Microdosing psilocybin for chronic pain: a case series
Matthew Lyes, Joel Castellanos, Timothy Furnish, Kevin H. Yang
Pain September 5, 2022 DOI: 10.1097/j.pain.0000000000002778 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 3 |
| Population | Individuals with chronic neuropathic pain |
| Intervention | Psilocybin |
| Dose | low-dose |
| Topics | Psilocybin Microdosing |
| Keywords | Series stratigraphy Chronic pain |
| Citations | 55 |
| Key findings | Low-dose psilocybin, self-administered, provided robust pain relief without psychedelic effects in three patients with chronic neuropathic pain. |
Abstract
Abstract Psychedelic serotonergic agonists such as psilocybin have recently been shown to produce sustained benefit in refractory depression, end of life anxiety, and addiction when administered in hallucinogenic doses and coupled with psychotherapy. Although it has been suggested that similar high-dose protocols may help chronic pain conditions, there are few published clinical trials of psychedelics for pain. The use of these agents in subpsychedelic doses for chronic pain management has received even less attention. This case series details the experiences of 3 individuals who have used low-dose psilocybin to manage chronic neuropathic pain. Although the nature and etiology of each patient's pain vary, they share a common experience, including inefficacy of current therapeutics and decreased quality of life. Through self-administration of psilocybin, these patients have achieved robust pain relief with decreased reliance on traditional analgesic medications. Despite varying preparations and uncertain potencies, the analgesic effects for all 3 patients occurred at doses without a psychedelic experience and with minimal cognitive or somatic adverse effects. Furthermore, the efficacy of pain relief and, in some cases, the duration of the effect were magnified when coupled with functional exercise. In addition, in 1 case, repeated dosing seemed to produce increased relief, suggesting a possible long-term plasticity-mediated effect. These commonalities highlight psilocybin's therapeutic potential in the treatment of chronic pain that warrants further investigation.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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Low-dose psilocybin self-administered by three patients provided robust pain relief without psychedelic effects and reduced reliance on traditional analgesics.
Synthesized
Comparable studies
Other case reports and case series on microdosing, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Microdosing of Psychoactive Substances in Business Practice Business managers and creative professionals | 2021 | Case study | |
| Treatment of neuropathic pain with repeated low-dose MDMA: a case report. 64-year-old male with neuropathic pain after chemotherapy and traumatic life experiences | 2025 | Case study | n = 1 |
| Psycholytic dosing or 'microdosing' of Amanita muscaria (red fly agaric) mushrooms—A retrospective case study A woman in her early thirties with depression, anxiety, and sleep disorders from... | 2023 | Case study | n = 1 |
| Clinical improvement following an integrative iboga microdosing protocol in post-concussive and hypoxic brain injury syndromes: a case series Three individuals with persistent neurologic symptoms after traumatic brain injury or... | 2026 | Case series | n = 3 |
| The use of drug checking legislation to facilitate illicit drug consumption research: psychedelic microdosing as a case example People who microdose (PWM) in New Zealand | 2026 | Case study |