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What is it like to microdose LSD for depression? a thematic analysis of participant interviews from an open-label trial.

Carina Joy Donegan, Dimitri Daldegan-Bueno, Rachael Sumner, Anna Forsyth, Will Evans, Nicholas Hoeh, Frederick Sundram, David B Menkes, Suresh Muthukumaraswamy, Lisa Reynolds

Therapeutic Advances in Psychopharmacology December 4, 2025 DOI: 10.1177/20451253251396253 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Open-label pilot trial (phase IIa) with post-intervention qualitative interviews Pilot study Peer reviewed
Sample size 17
Population Adults with major depressive disorder
Intervention Lysergic acid diethylamide (LSD) microdosing
Duration 8-week regimen, dosing twice weekly; interviews conducted following the intervention
Topics Depression LSD Microdosing
Keywords Qualitative research Open-label Psychedelics
Key findings Participants in an open-label LSD microdosing trial described interlinked benefits: enhanced self-determination, increased connectedness, improved cognitive processing, and better emotional well-being with reduced depressive symptoms. The authors report these effects were not universal, with some participants experiencing negative effects or no significant improvement, and caution that the absence of a placebo control prevents attributing changes specifically to LSD.

Abstract

Background: Depressive disorders affect approximately 280 million globally, with many finding treatments ineffective or limited by side effects. Growing evidence suggests that psychedelic therapies may help alleviate depressive symptoms. Among these, lysergic acid diethylamide (LSD) microdosing shows promise for major depressive disorder (MDD). However, research on LSD microdosing in clinical populations remains limited.

Objectives: This study aimed to understand the experiences of individuals participating in an open-label trial of LSD microdosing for MDD.

Design: Open-label pilot trial in target population (MDD; phase IIa).

Methods: Seventeen participants with MDD completed an 8-week LSD microdosing regimen, dosing twice weekly. Following the intervention, participants underwent semi-structured interviews regarding their experiences. Data were analysed using thematic analysis.

Results: Themes were grouped into five categories: enhanced self-determination, increased connectedness, improved cognitive processing, better emotional well-being, and negative effects.

Conclusion: Reported effects appeared to reinforce one another; that is, self-determination led to feeling more connected, which enhanced cognitive processing and ultimately improved emotional well-being and reduced depressive symptoms. However, this effect was not universal; some individuals reported negative effects or no significant improvement from microdosing LSD. This variability may be due to individual differences in response, insufficient dosage, or the treatment's lack of effectiveness for some individuals. The presence of side effects highlights the need for a careful titration protocol, while the lack of symptom improvement in some cases reinforces that microdosing is not a guaranteed solution, and expectations should remain realistic. The absence of a placebo control represents a key limitation as it precludes attribution of observed changes specifically to LSD.

Trial Registration: ANZCTR, ACTRN12623000486628. Registered on 12 May 2023 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385758).

In the evidence

This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.

  • Participants reported improved mood, increased energy, and greater emotional openness, alongside some negative experiences like anxiety.

    Synthesized

Comparable studies

Other non-randomized and open-label trials on LSD and microdosing, most cited first.

Study Year Design Participants
An open-label pilot trial assessing tolerability and feasibility of LSD microdosing in patients with major depressive disorder (LSDDEP1). Patients with major depressive disorder meeting DSM-5 criteria 2023 Open-label pilot trial n = 20
LSD microdosing in major depressive disorder: results from an open-label trial Participants with major depressive disorder, most taking antidepressant medication 2025 Open-label phase 2A trial n = 19
Evaluating the Potential of Microdosing 1cp-LSD for the Treatment of Canine Anxiety: A One-Month Case Study. A 13-year-old female dog with severe separation anxiety 2025 Pilot study, single-case study n = 1
LSD microdosing for major depressive disorder: Mood and pharmacokinetic outcomes from a Phase 2a trial People with depression 2026 Clinical trial
155. EXPLORING LSD MICRODOSING IN AN OPEN-LABEL PILOT FOR MAJOR DEPRESSIVE DISORDER: THE INTERPLAY OF BEHAVIORAL ACTIVATION, MOOD IMPROVEMENT, AND CONNECTEDNESS Individuals with major depressive disorder 2025 Open label trial n = 17

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