A new study published in the journal European Psychiatry has shed light on an unconventional approach to managing symptoms associated with Attention-Deficit Hyperactivity Disorder (ADHD). The findings suggest that small, repeated doses of substances like psilocybin and lysergic acid diethylamide (LSD) could potentially help reduce ADHD symptoms and enhance some aspects of emotion regulation. These findings could pave the way for new treatments that focus not only on the primary symptoms of ADHD but also on improving emotional and social functioning.
ADHD is typically marked by inattention, hyperactivity, and impulsiveness. Beyond these primary symptoms, many individuals with ADHD struggle with emotional regulation and empathy, which can impair their social interactions and relationships.
While conventional ADHD medications like amphetamines and methylphenidate effectively target the core symptoms, they often fall short in addressing these secondary issues. Interestingly, some adults with severe ADHD symptoms have turned to microdosing — taking minimal doses of psychedelics — as a self-treatment.
“Globally, up to 3% of adults are affected by ADHD. The core ADHD symptoms (i.e., inattention and hyperactivity/impulsivity) are known and can be very debilitating. However, less known is that adults with ADHD suffer from problems with emotion regulation too,” explained study author Eline C. H. M. Haijen, a PhD candidate at the Department of Neuropsychology and Psychopharmacology at Maastricht University.
“Some studies even suggest that emotion regulation should be considered a core component of ADHD, as it is experienced by up to 70% by adult with ADHD. Emotion regulation involves all attempts to influence emotional experience and responses. For example, it may involve the ability to reinterpret an emotion-eliciting situation (i.e., cognitive reappraisal), but also the inhibiting strong positive and negative emotional responses (i.e., expressive suppression).”
“Related to emotion regulation is empathy, and together, impairments in these constructs may impair emotional and social functioning. Current conventional ADHD medication, such as amphetamines and methylphenidate, seems to effectively address emotion regulation impairments, but to a lesser degree than their effect on core ADHD symptoms. Therefore, we wanted to investigate the effects of a potential future alternative treatment option, microdosing with psychedelics, to investigate if microdosing is effective in improving emotion regulation and empathy in adults with ADHD.”
The researchers conducted two studies to investigate psychedelic microdosing’s impact on adults with severe ADHD symptoms.
The first study included participants who either had a formal ADHD diagnosis or displayed severe symptoms indicative of the disorder. Individuals participated on their own initiative, deciding when and how to microdose. The researchers collected data using a series of online surveys that participants completed at baseline (before starting microdosing), and then again two and four weeks into their microdosing regimen.
These surveys included validated scales like the Conners’ Adult ADHD Rating Scale for assessing ADHD symptoms, the Emotion Regulation Questionnaire to measure strategies like cognitive reappraisal and expressive suppression, and the Interpersonal Reactivity Index to evaluate different facets of empathy. There were 233 participants at the start of the study, with sample sizes decreasing to 64 and 44 at the two- and four-week follow-ups, respectively.
The results indicated that after four weeks of microdosing, participants reported significant improvements in certain aspects of emotion regulation and empathy. Scores for cognitive reappraisal increased, suggesting that participants were better able to reinterpret stressful or emotional situations in a way that reduced their negative impact. Similarly, scores for expressive suppression decreased, indicating a reduction in the effort to inhibit emotional responses, which could suggest a healthier emotional expression and processing.
Additionally, the scores for perspective-taking improved, which implies an enhanced ability to understand others’ points of view. However, the changes in other areas of empathy, such as empathic concern and personal distress, were not significant, suggesting that the effects of microdosing might be more pronounced in cognitive aspects of empathy than emotional ones.
The second study introduced a control group for a more rigorous comparison. This group consisted of individuals with ADHD who were not microdosing but were continuing their usual ADHD medication treatments. The researchers collected data at the same three time points using the same surveys and scales that were used in the first study. They compared 180 participants who were only microdosing, with assessment completions by 50 and 38 participants at the two-week and four-week marks, to a control group of 37 individuals using conventional ADHD medications, with 27 and 28 completing the two and four-week follow-ups, respectively.
This comparative approach provided a clearer view of how microdosing stacks up against traditional treatments. The findings revealed that the microdosing group experienced a more significant decrease in ADHD symptom severity across several measures compared to the control group. This included scores for inattention and hyperactivity/impulsivity, which are traditionally targeted by ADHD medications.
But when comparing changes in emotion regulation and empathy, the results were mixed. While the microdosing group showed continued improvement in expressive suppression, similar to the first study, no significant differences were found in cognitive reappraisal between the microdosing and control groups after the study period. This suggests that while microdosing may help reduce the need to suppress emotions, it does not necessarily enhance the ability to reinterpret emotional stimuli when compared directly to conventional medications.
In terms of empathy, the results did not show significant improvements in the microdosing group compared to the control group, indicating that the benefits observed in the first study might be limited to self-perceived changes within individuals rather than relative to a standard treatment.
These findings suggest that microdosing could potentially offer some benefits over traditional medications, particularly in reducing ADHD symptoms and improving certain aspects of emotional regulation. However, the impact on empathy and the broader emotional and social functioning remains unclear and less consistent.
“We compared individuals with ADHD who were microdosing to individuals with ADHD who were using conventional ADHD medication,” Haijen told PsyPost. “We found that microdosing, compared to conventional ADHD medication, induced positive effects on core ADHD symptoms and one aspect of emotion regulation, expressive suppression, which might indicate improved emotion regulation after four weeks of microdosing compared to baseline.”
“Cognitive reappraisal, the other emotion regulation aspect we assessed, and all empathy facets, remained unaffected after microdosing. We highlight the potential therapeutic properties of microdosing in adults with ADHD, but also emphasize the importance of a control group, as initial findings seemed to be null findings after comparing them to control data. This study is an initial step, paving the way for future, more rigorously controlled clinical trials investigating microdosing in adults with ADHD.”
The naturalistic design of the study has several benefits, including providing real-world insights into how individuals use microdosing to manage ADHD symptoms on their own terms. This approach allows for observations of genuine behaviors and outcomes in everyday settings. But this method also comes with some inherent drawbacks.
“This was a naturalistic study, meaning we did not interfere with participants’ microdosing practices, meaning that respondents used the substance, dose, and dosing regimen that they preferred,” Haijen explained. “This is the main limitation of such a study design, limiting our ability to draw strong conclusions about the effectiveness of microdosing. However, it still provides enough reason to investigate microdosing in ADHD further.”
Regarding her long-term goals for this line of research, Haijen explained that she plans to continue “investigating if microdosing is a useful alternative option for adults with ADHD through controlled clinical trials. If so, we would like to investigate its working mechanism, and how it could be implemented in the current clinical care.”
The study, “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,” was authored by Eline C. H. M. Haijen, Petra P. M. Hurks, and Kim P. C. Kuypers.