Effects of Psychedelic Microdosing versus Conventional ADHD Medication Use on Emotion Regulation, Empathy, and ADHD Symptoms in Adults with severe ADHD symptoms: A Naturalistic Prospective Comparison Study

Adults with ADHD often struggle with emotional regulation (ER), impacting their ability to empathize and maintain relationships. Standard ADHD medications, although effective in addressing ADHD symptoms, seem less effective in addressing ER issues. Microdosing (MD) with psychedelics has shown promise for ADHD treatment, and previous MD studies reported social and emotional benefits. Here, we present two online prospective studies into the effects of MD on ER and empathy in adults with diagnosed ADHD or severe ADHD symptoms, spanning three assessments: baseline, two-, and four weeks post-initiation. Study 1 investigated adults with severe ADHD symptoms who started MD on their own (n= 233, n= 64, and n= 44, at each assessment moment). Positive effects were observed in ER (specifically cognitive reappraisal and expressive suppression) and aspects of empathy (specifically perspective-taking and personal distress). However, the absence of a control group prompted Study 2, which included a control group and a measure of ADHD symptom severity. Study 2 compared a subsample of Study 1 (i.e., those using solely MD; n= 180, n= 50, and n= 38) against those using conventional ADHD medication (n= 37, n=27, and n= 28). After four weeks, the MD group showed reduced ADHD symptoms compared to conventional medication users. Only the improvement in expressive suppression persisted after adding the control group; cognitive reappraisal and empathy enhancements disappeared. This study provides evidence for the potential positive effects of microdosing psychedelics on ADHD symptoms and ER in adults with severe ADHD symptoms while lacking evidence for effects on empathy.