Microdosing psychedelics and the risk of cardiac fibrosis and valvulopathy: Comparison to known cardiotoxins
Antonin Rouaud, Gregor Hasler, Abigail E. Calder
Journal of Psychopharmacology January 12, 2024 DOI: 10.1177/02698811231225609 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Microdosing |
| Keywords | Fibrosis |
| Citations | 36 |
| Key findings | Microdosing psychedelics may raise the risk of cardiac fibrosis due to structural similarities with drugs known to cause valvulopathy, but evidence remains unknown. |
Abstract
Though microdosing psychedelics has become increasingly popular, its long-term effects on cardiac health remain unknown. Microdosing most commonly involves ingesting sub-threshold doses of lysergic acid diethylamide (LSD), psilocybin, or other psychedelic drugs 2–4 times a week for at least several weeks, but potentially months or years. Concerningly, both LSD and psilocybin share structural similarities with medications which raise the risk of cardiac fibrosis and valvulopathy when taken regularly, including methysergide, pergolide, and fenfluramine. 3,4-Methylenedioxymethamphetamine, which is also reportedly used for microdosing, is likewise associated with heart valve damage when taken chronically. In this review, we evaluate the evidence that microdosing LSD, psilocybin, and other psychedelics for several months or more could raise the risk of cardiac fibrosis. We discuss the relationship between drug-induced cardiac fibrosis and the 5-HT2B receptor, and we make recommendations for evaluating the safety of microdosing psychedelics in future studies.
Comparable studies
Other narrative reviews on microdosing, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Big physics, small doses: the use of AMS and PET in human microdosing of development drugs | 2003 | Review | |
| Phase 0/microdosing approaches: time for mainstream application in drug development? | 2020 | Review | |
| Microdosing and drug development: past, present and future | 2013 | Review | |
| Microdosing and Other Phase 0 Clinical Trials: Facilitating Translation in Drug Development | 2016 | Review | |
| Expectancy Effects in Psychedelic Trials. | 2024 | Review |
Citations in the library
Cited by 38
- Are “mystical experiences” essential for antidepressant actions of ketamine and the classic psychedelics? European Archives of Psychiatry and Clinical Neuroscience February 27, 2024
- Psychedelics for the Treatment of Psychiatric Disorders: Interpreting and Translating Available Evidence and Guidance for Future Research. American Journal of Psychiatry 2025
- Is microdosing a placebo? A rapid review of low-dose LSD and psilocybin research Journal of Psychopharmacology June 14, 2024
- State Cannabis and Psychedelic Legislation and Microdosing Interest in the US. JAMA Health Forum June 7, 2024
- Uncovering Psychedelics: From Neural Circuits to Therapeutic Applications Pharmaceuticals January 19, 2025
and 33 more in the library
Cites 24
- Psychedelic effects of psilocybin correlate with serotonin 2A receptor occupancy and plasma psilocin levels Neuropsychopharmacology January 26, 2019
- Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews Expert Review of Clinical Pharmacology August 13, 2018
- Acute Subjective and Behavioral Effects of Microdoses of Lysergic Acid Diethylamide in Healthy Human Volunteers Biological Psychiatry June 3, 2019
- Microdosing psychedelics: personality, mental health, and creativity differences in microdosers Psychopharmacology January 2, 2019
- Positive expectations predict improved mental-health outcomes linked to psychedelic microdosing Scientific Reports January 21, 2021
and 19 more in the library