BlogMicrodosing and the placebo effect - setting up your own ‘self-blinding’ microdosing experiment

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Microdosing and the placebo effect - setting up your own ‘self-blinding’ microdosing experiment

13-06-2019

Everything you need to start microdosing

Why are people microdosing psychedelics?


On May 26 2019, this reporter attended a microdosing seminar organised by microdosing.nl in Amsterdam. Microdosing.nl and its co-founder, Jakobien, were already featured in a recent blogpost on the benefits of a microdosing community. This time around, the seminar focused on a number of research efforts undertaken by dr. James Fadiman, dr. Toby Lea and dr. Kim Kuypers.

Online survey on microdosing - the groundwork

From the research undertaken and curated by dr. James Fadiman, emerge a variety of reasons why people have taken up microdosing psychedelic substances : these include combating chronic pain, painful menstrual cycles, reducing anxiety, and  a desire to engage in spiritually fulfilling self development. Remarkably,  50% of the sample group mentioned microdosing as a way to alleviate symptoms of depression, often after being disillusioned by SSRI or MAOI antidepressants. James Fadiman and his collaborators set out to discover more about the ways in which these controversial and - more often than not - illegal psychedelic substances could have beneficial and therapeutic effects.

Over a period of 18 months, over a 1000 individuals from 59 countries participated in a study (published in March 2019) on the effects of microdosing. Participants were left to their own devices to come up with an acceptable dose and administration timetable but were asked to comment daily on their health and well-being. They followed their own format by submitting daily, subjective reports as well as delivering more standardized information through a PANAS checklist.

Past and present microdosing - expectations and effects

Recently, a similar research initiative was conducted by dr. Toby Lea, researcher at the German Institute for Addiction and Prevention Research. Through an international online survey, 1533 participants commented on their motivation, perceived health outcomes and potential harm reduction associated with a current or past habit of microdosing. Here as well, 40% or participants reported depression as their prime motivation.

From this broad survey, dr. Lea deduced a number of similarities grouping certain survey questions. It seems that microdosing psychedelic substances accounted for an improved mood and well-being and an increased appetite for social interaction. A large percentage of respondents indicated that microdosing either didn’t really work or caused anxiety but these complaints seemed to coincide with taking a daily dose instead of following an on/off protocol.

Dried magic mushrooms

Getting into the nitty-gritty of psychedelic research

Limitations in psychedelic research

Also present at the seminar was dr. Kim Kuypers, seasoned researcher into the effectiveness of psychedelic substances on our sense of well-being and creativity, currently employed by the University of Maastricht. Dr. Kuypers contributed to a 2018 study on the effects of a single dose of psilocybin on creativity. This study’s findings are encouraging and warrant further research, yet come with a number of interesting caveats. For one, its sample size is rather small (N=55) with about half (N=22) of participants completing all or some of the follow-up tests, 7 days after ingesting psilocybin. Many subjects, participants in a psilocybin retreat, had explicitly formulated certain expectations about the effectiveness of psilocybin in “understanding themselves” (83.6%) or “resolving problems” (49.1%). The mere fact that participants shared their experiences within a group of like-minded individuals could also have amplified a temporary sense of life satisfaction. All of these factors contribute to what is commonly referred to as the placebo effect.

In a similar, often-quoted study, researchers from the University of Leiden attenuated their findings by pointing to similar limitations. Participants - members of the Dutch Psychedelic Society - could be considered positively predisposed towards the idea of using psychedelics to improve their general sense of well-being.  Also, no control group was used in the study. Finally, cognitive tests taken before administering psilocybin in order to establish a baseline could lead participants to perform better on subsequent tests.

Placebo-controlled studies into psychedelics

Organising a placebo-controlled study in a clinical setting is often a complicated affair, even more so when it comes to psychedelics. After all, would you be willing to devote time and effort to participating in a study where there’s a 50% chance you’ll end up in the control group? Using (often illegal) psychedelics for scientific purposes requires doses to be uniform and certified to contain a certain percentage of active substances, with certification being a costly factor. Also, the periodic follow-ups by a trained professional and administering tests that go beyond simple questionnaires, are expensive.

In one such a placebo-controlled, double-blind (neither the test group nor the control group are informed about their role) study from 2016, patients with a life-threatening form of cancer and related depressive symptoms were given a single dose of psilocybin. The test group was given a high dose of psilocybin while the control group was given a dose that was almost sure to be pharmacologically inactive.

The study found a significant reduction in depressive and anxiety-related symptoms immediately after and up to 6 months after taking the dose. This response was significantly stronger in the test group compared to the control group. Interestingly, participants in both groups were informed they would be receiving psilocybin, thereby allowing for the ‘expectancy effects’ to be present in both groups.

At the end of dr. Kuypers’ presentation of her latest research on the ‘ideal’ amount of LSD used for microdosing, Jakobien asked to what extent the placebo effect could be recast as a ‘natural healing effect’. Much has been said about triggering the body’s natural healing response and it would be wrong to cast this ability in a negative light. Your body’s tendency to heal itself when you believe you’re being helped is a good thing and should be embraced. However, if the benefits of ingesting small doses of a psychedelic substance solely rely on the placebo effect, something seems awry. After all, wouldn’t any substance or practice that raises certain expectations and conjures up a host of positive associations be a valid alternative?

microdosing brain connections

Setting up your own ‘self blinding’ microdosing study


Seriously microdosing

In an attempt to fine-tune Fadiman’s research efforts concerning the effects and practices of microdosing, a group of researchers invite everyone and all (at least 18 year old) to participate in an online microdosing study with a degree of placebo control. This study is overseen by the Imperial College London and sponsored by the Beckley Foundation, a shadowy organisation bent on world domination. Just kidding, the Beckley Foundation is a NGO chaired by Amanda Fielding (Countess of Wemyss and March, and a person of interest, to say the least), dedicated to funding and aiding research into psychoactive substances and driving policy reform.

What’s your poison - LSD or psilocybin?

Respondents are required to prepare a number of microdosing capsules containing LSD or dried psilocybin mushrooms and a number of placebo capsules. This reporter chose to dry psilocybin truffles (galindoi) and regular mushrooms (chestnut) - the latter taste phenomenally when dried, just saying - and opting for a 0.4 gram microdose. The ideal microdose should be high enough to be pharmacologically active but low enough so you won’t experience any trippy effects.

I came up with this dose after consulting various sources on the good ol’ internet. The hard and fast rule would be to take 1/10 of a regular dose of fresh psilocybin truffles and then take anywhere between 30% and 50% of this weight (depending on your comfort level) for your microdose of dried truffles. After taking a 0.4 gram microdose I suspect I might have felt something but I’m not entirely sure, which is probably what you’d want for this study.  Before starting this experiment, take some time to determine a microdose you’re comfortable with and which doesn’t impair your daily routine.

Placebo-proofing your microdosing experiment

Before starting the experiment, you’ll be asked to determine a dosing schedule, where you’ll fix the days of the week you’ll be taking a capsule. The microdosing experiment runs for 10 weeks, with one week of no dosing, 4 weeks of actual dosing, followed by 5 weeks of no dosing and a number of follow-up reports. During your ‘dosing weeks’, you’ll be either following an actual microdosing regimen or be assigned a placebo week. Even your microdosing regime will include a number of placebo days.  

In total, you’ll prepare  8 microdosing capsules and 24 placebo capsules during the suggested setup of the experiment, with a random selection of half these capsules included in the actual dosing weeks. It’s therefore not clear how many ‘guaranteed’ microdosing capsules will be included in the experiment and it could very well be that the vast majority of these capsules will be placebos. The experiment uses QR-codes to determine retroactively for each of your ‘dosing days’ if you were really microdosing or just taking a placebo. Wouldn’t that be interesting to find out?

The aggregate results of this study will be published in late 2019 and data will be collected until well into this summer.

Everything you need to start microdosing



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