Psychedelic microdosing

Domain VII · Transpersonal, psychedelic & altered states

What it is

Microdosing is not a psychotherapy. It is a practice, mostly self-directed and outside the law, of repeatedly taking a classic psychedelic (most often psilocybin or LSD) at levels intended to stay below a full psychedelic experience, while going about ordinary life. In a codebook built from 278…

Format

• The stages below are a clinician's framework built on the HRIT model (pre-use harm reduction, then post-use integration) and on how trials screen and monitor participants. The staging, session counts and transition criteria are; the content of each stage is sourced as marked.
• Stage A. Disclosure and engagement (usually part of 1 session). Goal: the client feels safe telling you about use or plans. Method: open, nonjudgmental questions as part of routine substance and medication review. Move on when: you know the substance, how long the client has been using or planning,…

Who practises it, and how they are trained or regulated

• Stage C. Education and shared deliberation (1–2 sessions). Goal: an informed, autonomous decision, which may be to not start, to stop, to continue, or to join a trial. Content: what controlled trials found, known adverse effects, unknown long-term safety, risks of an unregulated supply, legal risk, and alternatives (psychotherapy, approved medication, clinical trials). Move on when: the client can state the main…
• Sources include: Szigeti et al. 2021 (eLife), Marschall et al. (J Psychopharmacol, online 2021, issue 2022), Anderson et al. 2019 (Psychopharmacology survey), the LSDDEP2 registry entry and the published LSDDEP2 protocol (Trials 2024; monitoring and stopping rules), the Beidas et al. 2026 protocol body text, and the registered protocol of the adult ADHD trial reported by Mueller et al. 2025 (NCT05200936). Confirmed:…
• What it is. Microdosing is not a psychotherapy. It is a practice, mostly self-directed and outside the law, of repeatedly taking a classic psychedelic (most often psilocybin or LSD) at levels intended to stay below a full psychedelic experience, while going about ordinary life. In a codebook built from 278 microdosers' own reports, the most common benefit categories were improved mood, focus, creativity,…

Evidence status, as the guide reports it

• Claimed mechanism, and what controlled studies show. Users and lay advocates attribute change to small cumulative pharmacological effects on mood and cognition. Controlled studies have so far found little or nothing beyond placebo:

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• requests for sources (decline, see section 5).
• your language drifting toward "guide" or "preparation".
• pressure to turn the plan into a protocol (decline; section 5).
• the client hearing this as you disapproving (see rupture, section 5).
• the client being excluded and feeling rejected; process this and return to 4.3.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.