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Does the placebo effect cause the benefits of microdosing with psychedelics?

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Do the benefits of microdosing psychedelics come from a placebo effect?

A first study into the possibility of a placebo effect with microdosing. Psychedelic drugs such as LSD or the active ingredient of magic mushrooms may provide mental benefits may be due to the placebo effect.

Microdosing is a term for when people regularly use small amounts of drugs, such as LSD. Users say that it doesn't get them high, but that they are more creative, sharper, or somehow improve their mental health. They can take 10 to 20 percent of a normal dose a few times a week.

Some research suggests larger doses psychedelics can help relieve anxiety, depression and other mental illnesses. But microdoses have only been tested in small, placebo-controlled studies, with mixed results. The placebo effect is when people derive physical or mental benefits from medical treatments because of the power of expectation.

New approach to investigate the placebo effect

Because it is difficult to get permission for research involving people receiving illegal drugs, Balázs Szigeti of Imperial College London and his colleagues came up with an unusual trial design. They used Internet forums to contact people who often microdose at home with LSD, the magic mushroom compound psilocybin or similar drugs, which were usually purchased online. The researchers did not analyze the difference in effects based on the medications the participants were taking.

New approach to investigate the placebo effect
New approach to investigate the placebo effect (Fig.)

Participants received empty medical capsules in the mail that they could open to insert a small piece of medicine-impregnated paper. When closed again, the loaded pills looked the same as empty ones. The 191 volunteers put the drug in some of their capsules, then put them in batches in envelopes with QR codes, and shook the envelopes so that they no longer knew which ones contained the drugs.

One third of the participants only took the drug microdoses for four weeks, one third received placebo capsules and another third received half and half. The volunteers should not have been able to tell what they were taking from the envelopes, but the researchers were able to find out by analyzing the QR codes at the end of the trial.

The volunteers also took objective online tests to measure mental acuity and answered subjective questionnaires about their mood and experiences, and also noted their guesses as to whether they took the drug or a drug. placebo had taken.

All three groups experienced similar improvements in their long-term psychological and cognitive outcomes over the four weeks.

People taking the real drugs showed “incredibly small” benefits over mood and creativity in their survey responses in tests performed a few hours after administration, Szigeti says, but only on the subjective tests. No benefit was seen in the objective tests.

In addition, these effects were most pronounced in people who had a good guess whether they had microdosed the real drugs, likely because of a mildly noticeable effect, suggesting that even these minor benefits were due to the placebo response, Szigeti says.

But the trial may not be the final word on microdosing, in part because the volunteers were not supervised by clinicians.

"Everyone says that about microdosing and that is what we as scientists want to know."

Bernhard Hommel of Leiden University in the Netherlands says the trial might also have found more effect if the researchers had measured people's creativity with objective tests, rather than simply asking people if they felt creative.

“The successful conduct of this study could provide inspiration for similar studies in a wide variety of scientific or medical contexts,” said the study's senior author, David Erritzoe, Clinical Senior Lecturer in Psychiatry at Imperial College London. “Considering the placebo effect is important when assessing trends such as the use of cannabidiol oils, fad diets or supplements where social pressure or user expectations can lead to a strong placebo response. Self-blinding citizen science initiatives can be used as a low-cost, initial screening tool before launching expensive clinical trials. †

Sources ao EuropeanPharmaceuticalReview (EN), Financial Times (EN), Newscientist (EN), The Guardian (EN)

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