Can psychedelic microdoses be used for treating ADHD?

Written by: Iva Totomanova

Psychedelics and ADHD | Recently, there has been a surge of interest in psychedelic substances, both from a recreational and from a scientific point of view. More people have started to use psychedelics to increase their wellbeing or productivity, and research on the matter has also picked up.

Organizations that focus on psychedelic research

Numerous organizations like the MIND Foundation, the OPEN Foundation, the multidisciplinary association for psychedelic studies (MAPS), and the Heffter Research Institute, among others, focus on conducting psychedelic research and promoting its therapeutic use. Research into psilocybin shows very promising results for psychological disorders like treatment-resistant depression and post-traumatic stress disorder (PTSD), and has been given a ‘breakthrough therapy’ status by the FDA1.

Indeed, studies show that psilocybin appears to be at least as effective as conventional antidepressants, and training in psilocybin-assisted psychotherapy is being offered by companies like COMPASS.

A novel therapeutic area of psychedelic research?

Besides mood disorders, another therapeutic area where psychedelics might be applied is the treatment of attention deficit and hyperactivity disorder (ADHD). ADHD is a prevalent chronic disorder, which may greatly impact one’s quality of life. The symptoms typically include problems with cognition and executive functions, such as focusing and maintaining attention, finding motivation for doing work, and issues with learning and memory, but the disorder also features mood disturbances and impulsivity2.

ADHD and current medication: the unmet medical need

Current first-line treatment for ADHD are stimulant medications, which are safe and effective in the short-term when taken in the prescribed doses. These stimulants have poor efficacy in the long-term3, however, as they can lead to unpleasant side effects and withdrawal-like symptoms4. It is also estimated that in about 30% of ADHD patients, stimulants are either not effective enough, or the adverse effects cannot be tolerated5. Thus, there is a medical need for better medications for this disorder, and psychedelic microdoses might prove to be beneficial.

Microdosing for ADHD

Research on this disorder is still scant, but it is slowly picking up and preliminary anecdotal evidence shows promising results. A microdosing approach to administering psychedelics might be more suitable for this purpose, as this does not involve any type of subjective experience. It nevertheless offers cognitive and emotional benefits which make it more appropriate for every-day tasks. This is similar to how one would take chronic stimulant medication for ADHD.  In fact, Albert Hoffmann himself, the Swiss chemist who synthesized LSD, was pro using small doses of the psychedelic as an alternative to Ritalin6. James Fadiman, a pioneer of microdosing research, has also been reported to suggest the use of microdoses as an “extremely healthy” alternative to Adderall7.

In this article, the focus is on this topic and it will be addressed what microdosing is and why it might be a potentially safer and effective route for ADHD treatment. To strengthen this point, the effects of psychedelics on the brain will be briefly discussed, as well as some preliminary research in this field.

Microdosing as a potentially safer route to treat ADHD

Psychedelics are one of the safest classes of drugs known, as they have negligible effects on the body, cannot cause death due to purely physical complications or an overdose, nor do they result in any long-lasting physiological changes. Psychedelics also have very low potential for addiction, as they are not physically rewarding8.9. The intensity of the ‘trip’ experience nevertheless carries inherent risks. Higher doses might increase the occurrence of psychological adverse effects. This can be the experience of a ‘bad trip’ accompanied by confusing thoughts and unpleasant emotions.

Although the incidence of unwanted psychological events is greatly reduced when there is a proper set and setting in place, a potentially safer route of using psychedelics is microdosing. Microdosing does not intoxicate the user and allows for going about everyday tasks as one normally would.

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What is microdosing?

Microdosing entails the use of doses that are below the threshold for a ‘trip’, and so do not involve a ‘trip’ experience with the accompanying hallucinations, ego-dissolution, and intense emotions. In fact, one should not feel any subjective effects at all (i.e. feel more or less sober) for the dose to be considered a proper microdose, and not just a very small dose (see Table 1).

Microdosing still involves the same mechanisms of action, uses the same neurotransmitters, and acts on the same brain areas as larger doses do. Thus, microdosing does lead to cognitive and emotional changes, even though those are subtle and may not be so explicitly felt. Following this logic, and after sufficient research on the matter, microdosing might be a suitable way to administer psychedelic substances as one would the currently available medications for ADHD.

Psychedelic SubstanceMicrodoses*
Psilocybin-containing mushrooms (dried; taken orally)0.1-0.5 g
LSD (taken orally)6-20 µg
DMT (smoked)8-9 mg
Table 1. Dose ranges for some classical psychedelics that are considered to be below the threshold of a trip, and thus a microdose. *These dose ranges are based on an average body weight of 70kg. This table has been adapted with permission from the paper by Polito and Liknaitzky (2021) https://doi.org/10.31234/osf.io/edhqz.

How do psychedelics affect the brain?

Changes in neurotransmitter levels

Classical psychedelics, including LSD, DMT, and psilocybin, exert their effects mainly through the release of serotonin, but they also affect the levels of other neurotransmitters, like dopamine and glutamate.

Serotonin

Activating serotonin receptors in the frontal regions of the brain can enhance certain brain functions that are involved in executive functioning, attention, and memory10,11. As ADHD features as dysfunctions in some of these frontal cerebral regions, psychedelics might be especially beneficial for this attention disorder.

Dopamine

On top of that, increasing dopamine might be involved in the enhancement of learning and memory mechanisms, and increasing motivation for goal-directed behaviour12,13. Difficulties with learning, motivation, and executing goals, is a crucial impairment in ADHD that may seriously impair quality of life. Increasing dopamine levels can act to diminish some of these symptoms.

In addition, brain imaging studies14 show that repeated exposure to psychedelics leads to a longer-lasting increase in dopamine receptors. Since ADHD patients have a deficit in their dopaminergic system, psychedelics seem like a good fit to improve dopamine levels.

Glutamate

Glutamate is the major excitatory neurotransmitter in the brain, so an increase in its activity might contribute to the greater connectivity between different brain areas, as well as to greater neuroplasticity and improved learning and memory15. This might also constitute a potential match with ADHD, since the disorder includes impairments in the connections and thus, communications, between some brain areas3.

Changes in brain function

The use of psychedelics can also lead to functional changes in some areas of the brain, mainly frontal regions and parts of the limbic system. As those brain areas are generally involved in emotion regulation, memory, learning and executive functions, altering their function is crucial for ADHD.

Amygdala

Psilocybin has been shown to reduce activity of the amygdala – a part of the limbic system, mainly involved in the experience of fear and negative emotions16. Reducing activity in this region might be beneficial for mood disorders like depression, but can also benefit those that have disorders like ADHD, since ADHD also features hyperactivity in the amygdala.

Cortico-striatal-thalamo-cortical (CSTC) circuit

Psychedelics also act on the so-called cortico-striatal-thalamo-cortical (CSTC) circuit, which is a feedback loop of interconnected brain regions in both frontal and deeper parts of the brain, which regulate executive functions, like learning and memory10. This circuit is also impaired in ADHD, leading to some of the executive dysfunctions seen in the disorder. By altering its activity, psychedelics might contribute to normalizing the functioning of this feedback loop and thus, relieve some of the symptoms in ADHD.

Changes in brain structure

With long-term and repeated use of psychedelics, the structure of certain brain areas might change with time. This might point to a potentially longer-lasting therapeutic effect compared to current stimulant medication, but this would have to be more explicitly tested in future studies.

Levels of BDNF

Some research17 has found that psychedelic use increases the levels of brain-derived neurotrophic factor (BDNF). This trophic factor plays a role in the growth and development of neurons, and promotes the expression of certain genes associated with neural plasticity. Brain plasticity, also known as neuroplasticity, is a term that refers to the brain’s ability to change and adapt as a result of experience. This might be particularly useful for learning, and thus also be beneficial for ADHD patients.

Brain Plasticity

The same study17 demonstrated that psychedelics are able to promote structural brain plasticity by increasing the number of places in neurons where they can communicate with other neurons (called dendritic spines). This effect is also achieved when administering amphetamines like Adderall. Psychedelics, however, were also able to increase the density of these dendritic spines, while amphetamine could not. This might point to a potentially similar working mechanism in both psychedelics and stimulants and suggest that psychedelics might be at least as effective as stimulant medication for ADHD treatment.

Scientific research: the effects of microdosing on ADHD

Rigorous scientific research that includes controlled experimental trials for the effects of microdosing on ADHD patients is lacking. Some anecdotal evidence, however, points to the usefulness of psychedelics in treating the attention deficit disorder. Many of these effects are self-reported by microdosers in observational studies, and are not yet confirmed by placebo-controlled experimental trials, so they should not be taken as a fact. Nevertheless, these studies do point to a possible beneficial effect of psychedelics on ADHD patients.

Studies in Healthy Volunteers

It is quite well-known that microdosing psychedelics can be helpful with productivity, attention, creativity, and learning, and has been used by silicon-valley professionals to boost their performance at work18.

Research into microdosing in healthy volunteers also finds that psychedelics are associated with improvements in cognition, attention and focus. Participants observed a decrease in mind wandering and distractibility, and saw improvements in processing and expressing their emotions, thus improving mental health19,20,21.

Psychedelics superior to stimulant meds?

A research study done by the Marine Corps for the search of new performance enhancing drugs concluded that psychedelic microdoses might be superior to ADHD medications for cognition enhancement, and do not produce as many negative effects22. These results are yet to be confirmed in other studies, however.

Studies in ADHD patients

Unfortunately, as also mentioned above, only anecdotal research with ADHD patients is currently available. Nevertheless, many people diagnosed with ADHD share their positive experiences with microdosing online, and this data also reveals the potential use of psychedelics in treating this disorder.

Less side effects

Observational studies of microdosing volunteers illustrate that there is a specific interest in microdosing from ADHD patients. These studies reveal that a large percentage of microdosers are diagnosed with the disorder and want to reduce the side effects they experience from their stimulant medication by combining or replacing it with psychedelic microdoses23,24. In another observational self-report study6, the researchers found a sub-group of participants who microdosed specifically to relieve their ADHD symptoms, and those participants reported improvements after microdosing, with less side effects compared to stimulants.

No crash after dose wears out

A recently published paper conducting an online questionnaire among users of psychedelic-themed websites found that those diagnosed with ADHD consistently rated psychedelic microdoses as more efficacious than conventional stimulant medications25. The authors of the paper argued that this might be due to the lack of unwanted effect connected to microdosing – these do not produce a ‘crash’ after their effect has worn off and do not require daily dosing, like stimulants do, which might act to further decrease any instances of side effects.

What does this all mean?

In conclusion, microdoses appear to be much safer than psychedelic macrodoses, and since they do not involve an intense, mystical experience, are more suitable for daily use as a ‘supplement’ to enhance cognition and functioning while going about one’s day. Compared to current stimulant medications, psychedelic microdoses appear to be safer and associated with less unwanted effects, and might be at least as effective in reducing ADHD symptoms.

It is perhaps also important to mention that even though this article focuses on microdosing, the ‘trip’ experience of a psychedelic macrodose might be therapeutic in itself. This is because macrodoses can act to ‘re-wire’ the brain in a relatively short time. For instance, those might be very beneficial as part of a psychotherapeutic program to dive deeper into one’s own consciousness and attempt to understand one’s own mind better.

Untapped capacity for Healing

It is clear that these drugs have a great potential for therapeutic use and specifically for ADHD, and should definitely be explored in further research. These powerful substances have a yet untapped capacity for healing. And in my opinion, this power should be harnessed to enhance the quality of life of ADHD patients, but also of others who need it.

Nevertheless, no firm conclusions about the clinical usefulness of psychedelics can be made at this time, as research is still in its infancy and rigorous experimental studies in patient populations are lacking. All of the results mentioned here need to be backed-up by more controlled clinical trials to establish more reliable relationships between psychedelics and ADHD.

Limitations of microdosing studies and suggestions for further research

It is also important to mention that many of the studies already conducted on microdosing have methodological limitations that make it difficult to interpret the results. For example, most of the evidence relies on self-reports and questionnaires, meaning that the truthfulness and accuracy of these reports cannot be measured.

In addition, most of these studies recruit volunteers, so naturally only a certain group of people, those who microdose psychedelics, participate in the study – this population might not be representative of the general population, so these results might not hold true when applied to all people. Due to a lack of a standardized protocol for microdosing, different studies use different regimes of dosing – some dose every day, others once a week. The frequency of microdoses might greatly impact the effects they have, since these are so subtle, and the great variety makes comparison of different studies flawed.

Furthermore, there is no ‘one’ dose that is considered a microdose, but rather a range of doses below a certain threshold (see Table 1), and it might be the case that the optimal dosage and dosing regime varies with each individual, further complicating the interpretation of results and comparison between studies. Further developments in the field should focus on addressing some of these limitations to maximize the benefits and minimize the potential unwanted effects of microdosing.

Disclaimer:

None of the information contained in this article is medical advice. Please do not make decisions about your health only based on the information presented here. It is always advised to contact a medical or health professional before making any changes to your medication routine, or combining psychedelics with other types of drugs. Stay safe!

Iva Totomanova

Iva Totomanova

is a 23 year-old student from Bulgaria, living in the Netherlands for about 5 years now. She has obtained her Bachelor of Science degree in Cognitive Neuroscience and Psychology from University College Utrecht in 2020, and is currently pursuing her Master’s degree in Cognitive and Clinical Neuroscience at Maastricht University.

Her primary personal and research interest lies within the realm of psychedelic science, and she is passionate to further develop this area of research in her career, as she wholeheartedly believes in the therapeutic potential of these substances.

She is also adamant to apply this knowledge in a clinical setting to enhance people’s mental health and well-being. Iva’s current research focus is on using microdoses for relieving ADHD symptoms, and she is excited to delve further into this topic.

You can contact Iva by e-mail on: i.totomanova@gmail.com

Link to Iva’s LinkedIn Profile

References used

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