How to Think About Microdosing, With Ayelet Waldman and Paul Austin

This week we’re talking about microdosing: using relatively low doses of psychedelics like LSD and the psilocybin mushroom to improve mood, focus, and productivity in daily life. We spoke to author Ayelet Waldman , author of A Really Good Day: How Microdosing Has Substantial Impact on My Mood, My Marriage, and My Life; Paul Austin, psychedelic advocate and founder of the Third Wave ; and Dr. Ingmar Gorman , a psychotherapist who helps those seeking psychedelic support.

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In this episode

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Note: Not included in the episode, but relevant to the conversation: Potential risk of microdosing LSD :

A more serious problem concerns other receptors activated by LSD. In particular, LSD is a potent activator of the 5-HT2B serotonin receptor. Activation of this receptor stimulates the growth of tissue in the heart’s ventricles and valves. The drug combination, marketed as Fen-Fen, resulted in stimulation of the 5-HT2B receptor and caused severe cardiac valvulopathy (valvular disease; HVD) in patients. It was taken off the market, leading to costly lawsuits for the pharmaceutical company. Likewise, the drug marketed as Permax for the treatment of Parkinson’s disease also stimulated the 5-HT2B receptor, leading to HVD in a certain percentage of patients, and it was also taken off the market. This is a very serious condition as the only long-term treatment for HVD is heart valve replacement surgery.

Some may downplay this concern, believing that microdoses are too small to cause HVD. However, a 2017 study found that the kinetics of LSD binding to the 5-HT2B receptor shows that it is “retained” within the receptor for many hours, and this retention may allow it to accumulate in the receptor. Thus, even low doses can be problematic. While some of these discussions may be speculative, the microdose user should ask themselves if the risk is worth the risk. Again, we lack thorough research that could help us better assess this aspect of LSD’s method of action.

What you need to know about microdosing

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