Anyone holding out hope for lysergic acid diethylamide (LSD) as a potential treatment for attention-deficit/hyperactivity disorder (ADHD) are going to be disappointed.
A new clinical trial reveals that microdosing LSD doesn’t significantly improve ADHD symptoms in adults compared to a placebo. The study, the first of its kind to conduct a double-blind, placebo-controlled randomized clinical trial on the potential treatment, challenges anecdotal claims about the efficacy of psychedelic microdosing.
“Altogether, these results do not confirm possible positive effects of low doses of LSD on ADHD symptoms as suggested by user surveys or naturalistic studies,” the researchers wrote. “This discrepancy underscores the need for randomized placebo-controlled trials when validly assessing potential benefits of low-dose psychedelics that are likely prone to a placebo response and expectancy bias.”
New Hope For ADHD Treatment
Standard ADHD treatment options typically include stimulant medications such as methylphenidate and amphetamines, as well as non-stimulants like atomoxetine. While these treatments are generally effective, anywhere between 20 percent and 40 percent of patients do fail to respond. Worse still, side effects – which contribute to poor long-term adherence – hinder their effectiveness. Only about half of methylphenidate users continue treatment after six years.
In recent years, researchers have increasingly turned their attention to microdosing psychedelics as a (potential) alternative approach to managing ADHD – as well as other mental health conditions. While anecdotal evidence has repeatedly hinted at the potential benefits of microdosing psychedelics, controlled clinical evidence has been scarce. Until now.
New Evidence Suggests Otherwise
Researchers running this recent phase 2A trial sought to rectify that. The team administered 20 micrograms of LSD twice weekly to adults with moderate to severe ADHD over a six-week period. The trial included 53 participants, with half of them receiving LSD and the rest receiving a placebo.
The study aimed to gauge the changes (if any) in ADHD symptoms from baseline to the end of the trial. The results revealed that both groups experienced notable symptom improvements.
But those improvements turned out to be the same for both groups. As a result, the researchers concluded that LSD microdosing offered no additional benefit over placebo in easing ADHD symptoms.
The researchers added that the participants tolerated the LSD microdoses well. Participants reported a handful of mild adverse effects – such as fatigue, headaches, insomnia, nausea, and mild visual alteration.
It’s worth noting that two participants from the LSD group pulled out because of strong acute side effects. One described the experience as intense and uncomfortable, while the other found the effects pleasant but they hindered most everyday activities.
Pharmacokinetic analysis revealed that the body absorbs LSD quickly, reaching peak plasma concentrations after a little more than an hour. The study’s 20-microgram dose, which many consider to be at the upper end of typical microdosing ranges, might have contributed to stronger than intended side effects. The researchers added that they pursued this dosage to maximize the likelihood of detecting potential benefits. As a result, lower doses (or alternative dosing intervals) might yield different outcomes.
Interestingly, most participants believed that they’d received LSD regardless of whether they really did. And those who shared that belief reported slightly better outcomes, reinforcing the potential influence of placebo effects – along with participant expectations.
Drawing Conclusions
The researchers suggested that the growing buzz around psychedelic treatments – along with the patients’ overwhelming desire for relief – could have contributed to this amplified placebo response. This lines up with earlier research involving healthy individuals, where both groups also reported improved well-being.
The study’s results contradict the persistent anecdotal claims that LSD microdosing eases ADHD symptoms. At the same time, the findings underscore the importance of rigorous, placebo-controlled research in evaluating psychedelic treatments.
The researchers concluded that future research must explore different dosing strategies, as well as potential psychological or environmental factors that might influence treatment outcomes. In the meantime, this trial casts doubt on the accelerating trend of self-medicating ADHD with psychedelics.
Further Reading
Tailored CBT Treatment Show Promise in ADHD Patients
Talking to Your Patients About Psychedelics
Therapeutic Potential of Psychedelics in the Treatment of Psychiatric Disorders
