Microdosing with psychedelics to self-medicate for ADHD symptoms in adults: A prospective naturalistic study

Abstract

ADHD in adulthood is often overlooked, which negatively affects the individual's well-being. First-line pharmacological interventions are effective in many ADHD patients, relieving symptoms rapidly. However, there seems to be a proportion of individuals who discontinue, or fail to respond to these treatments. For these individuals, alternative treatment options should be explored. A retrospective survey study reported that using classic psychedelics in low, repeated doses, so called microdosing (MD), was rated as being more effective than conventional treatments for ADHD. The current prospective study aimed to measure the effect of MD on ADHD symptoms, well-being and time perception. Adults with ADHD who had the intention to start MD on their own initiative to self-treat their symptoms were measured before MD and two- and four weeks later. It was expected that ADHD symptoms would decrease, well-being would increase, and performance on a time perception task would improve after MD. It was investigated if conventional medication use alongside MD and comorbidities alongside ADHD influenced the effect of MD. Sample sizes included N=233, N=66, and N=47, respectively. The results showed decreases and increases in ADHD symptoms and well-being, respectively. No improved performance on a time perception task was found. Conventional medication use and having comorbidities did not change the effect of MD on ADHD symptomatology and well-being after four weeks of MD. Placebo-controlled experimental studies are needed to explore further whether there is a beneficial effect of MD for ADHD, beyond the placebo-effect.

Keywords: ADHD; Microdosing; Psychedelics; Self-medication; Time perception; Well-being.

Fig. 1

Flowchart of included participants for each time point.

Fig. 2

Mean scores of the CAARS-S:SV DSM-IV total symptoms T-scores at baseline (0W) and two (2W) and four weeks (4W) after MD (A) of the whole sample, and (B) per conventional ADHD medication use. Error bars represent mean ​± ​SEM. ∗p ​< ​.05; ∗∗p ​< ​.001.

Fig. 3

Mean total scores of the WHO-5 at baseline (0W) and two (2W) and four weeks (4W) after MD (A) of the whole sample, and (B) per conventional ADHD medication use. Error bars represent mean ​± ​SEM. ∗p ​< ​.05; ∗∗p ​< ​.001.

Fig. 4

Correlations between changes in ADHD symptoms and well-being. Decreases in CAARS-S:SV DSM-IV total symptom T-scores were negatively related to increases in WHO-5 total scores at (A) two weeks and (B) four weeks after MD compared to baseline. The best-fit line is shown including the 95% confidence bands (dotted lines).

Fig. 5

Means of the relative difference scores of the time reproduction task (TRT) (A) for each time point, (B) for each interval per time point, and (C) for the 1000 ​ms interval for each time point per Medication use. Error bars represent mean ​± ​SEM. ∗p ​< ​.05; ∗∗p ​< ​.001.