Healthy VolunteersMicrodosingSubstance Use Disorders (SUD)Headache Disorders (Cluster & Migraine)Medicinal Chemistry & Drug DevelopmentChronic PainLSD

Pharmacokinetics and pharmacodynamics of lysergic acid diethylamide microdoses in healthy participants

In a double‑blind, placebo‑controlled crossover study in 23 healthy participants, LSD 5–20 µg produced dose‑proportional plasma concentrations (Cmax ≈151, 279, 500 pg/mL), Tmax ≈1.1 h and an elimination half‑life of ≈2.7–3 h. Psychotropic effects were absent at 5 µg, appeared about 1.1 h and peaked at 2.5 h after 10 µg (identified as the threshold dose), while 20 µg elicited both positive and some negative subjective effects.

Authors

  • Patrick Dolder
  • Matthias Liechti
  • Kim Kuypers

Published

Clinical Pharmacology and Therapeutics
individual Study

Abstract

“Microdoses” of lysergic acid diethylamide (LSD) are used recreationally to enhance mood and cognition. Increasing interest has also been seen in developing LSD into a medication. Therefore, we performed a pharmacokinetic‐pharmacodynamic study using very low doses of LSD. Single doses of LSD base (5, 10, and 20 µg) and placebo were administered in a double‐blind, randomized, placebo‐controlled crossover study in 23 healthy participants. Test days were separated by at least 5 days. Plasma levels of LSD and subjective effects were assessed up to 6 hours after administration. Pharmacokinetic parameters were determined using compartmental modeling. Concentration‐subjective effect relationships were described using pharmacokinetic‐pharmacodynamic modeling. Mean (95% confidence interval) maximal LSD concentrations were 151 pg/mL (127–181), 279 pg/mL (243–320), and 500 pg/mL (413–607) after 5, 10, and 20 µg LSD administration, respectively. Maximal concentrations were reached after 1.1 hours. The mean elimination half‐life was 2.7 hours (1.5–6.2). The 5 µg dose of LSD elicited no significant acute subjective effects. The 10 µg dose of LSD significantly increased ratings of “under the influence” and “good drug effect” compared with placebo. These effects began an average of 1.1 hours after 10 µg LSD administration, peaked at 2.5 hours, and ended at 5.1 hours. The 20 µg dose of LSD significantly increased ratings of “under the influence,” “good drug effects,” and “bad drug effects.” LSD concentrations dose‐proportionally increased at doses as low as 5–20 µg and decreased with a half‐life of 3 hours. The threshold dose of LSD base for psychotropic effects was 10 µg.

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Research Summary of 'Pharmacokinetics and pharmacodynamics of lysergic acid diethylamide microdoses in healthy participants'

Introduction

LSD (lysergic acid diethylamide) is a classic serotonergic psychedelic that is well absorbed orally and has been investigated for potential therapeutic uses including mood disorders, substance use disorders and cluster headache. A recent trend in recreational and investigational use is ‘‘microdosing’’, defined as repeated administration of very low doses of LSD (typically every 2–5 days) to enhance mood and cognition. However, pharmacokinetic data for very low single doses are sparse, and previous controlled studies either lacked sensitive assays to quantify plasma LSD at the lowest doses or did not collect pharmacokinetic samples, leaving gaps in knowledge about dose–concentration relationships, pharmacokinetic parameters and the threshold for subjective effects. Zhang and colleagues set out to characterise the pharmacokinetics, acute subjective effects, and pharmacokinetic–pharmacodynamic relationships of single very low oral doses of LSD base (5, 10 and 20 µg) compared with placebo in healthy volunteers. The primary aims were to obtain full concentration–time curves using a sensitive analytical method, model concentration–effect relationships, and determine the threshold dose for perceivable psychotropic effects. The study uses a double-blind, randomized, placebo-controlled crossover design to provide within-subject comparisons across doses.

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