risks of microdosing

Risks of microdosing

One of the most frequently asked questions about microdosing is: is it safe?

After all, we all know the disturbing stories about LSD and magic mushrooms from the past. Psychoses, acute schizophrenia, “thinking they can fly”, flashbacks. Those serious stories date back to the 1960s. In the meantime, the dangers and risks of psychedelics in a trip dosage have been accurately mapped. As it turns out, psychedelics are among the least dangerous from the “drugs” spectrum, still below weed, alcohol and MDMA.

drugs comparisons

Risks of Microdosing

Micro means small, so it is tempting to assume that the risks will automatically be limited as well. However, we cannot just simply assume this.

At the moment, various institutes are investigating the direct physiological effects of microdosing. Until those effects are all mapped, we can only assume what we know about higher dosages, side effects and contraindications reported by the experimental microdosers.

James Fadiman and Sophia Korb received reports of the microdosing experiences from more than 1800 people from 59 countries. They have been able to establish a provisional starting point, and that is: it’s safe. Because the dosage is so low, there seems to be no danger of a bad trip, psychosis or other acute experiences – positive or negative – that can entail a complete psychedelic trip. Among the gathered responses of microdosers there was not a single case of psychosis. However, it doesn’t mean that the opportunity doesn’t exist.

The most well known drawbacks of microdosing are:

  • Anxiety can increase. This is why anxious people are more likely to not benefit from microdosing.
  • People with paranoia may experience more paranoia and suspicion during microdosing.
  • Mushrooms can cause mild stomach upset and nausea in sensitive individuals.
  • Fatigue. There are people who experience fatigue while microdosing (mainly psilocybin). One experiences this as a disadvantage, the other does not and simply takes the microdose before going to bed.
  • Some men with color blindness reported mild hallucinations, or post-imagery and they stopped their cycle. This does not apply to everyone with color blindness though.
  • People diagnosed with bipolar disorder reported that they did benefit from microdosing during their depressive phase, but would discourage it during a manic phase.
  • The neurochemical functioning of LSD has shown that even in small amounts, it could, in theory, have a long-term effect on the functioning of the heart valves. This potential risk has been raised by the Heffter Institute. Whether this constitutes a real risk will most likely not be investigated. Since drugs are usually not tested for long term risk for more than 6 months, it is therefore unlikely that there will be money arranged to conduct this research. Since the 1960s, there have been no reports of people who have suffered from heart problems due to psychedelics.
  • Psilocybin can cause headaches.

For Whom Microdosing is Not Recommended?

  • Those who take the lithium carbonate medicine (Lithium). This combination is not recommended until more is known about it.
  • Those who once had psychosis. Although there have been no reports of people who have been diagnosed with psychosis due to microdosing, it is well known that higher doses of psychedelics can trigger this. Therefore, this possibility should not be ruled out for the time being.
  • Men with color blindness. They can start to see tracers in their field of view. This has been reported to Dr. Fadiman by a number of men. Sometimes those images or lingering colors persisted for days. Not all people with color blindness experience this, but there is a chance that it will occur.
  • People for whom anxiety, or an anxiety disorder, is the biggest problem. The fear can be magnified, or they become more aware of their fear. On the other hand for people who suffer from depression and have anxiety, it can help to ease their fears.
  • People who suffer from paranoia/suspicion. Microdosing can amplify paranoia.
  • For people under the age of 18.
  • It should rather not be in combination with alcohol or other drugs.
  • In pregnancy or during breastfeeding.

General note: the effects of microdosing in combination with many mental or physical disorders are not yet sufficiently known.

On the Other Hand

  • Almost all types of medications can be, in principle, combined with microdosing. BUT: with medium and macro dosages, this statement does not apply! Psychedelics containing MAO inhibitors, such as ayahuasca, should not be combined with some medications.
  • Set and setting are not microdosing requirements, but when you microdose with a good mindset and are aware in which setting you use it, that can work to your advantage.
  • If you follow the right routine, the active substance would not cause tolerance in the body. So it doesn’t get any less effective the more you do it.
  • Albert Hofmann has microdosed the last decades of his life, to his full satisfaction. He’s turned 102 with it.

Are these findings and comments decisive when it comes to safety? We don’t think so. The long-term effects are not yet known. Fadiman especially wants to emphasize that the benefits far outweigh the risks. And that not all of the disadvantages mentioned are also by definition a risk: some might be described as a point of attention, or something to take into account.

David Presti, professor of neurobiology at the University of California, Berkeley, who is an expert on the effects of drugs in the brain, told Ayelet Waldman, author of the book A really good day, that microdosing is definitely much safer than taking antidepressants.

James Rucker, a psychiatrist affiliated with Kings College London, has called for psychedelics to be reclassified – making them better examined and more available to researchers. However, he is cautious. In the interview with BBC, he said: “If you look at the medical side of microdosing, we don’t know anything yet. We don’t know the long-term effects yet”.

It must first get to the point where microdosing is recognised by the community of medical researchers and the authorities. Dr. Fadiman belongs to the group of researchers who think that won’t take long. “As long as we continue to find that microdosing has a very beneficial benefit-risk ratio, because its use seems to be very, very safe and has a whole range of benefits, we expect more pressure from the medical world to use this in people with complaints or disorders that we have not been able to help so far”.

Microdosing in Combination With Medicines

James Fadiman and Sophia Korb have compiled a list of supplements and medications that have not been, to date, reported as causing any negative interactions when combined with microdosing. You can find the list here: Microdosing: drugs and supplements.

Please note that this list is a result of their long-term research with hundreds of subjects around the world, who have microdosed independently with (mainly) LSD, 1P-LSD and psilocybin. For other substances, nothing is known yet.

We want to emphasize that this list does not guarantee that you can microdose safely and responsibly while taking any of the medications listed.


  • Always consult your doctor first if you plan to combine, stop or phase out.
  • Remember: no one is currently knowledgeable enough in the field of microdosing to be able to advise you on stopping drug use. If you want to phase it out because you suspect that microdosing is a better alternative, consult with your doctor and research the pros and cons!
  • Have you experienced problems with microdosing in combination with your medication? Or do you have an addition to the list? Please report this via this page or report it to us.

What Are the Pitfalls?

According to experts like Fadiman and Korb, there can be pitfalls of microdosing. It can certainly happen that your dose is a little too high at the beginning. This can be disturbing during your daily activities. Hence the advice to start on a day off, so that you can for example go for a walk in nature.

Fadiman says that from more than 1800 responses he received, there were only about 75 in which people claimed that they weren’t able to get too many positive effects from their experiences. People who reported that had a lot of anxiety or had predispositions to it. Some of them said they felt fine with microdosing, but they felt depressed again in the weeks they didn’t microdose. Some took it too often, and built tolerance. Tolerance for LSD, psilocybin and mescaline has not been demonstrated.

What Does the Trimbos Institute Say?

The Trimbos Institute is a Dutch independent knowledge institute for alcohol, tobacco, drugs and mental health. They don’t recommend experimenting with LSD itself.

“It is very difficult to measure what exactly microdosing is. You may want to take 10mcg, but it may also be that the drop of LSD is not evenly distributed over the seal. Then you take a lot more than you think. Also, there are resources that are sold as LSD, but contain other trip products. There is also a risk there.”

Microdosing in general also has a strong warning:

“The greatest risk of psychedelics is that it can trigger psychiatric problems. For example, if you are sensitive to developing psychosis or schizophrenia, we strongly discourage psychedelics. Also in low dosages. But the problem is that you never quite know how sensitive you are to this beforehand. Microdosing is portrayed as if it can counter fears and gloomy feelings, but there is no scientific evidence for this yet. It is also known that irresponsible use of psychedelics can actually exacerbate these feelings in some people. It would therefore be risky to use these types of resources for a longer period of time.”

“Finally, there is a possibility that without microdosing you will no longer feel cheerful, creative or productive enough. As a result, you can become dependent on the drug.”

If you’d like to read more about the risks of psychedelic drugs in high doses: here you will find everything about the (early) imaging around psychedelics and the real risks of a psychedelic trip.

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