictive effect. Conversely, nicotine is very quickly addictive, but does not alter one’s perception of their environment.”

What about quality?

Gabriel Thorens practices psychedelic-assisted psychotherapy (with full doses) in the context of compassion therapy, i.e. for people at the end of their life. However, the psychiatrist has some reservations about the practice of microdosing, as “the substances are currently only available on the black market. Unless individuals have them checked in a laboratory, they are often not safe, either in terms of dosage or quality.”

As for prescription use, Gabriel Thorens notes that much more research is needed to determine the real benefit and, consequently, whether to include it as part of therapy. “With a full dose, the intensity of the psychedelic experience itself provides therapeutic added value. With microdosing, the chemical would have its own affect on the brain. We are still at the hypothesis stage, but more and more studies on full doses with psychedelic action report that, for example for chronic depression, it could be a remarkable treatment.”/

These laws aimed to ban recreational use, but they also discouraged research

Testimonial Soraya Cadelli “I’ve been suffering from depression since I was a child. After years of going from doctor to doctor, I took the advice of a therapist and started microdosing with psilocybin. Based on discussions with researchers, Dr. Fadiman’s protocol emerged as the best option: 5 mg before 10 a.m. every three days and as needed. My mental and physical health improved immediately and I have had no side effects. However, psilocybin remains hard to come by in psychiatry due to legal restrictions. But the challenges do not discourage me, and more and more of people have united to take collective measures. And we’ll do it with or without the support of mainstream psychiatry.”



Old chemicals, new treatments

For several decades, psychiatric medication has basically revolved around four categories of drugs: antipsychotics, mood stabilisers, antidepressants and anxiolytics. While these drugs have proven effective in treating a wide range of pathologies, regained interest in older chemicals, such as LSD and psilocybin, could bring fresh momentum to psychopharmacology.