Prior double-blind, placebo-controlled trials, primarily involving healthy volunteers and focusing on single or limited repeated doses, have consistently documented acute enhancements in psychological domains. At LSD dosages of 5–20 µg, participants exhibited statistically significant improvements in mood, emotional well-being, vitality, openness, creativity, and interpersonal connectedness on administration days, as evidenced in studies such as those by Bershad et al. (2019) in Psychopharmacology, de Wit et al. (2022) in Neuropsychopharmacology, Hutten et al. (2022) in European Neuropsychopharmacology, and Kavenska et al. (2024) in Molecular Psychiatry. Although these immediate benefits surpass placebo effects, controlled environments have not substantiated enduring long-term advantages.
A more recent open-label trial, lacking a placebo control and published on November 5, 2025, explored the same microdosing protocol in 19 adults diagnosed with major depressive disorder. Administering 4–20 µg of LSD twice weekly, the study observed a mean MADRS score reduction of 59.5% by treatment conclusion, which persisted through a 6-month follow-up assessment. Safety profiles aligned with prior reports, with no serious adverse events noted. This uncontrolled investigation, detailed by Murphy et al. (2025) in the Journal of Psychopharmacology, underscores potential efficacy in non-blinded settings.
In synthesizing the rigorously evaluated evidence, repeated LSD microdosing within the 4–20 µg range demonstrates favorable safety and tolerability profiles. It consistently elicits transient positive mood and cognitive alterations in healthy subjects during dosing intervals.
However, in the context of major depression, the sole large-scale, triple-blind, active-placebo-controlled trial conducted in 2025 failed to establish antidepressant efficacy surpassing placebo effects after 8 weeks. Conversely, open-label designs yield more pronounced outcomes, emphasizing the substantial influence of placebo responses and participant expectations in psychedelic interventions.
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